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Dexamethasone Dosage

Medically reviewed by Drugs.com. Last updated on Aug 4, 2023.

Applies to the following strengths: 0.75 mg; 0.25 mg; 0.5 mg; 1.5 mg; 4 mg; 6 mg; 0.5 mg/5 mL; 4 mg/mL; 8 mg/mL; 24 mg/mL; 10 mg/mL; 1 mg/mL; 1 mg; 2 mg; 16 mg/mL; sodium phosphate; acetate; 0.1 mg/inh; 10 mg/mL preservative-free; 6 mg/25 mL-NaCl 0.9%; 4 mg/mL preservative-free; 0.4% preservative-free; 20 mg

Usual Adult Dose for Acute Mountain Sickness

Prevention of AMS and HACE:
Usual dose: 2 mg orally every 6 hours OR 4 mg orally every 12 hours

Duration of Therapy: Should not exceed 10 days to prevent glucocorticoid toxicity or adrenal suppression

Treatment of AMS: 4 mg orally/IV/IM every 6 hours

Treatment of HACE: 8 mg orally/IV/IM once; followed by 4 mg orally/IV/IM every 6 hours

Comments:

Uses:

Usual Adult Dose for Cerebral Edema

Initial dose: 10 mg IV once, followed by 4 mg IM every 6 hours until maximal response is noted


Comments:

Use: For the treatment of cerebral edema.

Usual Adult Dose for Cushing's Syndrome

Dexamethasone Suppression Tests:




Comment: The long suppression test provides greater accuracy in diagnosing Cushing's syndrome.

Uses: Diagnostic testing for Cushing's syndrome.

Usual Adult Dose for Nausea/Vomiting - Chemotherapy Induced

Highly emetogenic chemotherapy regimens:
12 to 20 mg oral/IV prior to chemotherapy followed by 8 mg oral/IV once or twice a day for 2 to 4 days

Moderately emetogenic chemotherapy regimens:
8 mg oral/IV prior to chemotherapy followed by 4 to 8 mg oral/IV on days 2 and 3

Low emetogenic chemotherapy regimens:
4 to 8 mg oral/IV prior to chemotherapy

Comments:


Use: For prophylaxis and treatment of chemotherapy induced nausea and vomiting.

Usual Adult Dose for Shock

Unresponsive shock:
1 to 6 mg/kg IV as a single dose or up to 40 mg initially followed by repeat IV doses every 2 to 6 hours while shock persists

Published protocols:
20 mg IV as a single dose followed by IV infusion of 3 mg/kg/24 hours
1 to 6 mg/kg IV as a single dose
40 mg IV as a single dose followed by repeat IV doses every 4 to 6 hours while shock persists

Comments:


Use: For the treatment of unresponsive shock.

Usual Adult Dose for Multiple Myeloma

40 mg oral/IV on days 1, 8, 15, 22, and repeated every 4 weeks

Comments:


Use: For the treatment of multiple myeloma.

Usual Adult Dose for Multiple Sclerosis

Acute exacerbation: 30 mg orally once a day for 1 week followed by 4 to 8 mg orally every other day for 1 month

Comments:


Use: For the treatment of acute exacerbations of multiple sclerosis.

Usual Adult Dose for Anti-inflammatory

Dosing should be individualized on the basis of disease and patient response

Oral:

Parenteral:

Maintenance dose: After a favorable initial response, dose should be decreased in small amounts to the lowest dose that maintains an adequate clinical response; if a positive response is not achieved after a reasonable period of time, alternative therapy should be sought.

Comments:

Uses: For use as a potent anti-inflammatory agent in managing disorders, diseases, and conditions affecting many organ systems including endocrine, dermatologic, ophthalmic, nervous. gastrointestinal, respiratory, musculoskeletal, and hematologic.

Usual Adult Dose for Immunosuppression

Dosing should be individualized on the basis of disease and patient response

Oral:

Parenteral:

Maintenance dose: After a favorable initial response, dose should be decreased in small amounts to the lowest dose that maintains an adequate clinical response; if a positive response is not achieved after a reasonable period of time, alternative therapy should be sought.

