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Dexamethasone Uses, Dosage, Side Effects & Warnings | DrugsAtlas

Authoritative Clinical Reference

Therapeutic Class
Corticosteroid
Subclass
Glucocorticoid (Long-acting, High Potency)
Speciality
Endocrinology
Schedule (India)
Schedule H
Routes
Oral, Intravenous (IV), Intramuscular (IM), Topical, Ophthalmic, Intra-articular
Formulations
  • Tablets: 0.5 mg, 0.75 mg, 4 mg
  • Injection: 4 mg/mL (1 mL, 2 mL ampoules), 8 mg/2 mL
  • Eye drops: 0.1% (5 mL, 10 mL)
  • Eye ointment: 0.1%
  • Topical cream/ointment: 0.05%, 0.1%
  • Inhalation solution/Respules: Limited availability in India
Fixed-Dose Combinations (FDCs) Available:
  • Dexamethasone + Neomycin + Polymyxin B (ophthalmic)
  • Dexamethasone + Chloramphenicol (ophthalmic)
  • Dexamethasone + Ciprofloxacin (ophthalmic/otic)
  • Dexamethasone + Clotrimazole (topical)
Adult indications

INDICATIONS + DOSING — FOR CLINICIAN USE ONLY

Primary Indications (Approved / Standard in India)

1. COVID-19 (Hospitalised Patients Requiring Supplemental Oxygen)
Per ICMR/AIIMS COVID-19 Management Guidelines
Parameter Dose
Starting dose
6 mg IV or oral once daily
Titration
Not applicable — fixed dose regimen
Usual maintenance dose
6 mg once daily
Maximum dose
6 mg/day
Duration: 5–10 days (up to 10 days or until discharge, whichever is earlier)
Clinical Notes:
  • Proven mortality benefit in RECOVERY trial; endorsed by ICMR and AIIMS
  • Use ONLY in patients requiring oxygen (SpO2 <94% on room air) or on ventilatory support
  • Do NOT use in mild COVID-19 without hypoxia — may worsen outcomes
  • May be given IV initially, switching to oral when stable
  • Monitor for secondary infections, hyperglycaemia

2. Cerebral Oedema (Associated with Brain Tumours, CNS Infections, Head Injury)
Loading Dose:
Parameter Dose
Starting dose
10 mg IV stat (or 8–12 mg)
Titration
Not applicable for loading
Maintenance:
Parameter Dose
Starting dose
4 mg IV every 6 hours
Titration
Taper based on clinical response once oedema controlled
Usual maintenance dose
4 mg IV/oral every 6–8 hours
Maximum dose
24 mg/day (higher doses rarely needed)
Duration: 5–14 days depending on aetiology; taper over 5–7 days once improvement noted
Clinical Notes:
  • Effective for vasogenic oedema (tumours, infections); less effective for cytotoxic oedema (stroke)
  • Begin taper as soon as clinically feasible to minimise steroid adverse effects
  • Switch to oral route when patient able to take orally
  • For bacterial meningitis: see specific dosing under indications

3. Acute Asthma Exacerbation / Severe COPD Exacerbation
Parameter Dose
Starting dose
4–8 mg IV/IM every 8–12 hours
Titration
Not applicable — short-term use
Usual maintenance dose
4–8 mg IV/IM twice daily initially; then 4 mg oral once or twice daily
Maximum dose
16 mg/day
Duration: IV for 48–72 hours; oral switch and taper over 5–7 days
Clinical Notes:
  • Prednisolone 40–50 mg/day oral often preferred for asthma exacerbations (more evidence)
  • Dexamethasone useful when IV route required or patient cannot swallow
  • Equivalent anti-inflammatory dose: 6 mg dexamethasone ≈ 40 mg prednisolone
  • No taper needed if course ≤5 days

4. Chemotherapy-Induced Nausea and Vomiting (CINV) — Prophylaxis and Treatment
High Emetogenic Chemotherapy (HEC):
Parameter Dose
Starting dose
12–20 mg IV/oral before chemotherapy (Day 1)
Titration
Not applicable
Usual maintenance dose
8 mg oral once or twice daily (Days 2–4)
Maximum dose
20 mg on Day 1; 8 mg twice daily on subsequent days
Moderate Emetogenic Chemotherapy (MEC):
Parameter Dose
Starting dose
8–12 mg IV/oral before chemotherapy
Titration
Not applicable
Usual maintenance dose
4–8 mg oral once daily (Days 2–3)
Maximum dose
12 mg/day
Clinical Notes:
  • Use in combination with 5-HT3 antagonists (ondansetron) ± NK1 antagonists (aprepitant)
  • Single-dose regimens may be sufficient for some protocols
  • Pre-medication typically given 30–60 minutes before chemotherapy

