Pulsed Dexamethasone Administration Guidelines

Rationale for Once Daily Dosing

The British Association of Dermatologists recommends pulsed dexamethasone as an intermittent administration of high doses given on one to five consecutive days without recommending dose splitting 2
The British Association of Dermatologists' 2017 guidelines define pulsed corticosteroid therapy as administration on up to five consecutive days without mentioning divided dosing 1

For pulsed therapy in pemphigus vulgaris, dexamethasone is typically administered at doses of 100-300 mg per day for 1-5 consecutive days, as recommended by the British Association of Dermatologists 1, 2
For antiemetic purposes, the American Society of Clinical Oncology recommends dexamethasone as a single daily dose rather than divided doses 4, 5
For sudden hearing loss, the American Academy of Otolaryngology-Head and Neck Surgery recommends high-dose dexamethasone (10 mg/day) as a single dose rather than divided 6

The British Association of Dermatologists advises not to confuse pulsed dexamethasone protocols with continuous corticosteroid regimens that may require tapering, with a strength of evidence based on clinical guidelines 3