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Dexamethasone Disease Interactions

There are 23 disease interactions with dexamethasone:

Corticosteroids (Includes Dexamethasone) ↔ (+) Tuberculin Test

Severe Potential Hazard, High plausibility

Applies to: History - Tuberculosis, Tuberculosis -- Latent

In patients with latent tuberculosis or tuberculin reactivity, the use of pharmacologic dosages of corticosteroids may cause a reactivation of the disease. Close monitoring for signs and symptoms of tuberculosis is recommended if corticosteroid therapy is administered to patients with a history of tuberculosis or tuberculin reactivity. During prolonged corticosteroid therapy, tuberculosis chemoprophylaxis may be considered.

References

  1. "Product Information. Decadron (dexamethasone)." Merck & Co, Inc, West Point, PA.
  2. "Product Information. Deltasone (prednisone)." Pharmacia and Upjohn, Kalamazoo, MI.
  3. "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn, Kalamazoo, MI.
View all 10 references

Corticosteroids (Includes Dexamethasone) ↔ Electrolyte Imbalance

Severe Potential Hazard, Moderate plausibility

Applies to: Hypernatremia, Hypocalcemia, Hypokalemia, Seizures

Corticosteroids can cause hypernatremia, hypokalemia, and fluid retention. These mineralocorticoid effects are most significant with fludrocortisone, followed by hydrocortisone and cortisone, then by prednisone and prednisolone. The remaining corticosteroids, betamethasone, dexamethasone, methylprednisolone, and triamcinolone, have little mineralocorticoid activities. However, large doses of any corticosteroid can demonstrate these effects, particularly if given for longer than brief periods. All corticosteroids also increase excretion of calcium and can cause hypocalcemia. Therapy with corticosteroids should be administered cautiously in patients with preexisting electrolyte disturbances. Caution is also advised when treating patients with seizure disorders, since electrolyte disturbances may trigger seizure activity.

References

  1. "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn, Kalamazoo, MI.
  2. "Product Information. Celestone (betamethasone)." Schering Corporation, Kenilworth, NJ.
  3. Morris GC, Egan JG, Jones MK "Hypokalaemic paralysis induced by bolus prednisolone in Graves' disease." Aust N Z J Med 22 (1992): 312
View all 15 references

Corticosteroids (Includes Dexamethasone) ↔ Gi Perforation

Severe Potential Hazard, Moderate plausibility

Applies to: Diverticulitis, Intestinal Anastomoses, Ulcerative Colitis

Corticosteroids may cause gastrointestinal perforation and hemorrhage, usually when given in high dosages or for prolonged periods. They may also mask symptoms of complications such as peritonitis or intraabdominal sepsis. Therapy with corticosteroids should be administered cautiously in patients with diverticulitis, nonspecific ulcerative colitis (if there is a probability of impending perforation, abscess, or other pyogenic infection), or recent intestinal anastomoses.

References

  1. Fadul CE, Lemann W, Thaler HT, Posner JB "Perforation of the gastrointestinal tract in patients receiving steroids for neurologic disease." Neurology 38 (1988): 348-52
  2. "Product Information. Deltasone (prednisone)." Pharmacia and Upjohn, Kalamazoo, MI.
  3. "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn, Kalamazoo, MI.
View all 18 references

Corticosteroids (Includes Dexamethasone) ↔ Infections

Severe Potential Hazard, High plausibility

Applies to: Infection - Bacterial/Fungal/Protozoal/Viral

The immunosuppressant and anti-inflammatory effects of corticosteroids, particularly in higher dosages, may decrease host resistance to infectious agents, decrease the ability to localize infections, and mask the symptoms of infection. Secondary infections may be more likely to develop. In general, corticosteroids should not be used in patients with active infections, especially systemic fungal infections, unless they are medically necessary and effective antimicrobial therapy or other appropriate treatment has been instituted. However, for corticosteroid-dependent patients who develop a severe or life-threatening infection, continuation of corticosteroid therapy with at least physiologic replacement dosages should be considered, since these patients may have secondary adrenocortical insufficiency. Removal of external steroid during periods of stress may be detrimental to these patients.

