Patients can eat and drink normally and take all their usual medications prior to the test. Estrogen containing medications, including the contraceptive pill and hormone replacement therapy, should be stopped for six weeks prior to measuring serum cortisol. This is because estrogen induces cortisol binding globulin and leads to elevations in measured serum cortisol. Any steroid containing medications should also be documented, and avoided if possible, as they may interfere with the hypothalamo-pituitary-adrenal axis, or cross react with the cortisol assay.
Dexamethasone Tablets are available in , , 1, , 2, 4 and 6 mg strengths. The initial dosage for Dexamethasone varies from .75 to 9 mg a day depending on the disease being treated. Infants born to mothers who have received substantial doses of corticosteroids during pregnancy should be carefully observed for signs of hypoadrenalism. Because of the potential for serious adverse reactions in nursing infants from corticosteroids, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother. Use in pediatric patients is recommended to be done in consultation with a pediatric specialist.