Given the long half-life of dexamethasone, what is an appropriate dose schedule?
For a patient receiving 16 mg/day, it is frequently prescribed as 4 mg q 6 hrs. This results in the patient being awoken at night, when sleep disturbance is already an issue.
Is 4 mg QID or 8 mg BID equally effective?
Answer from: Radiation Oncologist at Community Practice
After a discussion years ago with my fellowship-trained Neuro-oncologist friend (from Neurology track), I use dexamethasone only ever on a qam schedule. It doesn’t disrupt the sleep as much, there’s no waking for doses, the schedule is easy for patients and families to remember. In seven...
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Radiation Oncologist at Ohio State University James Cancer Center One other important point is that there are pharma...
Radiation Oncologist at University of Louisville School of Medicine I totally agree. I frequently saw patients who had...
Radiation Oncologist at UCLA | VA Greater Los Angeles Healthcare System Don't forget to prescribe a PPI. A gastric ulcer i...
Answer from: Radiation Oncologist at Community Practice
Hi @Thomas D. Wynne, I agree that waking patients at night for a Q6H dose is poor medicine. For higher dose decadron, I try to keep it 4mg TID after food. 25% less medication (TID) is unlikely to make a major difference compared to QID.
Once I get to BID decadron, I tell patients to take it after b...
Answer from: Radiation Oncologist at Academic Institution
I agree with the answers above that it is fine (preferable) to use less frequent dosing. I do once in the morning or BID and typically no more than 4-8 mg per day. This is also the practice of my colleagues in rad onc and neuro-oncology here.The half life is listed at 1.8-3.5 hours (Medscape), but t...
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Radiation Oncologist at Summit Medical Center I have seen multiple patients with brain mets or G...
Radiation Oncologist at UC San Diego Emphasis on “typically.” As with all t...
Radiation Oncologist at Weatherby Health Care Anyone on steroids for longer than 2 weeks also ne...
One other important point is that there are pharma...
I totally agree. I frequently saw patients who had...
Don't forget to prescribe a PPI. A gastric ulcer i...