References

  1. Swartz SL, Dluhy RG "Corticosteroids: clinical pharmacology and therapeutic use." Drugs 16 (1978): 238-55
  2. "Product Information. Hydeltrasol (prednisolone)." Merck & Co, Inc, West Point, PA.
  3. "Product Information. Hydrocortone (hydrocortisone)." Merck & Co, Inc, West Point, PA.
View all 19 references

Corticosteroids (Includes Dexamethasone) ↔ Mi

Severe Potential Hazard, Moderate plausibility

Applies to: Myocardial Infarction, Post MI Syndrome

The use of corticosteroids may be associated with left ventricular free-wall rupture in patients who have had a recent myocardial infarction. Pharmacologic dosages of corticosteroids should be administered with great caution in such patients.

References

  1. "Product Information. Decadron (dexamethasone)." Merck & Co, Inc, West Point, PA.
  2. "Product Information. Cortone Acetate (cortisone)." Merck & Co, Inc, West Point, PA.
  3. "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn, Kalamazoo, MI.
View all 9 references

Corticosteroids (Includes Dexamethasone) ↔ Ocular Herpes Simplex

Severe Potential Hazard, Moderate plausibility

Applies to: Ocular Herpes Simplex

Pharmacologic dosages of corticosteroids should be used cautiously in patients with ocular herpes simplex because of the risk of corneal perforation.

References

  1. "Product Information. Deltasone (prednisone)." Pharmacia and Upjohn, Kalamazoo, MI.
  2. "Product Information. Celestone (betamethasone)." Schering Corporation, Kenilworth, NJ.
  3. "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn, Kalamazoo, MI.
View all 9 references

Corticosteroids (Includes Dexamethasone) ↔ Pud

Severe Potential Hazard, High plausibility

Applies to: History - Peptic Ulcer, Peptic Ulcer

Corticosteroids may cause peptic ulcer disease and gastrointestinal (GI) hemorrhage, usually when given in high dosages or for prolonged periods. However, even conventional dosages may aggravate symptoms in patients with a history of peptic ulcers. Delayed healing of ulcers has also been reported. Therapy with corticosteroids should be administered cautiously in patients with active or latent peptic ulcers or other risk factors for GI bleeding. Some clinicians recommend the use of prophylactic antacids or H2-antagonists between meals when large doses of corticosteroids are necessary.

References

  1. Thomas TP "The complications of systemic corticosteroid therapy in the elderly." Gerontology 30 (1984): 60-5
  2. Heimdal K, Hirschberg H, Slettebo H, Watne K, Nome O, Sletteb H "High incidence of serious side effects of high-dose dexamethasone treatment in patients with epidural spinal cord compression." J Neurooncol 12 (1992): 141-4
  3. Weissman DE, Dufer D, Vogel V, Abeloff MD "Corticosteroid toxicity in neuro-oncology patients." J Neurooncol 5 (1987): 125-8
View all 21 references

Corticosteroids (Includes Dexamethasone) ↔ Scleroderma

Severe Potential Hazard, Moderate plausibility

Applies to: Systemic Sclerosis

In patients with scleroderma, corticosteroids may precipitate renal crisis with malignant hypertension, possibly via steroid-induced increases in renin substrate and angiotensin II levels and decreases in vasodilator prostaglandin production. Renal failure may ensue. Therapy with corticosteroids should be administered cautiously in patients with scleroderma. In addition, they should be limited to short-term use.

