{"id":12260,"date":"2020-06-22T13:49:27","date_gmt":"2020-06-22T17:49:27","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=12260"},"modified":"2026-01-28T13:47:34","modified_gmt":"2026-01-28T18:47:34","slug":"dexamethasone-vs-prednisone","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/dexamethasone-vs-prednisone\/","title":{"rendered":"Dexamethasone vs. prednisone: Comparing these corticosteroids"},"content":{"rendered":"

Steroid medications are used in a wide variety of emergency medical situations, as well as for many other acute and chronic inflammatory conditions and disease states. <\/span>Dexamethasone<\/span><\/a> and <\/span>prednisone<\/span><\/a> are two prescription steroids that are approved by the Food and Drug Administration (FDA). Both drugs are <\/span>corticosteroids<\/span><\/a>, also known as <\/span>glucocorticoids<\/span><\/a> or steroids. They are used for a wide variety of inflammatory conditions in many organ systems.\u00a0<\/span><\/p>\n

<\/span><\/p>\n

Difference between dexamethasone and prednisone<\/span><\/h2>\n

Corticosteroids work by causing metabolic effects and modifying the body\u2019s immune response to stimuli. Although dexamethasone and prednisone are both steroids, they have some differences.<\/span><\/p>\n

What is dexamethasone?<\/span><\/h3>\n

Dexamethasone<\/span><\/a> is a corticosteroid, or steroid, medication. Although dexamethasone is usually sold as a generic drug, some brand names that contain dexamethasone include Decadron, Hemady, and TaperDex. Oral dexamethasone is available as a tablet, oral solution, and injection. It is also available in certain ophthalmic products, such as eye drops. Dexamethasone is a long-acting drug with a <\/span>half-life<\/span><\/a> of 36 to 72 hours.<\/span><\/p>\n

What is prednisone?<\/span><\/h3>\n

Prednisone<\/span><\/a> is also a steroid medication. Prednisone may be referred to as Deltasone, but the brand name is no longer available. Prednisone is available as a generic product in the form of a tablet and oral solution. It is an intermediate-acting drug with a half-life of about three to four hours. Oral prednisone is most commonly prescribed as an immediate-release tablet, but there is also a delayed-release prednisone tablet called <\/span>Rayos<\/span><\/a>.<\/span><\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n
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Dexamethasone vs prednisone: Corticosteroids comparison<\/span><\/h2>\n<\/th>\n<\/tr>\n<\/thead>\n

<\/td>\nDexamethasone<\/b><\/td>\nPrednisone<\/b><\/td>\n<\/tr>\n
Drug class<\/strong><\/td>\nCorticosteroid (steroid), also known as a glucocorticoid<\/span><\/td>\nCorticosteroid (steroid), also known as a glucocorticoid<\/span><\/td>\n<\/tr>\n
Brand\/generic status<\/strong><\/td>\nBrand and generic<\/span><\/td>\nGeneric with a delayed-release brand name available<\/span><\/td>\n<\/tr>\n
What is the brand name?<\/strong><\/td>\nDecadron, Hemady, TaperDex\u00a0<\/span><\/td>\nDeltasone (no longer\u00a0 commercially available),<\/span><\/p>\n

Rayos (delayed-release tablets)<\/span><\/td>\n<\/tr>\n

What form(s) does the drug come in?<\/strong><\/td>\nTablet, injection, oral solution, ophthalmic drops (alone and in combination with other ingredients), ophthalmic ointments (in combination with other ingredients)<\/span><\/td>\nTablet, oral solution<\/span><\/td>\n<\/tr>\n
What is the standard dosage?<\/strong><\/td>\nVaries by indication and response to treatment\u00a0<\/span><\/td>\nVaries by indication and response to treatment<\/span><\/td>\n<\/tr>\n
How long is the typical treatment?<\/strong><\/td>\nShort-term; varies\u00a0<\/span><\/td>\nShort-term; varies<\/span><\/td>\n<\/tr>\n
Who typically uses the medication?<\/strong><\/td>\nAdults, sometimes in children<\/span><\/td>\nAdults, sometimes in children<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
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What are dexamethasone and prednisone used for?<\/span><\/h2>\n

Dexamethasone and prednisone have similar indications. Both medications are indicated for use in a wide variety of inflammatory conditions for various organ systems.\u00a0<\/span><\/p>\n

