What is the recommended dose of dexamethasone (corticosteroid) for a sore throat?

Dexamethasone Dosing for Sore Throat

A single dose of oral dexamethasone at 10 mg is recommended for adults with sore throat to provide effective symptom relief. 1, 2

Evidence-Based Recommendations

• A single low-dose corticosteroid treatment provides significant pain relief for patients with sore throat, with benefits seen within 24-48 hours 1
• The most commonly studied and effective dose for adults is 10 mg oral dexamethasone 2
• For children (5-18 years), the recommended dose is 0.6 mg/kg with a maximum of 10 mg 3

Mechanism and Efficacy

• Dexamethasone provides symptomatic relief through its anti-inflammatory properties, reducing pharyngeal inflammation and associated pain 1
• Patients receiving dexamethasone experience:
  • Twice the likelihood of pain relief at 24 hours compared to placebo (relative risk 2.2) 1
  • 1.5 times higher chance of complete pain resolution at 48 hours 1
  • Earlier onset of pain relief (by approximately 4.8 hours) 1
  • Earlier complete resolution of pain (by approximately 11.1 hours) 1

Administration Details

• Route of administration: Oral administration is preferred and equally effective as intramuscular injection 4
• Frequency: Single-dose administration is sufficient for most cases 2
• Timing: Administer at initial presentation/diagnosis for maximum benefit 2, 4

Special Considerations

• For severe cases or when oral administration is not possible, intramuscular dexamethasone at 8 mg can be considered 4
• While some studies have explored 3-day dexamethasone regimens, a single dose is generally sufficient for most patients 5
• Dexamethasone can be used as a standalone treatment or as an adjunct to antibiotics when indicated for bacterial pharyngitis 4

Safety Profile

• Single low-dose corticosteroid treatment has not been associated with significant adverse effects 1
• Studies report no increase in serious adverse events compared to placebo 1, 2
• The safety profile of single-dose dexamethasone is well-established, with minimal risk of complications 1

Clinical Pearls

• Dexamethasone is particularly effective for moderate to severe pharyngitis with significant pain and inflammation 3
• The benefits of dexamethasone are seen in both bacterial and viral pharyngitis, though some studies suggest greater benefit in non-streptococcal cases 3
• Consider dexamethasone as a first-line symptomatic treatment option to reduce pain and improve quality of life during acute pharyngitis 1, 2