Adult Dosing
Corticosteroid-responsive conditions
- 0.5-9 mg/day PO divided q6-12 hrs
- Note: Frequency varies by condition; taper dose gradually after long-term use
Adrenal insufficiency
- 0.03-0.15 mg/kg/day PO divided q6-12 hrs
Acute allergic disorders
- 4-8 mg IM on day 1
- 1.5 mg PO bid on days 2 & 3
- 0.75 mg PO bid on day 4
- 0.75 PO qd on days 5 & 6
Suppression tests
Tests for Cushing's syndrome
- 1 mg PO at 11 p.m; blood is withdrawn at 8.00 am the following morning
- Alt: 0.5 mg PO q6 hrs x 48 hrs
Tests to distinguish Cushing's syndrome due to pituitary ACTH excess from Cushing's syndrome due to other causes
Pediatric Dosing
Corticosteroid-responsive conditions
- 0.08-0.3 mg/kg/day PO divided q6-12 hrs
- Note: Frequency varies by condition; taper dose gradually after long-term use
Adrenal insufficiency
- 0.03-0.3 mg/kg/day PO divided q6-12 hrs
Croup [Non-FDA Approved]
- 0.15-0.6 mg/kg PO once. No advantage to higher dose than 0.15 mg/kg, and no advantage to injectable over oral administration. In severe croup, many providers will proceed with higher dose of 0.6 mg/kg [Max = 12 mg] IV
[Outline]
See Supplemental Patient Information
- Anaphylactoid and hypersensitivity reactions have occurred in patients receiving corticosteroid therapy
- Corticosteroids can cause elevation of blood pressure, sodium and water retention, and increased excretion of potassium. Dietary salt restriction and potassium supplementation may be needed
- Corticosteroids may mask signs of infection. May decrease host-defense mechanisms to prevent dissemination of infection
- Reversible hypothalamic-pituitary adrenal (HPA) axis suppression may occur
- Drug-induced secondary adrenocortical insufficiency may result from rapid withdrawal; taper gradually to discontinue
- Administration of live or live, attenuated vaccines is contraindicated in patients receiving immunosuppressive doses of corticosteroids
- Use with caution in active or latent peptic ulcers, diverticulitis, fresh intestinal anastomoses, and nonspecific ulcerative colitis, due to increased risk of perforation
- Prolonged use of corticosteroids may produce posterior subcapsular cataracts and glaucoma. Eye exams may be required during chronic therapy.
- Monitor weight, blood pressure, and electrolytes frequently
- Monitor chest X ray, BMD if prolonged treatment; ophthalmological exams if treatment > 6 wks
- Consider upper GI X-ray if history of peptic ulcer disease or significant dyspepsia
Cautions: Use cautiously in
- Hepatic impairment
- Seizure disorder
- Diabetes Mellitus
- Fluid and electrolyte imbalance
- Cardiovascular disease
- Hypertension
- Tuberculosis
Supplemental Patient Information
- Advise patient on signs of infection, hyperglycemia and fluid retention
- Advise patient against sudden discontinuation
Pregnancy Category:C
Breastfeeding: Safety Unknown. Alternate drugs might be preferred, especially while nursing a newborn or preterm infant. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 26 October 2009).
Pricing data from www.DrugStore.com in U.S.A.
- Dexamethasone 4 MG TABS [Bottle] (ROXANE)
90 mg = $21.99
180 mg = $32.97 - Dexamethasone 1 MG TABS [Bottle] (ROXANE)
30 mg = $19.99
60 mg = $28.98 - Dexamethasone 0.5 MG/5ML ELIX [Bottle] (MORTON GROVE PHARMACEUTICALS)
120 5ml = $49.99
360 5ml = $115.97 - Dexamethasone 0.75 MG TABS [Bottle] (ROXANE)
30 mg = $13.99
60 mg = $17.97 - Dexamethasone 0.5 MG TABS [Bottle] (ROXANE)
30 mg = $12.99
60 mg = $14.46 - Dexamethasone 2 MG TABS [Bottle] (ROXANE)
30 mg = $21.99
90 mg = $47.97 - Dexamethasone 1.5 MG TABS [Bottle] (ROXANE)
30 mg = $12.99
60 mg = $16.98 - Dexamethasone 6 MG TABS [Bottle] (ROXANE)
30 mg = $22.99
60 mg = $35.97
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