For example, both medications may be used for allergic conditions when conventional treatment is not effective. The allergic and dermatologic conditions that dexamethasone and prednisone may treat include acute exacerbations of asthma, atopic or contact dermatitis, drug hypersensitivity reactions, perennial or seasonal allergic rhinitis, Stevens-Johnson syndrome, and serum sickness.<\/span><\/p>\n

Because each category has many conditions, there are too many to list. Several examples for each category are listed in the chart below. Consult your doctor for more information. Also, some doctors prescribe these medications <\/span>off-label<\/span><\/a> for certain uses. Off-label prescribing is when a medicine is prescribed for an indication that is not FDA-approved. For example, steroids may be prescribed for certain cancers (in combination with other drugs), nausea and vomiting caused by chemotherapy, carpal tunnel syndrome (in combination with other drugs), and exacerbations of chronic obstructive pulmonary disease (COPD).\u00a0<\/span><\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
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Dexamethasone vs. prednisone uses<\/span><\/h2>\n<\/th>\n<\/tr>\n<\/thead>\n

Condition<\/b><\/td>\nDexamethasone\u00a0<\/b><\/td>\nPrednisone\u00a0<\/b><\/td>\n<\/tr>\n
Allergic and dermatologic conditions (acute asthma exacerbations<\/a>, dermatitis<\/a>, rhinitis<\/a>)\u00a0<\/strong><\/td>\nYes\u00a0<\/span><\/td>\nYes\u00a0<\/span><\/td>\n<\/tr>\n
Endocrine disorders (adrenocortical insufficiency\u2014in conjunction with a mineralocorticoid drug such as fludrocortisone, congenital adrenal hyperplasia)<\/strong><\/td>\nYes\u00a0<\/span><\/td>\nYes\u00a0<\/span><\/td>\n<\/tr>\n
Gastrointestinal diseases (enteritis, ulcerative colitis<\/a>)<\/strong><\/td>\nYes\u00a0<\/span><\/td>\nYes\u00a0<\/span><\/td>\n<\/tr>\n
Hematology disorders (certain types of anemia<\/a>, idiopathic thrombocytopenic purpura)<\/strong><\/td>\nYes\u00a0<\/span><\/td>\nYes\u00a0<\/span><\/td>\n<\/tr>\n
Neoplastic diseases (leukemia<\/a>, lymphoma)<\/strong><\/td>\nYes\u00a0<\/span><\/td>\nYes\u00a0<\/span><\/td>\n<\/tr>\n
Nervous system (acute multiple sclerosis exacerbations<\/a>, cerebral edema associated with primary or metastatic brain tumor, craniotomy, or head injury)<\/strong><\/td>\nYes\u00a0<\/span><\/td>\nYes\u00a0<\/span><\/td>\n<\/tr>\n
Ophthalmic diseases (temporal arteritis, uveitis)<\/strong><\/td>\nYes\u00a0<\/span><\/td>\nYes\u00a0<\/span><\/td>\n<\/tr>\n
Renal diseases (idiopathic nephrotic syndrome, lupus<\/a>)<\/strong><\/td>\nYes\u00a0<\/span><\/td>\nYes\u00a0<\/span><\/td>\n<\/tr>\n
Respiratory diseases (certain types of tuberculosis<\/a> or pneumonia<\/a>)\u00a0<\/strong><\/td>\nYes\u00a0<\/span><\/td>\nYes\u00a0<\/span><\/td>\n<\/tr>\n
Rheumatic disorders (certain types of arthritis<\/a>, lupus)\u00a0<\/strong><\/td>\nYes\u00a0<\/span><\/td>\nYes\u00a0<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Dexamethasone vs. prednisone potency and efficacy<\/span><\/h2>\n

Clinical trials comparing the two drugs head-to-head mostly looked at the use of dexamethasone vs. prednisone in young children with croup or acute asthma. A <\/span>2006 study<\/span><\/a> treated children who had mild-to-moderate croup with one single dose of oral dexamethasone or one dose of prednisolone (the active form of prednisone). The study found that prednisolone was less effective than dexamethasone in lowering the number of patients who returned to the hospital.\u00a0<\/span><\/p>\n