References

  1. "Product Information. Decadron (dexamethasone)." Merck & Co, Inc, West Point, PA.
  2. "Product Information. Deltasone (prednisone)." Pharmacia and Upjohn, Kalamazoo, MI.
  3. "Product Information. Celestone (betamethasone)." Schering Corporation, Kenilworth, NJ.
View all 10 references

Corticosteroids (Includes Dexamethasone) ↔ Strongyloidiasis

Severe Potential Hazard, High plausibility

Applies to: Strongyloidiasis

Unlike most helminths, Strongyloides stercoralis has the ability to replicate in the human host. In patients with strongyloidiasis, the use of pharmacologic or immunosuppressive dosages of corticosteroids may result in Strongyloides hyperinfection and dissemination with widespread larval migration, often accompanied by severe enterocolitis and potentially fatal gram-negative septicemia. Therapy with corticosteroids should be administered with extreme caution, if at all, in these patients.

References

  1. "Product Information. Hydrocortone (hydrocortisone)." Merck & Co, Inc, West Point, PA.
  2. "Product Information. Cortone Acetate (cortisone)." Merck & Co, Inc, West Point, PA.
  3. "Product Information. Decadron (dexamethasone)." Merck & Co, Inc, West Point, PA.
View all 11 references

Corticosteroids (Includes Dexamethasone) ↔ Depression/Psychoses

Moderate Potential Hazard, Moderate plausibility

Applies to: Psychosis, Depression

Corticosteroids may aggravate the symptoms of psychosis and emotional instability. Patients with these conditions should be monitored for increased or worsened symptoms during corticosteroid therapy.

References

  1. "Product Information. Hydrocortone (hydrocortisone)." Merck & Co, Inc, West Point, PA.
  2. "Product Information. Cortone Acetate (cortisone)." Merck & Co, Inc, West Point, PA.
  3. Sechi GP, Piras MR, Demurtas A, Tanca S, Rosati G "Dexamethasone-induced schizoaffective-like state in multiple sclerosis: prophylaxis and treatment with carbamazepine." Clin Neuropharmacol 10 (1987): 453-7
View all 27 references

Corticosteroids (Includes Dexamethasone) ↔ Diabetes

Moderate Potential Hazard, High plausibility

Applies to: Diabetes Mellitus, Abnormal Glucose Tolerance

Corticosteroids can raise blood glucose level by antagonizing the action and suppressing the secretion of insulin, which results in inhibition of peripheral glucose uptake and increased gluconeogenesis. Therapy with corticosteroids should be administered cautiously in patients with diabetes mellitus, glucose intolerance, or a predisposition to hyperglycemia. Patients with diabetes mellitus should be monitored more closely during corticosteroid therapy, and their antidiabetic regimen adjusted accordingly.

References

  1. Black DM, Filak AT "Hyperglycemia with non-insulin-dependent diabetes following intraarticular steroid injection." J Fam Pract 28 (1989): 462-3
  2. "Product Information. Celestone (betamethasone)." Schering Corporation, Kenilworth, NJ.
  3. Ludvik B, Clodi M, Kautzky-Willer A, Capek M, Hartter E, Pacini G, Prager R "Effect of dexamethasone on insulin sensitivity, islet amyloid polypeptide and insulin secretion in humans." Diabetologia 36 (1993): 84-7
View all 17 references

Corticosteroids (Includes Dexamethasone) ↔ Fluid Retention

Moderate Potential Hazard, Moderate plausibility

Applies to: Congestive Heart Failure, Fluid Retention, Hypertension, Renal Dysfunction

Corticosteroids may cause hypernatremia, hypokalemia, fluid retention, and elevation in blood pressure. These mineralocorticoid effects are most significant with fludrocortisone, followed by hydrocortisone and cortisone, then by prednisone and prednisolone. The remaining corticosteroids, betamethasone, dexamethasone, methylprednisolone, and triamcinolone, have little mineralocorticoid activities. However, large doses of any corticosteroid can demonstrate these effects, particularly if given for longer than brief periods. Therapy with corticosteroids should be administered cautiously in patients with preexisting fluid retention, hypertension, congestive heart failure, and/or renal dysfunction. Dietary sodium restriction and potassium supplementation may be advisable.

