This Health Facts for You will explain how to prepare and inject dexamethasone. Please review the steps every few months so that you are ready if you need to give an injection.

When to Give Injection

You should give an injectable stress dosing if your child:

  • Cannot take hydrocortisone by mouth.

  • Vomits more than once.

  • Is weak, unconscious or cannot wake up easily.

If your child is severely injured, or appears very ill (pale, sweaty, slow to respond):

  1. First, give injection of medicine

  2. Then, call 911


Only give the amount prescribed by your child’s doctor or nurse.

  • For ages over 5 years old, give all of the medicine (1 ml).

  • For ages 3 years old to 5 years old, give half the medicine (0.5 ml).

  • For ages less than 3 years old, give a quarter the medicine (0.25 ml).

Storage and Replacement

Keep stress dosing supplies together and ready to use (example: in a small plastic container).

Supplies include:

  • Vial(s) of dexamethasone

  • Syringes and needles

  • Alcohol wipes

  • This handout

Unused vials: Store at room temperature (less than 86º F) in a dark, dry area.

Opened vials: After the vial is opened, label the vial with the date and time. Once opened, the solution is good for only 24 hours. Keep it at room temperature.

Expiration dates: Check the expiration date on the vials. Call for a new prescription if the date is near.

How to Prepare a Dose of Dexamethasone


  • 1 vial of dexamethasone

  • Alcohol wipe

  • 3 ml syringe

  • ____ inch needle

Steps for Preparing Syringe

  1. Wash your hands.

  2. Remove the plastic tab on the top of the bottle.

  3. Wipe the top of rubber stopper with an alcohol wipe.

  4. Connect the needle and syringe. To draw air into syringe, pull plunger of the syringe down to the ____ml mark. Remove the needle cap and insert needle straight through the center of the stopper until you see the needle tip. Inject air into the vial. Do not remove the needle.

  5. Turn the vial and syringe upside down. Keeping the tip of the needle inside the liquid medicine, draw up ____ml of medicine into the syringe.

  6. Remove the needle and syringe from the vial. If you see any large air bubbles in the syringe, point the needle upright and carefully press on plunger until the air space is gone. The syringe is now ready to inject.

How to Inject

  1. Pick an injection site on the thigh (see picture).


  2. Clean the site with an alcohol wipe.

  3. Hold syringe like a dart at a 90º angle to the site.

  4. With your other hand, hold the muscle firmly at the site.

  5. Insert the needle straight into the skin with a quick firm motion.

  6. Slowly push down on plunger until the syringe is empty.

  7. Remove the needle quickly (at the same angle it was inserted). Apply gentle pressure to site with alcohol wipe, cotton ball, or gauze. The site may bleed a bit.

  8. Throw out the needle and syringe in a puncture proof container (like a liquid detergent bottle or Sharps container).

To Learn More

Ask about Health Facts for You #4424 “Guidelines for Cortisol or Steroid Dependent Children.”