Canterbury DHB
Dexamethasone and prednisone are the medications of choice.
These are particularly useful for pain related to:
It is advisable to use a high dose initially in order to gain symptomatic benefit as soon as possible e.g. dexamethasone 8 16 mg daily po or subcut infusion.
This can be given as a 5 -10 day trial and then stopped if not effective. If continued longer the dose must be tapered not stopped immediately.
If effective the dose should be reduced as low as possible to minimise side effects. Beware for hyperglycaemia regular review is essential.
It is preferable to give the dose as a once daily mane dose or divided mane and midday to mimic the physiologic release of steroid and minimize insomnia.
Note: An important side effect in patients with high dose steroids is paranoia/mania and depression.
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Topic Code: 4066