Drenex Adverse Reactions

The "therapeutically effective dose" of a corticosteroid varies with the indication and the requirement of the individual patients which makes it hardly possible to define an excessive dose. However, continued use of high doses necessary for clinical response in severe illness results in exaggeration of usual corticosteroid problems.
Adverse effects caused by dexamethasone and other corticosteroids include decreased carbohydrate tolerance, development of cushingoid state, glycosuria, hirsutism, hyperglycemia, increased requirements for insulin or oral hypoglycemic agents in diabetes, manifestations of latent diabetes mellitus, menstrual irregularities, secondary adrenocortical and pituitary unresponsiveness particularly in times of stress as in trauma, surgery or illness. These drugs may also cause suppression of growth in children, congestive heart failure in susceptible patients, fluid retention, hypertension, hypokalemic alkalosis, potassium loss, sodium retention, bradycardia, cardiac arrest, cardiac arrhythmias, cardiac enlargement, circulatory collapse, fat embolism, hypertrophic cardiomyopathy in premature infants, myocardial rupture following recent myocardial infarction, edema, pulmonary edema, syncope, tachycardia, thromboembolism, thrombophlebitis, and vasculitis.
Musculoskeletal and neurological adverse effects include aseptic necrosis of femoral and humeral heads, loss of muscle mass, muscle weakness, osteoporosis, pathological fracture of long bones, steroid myopathy, tendon rupture, vertebral compression fractures, convulsions, depression, emotional instability, euphoria, headache, increased intracranial pressure with papilledema (pseudotumor cerebri) usually after discontinuation of treatment, insomnia, mood swings, neuritis, neuropathy, paresthesia, personality changes, psychic disorders, and vertigo.
Dexamethasone and other corticosteroids may also cause abdominal distention, elevation of serum liver enzyme levels which is usually reversible upon discontinuation, hepatomegaly, increased appetite, nausea, pancreatitis, peptic ulcer with possible perforation and hemorrhage, perforation of the small and large bowel particularly in patients with inflammatory bowel disease, ulcerative esophagitis; acne, allergic dermatitis, dry scaly skin, erythema, increased sweating, impaired wound healing, petechiae and ecchymoses, thin fragile skin, rash, striae, thinning scalp hair, urticaria and may suppress reactions to skin tests.
Other possible adverse reactions include negative nitrogen balance due to protein catabolism, exophthalmos, glaucoma, increased intraocular pressure, posterior subcapsular cataracts, abnormal fat deposits, decreased resistance to infection, hiccups, increased or decreased motility and number of spermatozoa, malaise, moon face, weight gain, and allergic reactions including anaphylactoid reactions, anaphylaxis, and angioedema.