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Dexamethasone- Best Time- Myeloma-

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My experience as a myeloma patient as well as my research is that the best time to take dexamethasone is in the morning with light food or drink.

Probably the most common question I read in online MM groups is about dexamethasone. The two single greatest issues with dex are

  1. inability to sleep after dexamethasone administration and/or
  2. blood glucose increases causing diabetes

When I was prescribed dexamethasone with my induction chemotherapy regimen I was told to take 40 mg. a week. The common prescription for dex with a myeloma patient’s induction therapy these days is usually 20 mg. If the MM patient is elderly (75 years of age or older), they might be prescribed 5-10 mg. of dex. or none at all.

My point is that dexamethasone dosing has been steadily decreasing for years now. This is no wonder if you read the risks listed below- immunosuppression and osteoporosis!?

What are the risks and benefits of dexamethasone?

Dexamethasone is a corticosteroid medication that is used to treat various conditions due to its anti-inflammatory and immunosuppressive effects. It’s important to note that the risks and benefits of dexamethasone can vary depending on the specific medical condition being treated. Here are some general considerations:


  1. Anti-Inflammatory Properties: Dexamethasone is effective in reducing inflammation, which makes it valuable in treating conditions such as arthritis, allergic reactions, and certain skin disorders.
  2. Immunosuppression: It can suppress the immune system, which is beneficial in conditions where the immune system is overactive, such as autoimmune diseases.
  3. Respiratory Conditions: Dexamethasone has been shown to be beneficial in certain respiratory conditions, including severe cases of COVID-19. Studies have suggested that it may reduce mortality in critically ill COVID-19 patients by modulating the immune response.


  1. Adrenal Suppression: Prolonged use of dexamethasone can suppress the adrenal glands, leading to a reduction in the body’s natural production of cortisol. Abrupt discontinuation of the medication may result in adrenal insufficiency.
  2. Infection Risk: Dexamethasone’s immunosuppressive effects can increase the risk of infections. Patients taking the medication should be monitored for signs of infections, and vaccinations may be less effective during treatment.
  3. Osteoporosis: Long-term use of dexamethasone can lead to bone loss and an increased risk of osteoporosis.
  4. Glucose Intolerance: Dexamethasone can elevate blood sugar levels, leading to glucose intolerance and an increased risk of diabetes, especially in individuals with pre-existing conditions.

After reading the second study linked and excerpted below, I have to wonder why dexamethasone is prescribed to myeloma patients at all? The study clearly states “Curcumin, when used in a combination regimen in multiple myeloma patients, has comparable progression‐free survival without the adverse effects of steroid‐based combination therapies…”

If you are a newly diagnosed myeloma patient with bone damage or if you are a myeloma patient who is experiencing a low white blood cell count from your chemotherapy, consider asking your oncologist if you can reduce you dose of dexamethasone as much as possible while adding curcumin to your regimen.

Are you a newly diagnosed myeloma patient struggling with dexamethasone? Let me know- David.PeopleBeatingCancer@gmail.com


David Emerson

  • MM Survivor
  • MM Cancer Coach
  • Director PeopleBeatingCancer

Dexamethasone (Decadron®)

Pronounce: deks a METH a sone

Classification: Glucocorticoid

About: Dexamethasone (Decadron®)

Dexamethasone is a corticosteroid, similar to a hormone that is made naturally in your body. Corticosteroids (sometimes called “steroids”) are used to decrease inflammation (swelling and/or redness)…

Dexamethasone may be given to prevent a reaction to a medication, prevent or decrease nausea, or be used in high doses to treat certain cancers…

Oral tablet form dexamethasone is best taken with food, as it can bother your stomach. Oral dexamethasone liquid should be mixed with other liquids like water, juices, or soda, or semi-solid food like applesauce or pudding. Your provider will probably tell you to take your dose(s) of dexamethasone at certain time(s) of the day every day. Your dose will depend on what the medication is being used for. Serious side effects can occur if you stop dexamethasone abruptly. Do not stop taking this medication or change your dose without direction from your healthcare team.

It is important to make sure you are taking the correct amount of medication every time. Before every dose, check that what you are taking matches what you have been prescribed…

Certain medications can interfere with oral and liquid dexamethasone, so make sure your provider is aware of all the medications, vitamins, and supplements you are taking.

You, or anyone you live with, should avoid having live or live-attenuated vaccines while receiving this medication on a long-term basis. These include herpes zoster (Zostavax) for shingles prevention, oral polio, measles, nasal flu vaccine (FluMist®), rotavirus, and yellow fever vaccines…”

Use of Curcumin in Multiple Myeloma patients intolerant of steroid therapy

Curcumin, when used in a combination regimen in multiple myeloma patients, has comparable progression‐free survival without the adverse effects of steroid‐based combination therapies that is curcumin may be a viable alternative to corticosteroids in combination with an immunomodulatory drug or proteasome inhibitor…

This is the first reported case series of patients with MM who have been treated with adjuvant curcumin as opposed to Dex in combination with other antimyeloma agents. Curcumin‐based combination therapies may be capable of stabilizing disease progression without the adverse effects associated with steroid use. In our experience, the only observed side effect of curcumin is diarrhea which can be managed by either temporarily suspending therapy or reducing the dose. Therefore, curcumin can be considered to have comparatively minimal adverse effects and superior tolerability to typical steroid medications, such as commonly used dexamethasone…

Consequently, curcumin possesses the potential to impede myeloma activity and improve the quality of life in MM patients. Further randomized controlled trials should aim to elucidate and replicate the findings of this study…”



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