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Canterbury DHB

Corticosteroids

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.

Information about this Canterbury DHB document (4066):

Document Owner:

Palliative Care Service (see Who's Who)

Issue Date:

July 2009

Next Review:

July 2010

Note: Only the electronic version is controlled. Once printed, this is no longer a controlled document.

 

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Topic Code: 4066