Dexamethasone
Adults 6 mg (oral or intravenous) once daily for 10 days.
N.B. If 10 day course is not completed as in-patient, complete on discharge.
IV administration should only be used where tablets or oral solution are not appropriate or not available.
Once the oral route is available, re-prescribe the drug with the oral dose (i.e. cannot prescribe the same dose as oral/IV ).
When prescribing dexamethasone, consult the manufacturer’s information.
Alternative options (if dexamethasone unsuitable or unavailable)
Prednisolone:
40mg orally once daily for 10 days (preferred in pregnancy – see link to RCOG guidance below)
Hydrocortisone:
Adults: 50mg given intravenously every 8 hours for 10 days. A longer duration (up to 28 days) can be considered in patients with septic shock (as per REMAP-CAP trial).
Other factors
- Consider the risk of bleeding if on concurrent anticoagulation/ antiplatelet/ other pro-haemorrhagic therapy (particularly in the elderly) and need for gastric ulcer protection with proton pump inhibitors according to local policy.
- Monitor blood glucose levels.
Dosage in pregnancy
Follow Royal College of Obstetrics and Gynaecology guidance