References

  1. Klepikov PV, Kutyrina IM, Tareyeva IE "Steroid-induced hypertension in patients with nephrotic syndrome." Nephron 48 (1988): 286-90
  2. "Product Information. Kenalog (triamcinolone)." Bristol-Myers Squibb, Princeton, NJ.
  3. Pang S, Clark AT, Freeman LC, Dolan LM, Immken L, Mueller OT, Stiff D, Shulman DI "Maternal side effects of prenatal dexamethasone therapy for fetal congenital adrenal hyperplasia." J Clin Endocrinol Metab 75 (1992): 249-53
View all 18 references

Corticosteroids (Includes Dexamethasone) ↔ Hyperadrenocorticalism

Moderate Potential Hazard, High plausibility

Applies to: Hyperadrenocorticism, Hyperaldosteronism, Adrenal Tumor

Corticosteroids mimic the effects of endogenous cortisol and aldosterone. The use of these agents may aggravate conditions of hyperadrenocorticalism in a dose-dependent manner.

References

  1. "Product Information. Kenalog (triamcinolone)." Bristol-Myers Squibb, Princeton, NJ.
  2. Lieberman P, Patterson R, Kunske R "Complications of long-term steroid therapy for asthma." J Allergy Clin Immunol 49 (1972): 329-36
  3. "Product Information. Hydeltrasol (prednisolone)." Merck & Co, Inc, West Point, PA.
View all 14 references

Corticosteroids (Includes Dexamethasone) ↔ Hyperlipidemia

Moderate Potential Hazard, Moderate plausibility

Applies to: Hyperlipidemia

Corticosteroids may elevate serum triglyceride and LDL cholesterol levels if used for longer than brief periods. Patients with preexisting hyperlipidemia may require closer monitoring during prolonged corticosteroid therapy, and adjustments made accordingly in their lipid-lowering regimen.

References

  1. "Product Information. Florinef Acetate (fludrocortisone)." Bristol-Myers Squibb, Princeton, NJ.
  2. "Product Information. Kenalog (triamcinolone)." Bristol-Myers Squibb, Princeton, NJ.
  3. "Product Information. Hydeltrasol (prednisolone)." Merck & Co, Inc, West Point, PA.
View all 10 references

Corticosteroids (Includes Dexamethasone) ↔ Hypothyroidism

Moderate Potential Hazard, Moderate plausibility

Applies to: Hypothyroidism

Corticosteroids may have enhanced effects in hypothyroidism due to decreased metabolism of these agents. Patients with hypothyroidism should be monitored more closely for excessive cortisol effects. Dosage adjustments may be required secondary to changes in their thyroid condition.

References

  1. "Product Information. Celestone (betamethasone)." Schering Corporation, Kenilworth, NJ.
  2. "Product Information. Kenalog (triamcinolone)." Bristol-Myers Squibb, Princeton, NJ.
  3. "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn, Kalamazoo, MI.
View all 10 references

Corticosteroids (Includes Dexamethasone) ↔ Liver Disease

Moderate Potential Hazard, High plausibility

Applies to: Liver Disease

Corticosteroids are primarily metabolized by the liver and may have enhanced effects in patients with liver disease, especially cirrhosis. Dosage adjustments may be necessary in these patients.

References

  1. "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn, Kalamazoo, MI.
  2. "Product Information. Deltasone (prednisone)." Pharmacia and Upjohn, Kalamazoo, MI.
  3. "Product Information. Kenalog (triamcinolone)." Bristol-Myers Squibb, Princeton, NJ.
View all 10 references

Corticosteroids (Includes Dexamethasone) ↔ Myasthenia Gravis

Moderate Potential Hazard, High plausibility

Applies to: Myasthenia Gravis

Although corticosteroids are commonly used in the treatment of myasthenia gravis to increase muscle strength, these agents should nevertheless be administered with caution in such setting. Patients should be treated in an intensive care unit and receive respiratory support, since muscle strength may markedly decrease initially, particularly with high dosages. Preferably, therapy should begin with relatively low dosages (15 to 25 mg/day of prednisone or equivalent) and increased stepwise as tolerated (approximately 5 mg/day of prednisone or equivalent at 2- to 3-day intervals until marked clinical improvement or a dosage of 50 mg/day is reached). Improvement may be delayed and gradual. Thus, it is important not to discontinue therapy prematurely.

