Drug Interactions, Kratom Guides

Kratom & Dexamethasone: Are They Safe to Use Together?

Dexamethasone is a corticosteroid drug. It is used to treat autoimmune diseases and inflammatory diseases of the joints, soft tissues, eyes, and gastrointestinal tract. The drug is also valuable for altitude sickness and preventing nausea and vomiting.

An antagonistic reaction occurs when dexamethasone and kratom are consumed together. Kratom stimulates a good immune response. Dexamethasone suppresses immunity and inflammatory reactions. A common enzyme metabolizes both drugs, which can lead to a toxic accumulation of drugs in the bloodstream.

Last updated 2 months ago by Dr. Devin Carlson

Kratom & Dexamethasone: Are They Safe to Use Together?

Does Kratom Interact With Dexamethasone?

Dexamethasone and kratom can interact indirectly. Their interaction is described as mild to moderate due to the antagonistic reaction between kratom and dexamethasone. Seek professional medical advice before consuming these drugs together.

 The interaction of kratom with dexamethasone can occur in the following way:

1. Increased Effect (Antagonistic Interaction)

Kratom and dexamethasone have an antagonistic reaction. They have opposite effects on various physiological mechanisms in the body.

Dexamethasone has an immunosuppressant and anti-inflammatory action. But, kratom has alkaloid compounds that are immunostimulants. Dexamethasone works by inhibiting various functions of white blood cells, which are components of the human immune system. Kratom also affects inflammatory and immunity mediators.

Using kratom with dexamethasone results in a reduction of the anti-inflammatory and immunosuppressive action of dexamethasone. Both drugs are also known to lead to psychosis.

2. Slowed Elimination (Metabolic Competition)

There is a prolonged action duration when drugs metabolized by the same enzyme are consumed together. This is the result of competition for metabolism between these drugs. Most drugs’ metabolism occurs via enzymes released by the liver.

The two main enzymes responsible for dexamethasone metabolism are CYP3A4 and CYP17 [1]. The enzymes hydroxylate dexamethasone form 6 alpha-hydroxy dexamethasone and 6 beta-hydroxy dexamethasone. 

CYP3A4 and CYP17 are members of the cytochrome enzyme family. The metabolism of kratom also occurs via CYP3A4. There is a competition between kratom and dexamethasone for metabolism via the cytochrome pathway. This results in an accumulation of both drugs in the bloodstream and a prolonged duration of effect. The level of both drugs may reach a dangerous level that may lead to side effects.

Kratom & Corticosteroids Interactions

Dexamethasone is a corticosteroid drug. The drug has potent glucocorticoid action with minimal mineralocorticoid activity. The drug is an immunosuppressant. The wide anti-inflammatory action of dexamethasone allows its use in many diseases. It is helpful for allergies, cerebral edema, and inflammation.

Other corticosteroids interact with kratom similarly.

 Other related corticosteroids that kratom will interact with include:

  • Betamethasone (Celestone)
  • Cortisone (Cortone)
  • Fludrocortisone (Florinef)
  • Hydrocortisone (Cortef)
  • Methylprednisolone (Medrol, Solu-Medrol & Depo-Medrol)
  • Prednisolone (Orapred & Prelone)
  • Prednisone
  • Triamcinolone (Kenalog)

Is it Safe to Take Kratom With Dexamethasone?

No. It is not safe to take kratom with dexamethasone.

The interaction between kratom and dexamethasone is mild to moderate.

Kratom is an immunostimulant drug, while dexamethasone is used for immunosuppression and to reduce inflammation. Kratom acts via the modulation of inflammatory mediators and vascular permeability [2]. The consumption of kratom with dexamethasone can hinder the anti-inflammatory action of dexamethasone and cause severe inflammation or exacerbations of autoimmune diseases.

 Consult a doctor before consuming kratom and dexamethasone together. A severe inflammatory reaction requires quick medical intervention.

What is Dexamethasone?

Dexamethasone is a drug of the corticosteroid family. It has a potent glucocorticoid action and minimal mineralocorticoid action. The drug binds to receptors in the nucleus of cells, which changes gene expression and, ultimately, protein synthesis. This change in protein synthesis results in wide-ranging differences in the body. The drug decreases leukocyte migration to sites of inflammation and decreases vasodilation. 

