Corticosteroids dexamethasone, prednisolone and hydrocortisone for adults with confirmed SARS-CoV-2 infection

Corticosteroids dexamethasone, prednisolone and hydrocortisone for adults with confirmed SARS-CoV-2 infection

This was an interesting finding, but a validation study replicating the results has apparently not been published. But if you’re taking high doses for a long time, you may be at risk of some of the same side effects as steroid tablets. Your steroid preventer inhaler is unlikely to cause side effects, especially if you’re using your inhaler correctly. Find out why steroids are used to treat lung conditions like asthma and chronic obstructive pulmonary disease (COPD).

If you’ve never had chickenpox you should avoid contact with people who have chickenpox or shingles while you’re taking dexamethasone. If you’re exposed to these diseases either during treatment, or in the three months after stopping treatment, you should consult your doctor urgently. This is very important as these diseases can be life-threatening in people taking long courses of corticosteroids.

Steroid inhaler side effects

A steroid card lets healthcare professionals know you take steroid medicines and provides life-saving information in the event of an emergency. You’re most likely to be prescribed oral steroids if you have a flare-up of your symptoms or an asthma attack. This should be a short course to deal with symptoms, and once you’ve finished the course, your doctor will advise you how to safely stop taking them. If you have any concerns about the medicines you take for your asthma, COPD, or other lung condition, speak to your doctor, nurse, pharmacist or other healthcare professional and you can also call our helpline.

  • It’s important that you don’t stop taking dexamethasone suddenly if you’ve been taking it every day for more than three weeks (sometimes less – your doctor will advise).
  • Some people with COPD are given a short course of steroid tablets to keep at home, as part of their flare-up rescue pack, but you must have clear instructions about when and how to use them.
  • You should also show your steroid card to anyone who treats you for at least a year after you stop treatment with steroids.
  • If you’re worried about any side effects, ask your healthcare professional for advice as soon as you can.

So it’s important to see your doctor if you get any signs of infection while you’re taking dexamethasone. It is also useful for treating certain types of blood cancer where there is excessive production of certain white blood cells. Everything you need to know about this corticosteroid medicine, including COVID-19 treatment. IV administration should only be used where tablets or oral solution are not appropriate or not available.

Common conditions

This is usually only for people with asthma that’s difficult to control, or severe. If this is the case, you should be
under the care of a specialist. It’s understandable that people worry about side effects of using steroids.

Clinical Question

Taking of anti-inflammatory painkillers (NSAIDs) like aspirin, ibuprofen or naproxen painkiller with dexamethasone may increase the risk of side effects on the gut, such as stomach ulceration and bleeding. Avoid taking these painkillers if you’re taking dexamethasone, unless they’ve been prescribed by your doctor. Long courses of dexamethasone may increase your susceptibility to infections and can also mask the symptoms of infections, making you think they are less serious than they are.

You need to take this every day to keep down the inflammation in your airways. An older RCT looked at the role of the corticosteroid dexamethasone in OHCA.8 That trial failed to demonstrate improvement in survival to hospital discharge. Your doctor or asthma nurse will always aim to prescribe the lowest steroid dose in your preventer inhaler – enough for you to get good control over your symptoms, but as low as possible to reduce your risk of side effects. Dexamethasone may enhance the anti-blood-clotting effect of anticoagulant medicines such as warfarin.

Always carry a steroid card

If you have an accident the card contains information that could save your life. You should also show your steroid card to anyone who treats you for at least a year after you stop treatment with steroids. At your next appointment, ask your doctor or asthma nurse what your total daily dose of steroid medicine is, from your preventer medicine and any other steroid medicines you’re taking.

How does dexamethasone work?

This is important for your recovery, and unlikely to cause harmful side effects. Avoid taking antacids within two hours of taking dexamethasone because they could reduce its absorption from the gut and so make it less effective. If you think you could be pregnant while you’re taking dexamethasone you should ask your doctor for advice.

People with diabetes may need an increase in their dose of insulin or antidiabetic tablets. For patients who did not need oxygen or ventilation at the start of the study, dexamethasone was not shown to reduce the risk of dying. Dexamethasone may weaken your immune system, which means that vaccines may be less effective if given during treatment, because your body won’t produce sufficient antibodies in response to the vaccine.

Does Administering Steroids for Cardiac Arrest Lead to Better Neurological Outcomes?

He is on the Best Evidence in Emergency Medicine faculty and is creator of the knowledge translation project the Skeptics Guide to Emergency Medicine. You are more likely to have problems with your liver if you take dexamethasone with high-dose methotrexate. The benefits of using dexamethasone while breastfeeding will usually outweigh any risks.