Comments:

Uses: For use as a potent anti-inflammatory agent in managing disorders, diseases, and conditions affecting many organ systems including endocrine, dermatologic, ophthalmic, nervous. gastrointestinal, respiratory, musculoskeletal, and hematologic.

Usual Adult Dose for Brain/Intracranial Tumor

2 mg oral/IV/IM 2 to 3 times a day

Use: For palliative management of recurrent or inoperable brain tumors.

Usual Adult Dose for Allergic Reaction

First day: 4 to 8 mg IM once
Second and third day: 1.5 mg orally twice per day
Fourth day: 0.75 mg orally twice per day
Fifth and sixth day: 0.75 mg orally once a day
Seventh day: No treatment
Eighth day: Reassessment

Comments: This dosing schedule is designed to ensure adequate therapy during an acute episode while minimizing the risk of overdose in chronic cases.

Use: For the treatment of acute, self-limited allergic disorder or exacerbation of chronic allergic disorder.

Usual Adult Dose for Bursitis

Suggested doses:
Large joints: 2 to 4 mg
Small joints: 0.8 to 1 mg
Bursae: 2 to 4 mg
Tendon Sheaths: 0.4 to 1 mg

Injections may be repeated from once every 3 to 5 days to once every 2 to 3 weeks

Comments:


Use: As adjunctive therapy for an acute episode or exacerbation of synovitis of osteoarthritis, rheumatoid arthritis, acute and subacute bursitis, acute gouty arthritis, epicondylitis, acute nonspecific tenosynovitis, and posttraumatic osteoarthritis.

Usual Adult Dose for Osteoarthritis

Suggested doses:
Large joints: 2 to 4 mg
Small joints: 0.8 to 1 mg
Bursae: 2 to 4 mg
Tendon Sheaths: 0.4 to 1 mg

Injections may be repeated from once every 3 to 5 days to once every 2 to 3 weeks

Comments:


Use: As adjunctive therapy for an acute episode or exacerbation of synovitis of osteoarthritis, rheumatoid arthritis, acute and subacute bursitis, acute gouty arthritis, epicondylitis, acute nonspecific tenosynovitis, and posttraumatic osteoarthritis.

Usual Adult Dose for Rheumatoid Arthritis

Suggested doses:
Large joints: 2 to 4 mg
Small joints: 0.8 to 1 mg
Bursae: 2 to 4 mg
Tendon Sheaths: 0.4 to 1 mg

Injections may be repeated from once every 3 to 5 days to once every 2 to 3 weeks

Comments:


Use: As adjunctive therapy for an acute episode or exacerbation of synovitis of osteoarthritis, rheumatoid arthritis, acute and subacute bursitis, acute gouty arthritis, epicondylitis, acute nonspecific tenosynovitis, and posttraumatic osteoarthritis.

Usual Adult Dose for Tendonitis

Suggested doses:
Large joints: 2 to 4 mg
Small joints: 0.8 to 1 mg
Bursae: 2 to 4 mg
Tendon Sheaths: 0.4 to 1 mg

Injections may be repeated from once every 3 to 5 days to once every 2 to 3 weeks

Comments:


Use: As adjunctive therapy for an acute episode or exacerbation of synovitis of osteoarthritis, rheumatoid arthritis, acute and subacute bursitis, acute gouty arthritis, epicondylitis, acute nonspecific tenosynovitis, and posttraumatic osteoarthritis.

Usual Adult Dose for Gouty Arthritis

Suggested doses:
Large joints: 2 to 4 mg
Small joints: 0.8 to 1 mg
Bursae: 2 to 4 mg
Tendon Sheaths: 0.4 to 1 mg

Injections may be repeated from once every 3 to 5 days to once every 2 to 3 weeks

Comments:


Use: As adjunctive therapy for an acute episode or exacerbation of synovitis of osteoarthritis, rheumatoid arthritis, acute and subacute bursitis, acute gouty arthritis, epicondylitis, acute nonspecific tenosynovitis, and posttraumatic osteoarthritis.

