Dexamethasone

[Broseley]

My cousin has a brain tumour and is receiving radiotherapy. In addition, she has been prescribed 2mg daily dexamethasone steroids. I'm wondering what is the difference between this drug and prednisolone?

[PMRpro Ambassador]

It is far stronger and stays in the body for much longer. It would work for PMR - but tapering the dose would be a nightmare because of the strength - 1mg dexamethasone is the same potency as 6mg pred. Imagine splitting that tiny tablet! Pred works well for most on a single daily dose which is convenient,

It is used quite a lot in oncology to reduce inflammation and also stimulates appetite. My husband was given 4mg the day he arrived in the palliative unit and went from eating literally nothing to requesting 3 course meals!

[Broseley in reply to PMRpro]

Thanks, I knew you'd know! I tried Dr Google to no avail! My cousin will surely have to taper the dexamethasone though, eventually, assuming the tumour shrinks? It has grown back, and they can't operate again.

[PMRpro Ambassador in reply to Broseley]

Probably, I don't know how oncology use dexamethasone longterm to be honest. It is often used for brain cancers for various reasons so they may simply continue it to help keep the tumour effects manageable as it is used in tumours of the central nervous system which cause oedema even without radiotherapy and its inflammation. How long is she to have r/t for?

[Broseley in reply to PMRpro]

6 weeks, 5 days a week. She's halfway through.

[PMRpro Ambassador in reply to Broseley]

After 6 weeks they may feel stopping the dexamethasone is easy enough. But a great deal will depend on the results. Fingers crossed it helps.

[Broseley in reply to PMRpro]

Thanks.