Dexamethasone IM Dosing Guidelines

Condition-Specific Dosing

The National Comprehensive Cancer Network (NCCN) guidelines recommend 10 mg IV/IM every 24 hours for Grade 1 cytokine release syndrome (CRS) 2
For Grade 2 CRS, the NCCN guidelines suggest 10 mg IV every 12-24 hours for persistent refractory hypotension after anti-IL-6 therapy 2, 3
The NCCN guidelines recommend 10 mg IV every 6 hours for Grade 3 CRS 3
For Grade 4 CRS, the NCCN guidelines recommend 10 mg IV every 6 hours, and if refractory, escalate to methylprednisolone 1000 mg/day 3
Antifungal prophylaxis should be strongly considered in patients receiving prolonged steroids for immunotherapy toxicities, according to the NCCN guidelines 1

The risk of adrenal suppression occurs with 1 mg and 4 mg doses but resolves within 48 hours of discontinuation, although the exact citation for this fact is not provided, a similar fact is mentioned in relation to the NCCN guidelines for immunotherapy-related toxicities 1