Difference Between Dexamethasone and Methylprednisolone


Corticosteroids, commonly known as glucocorticoids or steroids, are used to treat a wide variety of conditions, including arthritis, skin and blood diseases, severe allergies, and more. Corticosteroids, such as dexamethasone and methylprednisolone, are given to Covid-19 patients to boost lung function.

Patients with coronavirus who were given 2mg/day of intravenous methylprednisolone had better medical outcomes on days 5 and 10 compared to those who were given 6mg/day of dexamethasone.

What is Dexamethasone?

Corticosteroid dexamethasone is used to treat immune system disorders and hormone deficiencies. Inflammation, allergic responses, rheumatoid arthritis, skin illnesses, intestinal disease flare-ups, multiple sclerosis, chemotherapy preparation, and adrenal insufficiency are all examples of such situations (University of Illinois-Chicago, 2020).

The Randomized Evaluation of COVID-19 Therapy, a nationwide clinical study conducted in the United Kingdom, concluded that dexamethasone was beneficial for critically sick patients with COVID-19, as reported by the World Health Organization (2020). (RECOVERY). Roughly a third fewer people on ventilators and about fifth fewer individuals on oxygen died after taking medicine. Daily dosing for dexamethasone is 6 milligrams.

Both generic versions of the pill and the brand-name medicine DexPak are on the market. It can be taken as a pill, a liquid, or a drop in the ear or the eye. The injectable or intraocular solution may be administered following surgery or intravenously (as in the treatment of severe COVID-19) (only by a healthcare provider).

Nausea, swelling, headache, emotional swings, insomnia, nervousness, hyperglycemia, and hypertension are among the most often reported adverse reactions. The most significant adverse reactions include extraordinary fatigue, blood in the feces or urine, abdominal bloating, signs of infection (fever, muscular pains, and joint pain), extreme swings in mood or personality, skin darkening, stomach ulcers, congestive heart failure, and osteoporosis.

Antibiotics, antifungal drugs, blood thinning agents, cholesterol-lowering agents, drugs for Cushing's syndrome, diabetes medications, diuretics, epilepsy medications, heart medications, hormones, HIV medications, nonsteroidal anti-inflammatory drugs (NSAIDs), and vaccines are just some of the medications, vitamins, and herbs with which dexamethasone may interact (i.e., MMR, intranasal flu, smallpox, chicken pox, rotavirus, yellow fever, and typhoid). In addition, dexamethasone might bring on respiratory difficulties and throat or tongue swelling in those who are allergic to it (University of Illinois-Chicago, 2020).

What is Methylprednisolone?

Methylprednisolone, a corticosteroid, has been shown to improve outcomes in hypoxic coronavirus patients.

Coronavirus patients who received 2mg/kg/day of intravenous Solu Medrol saw superior results, including a shorter hospital stay, less need for mechanical ventilation, and a better clinical state on days 5 and 10.

Similarities: Dexamethasone and Methylprednisolone

  • The inflammation-fighting properties of both steroids are utilized

  • Both are utilized as steroids in the therapy of cancer.

  • In extreme situations of COVID-19, both can greatly lower the mortality rate.

Differences: Dexamethasone and Methylprednisolone

The following table highlights the major differences between Dexamethasone and Methylprednisolone −

Characteristics

Dexamethasone

Methylprednisolone

Definition

Because of its anti-inflammatory (reduces inflammation) and immunosuppressant (suppresses the body's immune system) actions, the corticosteroid dexamethasone (Decadron) is utilised in a variety of medical diseases.

If you compare it to Methylprednisolone, you'll see that it's a far more cost-effective medicine.

Clinically, methylprednisolone's anti-inflammatory (anti-swelling) action is favoured and valued beyond that of other corticosteroids, including dexamethasone.

When it comes to lowering inflammation in lung disorders such acute lung transplant rejection, pneumonitis in various autoimmune ailments, and medication toxicities, methylprednisolone is a more powerful and effective steroid than dexamethasone.

As compared to Dexamethasone, it is a somewhat more expensive medicine.

Effectiveness

When compared to Methylprednisolone, its efficacy is diminished.

A higher percentage of lung tissue to plasma has been found while testing this method in animal models. Therefore, it is more useful and efficient in the event of a lung damage. Furthermore, it's a better option for curing SARS.

Lung penetration

Comparatively less airway penetration than methylprednisolone

Increased lung penetration makes it an ideal immunosuppressive medication for treating patients with coronavirus and addressing related respiratory difficulties.

Mortality rates

Patients with Covid who were given dexamethasone had a greater risk of dying.

In patients with Covid who were given methylprednisolone, there was a reduction in mortality.

Mechanical dependency

Dexamethasone patients were more reliant on ventilator support.

Methylprednisolone-treated patients required less assistance from ventilators.

Side effects

  • Depression and anxiety

  • Skin rash

  • Acne

  • Excessive weight

  • Bruises that happen easily

  • Sleeping issues

  • Nausea and puking

  • Erratic menstrual periods

  • Headache

  • Acne

  • Skin issues like discolouration, acne, thin and dry skin, bruises

  • Too slow healing of wounds

  • Dizziness and nausea

  • Abdomen pain

  • Insomnia

  • Mood changes

  • Bloating

  • Headache

  • Changes in location of body fat (in the face, legs, arms waist, neck, and breasts),

  • Spinning sensation,

  • Too much sweating

Conclusion

These steroids are used to treat both acute and chronic inflammatory disorders. In reducing the mortality rate caused by a coronavirus, methylprednisolone (Solu - Medrol) has been reported to be more effective and superior to dexamethasone (Decadron). However, in patients who required mechanical respiration due to ethers, both corticosteroids decreased the mortality % to a lower amount, and no discernible difference could be seen between the two glucocorticoids.

Updated on: 26-Apr-2023

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