VERIFIED CONTENTAuthor: Roman Wodowski

Dexamethasone is a synthetic hormone of the adrenal cortex from the group of glucocorticosteroids with long-lasting and very strong anti-inflammatory, antiallergic and immunosuppressive properties (lowering the immune system response).

Indications for the use of dexamethasone

The drug is primarily used in rheumatic and oncological diseases (in oncology it is also used in the prophylaxis of chemotherapy-induced vomiting), in exacerbations in severe asthma, acute angioedema.

In ophthalmology, it is used in allergic and inflammatory processes affecting the eyeball. Dexamethasone is also diagnosed diagnostically as part of the dexamethasone supression test (DST).

Contraindications to the use of dexamethasone

Contraindication to the use of the drug is:

  • hypersensitivity to dexamethasone,
  • systemic infection (unless specific anti-infective therapy is administered),
  • stomach or duodenal ulcer.

Vaccination with live vaccines is contraindicated during treatment with high therapeutic doses of dexamethasone due to the possibility of viral infection.

Available preparations

The drug can only be obtained with a doctor's prescription. It comes in a number of pharmaceutical forms (oral tablets, intra-articular injections, eye drops, aerosol for use on skin lesions).

Dexamethasone dosage

The dose is determined by the doctor depending on the indications, the severity of the disease and coexisting ailments. Dexamethasone tablets should be taken with or after a meal to minimize gastrointestinal irritation.

Avoid consuming drinks that contain alcohol or caffeine.

Dexamethasone side effects

These include :

  • endocrine disorders (growth retardation in infants, children
  • and adolescents, menstrual disorders, amenorrhea, Cushing's syndrome, hirsutism, reduced carbohydrate tolerance, increased need for insulin and antidiabetic drugs, prematureossification),
  • metabolism and nutrition disorders (weight gain, increased appetite, sodium and water retention, potassium loss),
  • immune system disorders (increased susceptibility to resistant infections, hypersensitivity reactions),
  • musculoskeletal and connective tissue disorders (osteoporosis, muscle weakness),
  • nervous system disorders (convulsions, worsening epilepsy, increased intracranial pressure, dizziness, headaches),
  • mental disorders (depression and mood changes, suicidal thoughts, hallucinations, worsening schizophrenia, sleep disorders, cognitive disorders),
  • eye disorders (posterior subcapsular cataract, increased intraocular pressure, glaucoma, exacerbation of viral and fungal diseases of the eye),
  • gastrointestinal disorders (indigestion, peptic ulcer, acute pancreatitis),
  • disorders of the skin and subcutaneous tissue (impaired wound healing, skin thinning, ecchymosis and haemorrhage, erythema, stretch marks, acne, increased sweating),

The frequency of expected side effects correlates with the dose and duration of therapy. The side effects also depend on the pharmaceutical form.

For example, the absorption of the active substance in the ophthalmic suspension from the conjunctival sac into the systemic circulation is so low that the systemic effects are negligible.

Interaction with other drugs and substances

  • Rifampicin, carbamazepine, phenobarbital, phenytoin, primidone may increase the metabolism of corticosteroids (including dexamethasone), which reduces their effectiveness,
  • Corticosteroids (including dexamethasone) show antagonistic activity to antidiabetic drugs (including insulin) and antihypertensive drugs,
  • Patients receiving corticosteroids and coumarin anticoagulants should have their prothrombin times monitored frequently, as corticosteroids may increase their effect,
  • Oral contraceptives (estrogens and progestogens) increase the concentration of corticosteroids in the blood serum, the antiviral drug ritonavir has a similar effect on dexamethasone,
  • Dexamethasone reduces the concentration of the antiviral drugs indinavir and saquinavir in the blood plasma,
  • Patients using non-steroidal anti-inflammatory drugs taking concomitant glucocorticosteroids should be carefully monitored for the possibility of the appearance or worsening of symptoms of gastric and duodenal ulcers,
  • Dexamethasone increases the toxic effect of digitalis glycosides, and in combination with drugsDiuretics increase the loss of potassium in the urine.

Effects on the ability to drive and use machines

No studies on the effects on the ability to drive and use machines have been performed. However, dexamethasone can cause confusion, dizziness, sleepiness, fatigue, fainting and blurred vision.

Pregnancy and breastfeeding

Dexamethasone crosses the placenta. Administration of corticosteroids may result in abnormal fetal development (including intrauterine growth inhibition). In pregnant women, the drug should only be used when, in the doctor's opinion, the benefit to the mother outweighs the potential risk to the fetus. Corticosteroids pass into breast milk. Adrenal suppression may occur in children of mothers taking high doses of corticosteroids over a long period of time.

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