II. Indications
- See Dexamethasone Suppression Test
- FDA approved indications
- Antiinflammatory or Immunosuppression
- Multiple Sclerosis acute exacerbation
- Cerebral edema
- Non-FDA Approved (Off-Label) indications
- Preterm Labor Management for Fetal Lung Maturity (off label use)
- Immune Thrombocytopenic Purpura
- Bacterial Meningitis (before first dose of Antibiotics for for HaemophilusInfluenzae or pneumococcal Meningitis)
- Antiemetic in Chemotherapy
- Acute Asthma exascerbation
- Bronchopulmonary Dysplasia
- Dexamethasone Suppression Test (Cushing"s Syndrome)
III. Mechanism
- See Systemic Corticosteroid
- See Pharmacokinetics below for relative potency
IV. Medications
- Dexamethasone (Decadron)
- Tablets: 0.5 mg, 0.75 mg, 1.0 mg, 1.5 mg, 2 mg, 4 mg, 6 mg
- Solution or Elixir: 0.5 mg/5 ml
- Non-Systemic formulations
V. Dosing
- Adult
- Antiinflammatory or Immunosuppression
- Dexamethasone 0.5 to 10 mg/day PO/IM/IV divided every 6-12 hours
- Multiple Sclerosis acute exacerbation
- Dexamethasone 30 mg/day for 1 week, then 4 to 12 mg every other day for 4 weeks
- Preterm Labor Management for Fetal Lung Maturity (off label use)
- Dexamethasone 6 mg IM every 12 hours for 4 doses
- Cerebral edema
- Load: 10 to 20 mg IV load
- Maintenance: 4 mg IV or IM every 6 hours (or 1 to 3 mg orally three times daily)
- Bacterial Meningitis (before first dose of Antibiotics for HaemophilusInfluenzae or pneumococcal Meningitis)
- Start Dexamethasone 15 minutes before first Antibiotic dose
- Dexamethasone 10 mg IV q6 hours for 4 days
- Antiemetic in Chemotherapy
- Treatment: 10 to 20 mg IV every 4 to 6 hours
- Prophylaxis: 8 mg IV or 12 mg orally before Chemotherapy, then 8 mg orally daily for 2 to 4 days
- Antiinflammatory or Immunosuppression
- Child
- General
- Dexamethasone 0.02 to 0.3 mg/kg/day divided every 6 to 8 hours
- Asthma Exacerbation (off-label)
- Dexamethasone 0.3 to 0.6 mg/kg/day up to 10-15 mg for 1-2 days
- Croup (off-label)
- Dexamethasone 0.15 to 0.6 mg/kg once up to 10 mg
- See Dexamethasone in Croup
- Bacterial Meningitis (before first dose of Antibiotics for pneumococcal Meningitis)
- Start Dexamethasone 15 minutes before first Antibiotic dose
- Dexamethasone 0.4 mg/kg every 12 hours IV for 2 days (or 0.15 mg/kg every 6 hours IV for 4 days)
- Bronchopulmonary Dysplasia in Premature Infants (off-label)
- Dexamethasone 0.5 mg/kg orally or IV divided every 12 hours for 3 days (followed by taper)
- General
VI. Pharmacokinetics
- Dexamethasone has high oral Bioavailability (80%) with onset of action within 1-2 hours
- Long Half-Life (36 to 54 hours)
- High potency
- High anti-inflammatory potency
- No Mineralocorticoid Activity
VII. Adverse Effects
VIII. Safety
- See Systemic Corticosteroid
- Pregnancy category C
- Avoid in Lactation
IX. Resources
- Dexamethasone Tablet (DailyMed)
- Dexamethasone Injection Solution (DailMed)
X. References
- Hamilton (2020) Tarascon Pocket Pharmacopoeia
- Swadron and Hope in Herbert (2018) EM:Rap 18(9):16-8
- Dvorin (2020) Am Fam Physician 101(2): 89-94 [PubMed]
- Lane (1998) Endocrinol Metab Clin North Am 27:465-83 [PubMed]
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Related Studies
| dexamethasone (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| DEXAMETHASONE 0.1% EYE DROP | Generic | $7.20 per ml |
| DEXAMETHASONE 0.5 MG TABLET | Generic | $0.10 each |
| DEXAMETHASONE 0.5 MG/5 ML ELX | Generic | $0.09 per ml |
| DEXAMETHASONE 0.5 MG/5 ML LIQ | Generic | $0.16 per ml |
| DEXAMETHASONE 0.75 MG TABLET | Generic | $0.18 each |
| DEXAMETHASONE 1 MG TABLET | Generic | $0.23 each |
| DEXAMETHASONE 1.5 MG TABLET | Generic | $0.29 each |
| DEXAMETHASONE 120 MG/30 ML VL | Generic | $1.25 per ml |
| DEXAMETHASONE 2 MG TABLET | Generic | $0.43 each |
| DEXAMETHASONE 4 MG TABLET | Generic | $0.38 each |
| DEXAMETHASONE 6 MG TABLET | Generic | $0.99 each |
| DEXAMETHASONE INTENSOL 1 MG/ML | Generic | $0.75 per ml |