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Dexamethasone nasal Side Effects

Applies to dexamethasone nasal: nasal aerosol with adapter

Endocrine

Endocrine abnormalities rarely include suppression of the hypothalamic-pituitary-adrenal axis. The risk of adrenal suppression is less than that associated with systemic corticosteroids and should only be of concern with use of higher than recommended doses or with prolonged therapy.[Ref]

Potential systemic endocrine side effects of intranasal use of dexamethasone include decreased carbohydrate intolerance, increased requirements for insulin or oral hypoglycemic in diabetic patients, menstrual irregularities, and hirsutism.[Ref]

Local

Intranasal dexamethasone may cause local irritation including burning, dryness, and soreness. Nose bleed and sore throat have been reported. Nasal septal perforation has also been reported rarely.[Ref]

Nervous system

Nervous system adverse effects include headache and dizziness in patients treated with intranasal dexamethasone.[Ref]

Gastrointestinal

Gastrointestinal side effects include nausea, vomiting, and dry mouth. Pharyngeal candidiasis has also been reported.[Ref]

Systemic side effects are less likely to occur with the nasal use as compared to oral or parenteral administration of dexamethasone. Potential gastrointestinal adverse reactions from absorption of dexamethasone from the nasal mucosa include peptic ulcer, hemorrhage, perforation of the small and large bowel, pancreatitis, abdominal distention, and ulcerative esophagitis.[Ref]

Ocular

Ocular adverse effects are more commonly seen with systemic administration of corticosteroids. However, posterior capsular cataracts have been occasionally reported with inhaled corticosteroids, especially with long-term use. Ocular hypertension and open-angle glaucoma have also been reported.[Ref]

Immunologic

In 1993, the American Academy of Allergy and Immunology (AAAI) requested that the FDA review its decision regarding the labeled risks of the use of inhaled corticosteroids during severe viral infections. The AAAI's request was based on the lack of data linking inhaled corticosteroids to increases in complications of viral infections.[Ref]

The danger of infections from immune suppression associated with inhaled corticosteroids has been debated. No conclusive evidence is available to support an increase in tuberculosis or viral infections in patients receiving nasal dexamethasone.[Ref]

Metabolic

Metabolic side effects are generally seen only with large doses used for a prolonged time period. Salt and water retention with a corresponding rise in blood pressure, and increased potassium and calcium excretion have been reported.[Ref]

Salt restriction and potassium supplementation may be necessary to correct electrolyte imbalances.[Ref]

References

1. "Product Information. Dexacort Phosphate in Turbinaire (dexamethasone nasal)." Medeva Pharmaceuticals, Rochester, NY.

2. Garbe E, LeLorier J, Boivin JF, Suissa S "Inhaled and nasal glucocorticoids and the risks of ocular hypertension or open-angle glaucoma." JAMA 277 (1997): 722-7

Not all side effects for dexamethasone nasal may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

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