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A Different Look at Corticosteroids | AAFP - Top Reads in Drug vs. Drug
Introduction Asthma is one of the most prevalent chronic respiratory diseases, which often leads to an emergency department visit. Prednisolone is the most commonly used corticosteroid in treatment of asthma exacerbation. Oral dexamethasone demonstrates bioavailability similar to that of oral prednisolone but has a longer half-life.
Objective To evaluate in adouble-blind,randomised clinical trial the efficacy of different doses of dexamethasone versus prednisolone in controlling asthma exacerbations in children. Methods We recruited 60 patients with asthma exacerbation, aged 2—11 years. Participants were randomly divided into three groups 20 patients each. Group I received a single dose of oral dexamethasone 0.
Vomiting, gastrointestinal tract cramps, ATAQ and relapse rate showed a non-statistically significant difference. You will be able to get a quick price and instant permission to reuse the content in many different ways. Skip to main content. Log in via OpenAthens. Log in using your username and password For personal accounts OR managers of institutional accounts. Forgot your log in details?
Register a new account? Forgot your user name or password? Search for this keyword. Advanced search. Latest content Current issue Archive Authors About. Log in via Institution. You are here Home Archive Volume 27, Issue 3 Two regimens of dexamethasone versus prednisolone for acute exacerbations in asthmatic Egyptian children. Email alerts. Article Text. Article menu. Original research.
Two regimens of dexamethasone versus prednisolone for acute exacerbations in asthmatic Egyptian children. Abstract Introduction Asthma is one of the most prevalent chronic respiratory diseases, which often leads to an emergency department visit.
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❿Decadron versus prednisone. Dexamethasone vs. prednisone: Differences, similarities, and which is better for you
Decadron versus prednisone.
Asthma is usually not diagnosed at such a young age due to the prevalence of bronchiolitis in this age-group Lastly, our meta-analysis was not adequately powered to detect differences in relapse rates and hospital readmission rates, as out of the seven included trials, three studies 1 , 19 , 20 were of small sample size recruiting only 23—51 patients per group. In our power analysis, all included studies were found to be underpowered for detection of significant difference in the primary outcome variable.
To conclude, despite our results indicating similar relapse rates and hospital re-admission rates with dexamethasone and prednisone when used for acute asthmatic exacerbations in children, strong conclusions cannot be drawn due to paucity of large scale RCTs and limited quality of evidence.
It is also not known if both drugs are equally efficacious in reducing asthma severity. Our results however indicate that, vomiting is significantly less with dexamethasone as compared to prednisone. Further large-scale homogenous RCTs comparing the two drugs are warranted to establish guidelines for the use of oral steroid therapy in acute asthma exacerbations in children.
JW and QC conceived and designed the study. JW was involved in the writing of the manuscript. All authors have read and approved the final manuscript. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Single-dose oral dexamethasone compared with three day course of oral prednisolone in children with moderate exacerbation of asthma-a pilot double-blinded randomised controlled trial. J Clin Diag Res. Scarfone RJ, Friedlaender E. Corticosteroids in acute asthma: past, present, and future. Pediatr Emerg Care. Different oral corticosteroid regimens for acute asthma.
Cochrane Database Syst Rev. Dexamethasone for acute asthma exacerbations in children: a meta-analysis. Is dexamethasone as effective as prednisone or prednisolone in the management of pediatric asthma exacerbations?
Ann Emerg Med. British Guideline on the Management of Asthma. PubMed Abstract Google Scholar. Comparative efficacy of oral dexamethasone versus oral prednisone in acute pediatric asthma. J Pediatr. Butler K, Cooper WO. Adherence of pediatric asthma patients with oral corticosteroid prescriptions following pediatric emergency department visit or hospitalization.
Randomized trial of single-dose intramuscular dexamethasone compared with prednisolone for children with acute asthma. Short report: crushed prednisolone tablets or oral solution for acute asthma? Arch Dis Child. A single dose of intramuscularly administered dexamethasone acetate is as effective as oral prednisone to treat asthma exacerbations in young children. Symptomatic improvement following emergency department management of asthma: a pilot study of intramuscular dexamethasone versus oral prednisone.
