Dexamethasone Side Effects

Dexamethasone

Dexamethasone Side Effects: Dexamethasone is available as brand name Decadron, available in 0.25 mg, 0.5 mg, 0.75 mg, 1.0 mg, 1.5 mg, 4 mg, 6 mg tablets and as a 0.5 mg/ml and 1 mg/ml solution for injection. Decadron is a highly potent corticosteroid medication used primarily for treatment of corticosteroid responsive conditions where high dose treatment is needed. These include but are not limited to brain tumor related edema, chemotherapy related nausea, severe inflammatory conditions, croup in children, and as a part of treatment of some lymphomas. It is also used for the dexamethasone suppression test, a test of adrenal axis functionality. Dexamethasone side effects are largely class effects of corticosteroid therapy.

Common Dexamethasone Side Effects: The most common dexamethasone side effects include gastrointestinal problems that include nausea, vomiting, dyspepsia, and appetite change including increased appetite followed by weight gain. Sodium retention leading to edema is common. Skin issues that are common with dexamethasone use include acne, bruising, and skin atrophy with long-term use. Common dexamethasone side effects with long-term use also include Cushing’s syndrome and impaired wound healing. Headache, dizziness, mood swings, insomnia and anxiety are common dexamethasone side effects of the nervous system. Hyperglycemia, especially in diabetic or pre-diabetic patients, is common. Menstrual irregularities are also common with dexamethasone use.

Serious Dexamethasone Side Effects: Unfortunately serious dexamethasone side effects are not uncommon. These include adrenal insufficiency, steroid psychosis, peptic ulcer, congestive heart failure, and with long term use immunosuppression and osteoporosis. Dexamethasone side effects unique to pediatric use include pseudotumor cerebri and pancreatitis. Steroid myopathy is another serious, though rare, dexamethasone side effect. For a complete list of common and serious dexamethasone side effects see the manufacturer’s prescriber guidelines.

Cautions and Drug Interactions: One of the common cautions encountered is use in patients with inactive TB infections where dexamethasone use can allow reactivation of the TB infection. Caution is also advised in patients with diabetes, hypertension, seizure disorder, osteoporosis, significant hepatic dysfunction, or systemic fungal infections. Drug interactions and cautions are very many, but more common medications include live vaccine use, oral contraceptives, many thiazide diuretic combination medications, bupropion, almost any medications that can affect serum electrolytes, almost any medications that can lead to dyspepsia or peptic ulcer disease, and almost any medication that can cause immunosuppression. To review the extensive list of potential drug interactions see the manufacturer’s prescribing guidelines.

Unusual Dexamethasone Side Effects: At times use of potent or high dose corticosteroids like dexamethasone can lead to what may seem like paradoxical dexamethasone side effects. These can include steroid myopathy, even though dexamethasone may be used to treat some types of myopathy, and steroid psychosis even though dexamethasone may be used to treat the edema of brain tumors which can also lead to psychologic symptoms.

Special Considerations: Dexamethasone is milligram for milligram among the most potent of the commonly used corticosteroids. It is very important to understand that the mg dose of one corticosteroid is not equivalent to the mg dose of another. One mg of dexamethasone is roughly equivalent to 5 mg of prednisone and to 20 mg of hydrocortisone, and dexamethasone side effects, prednisone side effects and the side effects of other corticosteroids in large part directly correlate to their dose and potency.