Dexamethasone vs. Prednisone

Are Dexamethasone and Prednisone the Same Thing?

Dexamethasone and prednisone are corticosteroids indicated for allergic states and allergic reactions, dermatologic diseases, endocrine disorders, gastrointestinal diseases, hematologic disorders, neoplastic diseases, nervous system, ophthalmic diseases, renal diseases, respiratory diseases, and rheumatic disorders.

Brand names for dexamethasone include Ozurdex and DexPak 6 Day or 13 Day.

Brand names for prednisone include Deltasone, Rayos, and Prednisone Intensol.

What Are Possible Side Effects of Dexamethasone?

Common side effects of Dexamethasone include:

  • vision changes,
  • swelling,
  • rapid weight gain,
  • sleep problems (insomnia),
  • mood changes,
  • acne,
  • dry skin,
  • thinning skin,
  • bruising or discoloration,
  • slow wound healing,
  • increased sweating,
  • headache,
  • dizziness,
  • spinning sensation,
  • nausea,
  • stomach pain,
  • bloating,
  • muscle weakness, or
  • changes in the shape or location of body fat (especially in your arms, legs, face, neck, breasts, and waist).

Rare instances of severe allergic reactions (anaphylaxis) have occurred in patients receiving corticosteroid therapy such as dexamethasone.

What Are Possible Side Effects of Prednisone ?

Common side effects of Prednisone include:

  • headache,
  • nausea,
  • vomiting,
  • acne, thinning skin,
  • weight gain,
  • restlessness, and
  • trouble sleeping.

Tell your doctor if you experience serious side effects of prednisone including

  • severe allergic reactions (skin rash, itching, hives, swelling of your lips/face/tongue),
  • mood changes or depression,
  • eye pain or vision changes,
  • fever,
  • cough,
  • sore throat,
  • difficulty urinating, or
  • high blood sugar (increased thirst, increased urination, confusion, or swelling of the ankles and feet).

What Is Dexamethasone?

Dexamethasone is a corticosteroid indicated for allergic states, dermatologic diseases, endocrine disorders, gastrointestinal diseases, hematologic disorders, neoplastic diseases, nervous system, ophthalmic diseases, renal diseases, respiratory diseases, and rheumatic disorders. Dexamethasone is available as a generic.

What Is Prednisone?

Prednisone is a glucocorticoid indicated to treat or manage many conditions, including endocrine disorders, rheumatic disorders, collagen diseases, dermatologic diseases, allergies, ophthalmic (eye) diseases, respiratory diseases, hematologic disorders, neoplastic diseases (cancers), edematous states, and gastrointestinal diseases. Prednisone tablets are available in generic form.

What Drugs Interact With Dexamethasone?

Dexamethasone may interact with aspirin (taken on a daily basis or at high doses), insulin or oral diabetes medications, blood thinners, cyclosporine, rifampin, or seizure medications.

Dexamethasone may also interact with diuretics (water pills) or ketoconazole.

What Drugs Interact With Prednisone ?

Prednisone may interact with diuretics (water pills), blood thinners, cyclosporine, insulin or oral diabetes medications, rifampin, azole antifungals, or seizure medications.

Prednisone may also interact with antibiotics, anticholinesterase, isoniazid, bupropion, cholestyramine, cyclosporine, digitalis glycosides, estrogens (including oral contraceptives), barbiturates, ritonavir, indinavir, nonsteroidal anti-inflammatory drugs (NSAIDs), quetiapine, skin tests, thalidomide, and live or inactivated vaccines.

Following prolonged therapy, withdrawal of corticosteroids such as dexamethasone or prednisone may result in symptoms of the corticosteroid withdrawal syndrome including muscle or joint pain and feeling unwell (malaise).

How Should Dexamethasone Be Taken?

Dexamethasone Tablets are available in 0.5, 0.75, 1, 1.5, 2, 4 and 6 mg strengths. The initial dosage for Dexamethasone varies from .75 to 9 mg a day depending on the disease being treated. Infants born to mothers who have received substantial doses of corticosteroids during pregnancy should be carefully observed for signs of hypoadrenalism. Because of the potential for serious adverse reactions in nursing infants from corticosteroids, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother. Use in pediatric patients is recommended to be done in consultation with a pediatric specialist.

How Should Prednisone Be Taken?

The initial dosage of prednisone may vary from 5 mg to 60 mg per day, depending on the specific disease entity being treated.

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References
Medical Editor: John P. Cunha, DO, FACOEP

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