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Antiemetic

Dexamethasone

Synthetic glucocorticoid · Decadron

Mechanism: Unclear antiemetic mechanism; anti-inflammatory.

Calculate dose for your patient

Enter weight (kg or lb). Always verify before administration.

Computed weight
70.0 kg · 154.3 lb
PONV prophylaxis
7.0 mg – 11 mg
= 1.75–2.63 mL (4 mg/mL)
Exceeds typical adult max 8 mg — cap and reassess.
Give post-induction (perineal itch if awake).

Weight is saved on this device for the next calculator you open.

Full dose calculator
Onset
Hours (analgesic effect ~1 h)
Duration
24+ h
Metabolism
Hepatic.

Dosing

Adult
PONV: 4–8 mg IV at induction.
Pediatric
0.15 mg/kg IV (max 8 mg).

Indications

  • PONV prophylaxis
  • Airway edema
  • Adjunct analgesia

Contraindications

  • Systemic fungal infection

Side Effects

  • Transient hyperglycemia
  • Perineal burning on rapid push

Clinical Pearls

1Synergistic with ondansetron — combine for high-risk PONV patients.

References & Further Reading

  1. 1
    Textbook

    Flood P, Rathmell JP, Shafer S. Stoelting's Pharmacology and Physiology in Anesthetic Practice. 5th ed. Philadelphia: Wolters Kluwer; 2015.

  2. 2
    Journal

    Apfel CC, Läärä E, Koivuranta M, Greim CA, Roewer N. A simplified risk score for predicting postoperative nausea and vomiting. Anesthesiology. 1999;91(3):693-700.

  3. 3
    Journal

    Apfel CC, Korttila K, Abdalla M, et al. A factorial trial of six interventions for the prevention of postoperative nausea and vomiting (IMPACT). N Engl J Med. 2004;350(24):2441-2451.

  4. 4
    Textbook

    Gropper MA, Miller RD, Cohen NH, et al., eds. Miller's Anesthesia. 9th ed. Philadelphia: Elsevier; 2020.

  5. 5
    Textbook

    Adriano A, Morris R, eds. 2021 CA-1 Tutorial Textbook (15th Ed.). Stanford University Medical Center, Department of Anesthesiology.

Citations are provided to direct further study. Always check the most current edition of guidelines and society recommendations — the information in this chapter is a teaching summary, not primary source material.