Steroids are commonly used in the medicinal world for various purposes. These anti-inflammatory medications are used for treating a range of conditions, including allergies, asthma, arthritis, and inflammatory bowel disease, among other things.
Steroids can be potent if taken without a doctor’s prescription and in appropriate dosages. While it’s unlikely that significant side effects would be caused by taking them for less than three weeks, long-term use can be detrimental if taken without a doctor’s guidance. This is why the drugs are only available on prescription.
Some steroid side effects that users need to be aware of include indigestion and heartburn, increased appetite and subsequent weight gain, difficulty sleeping, mood swings, increased risk of infections, high blood sugars, and weakening of the bones. Indeed, prolonged doses of steroid shot can cause thin skin that bruises easily. Eye conditions and mental health problems can also result.
Most steroid side effects are reversible and stop once the treatment is seized, which is why it is imperative to inform the doctor at the earliest if you are experiencing any troubling signs.
To minimize the risk of steroid side effects, it is best to take a steroid shot in the morning with breakfast. One should eat a healthy and well-balanced diet while on legal steroids and also exercise regularly. Close contact with people with infections should be avoided. It is advisable to ensure that you are fully vaccinated before starting steroid shots.
How does steroid shot work?
Steroids are basically a manmade version of the hormones produced by the adrenal glands in the body naturally. When you take steroid shots in doses higher than the amount produced by the body, they reduce redness and swelling. These are the signs of inflammation. Thus, steroids help alleviate inflammatory conditions like eczema, asthma, and many more.
Steroids also suppress the immune system, which is the natural defense of the body against potential diseases and infections. As a result, steroids can be used for treating autoimmune conditions like rheumatoid arthritis. These conditions occur when the immune system starts attacking the body mistakenly.
Keep in mind that steroid shots aren’t the same as anabolic steroids used by people for bodybuilding. Deca steroid (Nandrolone) is one of the most commonly used forms of steroid used in the medicinal world.
An overview of decadron steroid
Deca is a corticosteroid, similar to the natural hormone produced by the adrenal glands. It is used to treat a variety of conditions and cancer. It is also occasionally used in the management of cerebral edema.
Deca steroid is available in tablet form for oral administration in two potencies, including 0.5mg and 0.75mg. Other inactive ingredients of the drug include magnesium, lactose, calcium phosphate, and starch.
Who should use decadron steroids?
Decadron shots can only be taken on the advice of a physician. Let’s take a look at the conditions wherein decadron steroids (dexamethasone) can be of help.
This steroid shot can help control severe allergic conditions that aren’t responsive to conventional management. Examples of such diseases wherein deca can be used include asthma, contact dermatitis, atopic dermatitis, drug hypersensitivity reactions, and seasonal allergic rhinitis, among others.
- Skin diseases
Decadron shot can help alleviate the signs of various dermatologic conditions such as bullous dermatitis herpetiformis, mycosis fungoides, and pemphigus.
- Endocrine Disorders
Deca steroid is often used for the management of primary or secondary adrenocortical insufficiency and other disorders of the endocrine system, including congenital adrenal hyperplasia and hypercalcemia associated with cancer.
- GI disturbances
This steroid shot can help deal with a severe form of regional enteritis and ulcerative colitis.
- Hematologic Disorders
Some blood-related disorders like congenital hypoplastic anemia, autoimmune hemolytic anemia, and idiopathic thrombocytopenic purpura can be treated with these steroids.
- Neoplastic Diseases
Steroid shot is used for the palliative management of lymphomas and leukemias.
- Disorders of the Nervous System
Sometimes, acute exacerbation of multiple sclerosis and cerebral edema arising from a head injury and craniotomy might require a steroid shot.
- Ophthalmic Diseases
The inflammatory conditions unresponsive to corticosteroids might require a shot of deca steroids. These conditions include ocular inflammatory diseases, uveitis, and temporal arteritis.
- Renal Diseases
Patients suffering from idiopathic nephrotic syndrome and lupus erythematosus can be given a steroid shot to induce remission of proteinuria.
What is the appropriate dose of deca steroids?
This depends on the indication of the steroid shot. For oral administration, initially, the dose can vary from 0.75 to 9mg daily depending on the condition being treated. It is imperative to keep in mind that the dosage requirements are variable and can change according to the disease being treated and the individual’s response to it.
If the patient responds favorably to the steroid, a proper maintenance dose is determined by decreasing the initial dose administered gradually at regular time intervals till the lowest dose is achieved.
The doses have to be adjusted according to the changes in the clinical status of the patient, whether he is in remission or exacerbation, the response to it, and the effect of the patient exposure. Sometimes, the corticosteroid dose has to be increased for some time if the patient fails to respond to the dose administered. When the time comes to discontinue the drug after long-term therapy, it has to be gradually tapered off and not stopped abruptly.