References

  1. Fauci AS, Braunwald E, Isselbacher KJ, Wilson JD, Martin JB, Kasper DL, Hauser SL, Longo DL, eds. "Harrison's Principles of Internal Medicine. 14th ed." New York, NY: McGraw-Hill Health Professionals Division (1998):

Corticosteroids (Includes Dexamethasone) ↔ Myopathy

Moderate Potential Hazard, High plausibility

Applies to: Myopathy, Myoneural Disorder

Toxic myopathy has been observed with the chronic use or the administration of large doses of corticosteroids, often in patients with disorders of neuromuscular transmission such as myasthenia gravis or in patients receiving neuromuscular blocking agents. Fluorinated corticosteroids such as betamethasone, dexamethasone, and triamcinolone appear to cause more severe muscle atrophy and weakness than the nonfluorinated agents. Moreover, multiple-daily doses are more toxic than once-daily or, preferably, alternate-day morning doses. Steroid myopathy is generalized and sometimes accompanied by respiratory weakness and dyspnea. In some cases, it has resulted in quadraparesis. Elevations of creatine kinase may also occur, albeit infrequently. After withdrawal of corticosteroid therapy, recovery may be slow and incomplete. Therapy with corticosteroids should be administered cautiously in patients with preexisting myopathy or myoneural disorders, since these conditions may confound the diagnosis of steroid-induced myopathy. The presence of a normal serum CK level, minimal or no changes of myopathy on EMG, and type 2 muscle fiber atrophy on biopsy are helpful in suggesting steroid-induced weakness. If steroid myopathy is suspected, a dosage reduction or discontinuation of the steroid should be considered.

References

  1. Seale JP, Compton MR "Side-effects of corticosteroid agents." Med J Aust 144 (1986): 139-42
  2. "Product Information. Decadron (dexamethasone)." Merck & Co, Inc, West Point, PA.
  3. "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn, Kalamazoo, MI.
View all 19 references

Corticosteroids (Includes Dexamethasone) ↔ Ocular Toxicities

Moderate Potential Hazard, Moderate plausibility

Applies to: Glaucoma/Intraocular Hypertension, Cataracts

Prolonged use of corticosteroids may cause posterior subcapsular cataracts and elevated intraocular pressure, the latter of which may lead to glaucoma and/or damage to the optic nerves. Long-term therapy with corticosteroids should be administered cautiously in patients with a history of cataracts, glaucoma, or increased intraocular pressure.

References

  1. Kobayashi Y, Akaishi K, Nishio T, Kobayashi Y, Kimura Y "Posterior subcapsular cataract in nephrotic children receiving steroid therapy." Am J Dis Child 128 (1974): 671-3
  2. "Product Information. Decadron (dexamethasone)." Merck & Co, Inc, West Point, PA.
  3. "Product Information. Cortone Acetate (cortisone)." Merck & Co, Inc, West Point, PA.
View all 19 references

Corticosteroids (Includes Dexamethasone) ↔ Osteoporosis

Moderate Potential Hazard, High plausibility

Applies to: Osteoporosis

Corticosteroids reduce osteoblastic function and inhibit the absorption of intestinal calcium, which can result in bone resorption and bone loss during prolonged therapy. In addition, bone matrix may be affected by the protein-catabolic effects of corticosteroids, especially when given in high dosages or for prolonged periods, leading to aseptic necrosis and fractures. Long-term or high-dose corticosteroid therapy should be administered cautiously and only if necessary in patients with or at risk for osteoporosis. Adverse skeletal effects may be minimized by alternate-day or intermittent administration. Any patient receiving prolonged therapy with the equivalent of 7.5 mg prednisone/day or more are at risk for glucocorticoid-induced osteoporosis and should be managed according to The American College of Rheumatology (ACR) guidelines.

