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Corticosteroid (Antiemetic)

Dexamethasone (PONV Prevention)

Brand names: Dexamethasone (generic)

Dexamethasone is a long-acting corticosteroid given as a single intravenous dose at induction of anaesthesia to prevent postoperative nausea and vomiting, often combined with another antiemetic.

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.

Clinical monograph

How it works

Its precise antiemetic mechanism is unclear but is thought to involve central anti-inflammatory and prostaglandin-modulating effects; it also has analgesic-sparing properties.

Prescribing in practice

  • A single perioperative dose causes a transient rise in blood glucose, so anticipate and monitor hyperglycaemia particularly in patients with diabetes.
  • Rapid intravenous injection can cause an unpleasant transient perineal or genital sensation, so give slowly after induction.
  • Even a single dose is best avoided or used cautiously where there is active untreated systemic infection.

Monitoring

Monitor postoperative nausea and capillary blood glucose, especially in patients with diabetes or impaired glucose tolerance.

Counselling the patient

  • This single dose is given during your anaesthetic to help prevent sickness afterwards.
  • Your blood sugar may be checked, particularly if you have diabetes.

Evidence & guidelines

Single-dose dexamethasone for PONV prophylaxis is endorsed by consensus antiemetic guidelines and supported by multiple randomised trials.

Reference: Apfel CC et al PONV Risk Score; SAMBA PONV Guidelines 2020; 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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