Dosing & Uses
Adult Dosage Forms & Strengths
tablet
- 0.5 mg
- 0.75 mg
- 1 mg
- 1.5 mg
- 2 mg
- 4 mg
- 6 mg
injectable suspension
elixir/oral solution
oral concentrate
Inflammation
0.75-9 mg/day IV/IM/PO divided q6-12hr
Intra-articular, intralesional, or soft tissue: 0.2-6 mg/day
Multiple Sclerosis (Acute Exacerbation)
30 mg/day PO for 1 week; follow by 4-12 mg/day for 1 mo
Cerebral Edema
10 mg IV, then 4 mg IM q6hr until clinical improvement is observed; may be reduced after 2-4 days and gradually discontinued over 5-7 days
Shock
1-6 mg/kg IV once or 40 mg IV q2-6hr PRN
Alternative: 20 mg IV, then 3 mg/kg/day by continuous IV infusion
High-dose treatment not to be continued beyond 48-72 hours
Allergic Conditions
For control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment in asthma, atopic dermatitis, contact dermatitis, drug hypersensitivity reactions, perennial or seasonal allergic rhinitis, and serum sickness
Day 1: 4-8 mg IM
Days 2-3: 3 mg/day PO divided q12hr
Day 4: 1.5 mg/day PO divided q12hr
Days 5-6: 0.75 mg/day PO in single daily dose
Day 7: No treatment
Dexamethasone Suppression Test
Low-dose test
- Screening for Cushing syndrome
- Overnight test: 1 mg PO between 11:00 PM and midnight; cortisol level tested between 8:00 and 9:00 AM on following morning
- Standard 2-day test: 0.5 mg PO q6hr (9:00 AM, 3:00 PM, 9:00 PM, 3:00 AM) for 2 days; cortisol level tested 6 hours after final dose (9:00 AM)
High-dose test
- Confirmed Cushing syndrome in which further workup is needed to identify whether hormone excess is the result of cushing syndrome or other causes
- Standard 2-day test: After determination of baseline serum cortisol or 24-hr urinary free cortisol, 2 mg PO q6hr for 2 days; urine for free cortisol is collected during test, and serum cortisol is checked 6 hours after final dose
- Overnight test: After determination of baseline serum cortisol, 8 mg (typically) PO between 11:00 pm and midnight; cortisol level tested between 8:00 and 9:00 AM on following morning
- IV test: After determination of baseline serum cortisol, 1 mg/hr by continuous IV infusion for 5-7 hours
Chemotherapy-Induced Nausea & Vomiting (Off-label)
8-12 mg PO/IV alone or in combination with other antiemetics before chemotherapy, then 8 mg PO/IV q24hr for 1-3 days after chemotherapy (days 2-4)
Altitude Sickness (Off-label)
Prophylaxis
- 2 mg PO q6hr or 4 mg PO q12hr beginning on day of ascent; may be discontinued after 2- to 3-day stay at same elevation or initiation of descent
Treatment
- Acute mountain sickness (AMS): 4 mg PO/IV/IM q6hr
- High-altitude cerebral edema (HACE): 8 mg once followed by 4 mg PO/IV/IM q6hr until symptoms resolve
Spinal Cord Compression (Off-label)
10-100 mg IV, then 4-24 mg IV q6hr during radiation therapy, then tapered
Pediatric
Dosage Forms & Strengths
tablet
- 0.5 mg
- 0.75 mg
- 1 mg
- 1.5 mg
- 2 mg
- 4 mg
- 6 mg
injectable suspension
elixir/oral solution
oral concentrate
Airway Edema
0.5-2 mg/kg/day PO/IV/IM divided q6hr, starting 24 hours before extubation and continued for 4-6 doses afterward
Croup
0.6 mg/kg PO/IV/IM once; not to exceed 16 mg
Inflammation
0.08-0.3 mg/kg/day IV/PO/IM divided q6hr or q12hr
Meningitis
>6 weeks: 0.6 mg/kg/day IV divided q6hr for first 2-4 days of antibiotic therapy, starting 10-20 minutes before or simultaneously with first antibiotic dose
Cerebral Edema Associated With Brain Tumor
1-2 mg/kg IV/IM once; maintenance: 1-1.5 mg/kg/day IV/IM divided q4-6hr; not to exceed 16 mg/day
Spinal Cord Compression
2 mg/kg/day IV divided q6hr
Adrenal Cortical Hyperfunction Test
After determination of baseline cortisol level, 1 mg PO at bedtime
Plasma cortisol level then determined at 8:00 AM on following morning; level will be decreased in normal individuals but at baseline level in Cushing syndrome
Respiratory Distress Syndrome in Premature Infants (Off-label)
Prophylaxis
4 mg IM q8hr administered to mother for 2 days before delivery