Hi Cassy,

With a BSA of 0.97 m2, at a dose of 0.25 mg/m2/day, I get that your daughter needs approx. 0.24 mg per day, which is equiv. to 2.4 ml. This is essentially the same answer as what you got. However, it is only HALF the amount that her endo seems to be prescribing.

A couple of things that might be happening here. Your endo MIGHT be trying to equate your daughter’s current hydro dose to an equivalent dex dose by using a 40:1 relative equivalency. This is not accurate, when treating CAH, when closer to an 80:1 equivalency should be used.

Sooo...you might want to ask him/her, why such a large dose? Looked at a different way, the dose he is prescribing is approximately 0.5 mg/m2/day. This is much much higher than generally recommended these days, when using dex to treat CAH kids.

As for time of administration: suppression of excess androgens can probably be achieved whether the dose is given at night or in the morning. However, it is my personal opinion that there will be fewer side effects of the medication, if the dose is given in the morning.

As an aside, my son also takes liquid dex and has been doing so for almost 7 years. So, this is also from my personal experience and observation.