Dexamethasone

What is this medication for?

• Anti-inflammatory, immunosuppressive, diagnostic (ACTH suppression testing)

How is it given?

Give exactly as your veterinarian prescribed — never change the dose or stop on your own unless your veterinarian has told you to.

What if I miss a dose?

• Give it as soon as you remember — unless it is almost time for the next dose (then skip the missed one; never double up).
• Call your clinic if you miss more than one dose in a row.

Side effects — what should I watch for?

Effects listed as common in this handout

• None commonly reported; call your clinic with any concern.

Worth a phone call to your veterinarian

• PU/PD/PP, stomach/intestinal ulceration, hepatopathy (With sustained use)
• stomach/intestinal bleeding/colonic perforation (Documented risk in canine neurosurgical/spinal patients given high-dose dexamethasone)

⚠️ Contact your veterinarian or an emergency clinic IMMEDIATELY if you notice

• Hypotension, hemolysis, collapse (rapid into a vein of PEG-based solution) (Avoidable with slow administration/correct formulation)

Before starting (or refilling), tell your veterinarian if your pet:

• has or has had: Systemic fungal infection (unless Addison's replacement); into a muscle in idiopathic low platelet counts
• has or has had: Diabetic/cardiovascular-risk patients (potent hyperglycemic effect); causes more stomach/intestinal complications/bleeding than prednisone — prefer prednisone/prednisolone when high-dose steroid needed unless dexamethasone specifically indicated

• is pregnant, nursing, or used for breeding
• is taking any other medications, supplements, or flea/tick products, including:
  • NSAIDs
  • Ketoconazole, azole antifungals, macrolides
  • Phenobarbital, phenytoin, rifampin
  • Cyclosporine
  • Insulin
  • Live vaccines

Storage and handling

Room temperature, protect from light. Never give the polyethylene-glycol-based solution rapidly into a vein — use the sodium phosphate (water-soluble) form for into a vein administration.

Good to know

• Documented higher risk of stomach/intestinal bleeding and colonic perforation than prednisone/prednisolone in canine neurosurgical/spinal cord trauma patients — limit dose and duration in these cases, or use prednisone/prednisolone instead where clinically appropriate.
• Current evidence does not support high-dose "shock dose" steroids for CNS trauma, spinal injury, or septic shock — avoid this outdated practice.
• Confirm which formulation (sodium phosphate vs. PEG-based solution) is on hand before choosing into a vein administration.