Dexamethasone may be given prior to chemotherapy to help ease side effects, such as nausea and vomiting. However, it isn’t needed for all types of chemotherapy.

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Dexamethasone is a medication that has many uses. In some cases, it may be given to people who are undergoing chemotherapy treatment for cancer.

This article will help explain why dexamethasone is sometimes given to people prior to chemotherapy, how it’s administered, and what the side effects may be.

Dexamethasone is a steroid medication. It’s similar to a hormone that your body produces naturally that can help reduce inflammation and ease your immune response.

Dexamethasone can be used to treat nausea and vomiting after surgery. It can also be used with chemotherapy, especially for certain cancers like lung, breast, and pancreatic cancer.

Chemotherapy or chemo, is a powerful medication that’s used to slow or stop the growth of cancer cells. This class of medication is an effective cancer treatment that works by destroying rapidly-growing cancer cells.

But chemo drugs can’t tell the difference between cancerous and noncancerous fast-growing cells in the body. The result of this systemic effect can lead to side effects, including nausea and vomiting.

Dexamethasone can help prevent nausea and vomiting when given alongside chemotherapy.

There’s also some research that suggests dexamethasone may help decrease mortality rates in people undergoing certain types of cancer surgeries.

However, some reports have raised concerns that dexamethasone may make certain chemotherapy treatments less effective, particularly when chemotherapy is combined with immunotherapies.

What types of chemotherapy drugs may require dexamethasone?

The American Society of Clinical Oncology (ASCO) recommends dexamethasone as part of a preventive strategy for nausea and vomiting with the following chemotherapies:

Dosing and even prescribing recommendations can vary based on the likelihood of these different therapies causing nausea. For example, cisplatin has a high risk of causing nausea, while oxaliplatin has a lower risk, according to ASCO.

Treatment with dexamethasone isn’t necessary when only immunotherapy is used but according to ACSO, the addition of immunotherapy is not a reason to withhold dexamethasone at this time.

Despite suggestions that dexamethasone could potentially have a negative effect on chemotherapies combined with immunotherapies, ASCO still recommends using this medication alongside chemotherapy drugs that have a high risk of causing nausea and vomiting.

Dexamethasone as a cancer treatment

In addition to being used to treat nausea and vomiting caused by chemotherapy, dexamethasone is also sometimes used as a cancer treatment itself.

It may be combined with other medications for the treatment of cancers, such as:

Beyond some types of cancer, dexamethasone may also be prescribed to treat other medical conditions, such as:

Dexamethasone is available in several forms, including oral tablets or liquids and intravenous (IV) injections.

When given as a medication alongside chemotherapy, dexamethasone is usually administered as an IV medication. It’s typically combined with other medications on the first day of chemotherapy.

Dexamethasone may be combined with other medications that relieve nausea, including NK-1 antagonists and 5-HT-3 receptor antagonists.

Olanzapine, an antipsychotic medication, may also be used off-label with dexamethasone to relieve nausea and vomiting related to chemotherapy.

Additional doses of one or all of these medications may be given in the days following chemo treatment depending on the degree of nausea caused by the chemo drugs.

Some possible side effects of dexamethasone include:

  • stomach upset
  • vomiting
  • dizziness
  • headache
  • insomnia
  • restlessness
  • depression
  • anxiety
  • acne
  • faster hair growth
  • easily bruised skin
  • menstruation changes

Some side effects may be more serious. Let your healthcare team know if you notice any of the following side effects:

  • skin rashes
  • swelling of the face, legs, or ankles
  • vision changes
  • ongoing or frequent infections
  • muscle weakness
  • black or tarry stools

Dexamethasone is a medication that can help ease chemotherapy-induced nausea and vomiting.

Depending on the type of chemotherapy you need, and how likely you are to experience chemo-induced nausea and vomiting, your oncologist may or may not recommend dexamethasone.

Be sure to talk with your oncologist or healthcare team if you have questions about the use of dexamethasone with chemotherapy.