Hormonal drugs are sometimes used to treat many diseases. They are synthetic analogues of hormones produced by the adrenal glands. Typically, such drugs easily bind to proteins and penetrate into the cells, so they quickly remove inflammation, pain, swelling, allergic reactions. One of the most common drugs that are used in emergency cases or as part of complex therapy is Dexamethasone. Its effectiveness is much higher than that of some other hormonal drugs, and its low price makes treatment affordable for every patient. Despite the presence of many side effects, Dexamethasone injections are often used, as they can significantly improve the patient's condition or even save his life.
General characteristics of the drug
Dexamethasone belongs to the group of glucocorticoids. It is a synthetic hormone of the adrenal cortex. The international non-proprietary name (briefly INN) is “Dexamethasone”, but you can purchase a medicine with this composition under the names Dexazone, Metazon, Maxidex. These are all drugs from the glucocorticoid group. They are used for many pathologies, as they affect the body at the cellular level.
Dexamethasone is the most popular drug in this group. Its advantages include a low price, a wide scope, the ability to use in the complex treatment of many diseases. In addition, the effectiveness of its use is higher than that of Cortisone by 30 times. This medicine is inexpensive, the price of packaging varies from 35 to 100 rubles, depending on the form of release and dosage.
This drug is available in ampoules, tablets and eye drops. In addition, it is added to some complex medicines for internal and external use. The solution for intravenous or intramuscular administration contains dexamethasone sodium phosphate, glycerin, disodium phosphate and water for injection.
Dexamethasone injections are done in cases where for some reason it is impossible to use tablets. Usually these are serious conditions, severe pain, serious allergic reactions. Injections are made no longer than 3-5 days, then, if necessary, they switch to oral administration of the drug.
A solution of Dexamethasone is administered intravenously or intramuscularly. It depends on the age of the patient and the severity of his condition. It is very important that the use of this drug be supervised by a doctor, as serious side effects may develop. Therefore, in pharmacies this medicine is sold only by prescription.
Dexamethasone is packaged in ampoules of 1 ml. The solution is usually clear, slightly yellowish. Each ampoule contains 4 mg of active substance. The package includes 10 or 20 ampoules embedded in the contour cells, as well as instructions for use. Each ampoule usually has a sticker with a name. Sometimes there is a dot or ring on them, indicating the location of the break. Otherwise, a scarifier for breaking off the tip of the ampoule is attached to the package.
Store Dexamethasone in a place inaccessible to children. This is not necessarily a refrigerator, the main thing is that the temperature does not exceed 25 degrees, but it is also impossible to freeze the drug. It is necessary to protect the solution from exposure to sunlight, so the ampoules should always be in sealed packaging. After opening, the solution is not subject to storage, it can no longer be used.
What effect does
The use of Dexamethasone injection is justified in many diseases. It is prescribed when another therapy is ineffective.This glucocorticoid is a popular remedy due to its strong anti-inflammatory, anti-stress and anti-shock effects. In addition, he has the ability to remove allergic reactions, activate metabolic processes and reduce the abnormal activity of the immune system.
The action of the drug with intramuscular administration occurs in 6-8 hours, so in emergency cases it is usually administered intravenously. And if it is impossible to use the drug orally, it is administered into soft tissues. With this method of entering the body, the active substance quickly reacts with the proteins of the cell receptors, which allows it to penetrate into the nucleus.
It turns out that the effect of the drug is manifested at the cellular level. This explains its effectiveness in many pathological conditions. Dexamethasone is able to regulate metabolic processes. It inhibits the production of certain enzymes that can slow down the metabolism or accelerate the breakdown of proteins. Due to this, the condition of cartilage tissue and bones improves.
In addition, the use of Dexamethasone can reduce the activity of white blood cells and the immune system. This helps to reduce the inflammatory process in autoimmune pathologies. And due to a decrease in vascular permeability, this medicine prevents the spread of inflammation.
Indications for use
Injections of this drug are used only for health reasons, usually after another treatment has been tried, which turned out to be ineffective. Doctors of the ambulance can give a Dexamethasone injection in case of a shock, impaired adrenal function, rapidly growing cerebral edema, for example, after a traumatic brain injury.
Indications for such treatment include brain tumors, meningitis, and radiation damage. The drug is used after injuries, surgeries, with tumors, allergies or inflammatory joint diseases.
The main indications for the use of Dexamethasone are various joint diseases. Glucocorticoids quickly relieve the inflammatory process and pain, so they are often prescribed when conventional therapy does not bring positive results. And Dexamethasone is more effective than other similar drugs, so sometimes one injection is enough.
This drug improves the patient's condition with rheumatoid arthritis, ankylosing spondylitis, scleroderma, systemic lupus erythematosus, psoriasis. It accelerates recovery from various inflammatory diseases, for example, with bursitis, polyarthritis, epicondylitis or synovitis.
