Dexamethasone Uses

Dexamethasone is used to treat a wide range of conditions, including:

• Severe allergic conditions, including asthma, atopic dermatitis, contact dermatitis, seasonal allergic rhinitis, perennial allergic rhinitis, and drug hypersensitivity reactions
• Severe skin diseases, such as exfoliative erythroderma, pemphigus, bullous dermatitis herpetiformis, mycosis fungoides, and severe erythema multiforme (Stevens-Johnson syndrome)
• Hormonal disorders such as primary or secondary adrenocortical insufficiency, congenital adrenal hyperplasia, nonsuppurative thyroiditis, and hypercalcemia associated with cancer
• Gastrointestinal diseases such as enteritis and ulcerative colitis
• Blood disorders such as congenital (erythroid) hypoplastic anemia, pure red cell aplasia, autoimmune hemolytic anemia, idiopathic thrombocytopenic purpura, and some cases of secondary thrombocytopenia
• Certain cancers such as leukemias, lymphomas, and multiple myeloma; spinal cord compression due to tumors
• Acute exacerbation of nervous system disorders such as multiple sclerosis, cerebral edema (swelling) in people with primary or metastatic brain tumors, head injuries, craniotomy
• Eye disorders such as sympathetic ophthalmia, uveitis, ocular inflammatory conditions that are unresponsive to topical corticosteroids, temporal arteritis
• Kidney disorders such as idiopathic nephrotic syndrome, lupus nephritis 
• Rheumatic disorders, including acute exacerbations of gouty arthritis, ankylosing spondylitis, rheumatoid arthritis, juvenile rheumatoid arthritis, psoriatic arthritis, polymyositis, dermatomyositis, systemic lupus erythematosus, acute rheumatic carditis
• Lung conditions such as berylliosis, idiopathic eosinophilic pneumonias, symptomatic sarcoidosis, and fulminating or disseminated pulmonary tuberculosis (used with appropriate antitubercular drugs) 
• Diagnostic testing, for example, a dexamethasone adrenal suppression test, is done to measure the response of the adrenal glands to ACTH (cortisol levels are measured after a dose of dexamethasone, and free cortisol level should decrease in response to dexamethasone)

There may be other uses of dexamethasone—your doctor or health system pharmacists can give you further dexamethasone drug information.

Dexamethasone Mechanism of Action

Dexamethasone is similar to a hormone called cortisol that is made by the adrenal glands in the body. This drug acts on the immune system and suppresses the immune response, thereby relieving inflammation.

Dexamethasone Doses

The dose of dexamethasone and the duration of treatment are variable and are tailored to the condition being treated and your response. The starting dose of dexamethasone usually ranges between 0.75 mg and 9 mg per day. 

Higher doses may be necessary for certain conditions, such as acute exacerbation of multiple sclerosis, where doses of up to 30 mg daily of dexamethasone are prescribed for one week, followed by lower doses of 4 mg to 12 mg every other day for one month. 

The initial dose of dexamethasone in children depends on the specific disease being treated and typically ranges between 0.02 mg to 0.30 mg/kg/day in 3-4 divided doses.

If you have a favorable response to dexamethasone, your healthcare provider may decrease the dose gradually from the initial high doses. The final dose will be determined by decreasing the initial dose slowly until you reach the lowest dosage that can maintain therapeutic effectiveness.

It may be necessary to make dosage adjustments during dexamethasone therapy in response to changes in your clinical status, such as remissions or exacerbations of your condition. Stressful situations that are not related to your condition may necessitate an increase in the dosage of dexamethasone for a period of time. 

If you are stopping dexamethasone after long-term treatment, your doctor will recommend reducing the dose gradually rather than stopping the medicine suddenly.