Choosing the right dose
Neurological
Spinal cord compression or cauda equina syndrome
Dexamethasone: 16mg/day
Symptoms secondary to cerebral tumour(s).
Dexamethasone: 16mg/day
(4mg-8mg often sufficient for headache. More than 16mg may be required for patients with high risk of coning, or those taking enzyme inducing medications e.g. phenytoin, carbamazepine, phenobarbitone)
Nerve compression pain
Dexamethasone: 8mg/day
Respiratory
Superior vena caval obstruction SVCO
Dexamethasone: 16mg/day
Pneumonitis after radiotherapy
Dexamethasone: 16mg/day
Lymphangitis carcinomatosa
Dexamethasone: 16mg/day
Large airways obstruction
Dexamethasone: 16mg/day
Gastrointestinal Tract
Dysphagia
Dexamethasone: 6mg-16mg/day
Intestinal obstruction
Dexamethasone: 6mg-16mg/day
Rectal discharge
Rectal corticosteroid preparations e.g. hydrocortisone or prednisolone foam enema, or prednisolone suppositories. Once at night.
Miscellaneous
Ureteric obstruction/pelvic disease.
Dexamethasone: 6mg–16mg/day
Pain from hepatic metastases
Dexamethasone: 4mg–8mg/day
Bone pain (occasionally helpful)
Dexamethasone: 4mg–8mg /day
Anti-emetic
Dexamethasone: 4mg–8mg /day
Anorexia/to improve wellbeing (short term)
Dexamethasone: 2mg–4mg / day Prednisolone 15mg–40mg/day