Let us give you an example. If deca steroid is being used for the treatment of acute exacerbation of multiple sclerosis, a daily dose of 30mg for a week followed by a gradual decrease every other day for a month has shown promising results.
In the case of pediatric patients, the initial dose depends on the disease being treated. Usually, the range is 0.02 to 0.3 mg/kg/day in divided doses.
The dose of the steroids is designed such that the risk of overdosing can be minimized. In the management of cerebral edema, an initial dose of 10mg of decadron steroid is administered initially, followed by six hours of intramuscular injections of 4mg until the symptoms of the conditions resolve. The patient is closely observed for 12 to 24 hours to gauge the response to the drug, and the dose can then be gradually reduced after that.
Decadron tablets are available in compressed and pentagonal shapes, given different colors to distinguish potency. The tablets are coded and scored on one side and should be stored at a controlled room temperature.
It is vital that the medicine is taken as per the instruction of the doctor. They will explain to you the frequency and dose required for your condition in detail. Taking deca steroid with or immediately after a meal helps prevent the irritation of the stomach.
It is quite plausible that you forget to take a dose. In such an instance, take it as soon as you remember. If you realize it too late and the time has come for your next dose, it is best to skip the missed dose. Don’t take a double dose to make up for this. This can increase the risk of harmful side effects.
Although taking excessive steroid tablets once is unlikely to be too dangerous, it is advisable to talk to your doctor if that happens as a precaution. However, prolonged use of excessive steroid tablets can increase the risk of side effects significantly.
Make it a point to ensure that the steroids shouldn’t be stopped before discussing it with a doctor. If you have been on steroid shot therapy for a long period, the dose has to be reduced gradually. Abrupt stopping of the drug can lead to the adrenal gland to stop working, which can give rise to a condition called adrenal insufficiency. Symptoms of this adrenal insufficiency include extreme fatigue, feeling sick, dizziness, loss of appetite, and weight loss. There is also a chance of your original symptoms coming back suddenly.
Therefore, it is best to follow the advice of a doctor on how to stop taking steroids safely.
Steroid side effects
There are some potential side effects that you might have to face if you fail to follow your doctor’s instructions while using deca steroids. Let’s take a look at some of them.
- Allergic reactions
Increased doses of steroid shots can lead to anaphylactoid reactions and even angioedema.
- Effect on Cardiovascular system
Steroid shots can cause slowing of the heart rate and even cardiac arrest. It can lead to cardiac arrhythmias and cardiac enlargement as well. Congestive heart failure, myocardial rupture, and fat embolism can result. Prolonged use of deca steroids can cause syncope, palpitations, vasculitis, and thromboembolism.
- Dermatologic reactions
Steroid use can lead to acne and allergic dermatitis. It can impair wound healing of the skin and also increase sweating and rash. It makes the skin thin and fragile and can cause the formation of erythema and petechiae, among other things.
- Effect on the endocrine system
Steroids can decrease the tolerance to carbohydrates and glucose in the body and cause the development of a cushingoid state. It is common to have hyperglycemia due to the use of steroids, which leads to an increased requirement of insulin and oral hypoglycemic agents. It can also cause menstrual irregularities and pituitary unresponsiveness in patients.
- Electrolyte Disturbances
Vulnerable patients can develop congestive heart failure due to steroids. The drugs can also cause fluid retention in the body. Sodium retention and potassium loss are some other side effects of the prolonged use of decadron steroids.
- Gastrointestinal disturbances
Some patients on steroid therapy are noted to develop abdominal distention. There is an increase in their serum enzyme levels. But this is usually reversible, and the levels soon return to the normal range once steroids are discontinued. Steroids can increase appetite and also cause nausea. Risk of peptic ulcer and subsequent perforation increases with this drug.
- Metabolic reaction
Steroids cause protein catabolism, which can lead to negative nitrogen balance in the body.
- Reaction on the musculoskeletal system
Loss of muscle mass and muscle weakness can result due to the use of steroids. Therefore, deca steroids should never be confused with anabolic steroids used for bodybuilding. Decadron can cause pathologic fracture of long bone and tendon rupture.
- Neurological reactions
Depression, mood swings, and emotional instability are often associated with prolonged use of steroids. Patients also complain of headaches. Once the treatment is stopped, patients can develop insomnia, personality changes, and vertigo in the initial days.
Patients on steroid therapy are more likely to develop infections. During steroid use, the body has a decreased ability to develop resistance or localize infection. The infection can be mild or severe. Keep in mind that the rate of infectious complications is likely to increase with the increased dose of steroids. Furthermore, the signs of current infection can be masked due to the use of the steroid.
