Dexamethasone: What it’s For, How to Use & Side-Effects

Updated in December 2023

Dexamethasone is a type of corticiosteroid that has a potent anti-inflammatory action. It is frequently used for the treatment of different types of allergies, conditions resulting in inflammation (like rheumatoid arthritis), severe asthma and urticaria.  

This medication can be accessed at the pharmacy with a prescription. It is available in pill-form, as a syrup, as an injectable solution, as a topical cream, or as eye drops. 

Dexamethasone should be used as prescribed by the doctor. The route for use will depend on the location or type of illness being treated. 

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What it is used for

Dexamethasone is indicated to treat various allergy-related problems, as well as acute or chronic inflammation related to the skin, eyes, glands, lungs, or intestines. 

Intravenous and intramuscular injections of dexamethasone are usually recommended for acute illnesses. After the acute phase passes, the injectable solution can be substituted for pill-form.  

How to use

The use and dosing of dexamethasone can vary greatly depending on the problem being treated, the age of the patient, and other factors like the patient’s health history. When taking dexamethasone, you should follow the instructions as indicated by the prescriber. 

Dosing that is generally recommended is as follows: 

1. Oral pills or syrup 

Pills or syrup should be taken orally at the times indicated by the doctor. 

The initial dexamethasone dose for adults varies between 0.75 mg and 15 mg per day, depending on the type of illness, the severity of symptoms, and the patient’s response. Dosing should be gradually reduced if treatment lasts for several days. 

For children, dosing is calculated by the doctor and will also depend on the illness being treated.

Dexamethasone in pill-form can be found in doses of 0.5 mg, 0.75 mg or 4 mg, while the syrup is usually found at a concentration of 0.5 mg/5 mL. 

2. Injectable solution 

The initial dose of injectable dexamethasone is generally 0.5 mg to 20 mg per day. It can be injected directly into the vein or into a muscle by a health care professional, depending on the illness being treated. 

3. Dexamethasone eye drops 

Dexamethasone eye drops should only be used in the affected eye. It is important to shake the bottle well before using. 

The dose that is generally recommended for adults is 1 or 2 drops, which can be administered once per hour in more serious cases, or 4 to 6 times per day in mild cases. Eye drop dosing should be gradually reduced, depending on the effectiveness of the medication, and under medical supervision.  

Eye drops can be found in concentrations of 1 mg/mL. 

4. Topical cream 

Topical cream dexamethasone should be used externally, on the skin, as recommended by the doctor. Ensure you wash your hands and the affected area with water and mild soap and pat dry before applying. You should spread the cream generously over the treatment area and lightly massage it into the skin to promote absorption.   

The recommended dose of topical dexamethasone for adults it 1 application for the affected area 2 to 3 times per day until symptoms improve. This should be done under medical supervision. 

You should wash your hands after applying the cream, unless it is being used to treat the skin on your hands. 

In addition, you should avoid covering the treatment area, unless advised by the doctor. Covering the skin can increase absorption rates, resulting in non-intended side-effects. 

Possible side effects 

The most common side effects of dexamethasone include fluid retention, congestive heart failure, alkalosis secondary to decreased potassium levels in the blood, increased blood pressure, muscular weakness, muscle mass loss, osteoporosis, bone fragility, gastrointestinal problems, delay in wound healing, skin weakness, acne, red spots on the skin, bruising, excessive sweating, dermatitis, itching or angioedema. 

In addition, it is also possible to experience seizures, increased intracranial pressure, headaches, depression, euphoria or psychotic disturbances, changes to the endocrine system, vision disturbances, reduced immunity, anaphylactic shock or an oral yeast infection. Other conditions include reduced lymphocyte and monocyte blood levels, cardiac arrhythmias, cardiomyopathy, allergic reactions, thromboembolism, weight gain, increased appetite, nausea or general malaise.

Who should not take it

Dexamethasone should no be used by people with system fungal infections, sulfite allergies, or allergies to any other components present in the medication. In addition, it should not be administered in people who were recently injected with a liver vaccine. 

Women who are pregnant or breastfeeding should only take this medication as indicated by their doctor.