ModerateGlucocorticoids×Biguanides. Oral antihyperglycemic agents
Updated · Methodology
Mechanism
Dexamethasone stimulates gluconeogenesis and reduces tissue insulin sensitivity. The glycaemic effect is stronger than with prednisolone due to long half-life and high potency.
Symptoms
Return of thirst and polyuria, rising fasting glucose, fatigue. In type 2 diabetes, possible decompensation with HbA1c rise of 0.5–1.5%.
Management
For short dexamethasone pulses (1–3 days, e.g. cerebral oedema or post-chemotherapy), no metformin adjustment needed — transient hyperglycaemia is tolerated. For long-term therapy, increase metformin or add long-acting insulin. Check glucose twice daily in the first week.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
Summary of a multi-drug list →
Medicine list: everything you take in one place →
Sources
- FDA: Metformin hydrochloride tablet (Sciegen Pharmaceuticals Inc) – Prescribing Information (2017)– ; DailyMed setid 4e4c4ba9-65c6-4273-8f6b-2423ab521dad
- AEMPS: Ficha técnica: Dexametasona (nº registro 86123), sección 4.5 (2026)– AEMPS, CIMA, nº registro 86123, revisión 05/2026, sección 4.5