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Difference Between Dexamethasone and Methylprednisolone

What is dexamethasone and methylprednisolone?

Both are corticosteroids also termed as glucocorticoids or steroids used to treat arthritis, skin and blood disorders, severe allergies etc. Both dexamethasone and methylprednisolone are corticosteroids administered to Covid-19 patients for improving lung function. 

These steroids are used in a several medical emergencies as well as several chronic conditions of inflammation.  

Methylprednisolone (Solu – Medrol) has been reported to be more effective and superior to dexamethasone (Decadron) in bringing down the mortality percentage of coronavirus. However, in patients for whom ethers was need of mechanical ventilation, both corticosteroids reduced mortality percentage to decreased number and there was no difference between the two glucocorticoids could be detected.

In people suffering from coronavirus, 2 milligram of intravenous methylprednisolone every day resulted in decreased the length of hospital stay, requirement for mechanical ventilation and even improved medical condition on days five and ten in comparison to 6 milligram/ day of dexamethasone, 

What are the Similarities between dexamethasone and methylprednisolone?

  • Both steroids are used to reduce inflammation
  • Both are also used as steroids for cancer treatment.
  • Both can significantly reduce mortality percentage in severe cases of COVID-19

What is Dexamethasone?

Dexamethasone (brand name Decadron) is a long-acting corticosteroid. The corticosteroid (drug) is available in injection, tablet, oral solution and drops form.  

In comparison to methylprednisolone, 6 mg/day of dexamethasone has been reported to have increased dependency on mechanical ventilation and a longer hospital stay.

What Is Methylprednisolone?

In hypoxic coronavirus patients, methylprednisolone – one of the corticosteroids has been reported to demonstrate better results

Patients suffering from coronavirus when given 2mg/kg/day of intravenous Solu – Medrol resulted in decrease in the stay at the hospital, reduction in the requirement of mechanical ventilation and, improved outcomes, improvement in the condition of the patient (clinical condition) at day five and day ten

Difference between Dexamethasone and Methylprednisolone

Description

Dexamethasone

Dexamethasone (Decadron) is a corticosteroid used in a several medical conditions because of its anti-inflammatory (reduces inflammation) and immunosuppressant (Suppression of the body’s immune system) effects. It is a cheaper drug in comparison to Methylprednisolone

Methylprednisolone

Among other corticosteroids, and especially dexamethasone, methylprednisolone is more effective and preferred clinically for its anti-inflammatory (decreases inflammation) effect 

Methylprednisolone is a stronger and more effective steroid in comparison to dexamethasone for its inflammation reducing ability in lung diseases, such as in acute lung transplant rejection, pneumonitis in various autoimmune conditions, and drug toxicities. It is a little pricey drug in comparison to Dexamethasone

Effectiveness

Dexamethasone

It is less effective in comparison to Methylprednisolone

Methylprednisolone

It has been reported to achieve greater lung tissue-to-plasma ratios in animal models. So, it can be said that it is more beneficial and effective in case of injury of lungs. It is also more effective on treating SARS disease 

Lung penetration

Dexamethasone

Lower lung penetration in comparison to methylprednisolone 

Methylprednisolone

Higher lung penetration and hence it serves as a better immunosuppressive agent in coronavirus patient treatment and in improving respiratory issues 

Mortality rates

Dexamethasone

Mortality rates have been reported to be higher in covid patients who were administered dexamethasone

Methylprednisolone

Mortality rates have been reported to be lower in covid patients who were administered methylprednisolone 

Mechanical dependency

Dexamethasone

Patients who received dexamethasone showed more dependency on mechanical ventilation. 

Methylprednisolone

Patients who received methylprednisolone showed less dependency on mechanical ventilation. 

Side effects

Dexamethasone

  • Side effects include:
  • Depression and anxiety
  • Skin rash
  • Acne
  • Excessive weight
  • Bruises that happen easily
  • Sleeping issues
  • Nausea and puking
  • Erratic menstrual periods
  • Headache
  • Acne

Severe side effects of dexamethasone include;

  • Gastro Intestinal Bleeding
  • Elevation in ack of ability to resist some extraneous agent (many types of infections)

Methylprednisolone

Side effects include;

  • 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

Severe side effects of Medrol include: 

  • Low potassium
  • Seizures
  • Pancreatitis (is pathologic inflammation of the pancreas)
  • Pain in the chest
  • Blood in the vomit
  • High BP
  • Problems in vision
  • Alteration of the mental ability
  • Swelling
  • Shortness of breath
  • shortness of breath with swelling.

Summary

The points of difference between Dexamethasone and Methylprednisolone have been summarized as below:

Dexamethasone Vs Methylprednisolone


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    References :


    [0]Ranjbar, K., Moghadami, M., Mirahmadizadeh, A., Fallahi, M. J., Khaloo, V., Shahriarirad, R., ... & Saadi, M. H. G. (2021). Methylprednisolone or dexamethasone, which one is superior corticosteroid in the treatment of hospitalized COVID-19 patients: a triple-blinded randomized controlled trial. BMC infectious diseases, 21(1), 1-8.

    [1]Ko, J. J., Wu, C., Mehta, N., Wald-Dickler, N., Yang, W., & Qiao, R. (2021). A comparison of methylprednisolone and dexamethasone in intensive care patients with COVID-19. Journal of Intensive Care Medicine, 0885066621994057.

    [2]Veronese, N., Demurtas, J., Yang, L., Tonelli, R., Barbagallo, M., Lopalco, P., ... & Smith, L. (2020). Use of corticosteroids in coronavirus disease 2019 pneumonia: a systematic review of the literature. Frontiers in medicine, 7, 170.

    [3]Image credit: https://commons.wikimedia.org/wiki/File:Methylprednisolone_vial.jpg

    [4]Image credit: https://commons.wikimedia.org/wiki/File:Dexamethasone_phosphate_for_injection.jpg

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