Dexamethasone vs. Prednisone: Differences and Uses

Do you suffer from chronic pain or allergic reactions? If so, your doctor may have prescribed either Dexamethasone or Prednisone to help control the symptoms. 

Both medications are corticosteroids, also called glucocorticoids, which reduce inflammation by changing how the body responds to it. While these drugs might be the same type of medication, there are important differences between the two that you need to be aware of. 

In this blog post, we'll explore what conditions each medication is used for, circumstances  in which one may be preferred over the other, and their potential side effects. With a comprehensive understanding of these two powerful drugs and after consulting with your healthcare provider, you can decide which option is best for your health needs. 

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What is Dexamethasone?

Dexamethasone is a steroid medication frequently prescribed as a generic drug. However, several brand names contain Dexamethasone, including Hemady and TaperDex. 

This medication can be administered in several forms:

• tablets

• oral solution

• injection

• ophthalmic products

Its slow-release properties set Dexamethasone apart from other medications, as it's considered a long-acting drug with a half-life of 36 to 72 hours. 

What is Prednisone?

Prednisone, another type of steroid medication, comes in tablet and oral solution forms and is available as a generic product. 

Prednisone is an intermediate-acting drug with a half-life of around three to four hours. Physicians usually prescribe immediate-release Prednisone as a tablet, but delayed-release tablets are also available under the name Rayos.

What are Dexamethasone and Prednisone used for?

Since these steroids are similar, they are often used to treat similar conditions. Healthcare providers often use Dexamethasone and Prednisone for various inflammatory, allergic, and dermatologic conditions, from asthma exacerbations to allergic rhinitis to Stevens-Johnson syndrome. 

However, there are times when one medication might be used over the other. Prednisone is often the go-to medicine for gout, rheumatoid arthritis (RA), multiple sclerosis (MS), prevention of organ transplant rejection, and adrenal insufficiency. Dexamethasone is prescribed for eye inflammation, migraine prevention, and brain swelling (cerebral edema). 

Dexamethasone and Prednisone are also prescribed off-label for conditions like certain cancers or chemotherapy-related nausea and vomiting. 

What are the side effects of Dexamethasone and Prednisone?

Dexamethasone and Prednisone have similar side effects. As with any steroid medication, taking it as directed is important, including how to taper the dose.  

The most common side effects from Dexamethasone and Prednisone include: 

• High blood sugar levels

• Insomnia

• Increased appetite 

• Changes in mood

• Nausea

More severe side effects may occur, especially in people who are taking these medications long-term. Seek medical attention right away if you experience any of the following:

• Allergic reaction (trouble breathing, rash/hives, etc.)

• Heart problems, like changes in heart rate or chest pain

• Kidney injury

• Fluid retention/swelling 

• Pancreatitis

• Infection 

• Bone disease 

• Eye issues like blurred vision, glaucoma, or cataracts

Do Dexamethasone and Prednisone cause any drug interactions?

Yes, several medications and supplements can cause adverse reactions when taken with Dexamethasone or Prednisone. Dexamethasone and Prednisone’ most common drug interactions can occur when they are taken in combination with: 

• Blood thinners, like Warfarin (Jantoven)

• NSAIDs, like Aspirin, Ibuprofen, and Naproxen

• Anticonvulsants (antiseizure), like Phenytoin (Dilantin)

• Medications used to lower blood sugar, like Metformin

• Medicines containing ritonavir, like Paxlovid, and some HIV medications

• Certain medications used to lower cholesterol, like Cholestyramine (Prevalite)

• Desmopressin (DDAVP)

• Live vaccines, like the rotavirus vaccine

This is not an inclusive list. Consult with your pharmacist and healthcare provider to ensure your corticosteroid prescription doesn't negatively interact with any medications or supplements you currently take. 

Dexamethasone vs. Prednisone: Which is more effective?

While it's not entirely clear which steroid is more effective overall, some studies suggest that Dexamethasone and Prednisone are equally effective for specific medical conditions, such as pediatric asthma. 

It's worth noting that Dexamethasone is a bit more powerful compared to Prednisone since it lasts longer in the body. If you need a more heavy-duty steroid, your doctor will most likely prescribe Dexamethasone.

Can I take Dexamethasone and Prednisone together?

Dexamethasone and Prednisone shouldn't be taken together unless directed by your healthcare provider. Sometimes they may recommend Dexamethasone eye drops and Prednisone pills to treat two separate conditions. 

How much do Dexamethasone and Prednisone cost?

Since they're both available as generic medications, Dexamethasone and Prednisone are relatively affordable and covered under most health insurance plans.

It's always best to compare out-of-pocket costs with a CareCard prescription discount card to find the best price. 

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