J Asthma. A randomized trial of single-dose oral dexamethasone versus multidose prednisolone for acute exacerbations of asthma in children who attend the emergency department. PLoS Med. Higgins J, Green S. The Cochrane Collaboration Google Scholar. Cochrane statistical methods group and the cochrane bias methods group. Chapter 8: assessing risk of bias in included studies. The Cochrane Collaboration. Power dressing and meta-analysis: incorporating power analysis into meta-analysis. J Adv Nurs.
Single-dose oral dexamethasone in the emergency management of children with Exacerbations of Mild to Moderate Asthma. Two regimens of dexamethasone versus prednisolone for acute exacerbations in asthmatic Egyptian children.
Eur J Hosp Pharm. A comparison of oral dexamethasone with oral prednisone in pediatric asthma exacerbations treated in the emergency department. Clin Pediatr. Randomized trial of dexamethasone versus prednisone for children with acute asthma exacerbations. Corticosteroid prescription filling for children covered by medicaid following an emergency department visit or a hospitalization for asthma. Log in via OpenAthens. Log in using your username and password For personal accounts OR managers of institutional accounts.
Forgot your log in details? Register a new account? Forgot your user name or password? Search for this keyword. Advanced search. Further clinical trials were recommended to clarify the role of steroids in the treatment of alcoholic hepatitis.
Bacterial meningitis is a serious disease that may result in death or permanent neurologic complications such as seizures, paralysis or sensorineural hearing loss.
These produce inflammatory components such as cytokines, which lead to meningeal inflammation and increased intracranial pressure. Studies show that potent corticosteroids, such as dexamethasone, combined with appropriate antibiotics reduce the risk of acquired sensorineural deafness and the incidence of other neurologic sequelae in meningitis caused by Haemophilus influenzae.
The drug was administered in a dosage of 0. Corticosteroids may also be used in the treatment of tuberculous meningitis. In one randomized, controlled study 55 involving 47 patients in India, dexamethasone was found to be useful as an adjunct treatment in cases of tuberculous meningitis, especially in patients with severe disease. A more recent randomized trial 56 using prednisone in children with tuberculous meningitis showed that prednisone in a dosage of 2 to 4 mg per kg per day for one month improved survival rate and intellectual outcome.
Table 4 57 lists other unlabeled uses of corticosteroids. This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference.
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Edema Decreased salt intake Increased potassium excretion Potassium supplements may be necessary. Increased calcium excretion Use with caution in patients at increased risk of developing osteoporosis; calcium supplements may be necessary, especially in postmenopausal women. Gastrointestinal Gastric irritation Take with meals to prevent gastric upset.
Endocrine Hypercortisolism Cushingoid state , secondary adrenal insufficiency Associated with long-term use even at lower dosages Menstrual difficulties, including amenorrhea and postmenopausal bleeding Precipitation of diabetes mellitus Glucose intolerance, hyperglycemia In patients with diabetes, increased dosages of insulin or oral hypoglycemic agent and changes in diet should be expected.
Cardiovascular Hypertension Use with extreme caution in patients with recent myocardial infarction because of an apparent association with left ventricular free-wall rupture. Thromboembolism Use with caution in patients with thromboembolic disorders because of reports of rare increased blood coagulability.
Thrombophlebitis CHF exacerbation Ocular Posterior subcapsular cataracts Prolonged use may result in increased intraocular pressure or damaged ocular nerve. Use in patients with ocular herpes simplex may cause corneal perforation. Glaucoma May enhance secondary fungal or viral infections of the eye Musculoskeletal Muscle pain or weakness, muscle wasting, pathologic long bone or vertebral compression fractures, atrophy of protein matrix of bone, aseptic necrosis of femoral or humeral heads Use with caution in patients prone to development of osteoporosis; risk versus benefit should be reassessed if osteoporosis develops; elderly, debilitated or poorly nourished patients may be more prone to these effects.
Supplementation with calcium, 1, mg per day, and vitamin D, IU per day, is recommended. Neuropsychiatric Headache, vertigo, seizures, increased motor activity, insomnia, mood changes, psychosis Use with caution in patients with convulsive or psychiatric disorders. Use may aggravate preexisting psychiatric conditions. Steroid-induced psychosis is dose-related, occurs within 15 to 30 days of therapy and is treatable if steroid therapy must be continued.