5. Allergic and Inflammatory Conditions (Severe Acute Reactions)
Parameter Dose
Starting dose
4–8 mg IV/IM/oral
Titration
Reduce dose as symptoms improve
Usual maintenance dose
0.5–4 mg/day oral (if maintenance needed)
Maximum dose
16 mg/day for acute phase
Clinical Notes:
  • For anaphylaxis: dexamethasone is adjunctive (NOT a substitute for adrenaline)
  • For severe allergic reactions not requiring adrenaline: useful for preventing biphasic reactions
  • Short courses (3–5 days) generally do not require taper

6. Adrenal Insufficiency (Replacement Therapy — Alternative to Hydrocortisone)
Parameter Dose
Starting dose
0.5–0.75 mg orally once daily (morning)
Titration
Adjust based on symptoms and clinical response
Usual maintenance dose
0.5–0.75 mg once daily
Maximum dose
1.5 mg/day (equivalent to physiological replacement)
Clinical Notes:
  • Hydrocortisone (15–25 mg/day in divided doses) is preferred for physiological replacement
  • Dexamethasone lacks significant mineralocorticoid activity — add fludrocortisone if salt-wasting form
  • Long half-life allows once-daily dosing
  • Monitor for Cushingoid features if dose excessive

7. Bacterial Meningitis (Adjunctive Therapy)
Parameter Dose
Starting dose
0.15 mg/kg IV every 6 hours (adult equivalent: ~10 mg IV every 6 hours)
Titration
Not applicable
Usual maintenance dose
0.15 mg/kg IV every 6 hours
Maximum dose
10 mg IV every 6 hours
Duration: 4 days (start before or with first dose of antibiotics)
Clinical Notes:
  • Best evidence for Streptococcus pneumoniae meningitis
  • Must be given BEFORE or WITH first antibiotic dose for maximum benefit (reduces mortality and neurological sequelae)
  • Benefit uncertain if given after antibiotics already started
  • Per AIIMS and ICMR meningitis protocols

Secondary Indications – Adults (Off-label)

Indication Dose Duration Supervision Evidence Basis
Acute Spinal Cord Compression (Malignant) (OFF-LABEL)
Loading: 10–16 mg IV; Maintenance: 4–8 mg IV/oral every 6 hours Until definitive treatment (surgery/radiotherapy); then taper Specialist only (Oncology/Neurosurgery) Indian oncology practice; reduces oedema and may improve neurological function temporarily
ARDS (Non-COVID) (OFF-LABEL)
20 mg IV on Day 1, then 10 mg IV daily for Days 2–5, then taper 10–14 days total with taper Specialist only (Critical Care) DEXA-ARDS trial; reduces mortality and ventilator days; Indian ICU practice
Immune Thrombocytopenia (ITP) — First-line (OFF-LABEL)
40 mg oral once daily for 4 days; cycles may be repeated 4-day pulses; repeat PRN Specialist only (Haematology) High response rate; alternative to prednisolone; Indian haematology practice
Autoimmune Haemolytic Anaemia (AIHA) (OFF-LABEL)
0.5–1 mg/kg/day oral (equivalent prednisolone dose often used) Weeks to months; taper based on response Specialist only (Haematology) Indian haematology practice
Multiple Myeloma (as part of chemotherapy regimen) (OFF-LABEL)
20–40 mg oral weekly or per protocol (e.g., VRd, Rd) Per chemotherapy protocol Specialist only (Oncology) Standard component of myeloma regimens
Antenatal Corticosteroid for Fetal Lung Maturation (OFF-LABEL)
6 mg IM every 12 hours × 4 doses (total 24 mg) Single course (4 doses over 48 hours) Specialist only (Obstetrics) RCOG/WHO recommendations; used when betamethasone unavailable; Indian obstetric practice
Paediatric indications
PAEDIATRIC DOSING (Specialist Only)
āš ļø Steroid use in neonates should be under specialist supervision only due to risks of neurodevelopmental effects, infections, and adrenal suppression.

