The 7 Most Important Dexamethasone Side Effects to Know - GoodRx (2024)

Dexamethasone is a long-acting corticosteroid medication. It’s commonly prescribed to treat inflammatory health conditions and allergic reactions. It can also manage other conditions, such as endocrine (hormonal) conditions, stomach disorders, and more.

Dexamethasone works by mimicking a steroid hormone that your body produces naturally, called cortisol. In doing so, it helps manage inflammation that may be causing pain or discomfort. This is why dexamethasone is especially helpful for health conditions that stem from an overactive immune system or too much inflammation, such as rheumatoid arthritis.

If you take a higher dose of dexamethasone, or take it for a longer period of time, you’re more likely to experience side effects. However, some side effects can happen regardless of the dose or duration. Here, we’ll review seven dexamethasone side effects you should know about.

1. Difficulty sleeping

Trouble sleeping is one of dexamethasone’s most common side effects. Studies have shown that up to 57% of people may experience brain-related side effects, like insomnia, from corticosteroids.

While the exact way that steroids cause these sleep-related changes is unknown, there are a few potential theories. Steroids may cause difficulty sleeping since they alter a hormonal system that regulates our fight-or-flight response. They may also disrupt natural sleep-wake cycles and promote a state of alertness.

To help manage this side effect, try to take dexamethasone in the morning. If you take it too close to bedtime, it can make it harder to fall asleep. You can also promote a good night’s sleep by limiting screen time before bed and maintaining a consistent bedtime routine.

Speak with your healthcare provider if you’re taking dexamethasone in the morning and are still having trouble falling asleep. They may recommend an adjustment to your medication routine. They could also recommend a temporary sleep medication to help you fall asleep, if needed.

2. Stomach upset

Corticosteroids, including dexamethasone, can irritate your stomach. Possible gastrointestinal (GI)-related side effects of dexamethasone include abdominal bloating or swelling, stomach pain, and nausea.

Taking dexamethasone with food or milk should help prevent stomach upset. But if it becomes problematic or doesn’t go away, let your healthcare provider know. They can help you take other steps to manage this side effect.

More serious stomach side effects

More severe abdominal side effects from dexamethasone are possible, but rare.

Stomach ulcers are one example. But taking a corticosteroid by itself isn’t likely to result in stomach ulcers for most people. They’re more likely to develop when a steroid is combined with a non-steroidal anti-inflammatory drug (NSAID), such as Advil (ibuprofen) or Aleve (naproxen). Taking an NSAID with a corticosteroid is associated with a 4-fold increased risk of GI side effects.

Let your healthcare provider know if you’re planning to take any NSAIDs while you’re prescribed dexamethasone. They can determine whether it’s safe for you to take NSAIDs, or if it would be better to switch to an alternative, like Tylenol (acetaminophen), that doesn’t have the same risks.

3. Mood changes

Dexamethasone can sometimes contribute to mood changes, such as depression, anxiety, or an elevated, over-energetic mood (hypomania). Other mood changes associated with dexamethasone include restlessness or psychosis (visual or auditory hallucinations). These generally go away after stopping dexamethasone.

The reason why these mood changes happen isn’t fully known, but there are a few possible explanations. For instance, corticosteroids may affect the hippocampus. This is a part of the brain that helps process emotions and memories.

Speak with your healthcare provider if you notice any changes to your mood while taking dexamethasone. They may recommend adjusting your dose. If the changes are significant, they may switch you to a different medication. They may also recommend documenting your thoughts in a mood journal, diary, or smartphone app to track your symptoms over time.

4. Headache

Headaches are possible with dexamethasone. Thankfully, general tips can go a long way with managing or preventing headaches. Staying hydrated, avoiding alcohol, and getting a good night’s sleep are all important. If needed, your healthcare provider may also recommend an over-the-counter headache medicine, like Tylenol, for short-term relief.

5. High blood glucose

High blood glucose (sugar) is a commonly reported side effect of dexamethasone. This is because corticosteroids can increase insulin resistance, meaning cells don’t respond to insulin the way that they should. If your blood glucose is too high, you may feel thirsty or need to urinate more often.

Blood glucose changes are more problematic for people living with diabetes. If you have diabetes and are starting dexamethasone, your healthcare provider may tell you to monitor your blood glucose more often. They may also adjust the dose of your diabetes medication(s).

There’s a greater risk of experiencing blood glucose changes if you take a high dose of dexamethasone over a long period of time. However, if you stop taking dexamethasone, or if your dose is decreased, it’s common for blood glucose levels to return to normal.

6. Appetite changes and weight gain

A possible side effect of long-term corticosteroid use is weight gain. This is because corticosteroids like dexamethasone play a role in metabolism — the way our bodies break down nutrients. They can also affect how much water and electrolytes, such as salt, you retain. Dexamethasone can also increase your appetite.

Weight changes don’t affect everyone. But if you experience bothersome weight gain while taking dexamethasone, let your healthcare provider know. They can offer tips to help you meet your body weight goals. For instance, they may talk to you about exercising regularly, eating a healthy diet, and avoiding alcohol. Routinely monitoring your body weight is also a good idea.

Keep in mind: Weight gain isn’t likely with short-term use. You’re more likely to experience weight gain if you’re prescribed a high dose of dexamethasone or you’re taking dexamethasone for 30 days (1 month) or longer.

7. Other long-term side effects

While weight gain is one possible long-term side effect of dexamethasone, other long-term side effects are also possible. These are more likely if you’re taking a high dose of dexamethasone for more than 1 month at a time.

These are some of the more common risks linked to long-term dexamethasone use:

• Osteoporosis (weakened bones) and fractures

• Increased risk of infection

• Cataracts

• Glaucoma

• Heart disease and high blood pressure

• Changes in body fat/appearance

To reiterate: These side effects are much less likely to happen with short-term dexamethasone use. They’re more connected to long-term use, and even then they’re not very common. Speak with your healthcare provider for more information on these long-term side effects.

When should I contact my healthcare provider about dexamethasone side effects?

If you experience side effects that are bothersome or don’t go away, let your healthcare provider know at any point. They can help you manage them.

However, more serious side effects warrant prompt medical attention. Call 911 or go to the nearest emergency room if you experience side effects like these:

• Irregular or fluttering heartbeat

• Chest pain

• Difficulty breathing

• Sudden leg swelling

• Possible symptoms of a fungal infection, such as itchy or scaly skin, difficulty breathing, and night sweats

• Other symptoms of a serious infection, such as a high fever or shortness of breath