Drug interactions
Dexamethasone + Metyrapone
Severity: Moderate
Dexamethasone and Metyrapone: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Metyrapone is used to test or treat cortisol excess by blocking cortisol synthesis. Dexamethasone suppresses ACTH, which blunts the compensatory ACTH rise and the increase in 11-deoxycortisol that the metyrapone test relies on, so test results can be invalid.
What this interaction means in plain words
Dexamethasone and Metyrapone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Dexamethasone belongs to Endocrine; Metyrapone belongs to Endocrine.
Why it happens
Exogenous dexamethasone suppresses the pituitary-adrenal axis through negative feedback, counteracting metyrapone's effect on ACTH-driven steroid precursors.
What to do
Avoid dexamethasone around a metyrapone stimulation test unless it is part of a defined protocol. In treatment of hypercortisolism, monitor cortisol and adrenal function if steroid replacement is needed.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Dexamethasone
- Bcg vaccine live + Dexamethasone Contraindicated
- Dexamethasone + Mifepristone Contraindicated
- Dexamethasone + Rilpivirine Contraindicated
- Dexamethasone + Smallpox vaccine live Contraindicated
- Dexamethasone + Varicella virus vaccine live Contraindicated
- Dexamethasone + Yellow fever vaccine Contraindicated
Other interactions of Metyrapone
- Metyrapone + Pacritinib Major
- Budesonide + Metyrapone Moderate
- Cortisone + Metyrapone Moderate
- Cyproheptadine + Metyrapone Moderate
- Deflazacort + Metyrapone Moderate
- Desogestrel-ethinyl estradiol + Metyrapone Moderate
Frequently asked questions
Can I take Dexamethasone with Metyrapone?
MediHelp rates the interaction as moderate. Dexamethasone and Metyrapone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Metyrapone is used to test or treat cortisol excess by blocking cortisol synthesis. Dexamethasone suppresses ACTH, which blunts the compensatory ACTH rise and the increase in 11-deoxycortisol that the metyrapone test relies on, so test results can be invalid.
How serious is the interaction between Dexamethasone and Metyrapone?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid dexamethasone around a metyrapone stimulation test unless it is part of a defined protocol. In treatment of hypercortisolism, monitor cortisol and adrenal function if steroid replacement is needed.
What other medicines interact with Dexamethasone?
MediHelp also lists interactions of Dexamethasone with, for example, Bcg vaccine live, Mifepristone, Rilpivirine. The full list is on the Dexamethasone page.
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