Dexamethasone in emesis

Dexamethasone in cytotoxic drug-induced emesis

Highly potent corticosteroids like dexamethasone are useful agents for the treatment of both acute and delayed chemotherapy-induced emesis.

Acute emesis is thought to be reduced by a decrease in chemotherapy-induced 5-HT release from peripheral blood mononuclear cells. Recent experiments indicate that dexamethasone’s acute and delayed antiemetic actions may be at least partially due to its activity in the central nervous system (CNS).


However, there is little evidence for any of the postulated mechanisms:

  1. a blockade of prostanoid synthesis
  2. prevention of direct chemotherapy-induced toxicity to the medulla oblongata
  3. activation of glucocorticoid receptors in the nucleus tractus solitarius (in the medulla)