Dexamethasone: does it have side effects? Indication and how to take

Dexamethasone is a drug substance that acts in the treatment of numerous disorders, from its potent anti-inflammatory and immunosuppressive action. It is classified as corticoid.

This drug class usually needs more medical attention and guidance, considering that it can easily cause side effects. In addition to acting in a complete way in the organism, being able to alter its functioning.

Thinking about it, we separated some important information about this medication. Check out:

What is Dexamethasone?

Dexamethasone is a substance present in the formula of different medications as an active ingredient – including oral, injectable or topical remedies.

This drug is classified by ANVISA (National Health Surveillance Agency) as a corticosteroid (or corticoid). Which means that it has a predominantly anti-inflammatory and immunosuppressive action.

Thus, it is possible to use it in the treatment of several pathologies: severe allergic cases, rheumatisms, skin diseases, endocrinopathies, cerebral edema , among many others.

It should be noted, however, that this medication can cause many side effects, especially when used for long periods. Therefore, it is recommended that its use should only be carried out when other therapies are not effective or possible.

These guidelines are intended to avoid complications for the patient. Thus, when treatment with Dexamethasone is carried out, intensive therapy for a short period of time is prioritized.

Is dexamethasone corticosteroids?

-Yeah . Dexamethasone is a drug substance of the corticoid type. This therapeutic class consists of drugs that are derived from the hormone cortisol – it is produced by the adrenal glands, exerting anti-inflammatory and immunosuppressive action.

This means that this type of medication is indicated to treat inflammatory processes in the body ( arthritis , lupus , among many others). More than that, as mentioned, it acts as an immunosuppressant.

That is, its action suppresses the body’s defense mechanisms, which may be necessary in the case of procedures such as organ and / or graft transplants.

However, corticosteroids are a type of synthetic hormone and, unlike the body’s natural hormones, they do not work just where the problem is. As a result, as a side effect, they may end up altering the functioning of the entire organism – which reinforces the need to maintain medical monitoring.

What is Dexamethasone for?

According to the information in the package insert, Dexamethasone is a substance intended for the treatment of conditions that lack the anti-inflammatory and immunosuppressive effects of corticosteroids – its indication occurs, especially, in cases of intensive treatments for short periods.

In addition, there are recommendations in a more specific way. Check the conditions that may require the use of this drug substance:

  • Diagnostic pre-test (diagnostic exam) of Adrenal Hyperfunction (when the adrenal glands present a greater production of one or more hormones);
  • Control of severe or disabling allergic cases , when satisfactory results are not shown with other treatments – conditions such as seasonal or perennial allergic rhinitis, asthma, contact dermatitis, atopic dermatitis, etc;
  • Auxiliary therapy (short term) during an acute episode of rheumatic disorders such as psoriatic arthropathy, rheumatoid arthritis, post-traumatic arthrosis, etc;
  • Treatment of skin diseases – bullous herpetiform dermatitis, complications of Stevens-Johnson syndrome, exfoliative dermatitis, severe psoriasis, severe seborrheic dermatitis, etc;
  • Treatment of ophthalmic problems (severe, acute and chronic allergic and inflammatory disorders) – such as acute atopic conjunctivitis, ophthalmic herpes zoster, inflammation of the anterior segment of the eye, etc .;
  • Treatment of endocrine (hormonal) conditions – adrenocortical insufficiency, non-suppurative thyroiditis (subacute thyroiditis), cancer-associated calcium metabolism disorder, etc;
  • Treatment of pneumopathies – Loeffler’s pneumonia (uncontrollable by other means), fulminant or disseminated pulmonary tuberculosis (when simultaneously accompanied by adequate antituberculous chemotherapy), aspiration pneumonia (pneumonitis due to food or vomiting), etc;
  • Treatment of hemopathies (blood disorders) – idiopathic thrombocytopenic purpura (adults), secondary thrombocytopenia (adults), acquired hemolytic anemia (autoimmune), erythroblastopenia, congenital hypoplastic anemia (erythroid);
  • Assistance during the critical period of ulcerative colitis and Crohn’s disease ;
  • Induction of diuresis (elimination of urine) or remission of proteinuria (a disorder in which there is excess protein being excreted in the urine) in nephrotic syndrome without uremia;
  • Palliative treatment of adult leukemias and lymphomas and acute childhood leukemia;
  • Treatment of patients with cerebral edema (swelling of a delimited region of the brain or all of it) for different causes.