Steroids can worsen systemic fungal infections in the body. Therefore, unless there is some life-threatening indication, it is best to avoid deca steroids in patients with such infections. Cases have been reported wherein the use of steroids alongside antifungals has led to cardiac enlargement and congestive heart failure.
Steroids can also cause activation of latent disease or exacerbate an already existing infection caused by pathogens like candida, Nocardia, toxoplasma, and Cryptococcus, among others.
This is why it is advisable to rule out latent or active amebiasis before starting decadron steroid in any patient.
Steroids should be used with immense caution in patients who are suspected of having threadworm infestation. Decadron causes immunosuppression, which can worsen the septicemia in such patients. Indeed, it can even prove to be fatal. Similarly, steroids should never be used for the management of cerebral malaria.
Steroids should be used only in patients of active tuberculosis if they have disseminated tuberculosis. In this case, the steroid helps in the management of the condition. If the drug is indicated in latent tuberculosis, close observation is imperative. Prolonged therapy will require these patients to receive chemoprophylaxis to minimize the complications.
- Ophthalmic reactions
The use of decadron steroids can increase intraocular pressure and cause glaucoma and posterior subcapsular cataracts.
Some other side effects include
- Abnormal fat deposits in the body
- Increased motility
- Decreased resistance to infection
- Weight gain and malaise
How to minimize the risk of deca steroids?
If a patient is required to use steroids long-term, certain measures have to be taken to minimize the potentially fatal risks associated with it.
Large doses of steroids can lead to increased blood pressure, along with sodium and water retention in the body. It is critical to restrict salt in the diet and incorporate potassium supplementations during this period. Keep in mind that these corticosteroids also cause calcium excretion, so that has to be managed as well.
The use of decadron steroids can lead to reversible pituitary-adrenal axis suppression. Once the treatment is withdrawn, the patient can develop glucocorticosteroid insufficiency. Rapid withdrawal of the steroids can lead to adrenocortical insufficiency. Therefore, it is critical to reduce the dose gradually. The relative insufficiency can last for months after the therapy has been discontinued. Patients might have to be put on hormone therapy to counter this effect during the period.
Keep in mind that hypothyroid patients have impaired metabolic clearance of the steroids. Therefore, for such patients, the dose has to be adjusted accordingly.
What special precautions should I follow for deca steroid use?
Before using deca steroid, there are some measures you have to take to ensure that the risk of side effects and subsequent complications is minimized.
- Make sure that you notify your doctor if you are allergic to deca, aspirin, or any other drug beforehand so that he can prescribe you medications accordingly.
- Don’t forget to tell your doctor what medications you are already taking. This is particularly important if you are on some blood thinners like warfarin, aspirin, arthritis medications, digoxin, diuretics, estrogen, oral contraceptives, or vitamins. The doctor will have to take the potential drug interactions into consideration before prescribing you the medications.
- Don’t use deca steroids if you have a fungal infection unless you have discussed it with your physician. Make sure that you mention the infection to him.
- Let your doctor know if you have any preexisting medical conditions like liver, kidney, or heart-related issues. The doctor should know if you have high blood pressure, diabetes, any thyroid disorder, or osteoporosis. All these conditions can aggravate due to decadron, which is why caution is mandatory.
- Mention it to your doctor if you are pregnant or are planning to start a family. Lactating mothers should also be careful. Don’t delay in contacting your doctor if you become pregnant while you are on steroid therapy.
- Before any surgery, including dental one, ensure that your doctor is informed that you are on steroid therapy.
- Those with a history of ulcers or who have been taking large doses of aspirin and other arthritis medications should restrict alcohol consumption while they are on steroid therapy. This is vital because decadron will make your intestines and stomach vulnerable to the irritation caused by alcohol and arthritis medications. This will increase the risk of ulcers.
Is deca steroid safe?
This entirely depends on how you use it. There is no denying that the steroid is valuable in treating some medical conditions and can be life-saving in a lot of situations. You only have to be worried about the steroid side effects if you don’t follow the recommended dosage guidelines.
If you want to ensure that the steroid doesn’t cause any complications, you have to ensure that you use the drug only after discussing it with your doctor. This will minimize the risk of side effects and make sure that you aren’t in for any surprises. Furthermore, don’t alter the dose without having a word with your physician since abruptly stopping the drug can backfire too.
Decadron steroid helps in various inflammatory conditions and even cancer. But there is a reason that it is available only with a doctor’s prescription. Make sure that you abide by all the instructions given by your doctor while using the steroid. At the same time, restrict yourself to a healthy lifestyle while you are on therapy.
Only then will you be able to ensure that the potential complications and side effects of the steroid don’t harm you and you only get the benefits that the drug has to offer. Caution is mandatory while using deca steroid.
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Contact: MICHAEL NORWOOD, PH.D.
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