Usual Adult Dose for Epicondylitis

Suggested doses:
Large joints: 2 to 4 mg
Small joints: 0.8 to 1 mg
Bursae: 2 to 4 mg
Tendon Sheaths: 0.4 to 1 mg

Injections may be repeated from once every 3 to 5 days to once every 2 to 3 weeks

Comments:


Use: As adjunctive therapy for an acute episode or exacerbation of synovitis of osteoarthritis, rheumatoid arthritis, acute and subacute bursitis, acute gouty arthritis, epicondylitis, acute nonspecific tenosynovitis, and posttraumatic osteoarthritis.

Usual Adult Dose for Alopecia

Suggested doses:
Soft tissue infiltration: 2 to 6 mg
Ganglia: 1 to 2 mg

Comments:


Uses: As adjunctive therapy for keloids; localized hypertrophic, infiltrated, inflammatory lesion of lichen planus, psoriatic plaques, granuloma annulare, and lichen simplex chronicus (neurodermatitis); discoid lupus erythematosus; necrobiosis lipoidica diabeticorum; alopecia areata. May be useful in cystic tumors of an aponeurosis tendon (ganglia).

Usual Adult Dose for Lichen Simplex Chronicus

Suggested doses:
Soft tissue infiltration: 2 to 6 mg
Ganglia: 1 to 2 mg

Comments:


Uses: As adjunctive therapy for keloids; localized hypertrophic, infiltrated, inflammatory lesion of lichen planus, psoriatic plaques, granuloma annulare, and lichen simplex chronicus (neurodermatitis); discoid lupus erythematosus; necrobiosis lipoidica diabeticorum; alopecia areata. May be useful in cystic tumors of an aponeurosis tendon (ganglia).

Usual Adult Dose for Psoriasis

Suggested doses:
Soft tissue infiltration: 2 to 6 mg
Ganglia: 1 to 2 mg

Comments:


Uses: As adjunctive therapy for keloids; localized hypertrophic, infiltrated, inflammatory lesion of lichen planus, psoriatic plaques, granuloma annulare, and lichen simplex chronicus (neurodermatitis); discoid lupus erythematosus; necrobiosis lipoidica diabeticorum; alopecia areata. May be useful in cystic tumors of an aponeurosis tendon (ganglia).

Usual Adult Dose for Granuloma Annulare

Suggested doses:
Soft tissue infiltration: 2 to 6 mg
Ganglia: 1 to 2 mg

Comments:


Uses: As adjunctive therapy for keloids; localized hypertrophic, infiltrated, inflammatory lesion of lichen planus, psoriatic plaques, granuloma annulare, and lichen simplex chronicus (neurodermatitis); discoid lupus erythematosus; necrobiosis lipoidica diabeticorum; alopecia areata. May be useful in cystic tumors of an aponeurosis tendon (ganglia).

Usual Adult Dose for Lichen Planus

Suggested doses:
Soft tissue infiltration: 2 to 6 mg
Ganglia: 1 to 2 mg

Comments:


Uses: As adjunctive therapy for keloids; localized hypertrophic, infiltrated, inflammatory lesion of lichen planus, psoriatic plaques, granuloma annulare, and lichen simplex chronicus (neurodermatitis); discoid lupus erythematosus; necrobiosis lipoidica diabeticorum; alopecia areata. May be useful in cystic tumors of an aponeurosis tendon (ganglia).

Usual Adult Dose for Keloids

Suggested doses:
Soft tissue infiltration: 2 to 6 mg
Ganglia: 1 to 2 mg

Comments:


Uses: As adjunctive therapy for keloids; localized hypertrophic, infiltrated, inflammatory lesion of lichen planus, psoriatic plaques, granuloma annulare, and lichen simplex chronicus (neurodermatitis); discoid lupus erythematosus; necrobiosis lipoidica diabeticorum; alopecia areata. May be useful in cystic tumors of an aponeurosis tendon (ganglia).

Usual Adult Dose for Idiopathic (Immune) Thrombocytopenic Purpura

40 mg orally once a day for 4 days


Comments:

Use: For the treatment of immune thrombocytopenia.