In addition to all the conditions listed, in which the administration of Dexamethasone is common, this substance can also be indicated to treat other disorders. For more information in this regard, you can consult the package leaflet or professional assistance.

Dexamethasone presentations

As the information in the previous topic shows, Dexamethasone is used as therapy in different cases, covering different types of disorders.

Therefore, this drug substance is available in different types of presentation (eye drops, syrup, injectable, etc.). What facilitates its administration and effectiveness in the treatments.

Next, check out what these presentations are and in which cases they can be indicated:

Topical (cream, ointment, gel)

In some cases, Dexamethasone can be prescribed in topical presentations – cream, ointment or gel.

This may be necessary, for example, in the treatment of inflammatory and itchy (itchy) skin diseases. This can include problems such as:

  • Eczemas – that is, lesions of the skin folds, with itching and discharge;
  • Seborrheic dermatitis – are characterized by red, moist lesions that usually appear on the face or neck;
  • Neurodermatitis – appearance of dry and delimited lesions of the skin;
  • Severe psoriasis – an autoimmune condition in which skin cells accumulate and form scales, dry spots, among other complications.

Injectable

Dexamethasone in injectable version is characterized as highly effective and potent. Its application can be made through intravenous, intramuscular, intra-articular (applied to the joint), intralesional (applied to the inside of the lesion) or soft tissues (muscles, fatty tissue, tendons, nerves, etc.).

In general, the indications for use are very similar to other presentations. That is, in the treatment of disorders in which anti-inflammatory and immunosuppressive action is necessary.

However, its action on the body is different and faster and more efficient when compared to other presentations. Therefore, it is normally used in intensive treatments for short periods.

In addition, it is worth noting that although it can be used (with a prescription) in all treatments provided in the package insert, this version can also cause different side effects – fluid retention, weight gain, high blood pressure , high sugar levels in the blood, etc.

Eye drops

When the ophthalmic use of Dexamethasone is necessary, this is done through eye drops that contain this active substance.

Medications can be prescribed to treat conditions such as:

  • Blepharitis – inflammation of the eyelid that affects the eyelashes or tear production;
  • Acute atopic conjunctivitis;
  • Inflammation of the anterior segment of the eyeball;
  • Corneal trauma (in the cornea) due to burns or foreign body penetration;
  • Uveitis – inflammation of the middle layer of the eye (uvea).

In addition, it is also common to prescribe the use of this type of eye drops in the postoperative period of corneal surgery (keratoplasty). This indication can be made in order to suppress the organism’s reaction after the graft performed in the procedure – thus, inhibiting the inflammatory response of the organism.

Pills

Oral administration of pills is a very common prescription for Dexamethasone.

According to the medication information, the presentation can be indicated by the doctor for the treatment of all the disorders listed in the package insert of the substance. That is, it is recommended for cases in which anti-inflammatory and / or immunosuppressive action is necessary.

In this sense, it can be used in the treatment of musculoskeletal, rheumatic, endocrine, dermatological, ophthalmic, allergic, neoplastic diseases, among others.

Syrup / Elixir

The elixir is a hydroalcoholic solution, which means that part of its composition is made of water and another of alcohol.

Dexamethasone can be found in “elixir syrup” and other “elixir” versions.

Therefore, the oral solution can be recommended by the doctor in all conditions prescribed in the package insert of the substance – which includes rheumatic, cutaneous, ocular, pulmonary, blood disorders, etc.

Is dexamethasone useful for coughing?

The cough may appear as a symptom of different problems: allergies, flu , pneumonia , tuberculosis , etc. Among these, there are some cases in which the use of Dexamethasone may be prescribed – as in some pneumonia and severe allergies.

Therefore, when the cough is a symptom of any of the disorders that the medication treats, there will consequently be a relief from this discomfort.

However, considering the strong action of Dexamethasone in the body, it should not be used frequently, nor to treat problems that may be subject to other precautions.

Thus, the ideal is to seek a doctor in order to diagnose what is triggering the cough and be able to treat the problem properly – indicating common syrups or prescribing other therapies.

What does Dexamethasone do?

