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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 — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

DOSAGE AND ADMINISTRATION For Oral Administration The initial dosage varies from 0.75 to 9 mg a day depending on the disease being treated. It Should Be Emphasized That Dosage Requirements Are Variable And Must Be Individualized On The Basis Of The Disease Under Treatment And The Response Of The Patient. After a favorable response is noted, the proper maintenance dosage should be determined by decreasing the initial drug dosage in small decrements at appropriate time intervals until the lowest dosage that maintains an adequate clinical response is reached. Situations which may make dosage adjustments necessary are changes in clinical status secondary to remissions or exacerbations in the …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2025-10-29. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

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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