Pseudotumor cerebri reported during withdrawal. Other Increased susceptibility to infections, masked symptoms of infections Contraindicated in patients with systemic fungal infections except to control drug reactions associated with amphotericin B [Fungizone] therapy. Do not use live virus vaccinations during therapy.
Reactions to skin tests may be suppressed. Its half-life is 36 to 72 hours. Prednisone is also a steroid medication. Prednisone may be referred to as Deltasone, but the brand name is no longer available. Prednisone is available as a generic product in the forms of a tablet and oral solution. Prednisone is known as an intermediate-acting drug.
Its half-life is about three to four hours. Oral prednisone is most commonly prescribed as an immediate-release tablet, but there is also a delayed-release prednisone tablet called Rayos. Rayos delayed-release tablets What form s does the drug come in? Tablet, injection, oral solution, ophthalmic drops alone and in combination with other ingredients , ophthalmic ointments in combination with other ingredients Tablet, oral solution What is the standard dosage?
Varies by indication and response to treatment Varies by indication and response to treatment How long is the typical treatment? Short-term; varies Short-term; varies Who typically uses the medication? Adults, sometimes in children Adults, sometimes in children Want the best price on dexamethasone? Sign up for dexamethasone price alerts and find out when the price changes!
Get price alerts. Dexamethasone and prednisone have similar indications. Both medications are indicated for use in a wide variety of inflammatory conditions for various systems. For example, both medications may be used for allergic conditions, when conventional treatment is not effective.
The allergic and dermatologic conditions that dexamethasone and prednisone may treat include acute exacerbations of asthma, atopic or contact dermatitis, drug hypersensitivity reactions, perennial or seasonal allergic rhinitis, Stevens-Johnson syndrome, and serum sickness.
Because each category has many indications, there are too many to list. In the chart below, we will list several examples for each category. Consult your doctor for more information. Also, some doctors prescribe these medications off-label for certain uses. Off-label prescribing is when a medicine is prescribed for an indication that is not FDA-approved. For example, steroids may be prescribed for certain cancers in combination with other drugs , nausea and vomiting caused by chemotherapy, carpal tunnel syndrome in combination with other drugs , and exacerbations of chronic obstructive pulmonary disease COPD.
Studies comparing the two drugs head to head mostly looked at dexamethasone vs. A study treated children who had mild to moderate croup with one single dose of oral dexamethasone or one dose of prednisolone the active form of prednisone. The study found that prednisolone was less effective than dexamethasone in lowering the number of patients who returned to the hospital.
Both a review of studies in Pediatrics and a study in The Journal of Pediatrics , concluded that two doses of dexamethasone are an effective alternative to a 5-day prednisone treatment, in children with acute asthma. Because each drug can be used to treat a wide variety of medical conditions, it is difficult to say which drug is more effective. Your healthcare provider may choose dexamethasone if you need something that is longer-acting and more potent, or prednisone if you need something that is shorter-acting.
The best drug for you can only be determined by your healthcare provider, who can take into account your medical history and conditions, and other medications you take that could potentially interact with dexamethasone or prednisone. When taking steroid medication, it is important to take it exactly as directed.
Often, the directions will specify that you start with a higher dose and then taper down to a lower dose. Steroids like dexamethasone or prednisone should be taken with food to reduce stomach side effects. The tables below outline standard dosages for some of the conditions that these steroids treat.
More detailed information on dosing can be found for dexamethasone and prednisone on our dosing pages. Sources: Dexamethasone , Prednisone. Steroid dosing for children varies by weight and the condition being treated. Note: Doses listed in the tables above are standard doses per condition. Starting and maximum doses vary by drug and indication. The tables above are not a complete list of all possible indications or doses for dexamethasone or prednisone. Your healthcare provider will determine the best dosage for you based on your health condition and response to treatment.
Unless the patient requires oxygen, using a steroid does not benefit the patient and can cause serious side effects such as high blood sugar, stomach bleeding, psychosis, infections, and other long-term effects. Patients who are already taking a corticosteroid for another indication should continue treatment under supervision of their healthcare provider.
