Dexamethasone vs Prednisone
DexamethasonePrednisone
Corticosteroid (Glucocorticoid)Drug ClassCorticosteroid (Glucocorticoid)
About 25–30 times more potent than cortisolPotencyAbout 4–5 times more potent than cortisol
36–72 hours (long-acting)Half-Life18–36 hours (intermediate-acting)
1–2 hoursOnset of Action1–2 hours
36–72 hoursDuration of Action18–36 hours
Severe allergic reactions, Inflammatory diseases, Cerebral edema, Cancers (e.g., leukemia, lymphoma),COVID-19 (severe cases), Shock due to adrenal insufficiencyIndicationsAllergic conditions-Autoimmune disorders-Inflammatory conditions-Rheumatoid arthritis-Asthma, COPD-Organ transplantation (to prevent rejection)
Oral, IV, IM, topical, intravitrealAdministration RoutesOral, IV, IM
0.75 mg of dexamethasone ? 5 mg of prednisoneDosage Equivalence5 mg of prednisone ? 0.75 mg of dexamethasone
Insomnia - Hyperglycemia - Mood changes - Increased risk of infection - Fluid retention (less common)-Common Side EffectsWeight gain - Hyperglycemia - Mood changes - Increased risk of infection- Fluid retention (more common)
Active infections-Untreated systemic fungal infections-Known hypersensitivityContraindicationsActive infections - Untreated systemic fungal infections - Known hypersensitivity
CYP3A4 inducers (reduce effectiveness) - NSAIDs (increased GI risk)Drug InteractionsCYP3A4 inducers (reduce effectiveness)-NSAIDs (increased GI risk)
C (Risk cannot be ruled out; use only if benefits justify)Pregnancy CategoryC (Risk cannot be ruled out use only if benefits justify)
Typically more expensiveCostGenerally less expensive
Preferred for conditions requiring strong, long - lasting effects - Not ideal for long - term use due to high potencySpecial ConsiderationsPreferred for tapering or conditions needing less potency-Often used in tapering regimens
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