Dexamethasone - Side Effects

Side Effects

If dexamethasone is given orally or by injection (parenteral) over a period of more than a few days, side effects common to systemic glucocorticoids may occur. These may include:

• Stomach upset, increased sensitivity to stomach acid to the point of ulceration of esophagus, stomach, and duodenum
• Increased appetite leading to significant weight gain
• A latent diabetes mellitus often becomes manifest, glucose intolerance is worsened in patients with pre-existing diabetes
• Immunsuppressant action, particularly if given with other immunosuppressants, such as cyclosporine, may allow bacterial, viral, and fungal disease to progress more easily and can become life-threatening; fever as a warning symptom is often suppressed.
• Psychiatric disturbances, including personality changes, irritability, euphoria, or mania and mood swings.
• Osteoporosis under long term treatment, pathologic fractures (e.g., hip)
• Muscle atrophy, negative protein balance (catabolism)
• Elevated liver enzymes, fatty liver degeneration (usually reversible)
• Cushingoid (syndrome resembling hyperactive adrenal cortex with increase in adiposity, hypertension, bone demineralization, etc.)
• Depression of the adrenal gland is usually seen, if more than 1.5 mg daily are given for more than three weeks to a month.
• Hypertension, fluid and sodium retention, edema, worsening of heart insufficiency (due to mineral corticoid activity)
• Dependence with withdrawal syndrome is frequently seen.
• Increased intraocular pressure, certain types of glaucoma, cataract (serious clouding of eye lenses)
• Dermatologic: Acne, allergic dermatitis, dry scaly skin, ecchymoses and petechiae, erythema, impaired wound-healing, increased sweating, rash, striae, suppression of reactions to skin tests, thin fragile skin, thinning scalp hair, urticaria.

Pronounced night sweats.

• Allergic reactions (though infrequently): Anaphylactoid reaction, anaphylaxis, angioedema.

Other side effects have been noted, and should cause concern if they are more than mild.

The short-time treatment for allergic reaction, shock, and diagnostic purposes usually does not cause serious side effects.

Novelist Michael Cox believed his first book, The Meaning of Night was a side effect of prescription dexamethasone, giving him both "formidable energy" while quelling his creative doubts.