Background: This systematic review and meta-analysis was conducted to compare relapse rates and adverse effects with oral dexamethasone vs. Dosage of dexamethasone and prednisone varied across studies. Studies were grouped based on the follow-up period and duration of dexamethasone administration.
Results: There was no significant difference in the relapse rate between dexamethasone and prednisone at 1—5 days RR 1. Pooled analysis found no significant difference in relapse rates with 1-day RR 1. Hospital readmission rates after initial discharge were not significantly different between the two drugs RR 1.
Frequency of vomiting at ED RR 0. Conclusion: While our results indicate that both dexamethasone and prednisone have similar relapse rates when used for acute asthmatic exacerbations, strong conclusions cannot be drawn due to paucity of large scale RCTs and limited quality of evidence. Dexamethasone is however associated with lower incidence of vomiting as compared to prednisone.
Further homogenous RCTs are needed to provide robust evidence on this topic. Asthma is a common pediatric disease that results in significant limitation of activity and an estimated loss of The disease is characterized by chronic airway inflammation, airway edema, bronchoconstriction, and airway hyperresponsiveness which results in respiratory symptoms like wheezing, shortness of breath, chest tightness, and cough 2.
The intensity of the disease varies with time and episodes of exacerbation frequently require management in the pediatric Emergency Department ED 3. The primary line of treatment in acute exacerbations of asthma is directed at a quick reversal of bronchospasm and reduction of airway inflammation 4.
For this purpose, oral steroids are extremely effective for alleviating symptoms in children 5. Early use of oral steroid therapy is also recommended with prednisone being the drug of choice 6. Relapse after prednisone therapy has been attributed to several factors like the unpleasant bitter taste of the drug, side-effects like vomiting, and its multi-dose regimen of 3—5 days which may reduce patient compliance 8 — To improve patient compliance and reduce relapse rates, the role of dexamethasone has been evaluated in many trials 47.
Initial studies evaluating a single dose of intramuscular IM dexamethasone have found it to be as effective as a 3—5 day regimen of prednisone 11 Subsequently, studies have also compared oral 1 or 2-day therapy of dexamethasone against a 3—5 days regimen of oral prednisone 4 Oral formulations are desirable in children as they are associated with less pain. To date, two meta-analyses have compared oral dexamethasone and prednisone for acute exacerbations of asthma in children, with the last literature search performed in April 34.
Due to the limited number of studies analyzed in these previous reviews, this study aimed to provide an updated Level 1 evidence on relapse rates and adverse effects of oral dexamethasone vs. Studies including adult asthma patients and utilizing the parenteral route of administration of dexamethasone or prednisone were excluded.
We also excluded non-randomized studies, retrospective studies, case-series, and non-English language studies. The last literature search was conducted on 1st August After assessing the studies by their titles and abstracts, full-texts of selected articles were retrieved. Both the reviewers assessed individual studies based on inclusion criteria. Disagreements, if any, were resolved by mutual agreement. Using an abstraction form, two reviewers retrieved data from selected studies.
The primary outcome was the relapse rate defined by an unscheduled visit to the ED or clinic. Secondary outcomes were hospital readmission after discharge and incidence of vomiting at ED or home. Every study was evaluated for the following variables: random sequence generation, allocation concealment, blinding of participants and personnel, blinding of outcome assessment, incomplete outcome data, selective reporting, and other biases. We rated studies on each variable as low risk, high risk, or unclear risk of bias.
Anticipating heterogeneity amongst studies, a random-effects model was used to calculate the pooled effect size. Heterogeneity was calculated using the I 2 statistic. A sensitivity analysis was carried out to assess the influence of each study on the pooled effect size. Sub-group analysis was conducted for relapse rates based on follow-up period 1—5 days or 10—15 days and dosage of dexamethasone. Using the method described by Muncer et al.
Gpower software was used to calculate the power of studies. Out of the potentially relevant articles, 10 were selected for full-text analysis Figure 1. Three studies evaluated intramuscular dexamethasone vs. A total of seven unique articles were included in this systematic review and meta-analysis 171318 — Details of individual studies are presented in Table 1. All trials included pediatric patients, however, the age group varied across studies. All studies were performed in the ED with varying sample sizes 23— patients.
