Dexamethasone for brain tumor treatment

for patients not previously on steroids:

○ adult: 10 mg IVP loading, then 6 mg PO/IVP q 6 hrs ^{1) 2)} In cases with severe vasogenic edema, doses up to 10 mg q 4 hrs may be used

○ peds: 0.5–1 mg/kg IVP loading, then 0.25–0.5 mg/kg/d PO/IVP divided q 6 hrs. NB: avoid prolonged treatment because of growth suppressant effect in children

● for patients already on steroids:

○ for acute deterioration, a dose of approximately double the usual dose should be tried

Vasogenic edema: blood-brain barrier disrupted. Protein (serum) leaks out of the vascular system and therefore may enhance imaging. Extracellular space (ECS) expands. Cells are stable. Responds to corticosteroids (e.g. dexamethasone). Seen e.g. surrounding brain metastases.

see Dexamethasone for brain metastases