Immediate and Delayed Complications of Dexamethasone Cyclophosphamide Pulse Therapy

In a 2003 study of 146 pemphigus patients in India treated with Dexamethasone-cyclophosphamide pulse (DCP) therapy, researchers found a range of immediate and delayed side effects. Immediate side effects included flushing (78 patients), palpitations (11), hiccups (9), and numbness of feet (6). Delayed side effects were generalized weakness/malaise (81), sleep disturbances (36), headaches (23), arthralgias (21), taste alteration (19), and hair loss (13). Additionally, menstrual disturbances were reported in 28 females, vision blurring in 14 patients, increased insulin requirements in 13 out of 18 diabetic patients, and hypertension developed in four patients. The study concluded that DCP therapy, while having fewer side effects than conventional steroid therapy, still presents side effects such as hypertension and diabetes less frequently, but includes unique side effects like generalized weakness, flushing, headache, and taste alteration. Other side effects observed were cardiac arrhythmias, mood alterations, menstrual irregularities, susceptibility to infections, hair loss, and changes in taste, mainly due to the high doses of corticosteroids, with cyclophosphamide also contributing to hair loss and nail discoloration.