Dexamethasone Side Effects

Dexamethasone Side Effects

Dexamethasone is a steroid hormone drug of the glucocorticoid class. It is used especially as an anti-inflammatory and immunosuppressive. Dexamethasone can be used in different formulations –solution for injections, tablets, emulsions, eye and ear drops and nasal spray.
Read also Dexamethasone Drug Information

Dexamethasone can be used to treat such diseases as rheumatic conditions (rheumatoid arthritis, systemic lupus erythematosus, scleroderma, polyarteritis nodosa, dermatomyositis etc), arthritis (podagric, psoriatic) and other acute and chronic joint diseases (osteoarthrosis, polyarthritis, ankylosing spondylitis etc), comas (hepatic, cerbral), bronchial asthma, asthmatic status, bronchospasm, acute pulmonary alveolitis, pulmonary fibrosis, sarcoidosis, berylliosis, Löffler’s syndrome, anemias, agranulocytosis, panmyelopathia, idiopathic thrombocytopenic purpura, leukaemias, myeloma, anaphylactic shock and other anaphylactoid and allergic reactions, other shocks (burn, posttraumatic, postoperative, toxic, cardiogenic, posthemotransfusional), spinal cord injury, cerebral edema of all causes, bacterial meningitis, disseminated sclerosis, Crohn’s disease, ulcerative colitis, hepatitis, acute glomerulonephritis, idiopathic nephrotic syndrome, inherent adrenal insufficiency and Addison’s disease, congenital adrenal hyperplasia in female fetus (experimentally), subacute thyroiditis, thyrotoxic crisis, dermatitis (psoriatic, contact, atopic, exfoliative, etc), exema, toxic epidermal necrolysis (Lyell’s disease), Stevens-Johnson syndrome, eyes diseases (inflammatory, allergeic, uveitis, optic neuritis, conjunctivitis of different causes, iritis etc).

Besides, Dexamethasone can be used to treat altitude sickness, nausea prophylaxis in the case of cytostatic therapy (antiemetic effect). Dexamethasone is also used to prevent transplant rejection and lower blood calcium levels in people with bone cancers and in women at risk of preterm delivery, and to prevent RDS in premature infants, and in some dental surgeries (wisdom tooth removal)

Dexamethasone can also be used for diagnostic purposes in the case of Cushing’s syndrome.

Side effects

Although Dexamethasone is widely used in very different clinical situations, its application is associated with a very high level of the side effects incidence (more than 30%). The most common side effects of Dexamethasone are:

  • Headache
  • Dizziness
  • Weakness
  • Confusion
  • Cushing’s Syndrome (manifests in upper-body obesity, “moon” face, increased fat around the neck)
  • Mood swings
  • Exaggerated sense of well-being (euphoria)
  • General body discomfort
  • Insomnia
  • Irritability
  • Anxiety
  • Personality changes
  • Nervousness
  • Depression
  • Neuritis
  • Neuropathy
  • Paresthesia
  • Decreased resistance to infection
  • Fever (up to 38◦C)
  • Malaise
  • Prolonged sore throat
  • Hiccups
  • Shortness of breath
  • Chest pain
  • High blood pressure
  • Thrombophlebitis
  • Vasculitis
  • Increased appetite
  • Appetite loss
  • Heartburn
  • Nausea
  • Vomiting
  • Dyspepsia
  • Abdominal bloating
  • Abdominal distention
  • Abnormal fat deposits
  • Diarrhea
  • Puffing of the face (moon face)
  • Swelling of feet or legs (due to sodium and fluid retention)
  • Weight gain
  • Weight loss
  • Joint pain
  • Muscle pain
  • Muscle weakness
  • Loss of muscle mass
  • Eye infections
  • Hot flashes
  • Striae (skin stretching)
  • Acne
  • Change in skin pigmentation
  • Skin atrophy (thinning skin)
  • Dry scaly skin
  • Thinning scalp hair
  • Hirsutism  (hypertrichosis)
  • Unusual bruising
  • Rash
  • Ecchymoses
  • Petechiae
  • Erythema
  • Increased sweating
  • Osteoporosis
  • Menstrual irregularities (up to amenorrhea)

People who use Dexamethasone less often may still experience:

  • Impaired wound healing
  • Steroid myopathy (after longtime intake)
  • Secondary adrenocortical and pituitary unresponsiveness
  • Depression of the adrenal glands function
  • Thromboembolism
  • Loss of peripheral vision
  • Blurred or clouded vision
  • Double vision
  • Hallucinations
  • Fungal infections of the skin, nails, or mucous membranes including thrush infection in the throat with ulceration

