Dexamethasone Boosts COVID-19 Survival Chance: Know About The Drug, Its Uses & Side Effects

Low-cost Steroid For COVID-19 Approved By Health Ministry

On 16 June Tuesday, trial results showed that dexamethasone, a drug used for treating inflammation and diseases like arthritis have reduced death rates by around a third among the most severely ill Covid-19 patients [2]. The British Health Ministry approved the use of the drug after the study results were published and in addition, introduced export restrictions on the same.

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"This is a (trial) result that shows that if patients who have Covid-19 and are on ventilators or on oxygen are given dexamethasone, it will save lives, and it will do so at a remarkably low cost...It is going to be very hard for any drug really to replace this, given that for less than 50 pounds, you can treat eight patients and save a life" [3].

What Is Dexamethasone?

Dexamethasone is a corticosteroid (a class of drug that lowers inflammation in the body), that has similar properties like the natural hormone produced by your adrenal glands [4]. A prescription medicine, dexamethasone is available as an oral tablet, oral solution, eye drops, and eardrops.

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Mainly used for treating inflammation, dexamethasone relieves inflammation in various parts of the body and is used specifically to decrease swelling (oedema), associated with tumours of the spine and brain, and to treat eye inflammation [5].

The drug is a corticosteroid hormone (glucocorticoid) and helps decrease your body's natural defensive response and reduces related-symptoms such as swelling and allergic-type reactions.

What Are The Uses Of Dexamethasone?

The generic drug is used for treating the following health problems [6][7]:

• Rheumatoid arthritis and other rheumatic diseases such as psoriatic arthritis, juvenile rheumatoid arthritis, lupus and acute gouty arthritis
• Blood/hormone/immune system disorders
• Allergic reactions
• Skin diseases
• Eye infections
• Bowel disorders and intestinal problems
• Breathing problems
• Certain cancers such as leukaemia, lymphoma, and multiple myeloma
• Asthma and lung conditions
• Nausea and vomiting associated with some chemotherapy drugs
• Stimulate appetite in cancer patients with severe appetite problems
• Replace steroids in conditions of adrenal insufficiency

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How Does Dexamethasone Work?

Dexamethasone is a steroid and can be used to treat similar health conditions.

For conditions that cause inflammation, such as arthritis, dexamethasone helps by blocking the system's response to inflammation, which help prevent the tissue damage caused by an overactive immune system [8].

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For adrenal insuffiencicy, which arises when your adrenal glands do not release the hormones or releases lower amounts of certain hormones, dexamethasone helps by replacing these hormones and promote the smooth running of certain body function such as managing blood glucose, fighting infection and controlling stress [9][10].

What Are The Side Effects Of Dexamethasone?

In most cases, people do not experience all of the side effects listed here and the side effects are almost always reversible and diminishes once the treatment course is completed. One can also minimise or prevent the side effects caused by this drug.

Here are some of the common side effects of dexamethasone, which occurs in more than 30 per cent of people [11]:

• Slow wound healing
• Irritability
• Swelling in your ankles and feet (fluid retention)
• Difficulty sleeping (insomnia)
• Increased appetite
• Heartburn
• Muscle weakness
• Increased blood sugar levels
• Nausea
• Vomiting
• Stomach problems
• Headache
• Mood changes
• Anxiety
• Low potassium levels (causing tiredness)

The minor or mild symptoms may go away within a few days or a couple of weeks.

Here are some of the severe side effects of the drug dexamethasone, which are less common and occurs in less than 10 per cent of the people [12]:

• Blood in your stool, or black stools
• Blood in your urine
• Infections with fever, muscle pain and joint pain
• Severe mood and thought shifts along with a sense of euphoria (a feeling of intense happiness), trouble sleeping and personality changes
• Severe allergic reactions
• Unusual tiredness
• Unusual dizziness
• Unusual digestive upset
• Unusual swelling or bloating throughout your body
• Stomach ulcers
• Osteoporosis [13]

Does Dexamethasone Interact With Other Medicines?

Dexamethasone oral tablet can interact with other medications, vitamins or herbs [14]. This can cause the drug to be harmful or prevent the drug from doing its job. The drug can interact with the following medications [15]:

• Cushing's syndrome (a disease of the adrenal gland) drugs
• Antibiotics such as erythromycin
• Antifungal drugs
• Blood thinners
• Cholesterol drugs
• Diabetes drugs
• Diuretics (water pills)
• Epilepsy drugs
• Heart drugs
• Hormones
• HIV drugs
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Tuberculosis drugs
• Vaccines

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Are There Any Warnings Associated With Dexamethasone?

The steroid comes with several warnings and they are mentioned below [16]:

• May cause severe allergic reactions and avoid it if it has caused any allergy, because, taking it again could be fatal.
• For people with a fungal infection, the drug may make it worse.
• For people with congestive heart failure, dexamethasone can increase sodium levels, swelling and potassium loss, making it worse.
• For people with high blood pressure, the drug can increase your blood pressure.
• Dexamethasone can increase the risk of stomach or intestinal bleeding and ulcers.
• The drug decreases bone formation and bone resorption in people with osteoporosis.
• Long-term use of dexamethasone may cause eye problems such as cataracts or glaucoma.
• Dexamethasone can re-activate latent tuberculosis or tuberculin reactivity.
• Use of dexamethasone may lead to a tear in your heart in people who recently had a heart attack.

Dexamethasone is not recommended for women who are breastfeeding as the drug can pass to a child through breast milk and cause side effects [17].

On A Final Note…

Researchers who conducted the study suggested that dexamethasone should be made into standard care in patients with severe cases of the coronavirus infection. More details of the study will be published soon.