Primary Indications

1. Croup (Laryngotracheobronchitis)
Parameter Dose
Starting dose
0.15–0.6 mg/kg oral/IM as single dose
Titration
Not applicable — single dose usually sufficient
Usual maintenance dose
Not applicable
Maximum dose
12 mg (single dose)
Clinical Notes:
  • Single dose highly effective; repeat dosing rarely needed
  • 0.6 mg/kg is standard dose in most IAP/Indian protocols
  • If unable to tolerate oral: give IM or use nebulised budesonide as alternative
  • Onset of action: 1–2 hours; may use nebulised adrenaline for immediate relief in severe cases

2. Acute Severe Asthma / Bronchospasm
Parameter Dose
Starting dose
0.15–0.3 mg/kg IV/IM/oral
Titration
Not applicable for acute use
Usual maintenance dose
0.15–0.3 mg/kg/day in 1–2 divided doses
Maximum dose
6 mg/dose; 12 mg/day
Duration: 3–5 days; no taper needed for short course
Clinical Notes:
  • Prednisolone 1–2 mg/kg/day oral often preferred (more paediatric data)
  • Dexamethasone useful when IV required or if vomiting
  • Single-dose or 2-day dexamethasone regimens increasingly used for acute asthma

3. Bacterial Meningitis (Adjunctive)
Parameter Dose
Starting dose
0.15 mg/kg IV
Titration
Not applicable
Usual maintenance dose
0.15 mg/kg IV every 6 hours
Maximum dose
10 mg every 6 hours (adult equivalent)
Duration: 4 days; give before or with first antibiotic dose
Clinical Notes:
  • Start BEFORE or WITH first antibiotic dose — delayed administration reduces benefit
  • Best evidence for S. pneumoniae and H. influenzae type b meningitis
  • Per IAP and ICMR guidelines

4. Congenital Adrenal Hyperplasia (CAH) — Replacement Therapy
Parameter Dose
Starting dose
0.25–0.5 mg/m²/day oral in 1–2 divided doses
Titration
Adjust based on 17-OHP levels, growth, bone age
Usual maintenance dose
0.25–0.5 mg/m²/day
Maximum dose
Individualised; avoid over-replacement
Clinical Notes:
  • Hydrocortisone preferred in growing children (less growth-suppressive)
  • Dexamethasone may be used in post-pubertal patients or those with poor compliance (once-daily dosing)
  • Add fludrocortisone if salt-wasting form
  • Specialist (Paediatric Endocrinology) supervision mandatory

5. Chemotherapy Protocols (Leukaemia, Lymphoma)
Parameter Dose
Starting dose
Protocol-specific (typically 6–10 mg/m²/day)
Titration
Per protocol
Usual maintenance dose
Protocol-specific
Maximum dose
Protocol-specific (may exceed usual limits)
Clinical Notes:
  • Used in induction, consolidation phases of ALL protocols
  • Specialist (Paediatric Oncology) supervision mandatory
  • Monitor for hyperglycaemia, infections, mood changes, myopathy
Age-Based Dosing Reference (Croup/Asthma):
Age/Weight Single Dose (Croup) Asthma Dose (Daily)
6–12 months 1–2 mg 1–1.5 mg/day
1–2 years 2–3 mg 1.5–2 mg/day
2–5 years 3–4 mg 2–3 mg/day
6–12 years 4–8 mg 3–6 mg/day
>12 years 8–12 mg 6 mg/day

Secondary Indications – Paediatrics (Off-label)

Indication Age Dose Duration Supervision Evidence Basis
Antiemetic for Chemotherapy (OFF-LABEL)
≥1 year 4–8 mg/m² IV before chemotherapy; 2–4 mg/m² oral for 2–3 days Per chemotherapy cycle Specialist only (Paediatric Oncology) Standard paediatric oncology practice
Acute Lymphoblastic Leukaemia (ALL) — Induction (OFF-LABEL)
Any age 6–10 mg/m²/day in divided doses as per protocol 28-day induction cycle Specialist only (Paediatric Oncology) Standard ALL protocols (BFM, COG)
Safety Monitoring (All Paediatric Use):
  • Growth velocity and height percentile (long-term use)
  • Blood glucose (especially during acute illness or high-dose therapy)
  • Blood pressure
  • Signs of infection (fever may be masked)
  • Behavioural changes, mood disturbance
  • Bone density (if prolonged use)
  • Ophthalmologic examination (cataracts, glaucoma with chronic use)
  • Adrenal function before discontinuation if >2 weeks use
Age Restrictions:
  • Neonates: Avoid unless under neonatology/endocrinology specialist supervision
  • Use in infants <6 months should be carefully justified
Renal Adjustments
No dose adjustment required in renal impairment.
Renal Function Recommendation
All eGFR levels
No dose adjustment required
Haemodialysis
No supplemental dose required; not significantly dialysed
Peritoneal Dialysis
No dose adjustment required
Note: Monitor for fluid retention and electrolyte disturbances (hypokalaemia) in patients with renal impairment on long-term therapy.
Hepatic adjustment
Contraindications
  • Known hypersensitivity to dexamethasone or any corticosteroid
  • Systemic fungal infections (unless being treated with specific antifungals)
  • Cerebral malaria (may worsen outcome)
  • Administration of live or live-attenuated vaccines during immunosuppressive doses
  • Untreated systemic bacterial, viral, or parasitic infections (unless corticosteroid is part of treatment protocol)
  • Idiopathic thrombocytopenic purpura (IM injection contraindicated)
  • Herpes simplex keratitis (for ophthalmic use)