Since Dexamethasone can be used in different forms, it can have different side effects. The use of dexamethasone eye drops  is more typical to cause such adverse reactions as blurring of vision, persistent eye pain or redness, enlarged pupils, increased pressure in the eye, posterior subcapsular cataracts, continued or worsening itching or swelling, continuing blurred vision, eye discharge, glaucoma, and vision problems. The use of dexamethasone ear drops can cause ear irritation (burning, stinging and redness). Apart from the usual side effects (which also occur more frequently),  dexamethasone solution often causes clumsiness, dizziness, facial hot flush, feeling of whirling motion, general body discomfort, pain, swelling, redness or hypoderm atrophy at the injection site, seizures, tendon or bone pain, vision changes or other eye problems. In addition, Dexamethasone solution can cause serious adverse reactions more often.

Like any other medicine, Dexamethasone can cause allergic reactions in the form of  rash, hives, itching, breathing or swallowing difficulty, hoarseness, chest tightness , swelling of the face, eyes, mouth, lips, tongue, or throat. Dexamethasone can also cause severe anaphylactoid reaction, anaphylaxis, and angioedema. These reactions are serious and require immediate medical attention.

Changes in laboratory tests

Dexamethasone intake can cause some changes in your blood tests. Therefore, if your doctor founds in your laboratory tests such changes as eosinopenia, lymphopenia, neutropenia, liver enzymes elevations (alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, γ-glutamyl transpeptidase, and bilirubin), hypocoagulation, decreased glucose tolerance, hyperglycemia, hypocalcemia, hypernatremia (due to sodium retention), hypokalemia with hypokalemic alkalosis (due to potassium loss), glycosuria, blood in urine, increased or decreased motility and number of spermatozoa, you should keep in mind that these can be as a result of Dexamethasone use. However, these adverse reactions are usually reversible after the use of Dexamethasone has been discontinued.

Serious side effects

Dexamethasone can cause some serious side effects that require urgent medical attention. Some of the side effects are:

  • Extreme fatigue
  • Severe nausea or vomiting
  • Ulcerative esophagitis
  • Peptic ulcer with possible perforation and hemorrhage (steroid ulcer)
  • Coughing up blood
  • Vomiting material that looks like coffee grounds
  • Black, tarry stools
  • Perforation of the small and large bowel
  • Fatty liver degeneration
  • Hepatomegaly
  • Pancreatitis
  • Arrhythmias (irregular heartbeat)
  • Bradycardia
  • Tachycardia
  • Hypertension
  • Circulatory collapse
  • Congestive heart failure
  • Cardiac enlargement
  • Cardiac arrest
  • Pulmonary edema
  • Myocardial rupture (after myocardial infarction)
  • Fat embolism
  • Thromboembolism
  • Swelling, redness and/or pain in one extremity and not in the other
  • Difficult or painful urination
  • Increased intracranial pressure with papilledema
  • Syncope
  • Convulsions
  • Mania
  • Delusions
  • Severe depression
  • Steroid psychosis
  • Increased pressure in the eye (glaucoma)
  • Exophthalmos
  • Aseptic necrosis of femoral and humeral heads
  • Pathologic fracture of long bones
  • Tendon rupture
  • Vertebral compression fractures
  • Increased susceptibility to severe infection diseases and its latent course (including urinary tract infections)
  • Possible reactivation of TB infection
  • Adrenal insufficiency
  • Manifestations of latent diabetes and worsening of existing diabetes

Side effects in pregnant women

When used during pregnancy, Dexamethasone can lead to slowed development of the fetus, and adrenocortical insufficiency after giving birth. Dexamethasone also passes into breast milk and so it must be used under your doctor’s supervision.

Side effects in children

In addition to the common and serious side effects that can develop both in adults and in children, Dexamethasone can slow growth and cause development of the pseudotumor cerebri in little patients.

Conclusions

You may never experience any of the side effects listed above. Your doctor cannot predict your body’s reaction to Dexamethasone until you have tried it. That is why you should immediately inform your doctor of any changes in your health condition after taking Dexamethasone. Therefore, when you feel something is wrong, ask your doctor for advice and he or she will diagnose if your problem is connected with the medicine intake. You should also be careful because some of the side effects of Dexamethasone require urgent medical attention. In addition, it is strongly recommended not to stop Dexamethasone intake suddenly because this can lead to withdrawal syndrome.

All Side Effects