Both a <\/span>2014 review of studies<\/span><\/a> in <\/span>Pediatrics<\/span><\/i> and a <\/span>2017 study<\/span><\/a> in <\/span>The Journal of Pediatrics<\/span><\/i> concluded that two doses of dexamethasone are an effective alternative to a five-day prednisone treatment in children with acute asthma.\u00a0<\/span><\/p>\n

Because each drug can be used to treat a wide variety of medical conditions, it is difficult to say which drug is more effective. Your healthcare provider may choose dexamethasone if you need something that is longer-acting and more potent, or prednisone if you need something that is shorter-acting. The best drug for you can be determined by your healthcare provider, who can take into account your medical history, other conditions, and other medications you take that could potentially interact with dexamethasone or prednisone.<\/span><\/p>\n

Dexamethasone vs. prednisone dosage<\/span><\/h2>\n

When taking steroid medication, it is important to take it exactly as directed. Often, the directions will specify that you start with a higher dose and then taper down to a lower dose. Steroids like dexamethasone or prednisone should be taken with food to reduce stomach side effects. The tables below outline standard dosages for some of the conditions that these steroids treat. More detailed information on dosing can be found for <\/span>dexamethasone<\/span><\/a> and <\/span>prednisone<\/span><\/a> on our dosing pages.\u00a0\u00a0<\/span><\/p>\n\n\n\n\n\n\n\n\n\n\n\n
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Dexamethasone vs. prednisone dosage for adults<\/span><\/h2>\n<\/th>\n<\/tr>\n<\/thead>\n

Condition<\/b><\/td>\nDexamethasone\u00a0<\/b><\/td>\nPrednisone\u00a0<\/b><\/td>\n<\/tr>\n
General dosage<\/strong><\/td>\nInitial dose: <\/span>0.75 mg to 9 mg per day, depending on the condition being treated<\/span><\/td>\nInitial dose: <\/span>5 mg to 60 mg per day, depending on the condition being treated<\/span><\/td>\n<\/tr>\n
Adrenal insufficiency (Addison\u2019s disease)<\/strong><\/td>\n0.75 mg to 9 mg per day, given in two to four divided doses<\/span><\/td>\n5 mg in the morning and 2.5 mg in the evening<\/span><\/td>\n<\/tr>\n
Rheumatic disorders (acute gouty arthritis, ankylosing spondylitis, rheumatoid arthritis, juvenile rheumatoid arthritis, juvenile idiopathic arthritis)<\/strong><\/td>\nInitially, 0.75 mg to 9 mg per day, given in two to four divided doses, then adjusted according to patient response<\/span><\/td>\n5 mg to 30 mg daily<\/span><\/td>\n<\/tr>\n
Skin conditions (atopic dermatitis)<\/strong><\/td>\nInitially, 0.75 mg to 9 mg per day, given in two to four divided doses, then adjusted according to patient response<\/span><\/td>\n5 mg to 60 mg per day, given in one to four divided doses (only given when the patient does not respond to topical treatment)<\/span><\/td>\n<\/tr>\n
Asthma exacerbation<\/strong><\/td>\nInitially, 0.75 mg to 9 mg per day, given in two to four divided doses, then adjusted according to patient response<\/span><\/td>\n40 mg to 50 mg per day or 1 mg\/kg\/day(max: 50 mg\/day)<\/span><\/td>\n<\/tr>\n
Multiple myeloma<\/strong><\/td>\n20\u201340 mg by mouth on the specified day of the chemotherapy cycle\u00a0<\/span><\/td>\nVaries (used off-label)\u00a0<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Sources: <\/span>Dexamethasone<\/span><\/a>, <\/span>Prednisone<\/span><\/a><\/small><\/small><\/p>\n

Steroid dosing for children varies by weight and the condition being treated. The healthcare provider will decide the dosage based on the condition being treated, the severity of symptoms, the child\u2019s weight, and any other contributing factors.\u00a0<\/span><\/p>\n\n\n\n\n\n\n
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Dexamethasone vs. prednisone dosage for children<\/span><\/h2>\n<\/th>\n<\/tr>\n<\/thead>\n

