Last update April 18, 2022

9α-Fluoro-11β,17α,21-trihydroxy-16α-methylpregna-1,4-diene-3,20-dione

Likely Compatibility

Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.

Dexamethasone is a corticosteroid with mainly glucocorticoid activity. Oral, parenteral, topical cutaneous, intra-articular and ophthalmic administration.

Since the last update we have not found published data on its excretion in breast milk.

Its high volume of distribution makes it difficult to excrete it in breast milk.

A decrease of prolactin release after administration of dexamethasone has been observed (Hubina 2002, Risch 1987), that may decrease milk production mostly in the first post-partum weeks.

Other steroids (Betamethasone) that are administered prior to delivery can produce a delay of Lactogenesis phase II (milk's coming in) and a decrease of milk production within the first postpartum week. (Henderson 2008). Intra-articular injected large doses of other steroids (Triamcinolone, Methylprednisolone) may transiently affect milk production. (Smuin 2016, Babwah 2013, McGuire 2012)

Corticoids are frequently prescribed in Pediatrics with no side effects on the infant when indicated for short-term or sporadical use. On nursing mothers a timely use or not long-term treatment is compatible with breastfeeding along with the assessment of milk production.

Expert authors consider the use of this medication to be probably compatible during breastfeeding. (Hale, Briggs 2017, Reece 2017, Bordini 2016, Chen 2010)

WHO Model List of Essential Drugs 2002: Compatible with breastfeeding in single dose. No data is available on long-term use. (WHO 2002)


See below the information of this related product:

Alternatives

  • Methylprednisolone (Safe substance and/or breastfeeding is the best option.)
  • Prednisolone (Safe substance and/or breastfeeding is the best option.)
  • Prednisone (Safe substance and/or breastfeeding is the best option.)

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

9α-Fluoro-11β,17α,21-trihydroxy-16α-methylpregna-1,4-diene-3,20-dione is Dexamethasone in Chemical name.

Is written in other languages:

9α-Fluoro-11β,17α,21-trihydroxy-16α-methylpregna-1,4-diene-3,20-dione is also known as

Groups

9α-Fluoro-11β,17α,21-trihydroxy-16α-methylpregna-1,4-diene-3,20-dione belongs to these groups or families:

Tradenames

Main tradenames from several countries containing 9α-Fluoro-11β,17α,21-trihydroxy-16α-methylpregna-1,4-diene-3,20-dione in its composition:

  • Ak-Dex
  • Alin (Mexico)
  • Cresophene (Spain)™. Contains other elements than 9α-Fluoro-11β,17α,21-trihydroxy-16α-methylpregna-1,4-diene-3,20-dione in its composition
  • Dalalone
  • Decadran
  • Decadron
  • Decadronal
  • Dexaval
  • Dexmethsone
  • Fortecortin
  • Gano Dexacort Plus™. Contains other elements than 9α-Fluoro-11β,17α,21-trihydroxy-16α-methylpregna-1,4-diene-3,20-dione in its composition
  • Inzitan™. Contains other elements than 9α-Fluoro-11β,17α,21-trihydroxy-16α-methylpregna-1,4-diene-3,20-dione in its composition
  • Maxidex
  • Otobacid N™. Contains other elements than 9α-Fluoro-11β,17α,21-trihydroxy-16α-methylpregna-1,4-diene-3,20-dione in its composition
  • Paraflex Plus™. Contains other elements than 9α-Fluoro-11β,17α,21-trihydroxy-16α-methylpregna-1,4-diene-3,20-dione in its composition
  • Phonal Spray bucal y laringofarige
  • Rino Dexa™. Contains other elements than 9α-Fluoro-11β,17α,21-trihydroxy-16α-methylpregna-1,4-diene-3,20-dione in its composition
  • Sofradex™. Contains other elements than 9α-Fluoro-11β,17α,21-trihydroxy-16α-methylpregna-1,4-diene-3,20-dione in its composition
  • Una A™. Contains other elements than 9α-Fluoro-11β,17α,21-trihydroxy-16α-methylpregna-1,4-diene-3,20-dione in its composition
  • Vagicort™. Contains other elements than 9α-Fluoro-11β,17α,21-trihydroxy-16α-methylpregna-1,4-diene-3,20-dione in its composition

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 70 - 78 %
Molecular weight 392 daltons
Protein Binding 77 %
VD 0.7 - 1.3 l/Kg
pKa 12.4 -
Tmax 1 - 2 hours
3.3 - 6 hours

References

  1. Hale TW. Medications & Mothers' Milk. 1991- . Springer Publishing Company. Available from https://www.halesmeds.com Consulted on April 10, 2024 Full text (link to original source)
  2. Das N, Dave S, Dangaich R, Ganjekar S, Guddanti Venkata Naga P, Hanumanthapura Ramalingaiah A, Thippeswamy H, Chandra PS. Lactation failure following therapeutic steroid treatment in a mother with postpartum depression and spinal-dural arteriovenous fistula: Case report and literature review. Int J Gynaecol Obstet. 2024 Apr;165(1):389-391. Consulted on April 1, 2024 Abstract
  3. Reece-Stremtan Sarah, Campos Matilde, Kokajko Lauren, and The Academy of Breastfeeding Medicine. Breastfeeding Medicine. ABM Clinical Protocol #15: Analgesia and Anesthesia for the Breastfeeding Mother, Revised 2017. Breastfeed Med. 2017 Nov;12(9):500-506. Full text (link to original source) Full text (in our servers)
  4. Smuin DM, Seidenberg PH, Sirlin EA, Phillips SF, Silvis ML. Rare Adverse Events Associated with Corticosteroid Injections: A Case Series and Literature Review. Curr Sports Med Rep. 2016 May-Jun;15(3):171-6. Abstract Full text (link to original source)
  5. Bordini CA, Roesler C, Carvalho Dde S, Macedo DD, Piovesan É, Melhado EM, Dach F, Kowacs F, Silva Júnior HM, Souza JA, Maciel JA Jr, Carvalho JJ, Speciali JG, Barea LM, Queiroz LP, Ciciarelli MC, Valença MM, Lima MM, Vincent MB. Recommendations for the treatment of migraine attacks - a Brazilian consensus. Arq Neuropsiquiatr. 2016 Abstract Full text (link to original source) Full text (in our servers)
  6. Briggs GG, Freeman RK, Towers CV, Forinash AB. Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk. Wolters Kluwer Health. Tenth edition (acces on line) 2015
  7. Chen LH, Zeind C, Mackell S, LaPointe T, Mutsch M, Wilson ME. Breastfeeding travelers: precautions and recommendations. J Travel Med. 2010 Jan-Feb;17(1):32-47. Abstract Full text (link to original source) Full text (in our servers)
  8. Henderson JJ, Hartmann PE, Newnham JP, Simmer K. Effect of preterm birth and antenatal corticosteroid treatment on lactogenesis II in women. Pediatrics. 2008 Abstract Full text (link to original source) Full text (in our servers)
  9. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Abstract Full text (link to original source) Full text (in our servers)
  10. Hubina E, Nagy GM, Tóth BE, Iván G, Görömbey Z, Szabolcs I, Kovács L, Góth MI. Dexamethasone and adrenocorticotropin suppress prolactin secretion in humans. Endocrine. 2002 Abstract
  11. Risch SC, Janowsky DS, Judd LL, Gillin JC, Mott MA, Rausch JL, Huey L. Measurement of ACTH and prolactin in the dexamethasone suppression test. Acta Psychiatr Scand. 1987 Nov;76(5):535-40. Abstract

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