One study excluded patients with severe asthma exacerbation One included patients with moderate severity of exacerbation only 1 while another study included patients with moderate to severe exacerbations Asthma severity was measured on different scales across trials.
With an exception of one study 20there was no statistical significant difference between asthma severity scores of the two study groups. Dexamethasone was administered as a 1-day 11318 or 2-days therapy 720 In one trial, patients were randomized into three groups of 1-day dexamethasone, 2-days dexamethasone, and prednisone Data of both dexamethasone groups were compared separately with prednisone in our meta-analysis.
The dosage of dexamethasone in the included studies was 0. Majority studies had an institutional asthma management protocol wherein additional drugs were given to all patients of the trial. Inhaled or nebulized salbutamol, albuterol, and ipratropium bromide were commonly administered in the included studies.
The follow-up period ranged from 1 to 15 days. For the meta-analysis, two sub-groups were created based on the follow-up period of relapse rates 1—5 days and 10—15 days. There was no significant difference in the relapse rate between dexamethasone and prednisone at 1—5 days RR 1.
With an overall relapse rate of 8. Sub-group analysis was carried out for 1-day and 2-days dosage of dexamethasone vs. Figure 2.
Forrest plot for dexamethasone vs. Figure 3. Hospital readmission after initial discharge was evaluated by four trials 71318 With a re-admission rate of 1.
Data on the incidence of vomiting in ED were retrieved from four studies 71318 Patients receiving dexamethasone vomited less frequently as compared to prednisone RR 0. The frequency of vomiting at home was significantly higher with prednisone 5. Figure 4. Figure 5. There was no change in direction of effect size on sensitivity analysis for the variables: relapse rate, hospital readmission, and vomiting at home.
However, when the results of Qureshi et al. Figure 7. For the outcome variables, relapse rate and hospital readmission rate, all studies were underpowered. The weighted mean effect size for relapse rate was 0. The power of our meta-analysis for detecting significant difference in relapse rate was For the variables, vomiting at ED and vomiting at home, the weighted mean effect sizes were 0.
The authors' judgment of the risk of bias is presented in Figure 8. Randomization was adequately described in five studies 1131820 An appropriate method of allocation concealment was utilized in four trials 11318 Only three studies 11820 provided sufficient information on blinding of participants and personnel while only two trials 118 reported blinding of outcome assessment.
Attrition bias was found to be high in two studies 19 Figure 8. Risk of Bias assessment. Green, low risk of bias; Yellow, unclear risk of bias; Red, high risk of bias. Management of acute asthma exacerbations in children not only depends on the therapy provided in the ED but also on strict adherence to medications prescribed on discharge. On the other hand, Butler et al.
Non-compliance to medications on discharge has been attributed to several factors like inadequate funds or lack of insurance, insufficient knowledge on the necessity of treatment, fear of side-effects and prolonged course of treatment 38 Dexamethasone, a long-acting corticosteroid, has been studied as an alternative to prednisone to allow a shorter course of treatment in asthmatic patients 4.
While inhaled and single-dose IM dexamethasone may be used as a substitute to prednisone, oral formulation is preferable in managing children 9 Studies conducted on adult asthmatic patients have found no difference in relapse rates with 2-days oral dexamethasone and 5-days prednisone 24 Rehrer et al.
In our study, while comparing the use of oral dexamethasone and prednisone in pediatric asthma exacerbations, we found no difference in relapse rates between a short-course of dexamethasone as compared to the standard 3—5 days therapy of prednisone. The hospital readmission rates after initial discharge were slightly higher with dexamethasone as compared to prednisone 1. The results of our study are similar to the previous meta-analyses on this subject. Keeney et al. However, results from both IM and oral dexamethasone trials were pooled in their analysis.
Normansell et al.
