Hi Julia,

We only have to give the dex once a day, in the morning.  I usually give Nick his meds, as soon as he wakes up, which is normally around 7 AM.  The dex stays in circulation for about 16 hours, so the levels drop off right around 11 PM, when cortisol levels are naturally very low, anyway. 

I feel that the way dex is naturally cleared out of the system, coupled with the fact that once/day dosing is very convenient, makes it a very attractive alternative to treatment with HC.  Don't be surprised, though, if you get a negative response from your endo, if you bring this up. Up till recently, dex has been considered "growth toxic" because its potency relative to HC has been misconstrued.  Small wonder that kids treated on dex were all oversuppressed---they were getting more than twice the amount of medication that they needed!  If you get past the first hurdle with your endo, and would like more information about dex treatment, please let me know.  I'll be happy to fill you in on any other details that you might need, at that time.