Dexamethasone treats acute exacerbations of allergies, cerebral edema, multiple sclerosis, and shock. The drug is helpful for the treatment of inflammatory conditions such as dermatitis and rheumatoid arthritis. Dexamethasone also helps autoimmune disorders. The drug mainly comes in the form of oral tablets.

Details & Specifications:

Drug NameDexamethasone
Trade names Baycadron, Decadron, Dekpak, Dexacen, Dexasone, DexPak, Dexatenza, Dioptrol, Hexadrol, Hidex, Maxidex, Maxitrol, Neofordex, Ozurdex, Solurex, Taperdex, Tobradex, Zcort, Zema-Pak
ClassificationCorticosteroid
CYP MetabolismCYP3A4, CYP17
Interaction With KratomAntagonistic
Risk of InteractionModerate

What is Dexamethasone Used For?

Dexamethasone is used in the treatment of various diseases. The indications for the use of dexamethasone are:

Inflammatory Conditions

Dexamethasone is used for the treatment of various inflammatory conditions. The drug acts via steroid receptors that change gene transcription. This ultimately leads to various downstream effects that decrease the inflammatory response. There is inhibition of neutrophil emargination.

The drug also inhibits leukocyte migration, vasodilation, and transcription of inflammatory mediators. It is used in rheumatoid arthritis, plantar fasciitis, ulcerative colitis, and croup. The drug helps prevent prophylaxis for swelling before dental and eye surgeries [3].

The drug can reduce inflammation of ocular conditions such as uveitis and endophthalmitis. Dexamethasone reduces cerebral edema. It is also included in the regimen of drugs used for shock.

Endocrine Diseases

Dexamethasone treats Addison’s disease and adrenal insufficiency [4] when there is a poor response to other drugs, such as prednisone and methylprednisolone.

Dexamethasone is also used in congenital adrenal hyperplasia. The drug provides negative feedback, which suppresses ACTH production.

Glucocorticoid resistance is a rare disorder and an indication for the use of dexamethasone.

COVID-19

Dexamethasone helps severely ill COVID-19 patients who need ventilator support or supplemental oxygen [5]. The drug counteracts the inflammatory component of the disease.

High Altitude Sickness

High altitude cerebral edema and high altitude pulmonary edema are some manifestations of altitude sickness. These can be treated and prevented by using dexamethasone.

Nausea & Vomiting

Chemotherapeutic-induced and postoperative nausea and vomiting can be treated by using dexamethasone to potentiate the effect of antiemetics.

Autoimmune Diseases

Autoimmune conditions such as immune-mediated thrombocytopenic purpura can be controlled via dexamethasone. It is also used in lupus.

Premature Delivery

Dexamethasone increases surfactant levels and improves pulmonary circulation. It is given to pregnant females to promote fetal lung maturity.

What’s the Dose of Dexamethasone?

The dose of dexamethasone depends on the use of the drug. For the treatment of inflammatory conditions, the oral dose is 0.75 to 9 mg per day.

In an intravenous form, the dose is 1 to 6 mg per kg for circulatory shock. It is also used in an intramuscular form. 

Generic & Brand Name Versions

  • Decadron
  • Dekpak
  • Dexacen
  • Dexasone
  • DexPak
  • Dexatenza
  • Dioptrol
  • Hexadrol
  • Hidex
  • Maxidex
  • Maxitrol
  • Neofordex
  • Ozurdex
  • Solurex
  • Taperdex
  • Tobradex
  • Zcort
  • Zema-Pak

What Are the Side Effects of Dexamethasone?

Generally speaking, dexamethasone is a well-tolerated medication. However, in some cases, it may cause a series of unwanted side effects such as acne, insomnia, headaches, weight gain, nausea, vomiting, impaired skin healing and wound repair, and irritability.

Other serious side effects have been reported including adrenal suppression, arrhythmias, glaucoma, hypokalemia, depression, pulmonary edema, pseudotumor cerebri, and amnesia [6].

What is Kratom?

Kratom is the name of an evergreen tree native to Southeast Asia. People there have been using it medicinally for a long time, but it’s only recently become popular in the rest of the world. Workers chew the leaves straight from the trees for energy, pain relief, and stamina during long days.