References

  1. Anderton JM, Helm R "Multiple joint osteonecrosis following short-term steroid therapy. Case report." J Bone Joint Surg Am 64 (1982): 139-41
  2. Goldstein MF, Fallon JJ, Harning R "Chronic glucocorticoid therapy-induced osteoporosis in patients with obstructive lung disease." Chest 116 (1999): 1733-49
  3. "Product Information. Decadron (dexamethasone)." Merck & Co, Inc, West Point, PA.
View all 36 references

Corticosteroids (Includes Dexamethasone) ↔ Prematurity

Moderate Potential Hazard, Moderate plausibility

Applies to: Prematurity/Underweight in Infancy

The use of certain parenteral formulations of dexamethasone, hydrocortisone, methylprednisolone, prednisolone and triamcinolone is considered by the drug manufacturers to be contraindicated in neonates, particularly premature infants and infants of low birth weight. Some formulations of these drugs contain benzyl alcohol which, when used in bacteriostatic saline intravascular flush and endotracheal tube lavage solutions, has been associated with fatalities and severe respiratory and metabolic complications in low-birth-weight premature infants. However, many experts feel that, in the absence of benzyl alcohol-free equivalents, the amount of the preservative present in these formulations should not necessarily preclude their use if they are clearly indicated. The American Academy of Pediatrics considers benzyl alcohol in low doses (such as when used as a preservative in some medications) to be safe for newborns. Continuous infusions of high dosages of medications containing benzyl alcohol may, however, cause toxicity and should be avoided if possible.

References

  1. "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn, Kalamazoo, MI.
  2. "Product Information. Celestone (betamethasone)." Schering Corporation, Kenilworth, NJ.
  3. ""Inactive" ingredients in pharmaceutical products: update (subject review). American Academy of Pediatrics Committee on Drugs. Available from: URL: http://www.aap.org/policy/re9706.html." Pediatrics 99 (1997): 268-78
View all 10 references

Corticosteroids (Includes Dexamethasone) ↔ Thromboembolism

Moderate Potential Hazard, Low plausibility

Applies to: History - Thrombotic/Thromboembolic Disorder, Thrombotic/Thromboembolic Disorder

Corticosteroids may increase blood coagulability and have rarely been associated with the development of intravascular thrombosis, thromboembolism, and thrombophlebitis. Therapy with corticosteroids should be administered cautiously in patients with thrombotic or thromboembolic disorders.

References

  1. "Product Information. Kenalog (triamcinolone)." Bristol-Myers Squibb, Princeton, NJ.
  2. "Product Information. Hydeltrasol (prednisolone)." Merck & Co, Inc, West Point, PA.
  3. "Product Information. Florinef Acetate (fludrocortisone)." Bristol-Myers Squibb, Princeton, NJ.
View all 10 references

Corticosteroids (Includes Dexamethasone) ↔ Vaccination

Moderate Potential Hazard, High plausibility

Applies to: Vaccination

The administration of live or live, attenuated vaccines is contraindicated in patients receiving large or immunosuppressive doses of corticosteroids. Inactivated viral or bacterial vaccines should be used with caution, since their administration may pose a risk of neurological complications in these patients. Additionally, a diminished or inadequate serum antibody response may be anticipated. Immunization may be undertaken in patients receiving corticosteroids as replacement therapy, such as for Addison's disease.

References

  1. "Product Information. Florinef Acetate (fludrocortisone)." Bristol-Myers Squibb, Princeton, NJ.
  2. "Product Information. Kenalog (triamcinolone)." Bristol-Myers Squibb, Princeton, NJ.
  3. "Product Information. Hydeltrasol (prednisolone)." Merck & Co, Inc, West Point, PA.
View all 10 references

You should also know about...

dexamethasone drug Interactions

There are 791 drug interactions with dexamethasone

dexamethasone alcohol/food Interactions

There are 2 alcohol/food interactions with dexamethasone

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.

Do not stop taking any medications without consulting your healthcare provider.

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