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Systemic Corticosteroid

Dexamethasone (ICU / ARDS)

Brand names: Dexamethasone 3.3 mg/mL injection

Used in: Meningitis & Encephalitis

Dexamethasone is a potent, long-acting glucocorticoid with minimal mineralocorticoid activity, used for inflammatory and allergic conditions, raised intracranial pressure from tumour, croup, some chemotherapy-related nausea, and in COVID-19 requiring oxygen.

Dosing — not shown for this use

The product information we hold does not support a dose for this page's specific use, route or population, so none is shown. Follow your local or national guideline, and confirm against the product SmPC.

The licensed dosing — for the medicine's licensed uses, which may differ from this page's — is on Dexamethasone.

Clinical monograph

How it works

It activates glucocorticoid receptors to suppress inflammation and immune responses; its lack of mineralocorticoid effect is useful where fluid retention is undesirable.

Prescribing in practice

  • It is much more potent than prednisolone, so small numerical doses have large effects.
  • Do not stop abruptly after prolonged courses; the usual glucocorticoid adverse effects apply (hyperglycaemia, infection risk, mood, gastrointestinal).
  • Give it earlier in the day where possible to limit insomnia.

Monitoring

Monitor blood glucose and blood pressure; with longer courses consider infection and bone/gastric protection.

Counselling the patient

  • It can raise blood sugar and disturb sleep — take it in the morning if advised.
  • Do not stop a longer course suddenly; carry a steroid card if applicable.

Evidence & guidelines

Used across inflammatory, oncological and emergency indications (e.g. croup; and in COVID-19 needing oxygen, RECOVERY trial).

Reference: RECOVERY trial (Horby et al. NEJM 2021); DEXA-ARDS trial (Villar et al. 2020); NICE NG240 (Meningitis); WHO COVID-19 Therapeutics Guidelines 2023; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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