Given the long half-life of dexamethasone, what is an appropriate dose schedule?

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 years of pr...

Hi @Dr. First Last, 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 bre...

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...