A box of dexamethasone injection ampoules is photographed at a chemists shop in London on June 16, 2020.
AFP/Arman Soldin
What is dexamethasone? Is it effective vs COVID-19?
Ratziel San Juan (Philstar.com) - June 26, 2020 - 1:56pm

MANILA, Philippines — As the world struggles to find solutions to the novel coronavirus disease 2019 (COVID-19) pandemic, an occasional dose of hope comes to break the strain of dead ends.

Recently, the World Health Organization celebrated the steroid dexamethasone for its “life-saving potential for critically ill COVID-19 patients.”

“The next challenge is to increase production and rapidly and equitably distribute dexamethasone worldwide, focusing on where it is needed most. Demand has already surged, following the UK trial results showing dexamethasone's clear benefit. Fortunately, this is an inexpensive medicine and there are many dexamethasone manufacturers worldwide, who we are confident can accelerate production,” WHO Director-General Doctor Tedros Adhanom Ghebreyesus said in a Monday briefing.

This came after University of Oxford researchers found that dexamethasone reduces death in hospitalized patients with severe respiratory complications of COVID-19.

Here are your questions about dexamethasone, including its pros and cons, answered.

What is dexamethasone used for?

WHO: “Dexamethasone is a corticosteroid used in a wide range of conditions for its anti-inflammatory and immunosuppressant effects.”

Does it work against COVID-19?

Dexamethasone was tested on hospitalized COVID-19 patients as part of the United Kingdom’s national clinical trial RECOVERY (Randomised Evaluation of COVID-19 Therapy).

It was found to benefit critically ill patients in particular.

“According to preliminary findings shared with WHO (and now available as a preprint), for patients on ventilators, the treatment was shown to reduce mortality by about one third, and for patients requiring only oxygen, mortality was cut by about one fifth.”

Can dexamethasone be harmful?

WHO took care to remind global stakeholders that “dexamethasone should only be used for patients with severe or critical disease, under close clinical supervision. There is no evidence this drug works for patients with mild disease or as a preventative measure, and it could cause harm.”

The local Food and Drug Administration likewise warned against misuse or unsupervised chronic use of the drug, which they said could lead to serious adverse health reactions like:

  • Immunosuppression or impairment of the body’s ability to fight infections
  • Gastrointestinal bleeding and ulcers
  • Electrolyte imbalance
  • Osteoporosis
  • Muscle weakness
  • Poor wound healing
  • Prolonged use of the drug may cause suppression of growth among infants and children
  • Obesity

“If stopped abruptly, it may cause withdrawal symptoms such as hypotension, shock and coma.”

Related: FDA warns public vs non-prescribed use of steroid dexamethasone

Where does the Philippines stand?

Similar to WHO, the Department of Health has warned the Filipino public against non-prescribed use of dexamethasone, reminding that no prophylaxis (preventive treatment) or cure exists yets for COVID-19.

“We strongly urge the public not to rush to the drugstores, buy this drug, and take it without the supervision of a doctor, in order to be cured or be protected from the virus... It is highly important to note that though this may be considered as a breakthrough in science, the study on this drug as a cure for COVID-19 is yet to be peer-reviewed,” Health Undersecretary Maria Rosario Vergeire said last week.

“Dexamethasone is yet to undergo further trials and review, but we assure the public that the DOH is in coordination with the global medical community. The department remains in close collaboration with different experts both locally and internationally in the search for a cure and other treatments that are safe and effective against COVID-19.”

Related: DOH: Steroid dexamethasone no 'magic pill' vs COVID-19

The FDA also issued an advisory reminding that the unauthorized sale of dexamethasone is strictly prohibited.

“There are Dexamethasone products that are currently registered with the FDA. The drug should be only dispensed by licensed establishments to patients with valid prescription. The sale of unregistered Dexamethasone or sale of the drug without valid prescription or through online platforms is strictly prohibited.”

COVID-19 DEPARTMENT OF HEALTH DEXAMETHASONE DOH NOVEL CORONAVIRUS WHO WORLD HEALTH ORGANIZATION
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