Cautions

  • Diabetes mellitus — may significantly worsen glycaemic control; monitor blood glucose
  • Hypertension — may exacerbate; monitor BP
  • Heart failure — fluid retention may worsen symptoms
  • Osteoporosis or risk factors for bone loss — consider bone protection if prolonged use
  • Peptic ulcer disease or history of GI bleeding — increased risk of GI complications
  • Psychiatric disorders (depression, psychosis, mania) — may precipitate or exacerbate
  • Glaucoma — may increase intraocular pressure
  • Myasthenia gravis — initial worsening possible before improvement
  • Thyroid disorders — may alter thyroid function tests
  • Active or latent tuberculosis — may reactivate; screen before prolonged use
  • Strongyloides infection risk (endemic areas/immigrants) — screen before high-dose steroids
  • Concurrent anticoagulant therapy — increased bleeding risk
  • Recent myocardial infarction — myocardial rupture reported
  • Immunocompromised patients — increased infection risk
  • Children — growth suppression with prolonged use
  • Abrupt withdrawal after prolonged use — risk of adrenal crisis
Pregnancy
Parameter Information
Overall Safety
Use only if benefit outweighs risk; crosses placenta
Risk
First trimester: possible slight increase in orofacial cleft risk (data inconclusive); later pregnancy: generally well-tolerated short courses
Preferred Alternatives
Prednisolone or prednisone preferred for long-term use (greater placental metabolism, less fetal exposure)
Specific Indication
Fetal lung maturation (24–34 weeks): 6 mg IM every 12 hours × 4 doses; alternative to betamethasone
When Use May Be Justified
Severe maternal illness (asthma, ARDS, COVID-19); fetal lung maturation; obstetric specialist supervision
Monitoring
Maternal: blood glucose, BP, signs of infection; Fetal: growth if chronic exposure; Neonatal: glucose, adrenal function after maternal exposure
Lactation
Parameter Information
Compatibility
Generally compatible with breastfeeding for short courses
Expected Drug Level in Milk
Low (corticosteroids present in small amounts)
Risk to Infant
Minimal with short-term maternal use; theoretical risk of adrenal suppression with high-dose prolonged exposure
Preferred Alternatives
Prednisolone may be preferred (more data; greater maternal metabolism)
Infant Monitoring
Growth, feeding, signs of adrenal insufficiency (rare) with prolonged high-dose maternal therapy
Recommendation
Short courses acceptable; for prolonged high-dose use, consider alternatives or monitor infant
Elderly
Parameter Recommendation
Starting dose
Use lowest effective dose (typically lower end of dose range)
Titration
Slower titration and taper; elderly more susceptible to adverse effects
Increased Risks
Osteoporosis and fractures; hyperglycaemia and new-onset diabetes; hypertension; fluid retention and heart failure exacerbation; infections (including reactivation TB); delirium and psychiatric disturbance; GI bleeding (especially with NSAIDs); myopathy; cataracts; skin fragility
Additional Precautions
Consider bone protection (calcium, vitamin D, bisphosphonate) for courses >3 months; monitor glucose; use PPI if GI risk factors; avoid NSAIDs if possible
Major drug interactions
Interacting Drug Mechanism Effect Management
Rifampicin, Rifabutin
Strong CYP3A4 induction Significantly reduced dexamethasone levels and efficacy (may need 2–3× dose) Increase dexamethasone dose; monitor clinical response; consider alternative steroid
Phenytoin, Carbamazepine, Phenobarbital
CYP3A4 induction Reduced dexamethasone efficacy May need dose increase; monitor response
Ketoconazole, Itraconazole
CYP3A4 inhibition Increased dexamethasone levels and toxicity Use with caution; monitor for steroid adverse effects; reduce dose if necessary
Ritonavir, Cobicistat
Strong CYP3A4 inhibition Markedly increased dexamethasone exposure; Cushing syndrome risk Avoid if possible; if essential, reduce dexamethasone dose significantly; monitor closely