Usual Pediatric Dose for Cerebral Edema

0.2 mg/kg/24 hr oral/IV/IM in divided doses

Comments:


Use: For the treatment of cerebral edema

Usual Pediatric Dose for Meningitis

Meningitis (H. influenzae type b):
Infants and Children 6 weeks or older: 0.15 mg/kg/dose IV every 6 hours for the first 2 to 4 days of antibiotic treatment

Comments:


Note: For pneumococcal meningitis, data has not shown clear benefit from dexamethasone administration; risk and benefits should be considered prior to use.

Use: To reduce hearing loss and neurological sequelae associated with meningitis.

Usual Pediatric Dose for Anti-inflammatory

Dosing should be individualized on the basis of disease and patient response

Oral:


Comments:

Uses: For use as a potent anti-inflammatory agent in managing disorders, diseases, and conditions affecting many organ systems including endocrine, dermatologic, ophthalmic, nervous. gastrointestinal, respiratory, musculoskeletal, and hematologic.

Usual Pediatric Dose for Immunosuppression

Dosing should be individualized on the basis of disease and patient response

Oral:


Comments:

Uses: For use as a potent anti-inflammatory agent in managing disorders, diseases, and conditions affecting many organ systems including endocrine, dermatologic, ophthalmic, nervous. gastrointestinal, respiratory, musculoskeletal, and hematologic.

Usual Pediatric Dose for Nausea/Vomiting - Chemotherapy Induced

Highly Emetogenic Chemotherapy Regimens:
6 mg/m2 oral/IV every 6 hours

Moderately Emetogenic Chemotherapy Regimens:


Comments:

Use: For the prevention of nausea and vomiting associated with chemotherapy.

Usual Pediatric Dose for Asthma - Acute

0.6 mg/kg oral/IV/IM once

Comments:


Use: For the treatment of acute asthma exacerbation.

Usual Pediatric Dose for Croup

0.6 mg/kg oral/IM/ IV once
Maximum dose: 16 mg

Comment: Further dosing and route of administration determined by clinical course

Use: For the treatment of childhood croup (laryngotracheobronchitis).

Usual Pediatric Dose for Acute Mountain Sickness

0.15 mg/kg oral/IV/IM every 6 hours

Comments:


Use: For the treatment of acute mountain sickness.

Usual Pediatric Dose for Idiopathic (Immune) Thrombocytopenic Purpura

0.6 mg/kg/day oral/IV for 4 days every 4 weeks for 6 cycles

Comments:


Use: For the treatment of immune thrombocytopenia.

Renal Dose Adjustments

No dose adjustment recommended

Liver Dose Adjustments

Use with caution

Dose Adjustments

Elderly: The more serious consequences of common side effects should be carefully considered when initiating therapy.

Doses should be titrated based on patient response and severity of the condition; patients should be continuously monitored for signs that may require a dosage adjustment:


Gradual discontinuation of therapy is warranted if therapy is to be stopped after more than a few days.

Approximate Equivalents (IV or oral formulations):
Dexamethasone is approximately equivalent to betamethasone
Dexamethasone is approximately 4 to 6 times more potent than methylprednisolone and triamcinolone
Dexamethasone is approximately 6 to 8 times more potent than prednisone and prednisolone
Dexamethasone is approximately 25 to 30 times more potent than hydrocortisone
Dexamethasone is approximately 35 times more potent than cortisone

Precautions

Consult WARNINGS section for additional precautions.

Dialysis

Supplemental dose is not necessary

Other Comments

Administration advice:
Oral:


Concentrated oral solution (Intensol[R]):

Parenteral:
Dexamethasone sodium phosphate 4 mg/mL: For IV, IM, intra-articular, intralesional, and soft tissue injection
Dexamethasone sodium phosphate 10 mg/mL: For IV and IM administration only

Storage requirements:
Concentrated oral solution (Intensol[R]): Discard bottle 90 days after opening; do not use if solution contains a precipitate

Reconstitution/preparation techniques:

IV compatibility: Compatible with normal saline and dextrose solutions

General:

Monitoring:

Patient advice:

Frequently asked questions

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.