Still, dexamethasone is more potent (stronger) than prednisone. If you're in a situation where you need a more potent steroid, dexamethasone. Compare Dexamethasone and Prednisone side effects, costs and risks for treating inflammation, itching, redness, swelling, and pain. Prednisone and methylprednisolone, which are intermediate-acting products, are four to five times more potent than hydrocortisone. Dexamethasone. Findings of this meta-analysis shows that DEX is better than PRED in tolerability and as efficacious as PRED, which indicates that DEX is a suitable alternative. Both prednisone (1 to 2 mg/kg daily for 5 days) and dexamethasone ( to mg/kg Comparative efficacy of oral dexamethasone versus oral prednisone in. The study found that prednisolone was less effective than dexamethasone in lowering the number of patients who returned to the hospital. You will be able to get a quick price and instant permission to reuse the content in many different ways. To date, two meta-analyses have compared oral dexamethasone and prednisone for acute exacerbations of asthma in children, with the last literature search performed in April 34.Steroid medications are used in a wide variety of emergency medical situations as well as for many other acute and chronic inflammatory conditions and disease states.
Both drugs are corticosteroids , also known as glucocorticoids or steroids. They are used for a wide variety of inflammatory conditions in many organ systems. Although dexamethasone and prednisone are both steroids, they have some differences, which we will describe below. Dexamethasone is a corticosteroid, or steroid, medication. Although dexamethasone is usually filled as a generic drug, some brand names that contain dexamethasone include Decadron, Hemady, and TaperDex.
Oral dexamethasone is available as a tablet and oral solution. It is also available as an injection and in certain ophthalmic eye products. Dexamethasone is known as a long-acting drug. Its half-life is 36 to 72 hours. Prednisone is also a steroid medication. Prednisone may be referred to as Deltasone, but the brand name is no longer available.
Prednisone is available as a generic product in the forms of a tablet and oral solution. Prednisone is known as an intermediate-acting drug. Its half-life is about three to four hours. Oral prednisone is most commonly prescribed as an immediate-release tablet, but there is also a delayed-release prednisone tablet called Rayos.
Rayos delayed-release tablets What form s does the drug come in? Tablet, injection, oral solution, ophthalmic drops alone and in combination with other ingredients , ophthalmic ointments in combination with other ingredients Tablet, oral solution What is the standard dosage? Varies by indication and response to treatment Varies by indication and response to treatment How long is the typical treatment?
Short-term; varies Short-term; varies Who typically uses the medication? Adults, sometimes in children Adults, sometimes in children Want the best price on dexamethasone? Sign up for dexamethasone price alerts and find out when the price changes! Get price alerts. Dexamethasone and prednisone have similar indications. Both medications are indicated for use in a wide variety of inflammatory conditions for various systems. For example, both medications may be used for allergic conditions, when conventional treatment is not effective.
The allergic and dermatologic conditions that dexamethasone and prednisone may treat include acute exacerbations of asthma, atopic or contact dermatitis, drug hypersensitivity reactions, perennial or seasonal allergic rhinitis, Stevens-Johnson syndrome, and serum sickness.
Because each category has many indications, there are too many to list. In the chart below, we will list several examples for each category. Consult your doctor for more information.
Also, some doctors prescribe these medications off-label for certain uses. Off-label prescribing is when a medicine is prescribed for an indication that is not FDA-approved. For example, steroids may be prescribed for certain cancers in combination with other drugs , nausea and vomiting caused by chemotherapy, carpal tunnel syndrome in combination with other drugs , and exacerbations of chronic obstructive pulmonary disease COPD.
Studies comparing the two drugs head to head mostly looked at dexamethasone vs. A study treated children who had mild to moderate croup with one single dose of oral dexamethasone or one dose of prednisolone the active form of prednisone. The study found that prednisolone was less effective than dexamethasone in lowering the number of patients who returned to the hospital. Both a review of studies in Pediatrics and a study in The Journal of Pediatrics , concluded that two doses of dexamethasone are an effective alternative to a 5-day prednisone treatment, in children with acute asthma.
Because each drug can be used to treat a wide variety of medical conditions, it is difficult to say which drug is more effective. Your healthcare provider may choose dexamethasone if you need something that is longer-acting and more potent, or prednisone if you need something that is shorter-acting. The best drug for you can only be determined by your healthcare provider, who can take into account your medical history and conditions, and other medications you take that could potentially interact with dexamethasone or prednisone.
When taking steroid medication, it is important to take it exactly as directed. Often, the directions will specify that you start with a higher dose and then taper down to a lower dose. Steroids like dexamethasone or prednisone should be taken with food to reduce stomach side effects. The tables below outline standard dosages for some of the conditions that these steroids treat.