According to the information in the package insert, Dexamethasone is classified as a synthetic glucocorticoid, with potent anti-inflammatory effects – 25 to 30 times more than hydrocortisone, another type of corticoid.

In addition, this drug substance has immunosuppressive, anti-tumor, antiemetic properties (drugs that prevent vomiting) and small mineralocorticoid activity (influences the balance of the body’s ion and water balance).

In many cases, it is used in order to perform anti-inflammatory action, which occurs by suppressing the migration of neutrophils (agents of the immune system) in the body.

Another factor that is related to the action of Dexamethasone in the body is the fact that it decreases the production of inflammatory mediators and reverses the increase in capillary permeability – a property that allows the penetration of substances or liquids.

Its immunosuppressive action occurs according to other drugs in the same therapeutic class. That is, it suppresses the body’s defense mechanisms, which is necessary to help the body not to reject transplanted organs, for example.

Finally, it is worth noting that Dexamethasone reduces the circulation of white blood cells (leukocytes) in the blood. So, since they are related to the defense of the organism, inhibiting their action is useful in the case of autoimmune diseases and even in the treatment of certain tumors.

What milligram is available?

Considering that Dexamethasone is only the active ingredient of different medications, the available milligram will vary according to each medication and its different presentations (pills, eye drops, etc.). Here are some of the options:

  • Bexeton – elixir version, with 0.1mg / mL of Dexamethasone;
  • Koidexa – elixir version, with 0.1mg / mL or 1mg / mL of Dexamethasone;
  • Decadron – injectable version, with 2mg or 4mg of Dexamethasone;
  • Maxidex – ointment for ophthalmic use with 1mg / g or eye drops with 1mg / mL of Dexamethasone;
  • Decadron – tablet with 0.5mg or 0.75mg or 4mg of Dexamethasone. Also available in an elixir version with 0.5mg / 5mL of the substance.

Considering the different presentations and different availability of milligrams, it is important to keep in mind the importance of professional accompaniment.

How to use Dexamethasone?

According to the instructions on the package insert, the dosage of Dexamethasone is variable and individualized, according to the severity of the disorder in question and the response of the patient’s organism. In this sense, the fact that medical monitoring is necessary is reinforced.

Considering that the professional can indicate which version is appropriate for each type of treatment – cream, injectable, syrup, tablet, etc.

More than that, it will be possible to prescribe instructions as to the form of administration. Although, usually, the initial dose of Dexamethasone can vary between 0.75 to 15mg per day for adults (oral or injectable use).

Highlighting the fact that for lactating women and children, the daily dose is lower. Although, in general, the amount is dictated more by the severity of the problem than by the age or body weight of the patient.

How many times a day do you take Dexamethasone?

The daily dose will vary depending on each condition. In this sense, the package insert provides some information regarding how many times to take Dexamethasone throughout the day according to different clinical conditions. Check out:

  • Potentially fatal chronic diseases (such as lupus) – the initial dose is 2 mg to 4.5 mg per day;
  • Cerebral edema (in cases of maintenance therapy for palliative control) – the initial dosage is 2mg (2 or 3 times a day);
  • Acute life-threatening illness (severe allergic reactions, neoplasms, etc.) – the initial dosage ranges from 4mg to 10mg per day, administered in at least four divided doses.

In combination therapies, that is, together with other medications or care, the doses will change according to the association.

It is worth mentioning that these are just some of the examples of daily intake, so that all of these data may change (for more or less). It is essential to follow the medical recommendation as to how to administer the medication in your case.

How many mL of Dexamethasone per kg?

Generally, administration based on kg is used in the case of pediatric use, in order not to exceed the limit borne by the child’s organism. So that, in adults, the doses usually do not vary due to this factor.

Therefore when dexamethasone is prescribed for children (under 12 years), the guidance is that the limit of 6mcg to 40 mcg per kg body weight (or from 0.235 to 1.25 mg per square meter body surface area), with one administration or twice a day.

Regardless of the medical criterion to decide the ideal amount, follow the recommendations prescribed by the professional in order to make it safe to use.

When does Dexamethasone start to take effect?

In general, Dexamethasone does not take long to start taking effect when it comes into contact with the body.

The information on this drug substance indicates that in general its action starts between 10 and 60 minutes after oral ingestion or topical application – in some situations, it can take a maximum of 2 hours to act.

