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Anyone taken a course similar to 196mg of Dexamethasone (eleven 6mg pills 3x a day)? Seems like a very high dose and I haven’t found many answers on here about the orals. Thanks!
@A MyMSTeam Member Yep. He confirmed and I started today. Keep your fingers crossed for me 🤞🏻. Thanks again for the calculations. Too bad I have to do this at home and on Thanksgiving, but hopefully it'll help keep a relapse away.
Yeah I would speak to him cause that is a really high dose, I understand the pharmacist’s hesitation cause that unusual. Doesnt necessarily mean its wrong its just not routinely done. Sometime even though you do the math converting one drug to another, there are differences between drugs and so the dose is often reduced on that basis. The problem is, as you’ve pointed out, there isnt really a consensus yet for oral steroid dosing like there is for IV in treatment of a relapse. I just did a quick search and there are a couple of papers one showing 16mg/day was successful, another which did look more comprehensive suggested 30mg/day for a week then tapering the dex is appropriate. That suggests to me you should be able to do a lower dose. But see what your neuro says.
I’d bet what your neuro did was do a direct conversion from IV solumedrol to oral dexamethasone. When you convert the dose, 1000mg of solumedrol is roughly equivalent to 188mg of dexamethasone which is kind of close to what your prescibed. I know 1000mg of solumedrol is high but thats standard dosing for MS so it doesnt seem so crazy as opposed to the dex version. Is there a reason you didnt want to do IV?
@A MyMSTeam Member I wasn’t given an IV option. My pharmacist didn’t want to fill it because of the high dose, my family is freaking out that I’m taking that much at a time, etc.
I’m going to call him Monday just to verify that he wants the 6mg tablets.
I appreciate your answer because there’s tons of people in the Q&A that have done the IV or say oral in high doses but don’t actually say the dosing. I just don’t want to end up in a hospital.
That’s a lot of dexamethasone, so its 6mg three times a day or are you saying 11 6mg tabs 3x a day is 66mg 3 times a day? If its the latter I have NEVER heard of a dose that big being given. As a point of reference, for swelling associated with brain tumors the typical dose is 4mg 3-4 times a day. I’d double check that for sure. Maybe it is a standard MS thing your neuro uses but man its a lot!
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