Live Vaccines (BCG, OPV, MMR, Varicella, Yellow Fever)
Immunosuppression Risk of disseminated vaccine infection
Avoid live vaccines during high-dose immunosuppressive therapy and for 3 months after
NSAIDs
Additive GI toxicity Significantly increased risk of peptic ulceration and GI bleeding Avoid combination if possible; if essential, co-prescribe PPI; monitor for GI symptoms
Warfarin and other Vitamin K Antagonists
Unclear mechanism; variable effect on INR May increase or decrease anticoagulant effect Monitor INR closely when starting, stopping, or changing dexamethasone dose
Moderate drug interactions
Interacting Drug Effect Management
Insulin, Oral Antidiabetics
Corticosteroids antagonise glucose-lowering effect Monitor blood glucose frequently; adjust antidiabetic doses as needed
Antihypertensives
Corticosteroids may reduce efficacy (fluid retention, vasoconstriction) Monitor BP; may need antihypertensive dose adjustment
Diuretics (Thiazides, Loop)
Additive hypokalaemia Monitor potassium; supplement if needed
Digoxin
Steroid-induced hypokalaemia may increase digoxin toxicity Monitor potassium and digoxin levels
Amphotericin B
Additive hypokalaemia Monitor potassium closely; supplement as needed
Fluoroquinolones (Ciprofloxacin, Levofloxacin)
Increased risk of tendon rupture Use with caution; advise patient to report tendon pain
Cyclosporine, Tacrolimus
Mutual inhibition of metabolism; possible additive immunosuppression Monitor drug levels; watch for toxicity of both agents
Aspirin (Anti-inflammatory doses)
Additive GI bleeding risk; steroids may increase aspirin clearance Co-prescribe PPI; monitor for GI symptoms; may need aspirin dose adjustment
Oestrogens / Oral Contraceptives
May increase corticosteroid effect (reduced clearance) Monitor for steroid adverse effects
Neuromuscular Blocking Agents (Pancuronium, Vecuronium)
May enhance or prolong neuromuscular blockade Use with caution in ICU setting
Common Adverse effects
Short-term Use (<2 weeks):
  • Hyperglycaemia
  • Insomnia
  • Increased appetite, weight gain
  • Mood changes (euphoria, irritability, anxiety)
  • Dyspepsia, gastritis
  • Fluid retention, facial flushing
  • Increased energy/restlessness
Long-term Use:
  • Cushingoid features (moon face, buffalo hump, central obesity)
  • Skin thinning, easy bruising, striae
  • Muscle weakness (proximal myopathy)
  • Hypertension
  • Hypokalaemia
  • Immunosuppression, increased infection risk
  • Acne
  • Hirsutism
  • Menstrual irregularities
Serious Adverse effects
Adverse Effect Clinical Action
Adrenal Suppression / Adrenal Crisis (on abrupt withdrawal after prolonged use)
Never stop abruptly after >7–10 days use; taper gradually; stress-dose steroids during illness/surgery
Peptic Ulcer with Haemorrhage/Perforation
Consider PPI prophylaxis in high-risk patients; discontinue if severe GI symptoms; endoscopy if bleeding
Avascular Necrosis (Osteonecrosis) (especially femoral head)
High-dose/prolonged use; investigate hip pain; MRI for diagnosis; orthopaedic referral
Severe Infections / TB Reactivation / Opportunistic Infections
Screen for latent TB before prolonged use; maintain high suspicion for infection (fever may be masked)
Hyperglycaemia / New-Onset Diabetes / DKA
Monitor glucose; treat with insulin if needed; may require admission in severe cases
Severe Psychiatric Reactions (psychosis, severe depression, mania, suicidal ideation)
May require dose reduction or discontinuation; psychiatric consultation
Posterior Subcapsular Cataract / Glaucoma
Ophthalmologic evaluation for chronic use; may need treatment
Osteoporotic Fractures
Bone protection for prolonged use; DEXA scan; treat osteoporosis
Growth Suppression in Children
Use lowest effective dose; alternate-day therapy if possible; monitor growth
Myopathy (Steroid Myopathy)
