Usually Dexamethasone well tolerated. It has a low mineralocorticoid activity, i.e. its effect on water-electrolyte exchange is small. As a rule, low and medium doses of Dexamethasone do not cause delays in sodium and water in the body, increased excretion of potassium.
The following effects are described:
From the endocrine system: depression of glucose tolerance, steroid diabetes mellitus or manifestation of latent diabetes mellitus, oppression of the adrenal gland function, Itenko-Cushing syndrome (lunar face, pituitary type, hirsutism, increased blood pressure, dysmenorrhea, amenorrhea, muscle weakness, striae), delay in sexual development in children .
From the digestive system: nausea, vomiting, pancreatitis, steroid ulcer of the stomach and duodenum, erosive esophagitis, bleeding and perforation of the gastrointestinal tract, increase and decrease in appetite, digestive disorders, flatulence, hiccough.In rare cases - increased activity of "liver" transaminases and alkaline phosphatase.
From the cardiovascular system: arrhythmias, bradycardia (up to cardiac arrest); development (in predisposed patients) or increased heart failure, ECG changes characteristic of hypokalemia, increased blood pressure, hypercoagulation, thrombosis. In patients with acute and subacute myocardial infarction - the spread of the focus of necrosis, slowing the formation of scar tissue, which can lead to rupture of the heart muscle.
From the nervous system: delirium, disorientation, euphoria, hallucinations, manic-depressive psychosis, depression, paranoia, increased intracranial pressure, nervousness or anxiety, insomnia, dizziness, vertigo, pseudotumor, cerebral palsy, headache, convulsions.
From the sense organs: sudden loss of vision (with parenteral administration in the region of the head, neck, nasal concha, scalp may be the deposition of drug crystals in the vessels of the eye), posterior subcapsular cataract, increased intraocular pressure with possible damage to the optic nerve,propensity to develop secondary bacterial, fungal or viral infections of the eyes, trophic changes in the cornea, exophthalmos.
From the side of metabolism: increased calcium excretion, hypocalcemia, weight gain, negative nitrogen balance (increased protein breakdown), increased sweating.
Due to mineralocorticoid activity - fluid retention and sodium (peripheral edema), hypernatremia, hypokalemic syndrome (hypokalemia, arrhythmia, myalgia or muscle spasm, unusual weakness and fatigue).
From the musculoskeletal system: slowing growth and ossification processes in children (premature closure of the epiphyseal growth zones), osteoporosis (very rare - pathological fractures, aseptic necrosis of the femoral head and the humerus), rupture of tendons of muscles, steroid myopathy, loss of muscle mass (atrophy).
From the skin and mucous membranes: Delayed wound healing, petechiae, ecchymoses, skin thinning, hyper- or hypopigmentation, acne, striae, propensity to develop pyoderma and candidiasis.
Allergic reactions: generalized (skin rash, itching, anaphylactic shock), local allergic reactions.
Local: burning, numbness, pain, tingling, flushing at the injection site, infections at the injection site; rarely - necrosis of surrounding tissues, scar formation at the injection site, atrophy of subcutaneous tissue and skin with the / m introduction (especially dangerous is the introduction to the deltoid muscle).
Other: development or exacerbation of infections (the emergence of this side effect is facilitated by jointly used immunosuppressants and vaccination), leukocyturia, withdrawal syndrome.
With IV introduction: arrhythmias, "tides" of blood to the face, seizures.