More detailed information on dosing can be found for dexamethasone and prednisone on our dosing pages. Sources: Dexamethasone , Prednisone. Steroid dosing for children varies by weight and the condition being treated.
Note: Doses listed in the tables above are standard doses per condition. Starting and maximum doses vary by drug and indication. The tables above are not a complete list of all possible indications or doses for dexamethasone or prednisone. Your healthcare provider will determine the best dosage for you based on your health condition and response to treatment.
Unless the patient requires oxygen, using a steroid does not benefit the patient and can cause serious side effects such as high blood sugar, stomach bleeding, psychosis, infections, and other long-term effects. Patients who are already taking a corticosteroid for another indication should continue treatment under supervision of their healthcare provider. In patients who are hospitalized and have suspected or confirmed severe COVID , and are on oxygen or a ventilator, a steroid may be used if the healthcare provider determines it will be useful.
If dexamethasone is used, the dose is usually 6 mg by mouth or IV daily. If dexamethasone is not available and prednisone is used, the dosage is usually 40 mg daily.
When taking a steroid such as dexamethasone or prednisone, your healthcare provider will provide instructions for gradually tapering the medication over some time depending on how long you took the medicine. Steroids must always be tapered if taken for more than a few days. If your total time taking the steroid is a week or so, you will only taper for the last few days of the week.
However, if you took steroids for many months, your healthcare provider will instruct you to taper much more gradually, over several weeks or even months. This is because prednisone affects the adrenal glands , so stopping the medicine slowly allows the adrenal glands to return to their normal function. Stopping a steroid too quickly can cause withdrawal symptoms such as extreme tiredness, weakness, lightheadedness, body aches, joint pain, nausea, and appetite loss.
Sign up for prednisone price alerts and find out when the price changes! When you are prescribed a steroid medication, it is important to take the medication as directed, and taper the dose as directed by your healthcare provider when instructed to do so. Below is a list of potential side effects that may occur with either dexamethasone or prednisone. This is not a full list of side effects. Consult your healthcare provider for a full list of adverse events. Source: DailyMed dexamethasone , DailyMed prednisone.
Patients taking an anticoagulant , such as warfarin, should be monitored while taking steroid medication. Medications used for diabetes may need to be adjusted because steroids may affect blood glucose levels. Certain medications that are metabolized by an enzyme called CYP3A4 may affect the metabolism of the steroid, requiring dosage adjustment. This is not a full list of drug interactions.
Consult your healthcare provider for a full list of drug interactions. Pioglitazone Antidiabetic agents Yes Yes Carbamazepine. These steroids should not be mixed with alcohol. Combining steroid medication with alcohol can lead to a higher risk of stomach ulcers, perforation, and bleeding. Dexamethasone but not prednisone interacts with grapefruit and grapefruit juices. The combination can lead to higher levels of dexamethasone in the body, which can cause serious side effects from the steroid.
Avoid grapefruit and grapefruit juice while taking dexamethasone. Check labels of any products that may contain grapefruit products, such as fruit punch. Warnings of corticosteroid treatment with dexamethasone or prednisone include:. Generic medications are more often covered by insurance, including Medicare and Medicaid.
However, the cost of dexamethasone and prednisone with any insurance provider will vary. Cost factors include:. Prescription drug prices often change. These are the most accurate medication prices at the time of publishing. Click the coupon buttons to see updated drug prices.
Corticosteroids, also known as steroids, are used for various conditions that cause inflammation. Steroids work by reducing inflammation and decreasing immune system activity. Like any type of drug, corticosteroids can have many side effects. Some side effects are common, such as stomach pain and headache. Others can be very serious, and not as common, especially when the steroid is taken for a long period of time. Your healthcare provider will tell you how to take the steroid, and how to taper off of the medication, without abruptly stopping it.
When you hear about people misusing steroids, the steroids in question are not corticosteroids. They are anabolic steroids. While corticosteroids are used for inflammatory conditions, anabolic steroids are related to testosterone. While they can be prescribed for legitimate uses, some athletes and bodybuilders misuse anabolic steroids to try to improve their performance or appearance.
Although they are similar, they are not exactly the same. The information above is a helpful comparison between the two drugs.
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