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Dexamethasone Taper — SCE Medical Oncology MCQ

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ModerateSupportive & Palliative OncologyDexamethasone TaperSCE Medical Oncology

A 60-year-old woman with cancer on high-dose dexamethasone needs to stop steroids before ICI. How should dexamethasone be tapered?

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Correct answer: C — Taper gradually (reduce 1-2 mg every 3-5 days) aiming for ≤10 mg prednisolone equivalent before ICI — abrupt cessation risks adrenal crisis after prolonged use

Prolonged dexamethasone (>3 weeks supraphysiological) suppresses HPA. Taper: reduce 1-2mg every 3-7 days. Target ≤10mg prednisolone equivalent (≤1.5mg dexamethasone) before ICI start.

Reference: BNF; ESMO irAE/Brain Mets