Page 111 - 2026 SMOG

DEXAMETHASONE (DECADRON)
Class/Mechanism of Action
• Synthetic glucocorticoid steroid
Anti-inflammatory, immunosuppressant.
˚ Onset of action—IV: Rapid; Duration—IV: 72hr
Indications
• Labeled Indications
˚ Anti-inflammatory or immunosuppressant in treatment of a variety of diseases: allergic,
dermatologic, endocrine, hematologic, inflammatory, neoplastic, renal, respiratory,
rheumatic, and autoimmune
˚ Management of cerebral edema
• Off-Label Indications
˚ Treatment of acute mountain sickness (AMS) and high-altitude cerebral edema
Contraindications
• Hypersensitivity to dexamethasone or any component of the formulation
• Systemic fungal infection
Adverse Reactions/Precautions
• Not for use in the treatment of head injury. Increased mortality has occurred in head injury
patients treated with a high dose of IV methylprednisolone. Do not use corticosteroids in
head injuries.
• May cause hyperglycemia/reduced glucose tolerance, especially in patients predisposed to
diabetes mellitus
• Pregnancy: Avoid chronic highdose use.
• Lactation: Single dose compatible
Dose/Administration
PEDIATRIC
ADULT
(Always reference Broselow Tape)
Acute Mountain Sickness (AMS) Upper Airway Edema in Croup/Acute
(Off-Label use) Asthma Exacerbation
• PO/IM/IV • PO/IV/IM
˚ 4mg q6hr. Continue until 24hr after ˚ 0.6mg/kg as one dose for croup
and q24hr for asthma exacerbation
symptoms resolve or descent is completed
(not longer than 7 days total) (max dose: 16mg)
High Altitude Cerebral Edema (HACE) Acute Mountain Sickness (AMS),
(Off-Label use) High Altitude Cerebral Edema (HACE)
• PO/IM/IV (Off-Label use)
˚ 8mg as a single dose, followed by 4mg • PO/IM/IV
˚
0.15mg/kg/dose q6hr (max: 4mg/dose)
q6hr until descent is complete and
symptoms resolve Note: Consider use in possible High Altitude
Pulmonary Edema because of the associated
cerebral edema with pulmonary edema

2026 Standard Medical Operating Guidelines (SMOG) • 103