Anchor
Glucocorticoid

Dexamethasone

DecadronDex

How it works

Potent anti-inflammatory and anti-emetic. Used as premedication before chemo to reduce infusion reactions and nausea.

Prophylactic dex is standard on chemo days. The post-pulse symptom window — most commonly D3-D5 — is well documented (Vardy 2006: 45% insomnia, 27% agitation, 27% dyspepsia). Normalize it; surface a mood check-in.

Dosing

Typical doses

  • 8 mg on chemo day (BD)
  • 4 mg BD D1–D3

Schedule

  • D1–D2 of cycle (tapered by D3)
    cycle_linked

Side Effects

  • Insomnia (if given in evening)
  • Increased appetite, mood elevation
  • Hyperglycemia (especially in diabetics)
  • Mild gastric upset
  • Steroid crash (D3–D5): depression, tearfulness, irritability
  • Long-term use: osteoporosis, immunosuppression, muscle wasting

Monitoring

  • Give in morning (08:00) to avoid evening insomnia
  • Taper rather than stop abruptly (adrenal suppression risk)