- Anti-inflammatory
- Immunosuppressant
- Antileukemic
- Antiemetic for chemotherapy-induced nausea and vomiting
- Available as 4 mg/mL solution
- Protect from light and freezing
- Diluted solutions stable 24 hours at room temperature
- Solutions Compatible: D5W, 0.9% NaCl
- Additives/Above Cassette Compatible: furosemide, granisetron, hydromorphone
- Y-site Compatible: morphine, KCl (up to 40 mmol/L), TPN (amino acids/dextrose), ondansetron, meropenem
- Incompatible: daunorubicin, vancomycin, diphenhydramine, ciprofloxacin
(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)
| SC | NO |
| IM |
YES |
| IV Direct |
YES: Dose <10 mg only (Doses greater than or equal to 10 mg must be given IV intermittent) Infusion time: 3-5 minutes |
| IV Intermittent Infusion |
YES - 0.4 mg/mL for dose less than 1 mg |
| IV Continuous Infusion | NO |
(For neonatal dosages, refer to Neonatal IV Drug Manual.)
Pediatric:
- Cerebral edema:
- Initial: 1-2 mg/kg/dose IM/IV as a single dose
- Maintenance: 1-1.5 mg/kg/day IM/IV ÷ Q 4-6 hours × 5 days, then taper (Maximum: 16 mg/day)
- Anti-Emetic:
- 8 mg/m2/dose IV Q6H (Maximum: 20 mg/dose)
- Anti-inflammatory: 0.08-0.3 mg/kg/day ÷ Q 6-12 hours
- Meningitis: 0.15 mg/kg/dose IV Q 6 hours × 4 days
- Airway edema or extubation:
- 0.5-2 mg/kg/day IM/IV ÷ Q 6 hours: begin 24 hours prior to extubation and continue for 4-6 doses after extubation
- Croup: 0.6 mg/kg/dose x 1
- COVID-19 Infection: 0.15 mg/kg/day (max:6mg) IV/PO q24h x 10 days
Adults:
- Cerebral edema:
- Initial: 10 mg IV
- Maintenance: 4 mg IV/IM Q 6 hours
- Anti-inflammatory:
- 0.75-9 mg/day IM/IV ÷ Q 6-12 hours
- Anti-emetic:
- 8-20 mg given before chemotherapy, additional lower doses may be given over next 24-72 hours
- COVID-19 Infection: 6mg IV/PO q24h x 10 days
- Increased blood pressure with large doses
- Perineal irritation with high doses (slow infusion may reduce likelihood)
- Growth suppression in children, cushing?s syndrome, edema, hypokalemia
- May mask signs of infection
- Hypertension, edema
- Psychosis, insomnia
- Osteoporosis, muscle weakness
- Withdrawal of therapy should be gradual to avoid the symptoms of adrenal insufficiency (after >10-14 days of continuous therapy)
- Contraindicated in systemic fungal infections, mycobacterium infections
- Delay live virus vaccinations for 1 month after ending a >2 week course of high dose corticosteriods (0.3 mg/kg/day of dexamethasone)