Condition<\/b><\/td>\nDexamethasone\u00a0<\/b><\/td>\nPrednisone\u00a0<\/b><\/td>\n<\/tr>\n
All conditions that respond to steroids (general dosing)<\/strong><\/td>\n0.08-0.3 mg\/kg\/day divided into two to four doses per day<\/span><\/td>\n0.05\u20132 mg\/kg\/day divided into one to four doses per day<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Note<\/b>: Doses listed in the tables above are standard doses per condition. Initial and maximum doses vary by drug and indication. The tables above are not a complete list of all possible indications or doses for dexamethasone and prednisone. Your healthcare provider will determine the best dosage for you based on your health condition and response to treatment.<\/span><\/small><\/small><\/p>\n

COVID-19 Dosage<\/span><\/h3>\n

Patients with mild-to-moderate COVID-19<\/span><\/h4>\n

Systemic corticosteroids, such as dexamethasone and prednisone, are <\/span>not recommended<\/span><\/a> in patients with <\/span>mild or moderate<\/b> COVID-19 who do not require oxygen. Unless the patient requires oxygen, using a steroid does not provide benefit and can cause serious side effects, such as high blood sugar, stomach bleeding, psychosis, infections, and other long-term effects.<\/span><\/p>\n

Patients who are already taking a corticosteroid for another indication should continue treatment under the supervision of their healthcare provider.\u00a0<\/span><\/p>\n

Patients with severe COVID-19<\/span><\/h4>\n

In patients who are hospitalized, have suspected or confirmed <\/span>severe<\/b> COVID-19, and are on oxygen or a ventilator, a steroid may be used if the healthcare provider determines it will be useful. If dexamethasone is used, the dose is usually 6 mg (by mouth or IV) daily. If dexamethasone is not available and prednisone is used, the dosage is usually 40 mg daily.\u00a0<\/span><\/p>\n

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Dexamethasone and prednisone side effects\u00a0<\/span><\/h2>\n

When you are prescribed a steroid medication, it is important to take the medication as directed and taper the dose when instructed to do so by your healthcare provider. Below is a list of <\/span>potential side effects<\/span><\/a> that may occur with either <\/span>dexamethasone<\/span><\/a> or <\/span>prednisone<\/span><\/a>. This is not a full list of side effects. Consult your healthcare provider for a full list of adverse events.<\/span><\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
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Dexamethasone and prednisone side effects<\/span><\/h2>\n<\/th>\n<\/tr>\n<\/thead>\n

System\u00a0<\/b><\/td>\nPotential side effects<\/b><\/td>\n<\/tr>\n
Allergic\u00a0<\/strong><\/td>\nAllergic reaction, anaphylaxis, angioedema<\/span><\/td>\n<\/tr>\n
Cardiovascular\u00a0<\/strong><\/td>\nCardiac arrest\/arrhythmia, cardiac enlargement, changes in heart rate, circulatory collapse, heart failure, hypertension, edema, syncope, tachycardia, thromboembolism<\/span><\/td>\n<\/tr>\n
Dermatologic\u00a0<\/strong><\/td>\nAcne, allergic dermatitis, dry\/scaly skin, erythema (redness), impaired wound healing, increased sweating, rash<\/span><\/td>\n<\/tr>\n
Endocrine\u00a0<\/strong><\/td>\nDecreased carbohydrate\/glucose tolerance, development of a cushingoid state, hyperglycemia (high blood sugar), hirsutism (excess hair growth), menstrual irregularities, suppression of growth in pediatric patients<\/span><\/td>\n<\/tr>\n
Fluid\/electrolyte disturbances\u00a0<\/strong><\/td>\nCongestive heart failure, fluid retention, potassium loss, sodium retention<\/span><\/td>\n<\/tr>\n
Gastrointestinal\u00a0<\/strong><\/td>\nIncreased appetite, nausea, pancreatitis, peptic ulcers, perforation of the small and large intestine, ulcerative esophagitis<\/span><\/td>\n<\/tr>\n
Musculoskeletal\u00a0<\/strong><\/td>\nLoss of muscle mass, muscle weakness, osteoporosis, long bone fractures, tendon ruptures, vertebral compression fractures<\/span><\/td>\n<\/tr>\n
Neurological\/psychiatric\u00a0\u00a0<\/strong><\/td>\nConvulsions, depression, emotional instability, euphoria, headache, increased intracranial pressure with papilledema (increased pressure in the skull) usually following discontinuation of treatment, insomnia, mood swings, neuropathy, paresthesia (\u201cpins and needles\u201d feeling), personality changes, vertigo<\/span><\/td>\n<\/tr>\n
Ophthalmic<\/strong><\/td>\nGlaucoma, cataracts, blurred vision<\/span><\/td>\n<\/tr>\n
Other\u00a0<\/strong><\/td>\nA<\/span>bnormal fat deposits, increased susceptibility to infectious diseases, hiccups, moon face, weight gain<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Sources: <\/span>Dexamethasone<\/span><\/a>, <\/span>Prednisone<\/span><\/a>\u00a0<\/span><\/small><\/small><\/p>\n

