Dexamethasone is one of a group of corticosteroids (cortisone-like medicines) that are used to relieve inflammation in different parts of the body. Corticosteroids are used in MS for the management of acute exacerbations because they have the capacity to close the damaged blood-brain barrier and reduce inflammation in the central nervous system. Although dexamethasone is among the most commonly used corticosteroids in MS, it is only one of several possibilities. Other commonly used corticosteroids include, prednisone, betamethasone, and methylprednisolone. The following information pertains to all of the various corticosteroids.
Most neurologists treating MS believe that high-dose corticosteroids given intravenously are the most effective treatment for an MS exacerbation, although the exact protocol for the drug's use may differ somewhat from one treating physician to another. Patients generally receive a four-day course of treatment (either in the hospital or as an out-patient), with doses of the medication spread throughout the day (see Methylprednisolone). The high-dose, intravenous dose is typically followed by a gradually tapering dose of an oral corticosteroid (usually ranging in length from ten days to five or six weeks). Dexamethasone is commonly used for this oral taper. Oral dexamethasone may also be used instead of the high-dose, intravenous treatment if the intravenous treatment is not desired or is medically contraindicated.
This medication can cause indigestion and stomach discomfort. Always take it with a meal and/or a glass or milk. Your physician may prescribe an antacid for you to take with this medication.Take this medication exactly as prescribed by your physician. Do not stop taking it abruptly; your physician will give you a schedule that gradually tapers the dose before you stop it completely.
Since corticosteroids can stimulate the appetite and increase water retention, it is advisable to follow a low-salt and/or a potassium-rich diet and watch your caloric intake.
Corticosteroids can lower your resistance to infection and make any infection that you get more difficult to treat. Contact your physician if you notice any sign of infection, such as sore throat, fever, coughing, or sneezing.
Avoid close contact with anyone who has chicken pox or measles. Tell your physician immediately if you think you have been exposed to either of these illnesses. Do not have any immunizations after you stop taking this medication until you have consulted your physician. People living in your home should not have the oral polio vaccine while you are being treated with corticosteroids since they might pass the polio virus on to you.
Corticosteroids may affect the blood sugar levels of diabetic patients. If you notice a change in your blood or urine sugar tests, be sure to discuss it with your physician.
The risk of birth defects in women taking corticosteroids during pregnancy has not been studied. Overuse of corticosteroids during pregnancy may slow the growth of the infant after birth. Animal studies have demonstrated that corticosteroids cause birth defects.
Corticosteroids pass into breast milk and may slow the infant's growth. If you are nursing or plan to nurse, be sure to discuss this with your physician. It may be necessary for you to stop nursing while taking this medication.
Corticosteroids can produce mood changes and/or mood swings of varying intensity. These mood alterations can vary from relatively mild to extremely intense, and can vary in a single individual from one course of treatment to another. Neither the patient nor the physician can predict with any certainty whether the corticosteroids are likely to precipitate these mood alterations. If you have a history of mood disorders (depression or bipolar disorder, for example), be sure to share this information with your physician. If you begin to experience unmanageable mood changes or swings while taking corticosteroids, contact your physician so that a decision can be made whether or not you need an additional medication to help you until the mood alterations subside.
Possible Side Effects
Side effects that may go away as your body adjusts to the medication and do not require medical attention unless they continue or are bothersome: increased appetite; indigestion; nervousness or restlessness; trouble sleeping; headache; increased sweating; unusual increase in hair growth on body or face.
Less common side effects that should be reported as soon as possible to your physician: severe mood changes or mood swings; decreased or blurred vision*; frequent urination*.
Additional side effects that can result from the prolonged use of corticosteroids and should be reported to your physician: acne or other skin problems; swelling of the face; swelling of the feet or lower legs; rapid weight gain; pain in the hips or other joints (caused by bone cell degeneration); bloody or black, tarry stools; elevated blood pressure; markedly increased thirst (with increased urination indicative of diabetes mellitus); menstrual irregularities; unusual bruising of the skin; thin, shiny skin; hair loss; muscle cramps or pain. Once you stop this medication after taking it for a long period of time, it may take several months for your body to readjust.
* Since it may be difficult to distinguish between certain common symptoms of MS and some side effects of dexamethasone, be sure to consult your health care professional if an abrupt change of this type occurs.