Proximal weakness; CK usually normal; reduce dose; physiotherapy
SJS/TEN (rare)
Discontinue immediately; dermatology consultation; hospitalisation
Anaphylaxis (rare, especially with IV)
Discontinue; emergency management
Monitoring requirements
Timing Parameters
Baseline (before starting, especially for prolonged use)
Blood glucose (FBG, HbA1c); blood pressure; weight; serum electrolytes (potassium); complete blood count; chest X-ray or Mantoux/IGRA for latent TB (if >2 weeks planned use); bone density (DEXA) if osteoporosis risk; ophthalmologic examination (baseline)
Short-term use (<2 weeks)
Blood glucose (daily if diabetic or hospitalised); BP; clinical assessment for adverse effects
After initiation of prolonged therapy (2–4 weeks)
Blood glucose; electrolytes; BP; weight; signs of infection; mood/behaviour
Long-term use (every 1–3 months)
Blood glucose/HbA1c; BP; weight; potassium; signs of Cushing syndrome; infections; mood; growth (children); DEXA annually; ophthalmologic examination annually
Before discontinuation
Assess HPA axis suppression (if >2 weeks use); plan taper; educate on stress dosing
Brands in India
Tablets:
  • Dexonaā„¢ (Zydus Cadila) — 0.5 mg, 4 mg
  • Decadronā„¢ — 0.5 mg
  • Dexamethā„¢ (Cadila) — 0.5 mg
  • Wysolone-Dā„¢ — 0.5 mg
  • Generic dexamethasone — 0.5 mg, 4 mg
Injection:
  • Dexonaā„¢ Injection (Zydus) — 4 mg/mL
  • Decmaxā„¢ (Mankind) — 4 mg/mL
  • Dexamethasone Injectionā„¢ (Various) — 4 mg/mL, 8 mg/2mL
Ophthalmic:
  • MaxDexā„¢ Eye Drops — 0.1%
  • Dexacortā„¢ Eye Drops — 0.1%
  • Various FDCs (Dexamethasone + antibiotic)
Topical:
  • Desowenā„¢ (though this is desonide, often confused)
  • Various FDC topical preparations
Price range (INR)
0.5 mg tablet ₹0.80–₹3.00 per tablet —
4 mg tablet ₹2.00–₹6.00 per tablet —
4 mg/mL injection (2 mL) ₹8–₹25 per ampoule NLEM listed
8 mg/2mL injection ₹15–₹40 per ampoule —
0.1% eye drops (5 mL) ₹25–₹60 —
Regulatory: Injectable formulation listed under NLEM 2022; NPPA price controlled for scheduled formulations; widely available in government supply
Clinical pearls
  1. COVID-19: oxygen-dependent only — Dexamethasone 6 mg/day reduces mortality in hypoxic COVID-19 patients; do NOT use in mild cases without hypoxia — may be harmful
  2. Tapering after prolonged use — HPA axis suppression occurs after >7–10 days of systemic steroids; taper gradually (reduce by 10–20% every few days to weeks depending on duration/dose); abrupt withdrawal may precipitate adrenal crisis
  3. Meningitis timing critical — Give dexamethasone BEFORE or WITH the first antibiotic dose; benefit lost if started after antibiotics
  4. Equivalent potency — Dexamethasone is ~6–7× more potent than prednisolone; 6 mg dexamethasone ≈ 40 mg prednisolone (anti-inflammatory equivalence)
  5. GI protection — Co-prescribe PPI in patients on high-dose steroids, elderly, or those with history of peptic ulcer or concurrent NSAID/anticoagulant use
  6. Drug interactions with TB treatment — Rifampicin significantly reduces dexamethasone efficacy; may need 2–3× usual dose to achieve clinical effect in patients on anti-TB therapy
Version
RxIndia v1.1 — 02 Apr 2025
Reference
  • CDSCO Product Information
  • Indian Pharmacopoeia (IP)
  • National List of Essential Medicines (NLEM) 2022
  • ICMR COVID-19 Management Guidelines
  • AIIMS COVID-19 Treatment Protocol
  • API Textbook of Medicine
  • AIIMS and PGIMER Protocols for Cerebral Oedema
  • Harrison's Principles of Internal Medicine
  • Goodman & Gilman's The Pharmacological Basis of Therapeutics
  • IAP Guidelines (Croup, Asthma, Meningitis)
  • MoHFW National Asthma and COPD Treatment Modules
  • RECOVERY Trial (NEJM 2020) — COVID-19 evidence
  • DEXA-ARDS Trial — ARDS evidence (off-label)
  • European Society of Medical Oncology (ESMO) Antiemetic Guidelines — CINV evidence
āš–ļø

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