Dexamethasone and prednisone interactions<\/span><\/h2>\n

Patients taking an <\/span>anticoagulant<\/span><\/a>, such as warfarin, should be monitored while taking steroid medications. Medications used for diabetes may need to be adjusted because steroids may affect blood glucose levels. Certain medications that are metabolized by an enzyme called CYP3A4 may affect the metabolism of the steroid, requiring a dosage adjustment. This is not a full list of drug interactions. Consult your healthcare provider for a full list of drug interactions.<\/span><\/p>\n\n\n\n\n\n\n\n\n\n\n\n
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Dexamethasone vs. prednisone drug interactions<\/span><\/h2>\n<\/th>\n<\/tr>\n<\/thead>\n

Drug<\/b><\/td>\nDrug class<\/b><\/td>\nDexamethasone\u00a0<\/b><\/td>\nPrednisone\u00a0<\/b><\/td>\n<\/tr>\n
Warfarin<\/span><\/a><\/td>\nAnticoagulant<\/span><\/td>\nYes<\/span><\/td>\nYes<\/span><\/td>\n<\/tr>\n
Digoxin<\/span><\/a><\/td>\nCardiac glycoside<\/span><\/td>\nYes<\/span><\/td>\nYes<\/span><\/td>\n<\/tr>\n
Glipizide<\/span><\/a><\/p>\n

Glyburide<\/span><\/a><\/p>\n

Insulin<\/span><\/a><\/p>\n

Metformin<\/span><\/a><\/p>\n

Pioglitazone<\/span><\/a><\/td>\n

Antidiabetic agents<\/span><\/td>\nYes<\/span><\/td>\nYes<\/span><\/td>\n<\/tr>\n
Carbamazepine<\/span><\/a><\/p>\n

Phenobarbital<\/span><\/a><\/p>\n

Phenytoin<\/span><\/a><\/p>\n

Rifampin<\/span><\/a><\/td>\n

CYP3A4 inducers<\/span><\/td>\nYes<\/span><\/td>\nYes<\/span><\/td>\n<\/tr>\n
Azithromycin<\/span><\/a><\/p>\n

Erythromycin<\/span><\/a><\/p>\n

Ketoconazole<\/span><\/a><\/td>\n

CYP3A4 inhibitors<\/span><\/td>\nYes<\/span><\/td>\nYes<\/span><\/td>\n<\/tr>\n
Aspirin<\/span><\/a><\/p>\n

Ibuprofen<\/span><\/a><\/p>\n

Meloxicam<\/span><\/a><\/p>\n

Naproxen<\/span><\/a><\/td>\n

Nonsteroidal anti-inflammatory drugs (NSAIDs)<\/span><\/td>\nYes<\/span><\/td>\nYes<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

There are also some food interactions to take note of with steroids like dexamethasone and prednisone. These steroids should not be mixed with alcohol. Combining steroid medications with alcohol can lead to a higher risk of stomach ulcers, perforation, and bleeding.\u00a0<\/span><\/p>\n

Dexamethasone, but not prednisone, interacts with grapefruits and grapefruit juices. The combination can lead to higher levels of dexamethasone in the body, which can cause serious side effects from the steroid. Avoid grapefruits and grapefruit juice while taking dexamethasone.<\/span><\/p>\n

Dexamethasone and prednisone warnings\u00a0<\/span><\/h2>\n

Rarely, an allergic or anaphylactic reaction may occur. Seek emergency medical treatment if you experience symptoms of anaphylaxis, such as trouble breathing, swelling of the face, neck, tongue, or lips, or a lack of responsiveness.<\/span><\/p>\n

Steroids should be used with caution in patients with any of the following conditions:<\/span><\/p>\n