Dexamethasone is a corticosteroid, a synthetic hormone similar to cortisol, naturally produced by the body’s adrenal glands. It is utilized for its potent anti-inflammatory and immunosuppressive properties. It plays a significant role in cancer treatment plans, often administered alongside chemotherapy to manage specific effects.
Why Dexamethasone is Given
Dexamethasone is given before chemotherapy primarily to improve patient comfort and safety. It functions as an anti-nausea and anti-vomiting agent. It helps prevent and reduce chemotherapy-induced nausea and vomiting by dampening signals in the brain’s vomiting center.
The medication also functions as a powerful anti-inflammatory. Chemotherapy can cause inflammation in various parts of the body, and dexamethasone helps to mitigate this. Reducing inflammation alleviates symptoms like swelling and pain, improving treatment tolerance.
Additionally, dexamethasone prevents or minimizes allergic reactions to certain chemotherapy drugs. Its corticosteroid properties help to stabilize immune cells and reduce the release of inflammatory chemicals that cause allergic symptoms. For some cancers, like certain blood cancers, dexamethasone directly contributes to an anti-cancer effect by promoting cell death. It can also reduce swelling around tumors, particularly brain tumors, alleviating neurological symptoms.
Common Side Effects
Patients receiving dexamethasone may experience common, usually temporary, side effects. Insomnia or sleep disturbances are common, often due to the stimulating effect of the steroid on the central nervous system. Taking the medication earlier in the day, typically in the morning, can help minimize its impact on sleep.
Increased appetite is another common side effect, as dexamethasone influences metabolic processes. This may lead to temporary weight gain and fluid retention. Patients might also notice mood changes, such as irritability, anxiety, or increased energy, related to the steroid’s effects on the brain.
Fluid retention, manifesting as swelling in the hands, feet, or face, can occur because dexamethasone causes the body to retain sodium and water. Indigestion or heartburn may also be experienced, as steroids can irritate the stomach lining. Eating smaller, more frequent meals and avoiding spicy or acidic foods can help manage discomfort. Temporary elevation of blood sugar levels is also possible, even in individuals without diabetes, due to the steroid’s influence on glucose metabolism.
How Dexamethasone is Administered and Important Considerations
Dexamethasone is typically administered as oral tablets or through intravenous injection. For chemotherapy, it is often given a few hours before the infusion begins, to allow the medication to take effect. In some cases, patients may continue dexamethasone for a few days after chemotherapy, depending on the regimen and anticipated side effects.
Following the healthcare team’s precise instructions regarding dosage and timing is extremely important. Deviating from the prescribed schedule can impact the medication’s effectiveness. Patients should never stop taking dexamethasone abruptly without consulting their doctor. Sudden discontinuation can lead to withdrawal symptoms, including fatigue, weakness, body aches, and a drop in blood pressure, as the body needs time to readjust.
Dexamethasone can interact with other medications, such as blood thinners like warfarin, certain antacids, and some anti-seizure drugs, which can alter the effectiveness of either medication. Therefore, inform the healthcare team about all current medications, including over-the-counter drugs and supplements. Patients with pre-existing conditions like diabetes, active infections, or glaucoma should discuss these with their doctor, as dexamethasone might require careful monitoring or dosage adjustments. Any new or worsening side effects or concerns should be promptly reported.