Classification of the incidence of adverse events (WHO):
very often -> 1/10
often from> 1/100 to <1/10
infrequently - from> 1/1000 to <1/100
rarely from> 1/10000 to <1/1000
very rarely - from <1/10000, including individual messages.
From the immune system
- infrequently: reactions of hypersensitivity, decreased immune response and increased susceptibility to infections.
From the endocrine system
- often: transient adrenal insufficiency / growth retardation in children and adolescents, adrenal insufficiency and atrophy (reduction of response to stress), Itenko-Cushing syndrome, menstrual cycle disorder, hirsutism, the transition of latent diabetes mellitus to clinically manifested, increased need for insulin or oral hypoglycemic drugs in patients with diabetes mellitus, delayed sodium and water, increased loss of potassium;
- very rarely: hypokalemic alkalosis, negative nitrogen balance due to protein catabolism.
Metabolic and nutritional disorders
- often: decreased tolerance to carbohydrates, increased appetite and weight gain, obesity;
- infrequently: hypertriglyceridemia.
From the nervous system
- often: mental disorders;
- infrequently: edema of the papillae of the optic nerve and increased intracranial pressure (pseudotumor of the brain) after the abolition of therapy, dizziness, headache;
- very rarely: convulsions, euphoria, insomnia, irritability, hyperkinesia, depression;
- rarely: psychosis.
From the digestive system
- infrequently: peptic ulcers, acute pancreatitis, nausea, hiccups, stomach ulcers or duodenal ulcers;
- very rarely: esophagitis, perforation of the ulcer and bleeding of the gastrointestinal tract (hematomasis, melena), pancreatitis, perforation of the gallbladder and intestines (especially in patients with chronic inflammatory diseases of the large intestine).
From the sense organs
- infrequently: posterior subcapsular cataract, increased intraocular pressure, propensity to develop secondary bacterial, fungal or viral eye infections, trophic corneal changes, exophthalmos.
From the side of the cardiovascular system
- infrequently: arterial hypertension, hypertensive encephalopathy;
- very rarely: polyfocal ventricular extrasystoles, transient bradycardia, heart failure, myocardial rupture after a recent acute infarction.
From the skin
- often: erythema, thinning and fragility of the skin, delayed healing of wounds, striae, petechiae and ecchymosis, increased sweating, steroid acne, suppression of skin reaction during allergological tests;
- very rarely: angioedema, allergic dermatitis, urticaria.
From the side of the musculoskeletal system
- often: muscle atrophy, osteoporosis, muscle weakness, steroid myopathy (muscle weakness due to catabolism of muscle tissue);
- infrequently: aseptic necrosis of bones;
- very rarely: compression fractures of the vertebrae, tendon ruptures (especially when certain quinolones are used together), articular cartilage damage and bone necrosis (associated with frequent intraarticular injections).
On the part of the hematopoiesis system
- rarely: thromboembolic complications, a decrease in the number of monocytes and / or lymphocytes, leukocytosis, eosinophilia (as in other glucocorticosteroids), thrombocytopenia and non-thrombocytopenic purpura.
Allergic reactions
- rarely: skin rash, itching, angioedema, bronchospasm, anaphylactic shock.
From the genitourinary system
- rarely: impotence.
Signs and symptoms of glucocorticosteroid withdrawal syndrome
If a patient taking long-term glucocorticosteroids quickly decreases the dose of the drug, signs of adrenal insufficiency, arterial hypotension, and death may develop.
In some cases, the withdrawal symptoms may be similar to the symptoms and signs of an exacerbation or relapse of the disease, for which the patient is receiving treatment.
With the development of severe adverse events, drug treatment Dexamethasone must be terminated.