Corticosteroid therapy for emergency management of malignant spinal cord compression in palliative care

If corticosteroid therapy is indicated for emergency management of malignant spinal cord compression in palliative care (see Approach to managing malignant spinal cord compression in palliative care), seek specialist advice if possible.

Evidence to guide corticosteroid dosage for malignant spinal cord compression is unclear; doses at the lower end of the range below may be as effective as the higher doses, with higher doses associated with an increased risk of adverse effects. UseKumar, 2017National Institute for Health and Care Excellence (NICE), 2008:

1dexamethasone 8 to 16 mg orally, as a single dose; see Ongoing corticosteroid therapy for malignant spinal cord compression in palliative care dexamethasone

OR

1dexamethasone 8 to 16 mg subcutaneously or intravenously, as a single dose; see Ongoing corticosteroid therapy for malignant spinal cord compression in palliative care. dexamethasone

If dexamethasone is unavailable, use an equivalent dose of another corticosteroid—see the Bone and Metabolism guidelines for approximate relative potencies of oral and intravenous corticosteroids.