Corticosteroids for life-threatening malignancy-related superior vena cava obstruction in palliative care
Evidence for use of corticosteroids and their dosing is unclear; however, they can be trialled as a temporising option in life-threatening situations while specialist advice is being sought and discussions about prognosis with family or carers occur. Dosing varies in practice.
For patients with palliative care needs who have life-threatening malignancy-related superior vena cava obstruction, consider:
dexamethasone 8 to 16 mg intravenously or subcutaneously, as a single dose while seeking specialist advice. dexamethasone
If dexamethasone is unavailable, an equivalent dose of another parenteral corticosteroid may be used initially—see Approximate relative potency and
duration of effect of glucocorticoids in the Bone and Metabolism guidelines for approximate relative potencies of oral and intravenous corticosteroids.