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Effect of intranasal dexamethasone on endogenous cortisol level and intraocular pressure
Author(s) -
Martino Benjamin J.,
Church Christopher A.,
Seiberling Kristin A.
Publication year - 2015
Publication title -
international forum of allergy and rhinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.503
H-Index - 46
eISSN - 2042-6984
pISSN - 2042-6976
DOI - 10.1002/alr.21514
Subject(s) - medicine , dexamethasone , nasal administration , nasal spray , dexamethasone sodium phosphate , intraocular pressure , corticosteroid , morning , endocrinology , anesthesia , surgery , pharmacology
Background Medical treatment of chronic rhinosinusitis with nasal polyposis (CRSwNP) centers on the administration of steroids. High‐dose topical nasal steroids (HDTNS) have shown promising results with less systemic effects than oral steroids. One promising HDTNS is 0.132% dexamethasone nasal spray. We investigated whether intranasal dexamethasone was associated with changes in serum cortisol and/or intraocular pressure (IOP). Methods Patients with CRSwNP were treated with dexamethasone sodium phosphate 0.132% nasal spray twice daily. Morning serum cortisol and IOP were checked after at least 6 weeks of therapy. Results Twenty‐eight patients met study criteria. The average serum cortisol level after at least 6 weeks of therapy (average duration of 38.3 weeks) was 9.8 μg/dL (normal range, 4 to 22 μg/dL). Ten patients had suppressed cortisol levels (average, 2.5 μg/dL). Ten patients underwent IOP measurements and none revealed ocular hypertension on tonometry. Conclusion High‐dose dexamethasone nasal spray given for a period of at least 6 weeks does appear to have the potential to cause a decrease in serum cortisol levels; however, future studies with greater power are necessary to support this claim. Additionally, similar administration of high‐dose dexamethasone nasal spray did not reveal IOP diagnostic of ocular hypertension on single‐measurement tonometry readings.