Dexamethasone for Tonsillectomy Patient

These instructions are for Children’s Hospital of Philadelphia (CHOP) patients prescribed dexamethasone after a tonsillectomy.

Important information about dexamethasone:

• Dexamethasone is a steroid that reduces inflammation (swelling). This can help with pain relief. Your surgeon has prescribed dexamethasone for your child after their tonsillectomy or adenoidectomy. You may give this to your child if their pain increases. 

Instructions for giving dexamethasone:

• Give dexamethasone 48 to 72 hours (2-3 days) after surgery if the other pain treatments of celecoxib (Celebrex®) and acetaminophen (Tylenol®) or ibuprofen (Motrin®) and acetaminophen (Tylenol) do not relieve your child’s pain. 

• You will have a total of 3 doses which can be given every 48 to 72 hours as needed for pain. You do not need to give all 3 doses if your child is comfortable and drinking well on the other pain relievers.

• The medicine is a tablet. It can be crushed if your child is unable to swallow it whole.

• Place the tablet(s) in a Ziploc® bag and crush with the back of a spoon. Sprinkle or mix it in a spoonful of pudding or other soft food.

What are possible side effects of dexamethasone?

• Upset stomach, vomiting, headache, dizziness, restlessness, sweating, weight gain, trouble sleeping, hiccups.

When can I stop the dexamethasone? 

• If your child’s pain is relieved by other pain medicines such as Celebrex and Tylenol or Motrin and Tylenol, you may stop the dexamethasone. 

• After you have given all 3 doses of dexamethasone, stop this medicine.

• There is no need to start this medicine if your child’s pain is relieved by the other prescribed pain relievers.

Call your CHOP ENT team at 215-590-3440 for the following reasons:

• If the pharmacy has problems filling the medicine

• If your child refuses to take the medicine

• If the pain is not relieved by any of the provided pain measures

Reviewed February 2024 by Terri Giordano, DNP, CRNP, CORLN