Ask Mac – Questions ListCategory: BronchoconstrictionContraindications for Dexamethasone
asked 1 year ago
Currently on PO or parenteral steroids is the contraindication for dexamethasone. Are routine cortisone injections or anabolic steroid use considered current use or only the day it was taken? For patients who have been prescribed prednisone can dex be administered the day after the prescription has ended or should there be a wait time?
1 Answers
answered 1 year ago
Thank you for your question! The are two different classes of steroids. These include Corticosteroids (ie. dexamethasone and prednisone) and Anabolic steroids (ie. testosterone). Corticosteroids work on the pathways to reduce inflammation and results in the positive effects we see when treating croup and allergic reactions. Corticosteroids can be administered orally, intravenously, topically, and they can be inhaled. How they are administered does affect the overall systemic absorption of the medication. For example, inhaled steroids (ie. Flovent) have much less systemic absorption compared to oral steroids such as dexamethasone. Whereas oral and IV steroids have very similar systemic absorption. If a patient has been using inhaled steroids, no matter when it was last administered, this would not be considered to be a contraindication for dexamethasone.  If a patient has taken oral steroids in the last 48hrs it is less likely an additional dose will have much effect on their clinical outcome in the prehospital setting. There is no contraindication to give corticosteroids no matter when any anabolic steroids may have been used.