Hello, I read your message and understood your problem. Dexamethasone can cause hoarseness in voice especially in women who are over 60. But can happen to all people and it is not very common as a side effect and it is an important issue. I need to know about your general health to complete my opinion. What other diseases you have and what other medications you take? Maybe the hoarseness of voice is not because of dexamethasone use itself but because of something else. If it is due to the dexamethasone use for sure, there is nothing to worry about because it is just a minor effect and it will go away as the time passes. As about the dosage, you are not taking a large dose. The initial doses of dexamethasone are 0.75-9 mg daily. Four tablets of 4 mg each make a normal daily dose of just 8 mg daily. Please, take the drug as prescribed once daily. Do not separate the dose throughout the day without consulting your doctor. The dexamethasone drug may cause side effects in your heart like fast heart beats, bradycardia, and arrhythmias. If you have not had any heart troubles before and you do not suffer from any heart disease and noticed the fast heart beating only after the use of this drug consult your doctor for the option to change the drug as the side effects are present. But do not decide by your own. Hope this is helpful for you.