Dexamethasone Dosing for Vestibular Neuritis

Recommended Corticosteroid Regimen

The American Academy of Otolaryngology-Head and Neck Surgery recommends oral dexamethasone 10 mg/day for 5 days, followed by a tapering dose over the next 5 days for vestibular neuritis treatment 1
Alternative corticosteroid options include prednisone 60 mg/day (1 mg/kg/day, max 60 mg) for 5 days, then taper, and methylprednisolone 48 mg/day for 5 days, then taper 1

Monitor for common adverse effects of short-term corticosteroid use, including hyperglycemia and sleep disturbances 1

Underdosing is a common pitfall - ensure adequate initial dosing for maximum benefit 1
The commonly prescribed methylprednisolone dose pack provides insufficient total corticosteroid exposure compared to the recommended regimen 1
While serious side effects are rare with short-term corticosteroid use, patients should be monitored for adverse effects, particularly those with pre-existing conditions such as diabetes 1
Treatment benefits diminish when initiated after 72 hours from symptom onset, though some benefit has been reported up to 6 weeks 1