Raised Intracranial Pressure
Dexamethasone (combined as needed with an opioid) is the most effective drug for relieving pain caused by raised intracranial pressure in patients for whom no other definitive therapies are indicated or justified by their prognosis. When patients who are receiving home care need a steroid but cannot swallow, it may given into the subcutaneous (SC) tissue.
Many palliative care specialists recommend once-a-day administration of dexamethasone because of its relatively long half-life and side effects, which include sleep impairment.
When raised intracranial pressure is associated with a rapid deterioration in the patient's mental status, a large increase in the opioid dosage may be more appropriate than initiating corticosteroid therapy.