It is worth mentioning that, as with other medications, when the use of this medicine is made by injection, the action tends to be faster.

It is also important to note that to notice symptom relief, it is often necessary to wait a few more days of treatment (following the prescription). That is, the patient may not immediately feel a complete improvement.

What are the side effects of Dexamethasone?

The use of any medicated substance can cause side effects. But it is important to keep in mind that some people may not suffer from any complications, while others may even have more than one adverse reaction.

In the case of Dexamethasone, the package insert cites as possible side effects:

  • Liquid and electrolyte disorders: sodium and / or liquid retention, congestive heart failure (in susceptible patients), loss of potassium, hypokalemic alkalosis and hypertension;
  • Skeletal muscle: muscle weakness, steroid myopathy, loss of muscle mass, osteoporosis, vertebral compression fractures, aseptic necrosis of the femoral and humeral heads, pathological fracture of the long bones and tendon rupture;
  • Gastrointestinal: peptic ulcer, perforation of large and small intestine (in patients with inflammatory bowel disease), pancreatitis, bloating and ulcerative esophagitis;
  • Dermatological: delayed wound healing, skin fragility, acne, erythema, hypersudoresis, allergic dermatitis, urticaria, angioneurotic edema;
  • Neurological: seizures, increased intracranial pressure with papilledema (brain pseudotumor, usually after treatment), dizziness and headache;
  • Psychiatric: depression, euphoria and psychotic disorders;
  • Endocrines: menstrual irregularities, suppression of the child’s growth, hyperglycemia, decreased tolerance to carbohydrates, manifestation of latent diabetes mellitus, increased needs for insulin or oral hypoglycemic agents in diabetics, etc .;
  • Ophthalmic: posterior subcapsular cataract, increased intraocular pressure, glaucoma and exophthalmos;
  • Metabolic: negative nitrogen balance due to protein catabolism;
  • Immunological: immunosuppression, anaphylactoid reaction and oropharyngeal candidiasis;
  • Hematological: decreased lymphocyte count and abnormal monocyte count;
  • Cardiovascular: hypertension, arrhythmias, cardiomyopathy and myocardial rupture (after recent infarction);
  • Others: hypersensitivity, thromboembolism, weight gain, increased appetite, nausea, malaise and hiccups.

Read more: Glaucoma: what it is, symptoms and treatment

It is worth noting that the frequency with which these adverse reactions occur is unknown. Remembering that these can manifest themselves as much from the use of any version of the medicine.

In addition, there is also information regarding some rare side effects that can occur from the administration of the pills . You can talk to the doctor about it or read the package leaflet.

Do you sleep?

Among the possible side effects of using Dexamethasone, sleep disorders (such as insomnia or excessive sleepiness) are not mentioned . This reaction is only posed as a rare complication from the use of the substance in tablets.

Therefore, it is very difficult for someone to experience changes in sleep habits during treatment with Dexamethasone. But in rare cases, it can occur.

If you experience this type of change, seek to inform the responsible physician immediately. Thus, it will be possible to diagnose whether the problem is related to the use of this medication or not – in addition to taking the necessary measures.

Price: what is the average value of Dexamethasone?

The price of drugs that rely on Dexamethasone in its formula can vary widely. Especially due to the different forms of presentation.

Following, you can check the price * of some of the options available for this drug substance:

  • Maxidex (eye drops) – 1 vial with 5mL of solution is around R $ 10;
  • Dexamethasone Farmace (elixir) – 1 vial with 100mL of solution costs an average of R $ 10;
  • Decadron (injectable) – 1 ampoule with 2.5mL of solution costs an average of R $ 13;
  • Decadron (pills) – the box with 20 pills is around R $ 10;
  • Teuto Dexamethasone Acetate (cream) – 1 tube with 10g of cream varies between R $ 3 and R $ 9.

When making the purchase, remember to follow the medical prescription as to which option to choose. Also follow the recommendations regarding the administration of the treatment!

* Prices consulted in July 2020. Prices may change.


All medications need to be administered with professional monitoring, since self-medication is never recommended. However, some are even more lacking, as is the case with corticosteroids (such as Dexamethasone).

Therefore, staying attentive to the information on the package insert and following medical recommendations is essential.

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