What’s Kratom Used For?

Kratom has contradictory uses, depending on the dose. Here are the most popular uses for it.

What is the Dose of Kratom?

Kratom dosage varies a lot, but there are dosing guidelines to help you narrow it down.

  • Small doses (2-4 g) are stimulating and best for focus, mood, and creativity.
  • Medium doses (5-8 g) will be more relaxing, even sedating for some people, and will start to offer strong anxiety and pain relief.
  • Large doses (9-12 g) should be used sparingly and provide heavy sedation and pain relief.

What Are the Side Effects of Kratom?

Some “sources” claim kratom is dangerous, but this is not the case. Current research and the World Health Organization say kratom is well-tolerated and safe with responsible use.

Still, there are some side effects to be aware of — though most are short-lived and more uncomfortable than anything.

Kratom can be addictive, though unlikely to cause severe withdrawal symptoms or overdose. Avoid dependency by sticking to as small a dose as possible and taking breaks from it.

What Are the Different Types of Kratom?

You’ll want to pay attention to your dose more than anything, but the strain you choose plays a crucial role in the effects you’ll get.

Before you buy anything, read through this description of the major strains.

White Vein Kratom

White vein kratom comes from the leaves of kratom at an earlier stage of maturity. This form of kratom boosts energy, similar to a caffeine rush. It gives mild euphoria and also helps to improve mental focus. There is an increase in cognitive functioning with this form of kratom. 

  

Red Vein Kratom

Red veins are formed on a fully mature kratom leaf. The form of kratom derived from this type of leaf is potent. This kind of kratom is best for sedation, relieving pain, or managing anxiety.

Green Vein Kratom

Green vein kratom comes from leaves in the middle of their life cycle. This strain produces a mild effect that lasts long and provides euphoria and an improved mood.

Yellow Vein Kratom

Yellow kratom is sometimes made by fermenting or mixing various other forms of kratom leaves. This kind is used for the relief of anxiety and to decrease pain.

Key Takeaways: Is it Safe to Mix Kratom & Dexamethasone?

Kratom and dexamethasone have a low level of interaction. An antagonistic reaction occurs between them. Kratom has immunostimulant properties that have the opposite effect to the immunosuppressive properties of dexamethasone.

The same enzyme metabolizes kratom and dexamethasone, so there may be an accumulation of these drugs, which can lead to toxic side effects. It is essential to seek professional advice before consuming these drugs together.

References

  1. Tomlinson, E. S., Lewis, D. F., Maggs, J. L., Kroemer, H. K., Park, B. K., & Back, D. J. (1997). In vitro metabolism of dexamethasone (DEX) in human liver and kidney: the involvement of CYP3A4 and CYP17 (17,20 LYASE) and molecular modeling studies. Biochemical pharmacology, 54(5), 605–611.
  2. Fluyau, D., & Revadigar, N. (2017). Biochemical Benefits, Diagnosis, and Clinical Risks Evaluation of Kratom. Frontiers in psychiatry, 8, 62.
  3. Grzybowski, A., Brockmann, T., Kanclerz, P., & Pleyer, U. (2019). Dexamethasone Intraocular Suspension: A Long-Acting Therapeutic for Treating Inflammation Associated with Cataract Surgery. Journal of ocular pharmacology and therapeutics: the official journal of the Association for Ocular Pharmacology and Therapeutics, 35(10), 525–534.
  4. Myers, K. A., & Kline, G. A. (2010). Addison disease presenting with acute neurologic deterioration: a rare presentation yields new lessons from old observations in primary adrenal failure. Endocrine practice: official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 16(3), 433–436.
  5. Agarwal, A., Rochwerg, B., Lamontagne, F., Siemieniuk, R. A., Agoritsas, T., Askie, L., Lytvyn, L., Leo, Y. S., Macdonald, H., Zeng, L., Amin, W., Barragan, F., Bausch, F. J., Burhan, E., Calfee, C. S., Cecconi, M., Chanda, D., Dat, V. Q., De Sutter, A., Du, B., … Vandvik, P. O. (2020). A living WHO guideline on drugs for covid-19. BMJ (Clinical research ed.), 370, m3379.

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