Prolonged use of such injections or exceeding the recommended dose is unacceptable. The active substance of this drug can negatively affect the state of cartilage and even cause weakening or rupture of tendons. Therefore, with pathologies such as osteoarthritis or osteochondrosis, it is rarely used and only under the supervision of a doctor.
It inhibits the secretion of thyroid-stimulating hormone and follicle-stimulating hormone.
Increases the excitability of the central nervous system, reduces the number of lymphocytes and eosinophils, increases the number of red blood cells (stimulates the production of erythropoietins).
It interacts with specific cytoplasmic receptors and forms a complex that penetrates the cell nucleus, stimulates the synthesis of matrix ribonucleic acid (mRNA), the latter induces the formation of proteins, including lipocortin mediating cellular effects. Lipocortin inhibits phospholipase A2, inhibits the release of arachidonic acid and inhibits the synthesis of endoperoxides, prostaglandins, leukotrienes. contributing to inflammation, allergies and others.
Protein metabolism: reduces the amount of protein in plasma (due to globulins) with an increase in the albumin / globulin coefficient, increases the synthesis of albumin in the liver and kidneys, and enhances protein catabolism in muscle tissue.
Lipid metabolism: increases the synthesis of higher fatty acids and triglycerides, redistributes fat (fat accumulation mainly in the shoulder girdle, face, abdomen), leads to the development of hypercholesterolemia.
Carbohydrate metabolism: increases the absorption of carbohydrates from the gastrointestinal tract, increases the activity of glucose-6-phosphatase, which leads to an increase in the flow of glucose from the liver to the blood, increases the activity of phosphoenolpyruvate carboxylase and the synthesis of aminotransferases, leading to the activation of gluconeogenesis.
Water-electrolyte metabolism, retains sodium ions and water in the body, stimulates the excretion of potassium ions (mineralocorticosteroid activity), reduces the absorption of calcium ions from the gastrointestinal tract, “leaches” calcium ions from bones, increases the excretion of calcium ions by the kidneys.
The anti-inflammatory effect is associated with inhibition of the release of inflammatory mediators by eosinophils, inducing the formation of lipocortins and a decrease in the number of mast cells producing hyaluronic acid, with a decrease in capillary permeability, stabilization of cell membranes and organelle membranes (especially lysosomal).
The antiallergic effect develops as a result of suppression of the synthesis and secretion of allergy mediators, inhibition of the release of histamine and other biologically active substances from sensitized mast cells and basophils, and a decrease in the number of circulating basophils. inhibiting the development of lymphoid and connective tissue, reducing the number of T- and B-lymphocytes, mast cells, reducing the sensitivity of effector cells to allergy mediators, suppressing antibody formation, changing the body's immune response.
In chronic obstructive pulmonary disease, the action is mainly based on inhibition of inflammatory processes, inhibition of development or prevention of edema of the mucous membranes, inhibition of eosinophilic infiltration of the submucosal layer of the bronchial epithelium, deposition of circulating immune complexes in the bronchial mucosa, and inhibition of erosion and desquamation of the mucous membrane. Increases the sensitivity of beta-adrenergic receptors of small and medium caliber to endogenous catecholamines and exogenous sympathomimetics, reduces the viscosity of mucus due to inhibition or reduction of its production.
Antishock and antitoxic effects are associated with an increase in blood pressure (due to an increase in the concentration of circulating catecholamines and restoration of the sensitivity of adrenoreceptors to them, as well as vasoconstriction), a decrease in the permeability of the vascular wall, membrane-protective properties, and activation of liver enzymes involved in the metabolism of endo- and xenobiotics.
The immunosuppressive effect is due to inhibition of the release of cytokines (interleukin-1, interleukin-2, interferon gamma) from lymphocytes and macrophages.
Suppresses the synthesis and secretion of adrenocorticotropic hormone (ACTH). and secondly, the synthesis of endogenous glucocorticosteroids.
The peculiarity of the action is a significant inhibition of the pituitary function and the almost complete absence of mineralocorticosteroid activity. Doses of 1-1.5 mg / day inhibit the adrenal cortex, the biological half-life is 32-72 hours (the duration of inhibition of the hypothalamus-pituitary-cortical layer of the adrenal glands).
According to the strength of glucocorticoid activity, 0.5 mg of dexamethasone corresponds to approximately 3.5 mg of prednisolone, 15 mg of hydrocortisone or 17.5 mg of cortisone for oral dosage forms.
After oral administration, it is rapidly and completely absorbed, the maximum concentration of dexamethasone in the blood plasma is 1-2 hours.In the blood binds (60-70%) with a specific carrier protein - transcortin. It easily passes through the histohematological barriers (including through the blood-brain and placental barriers). It is metabolized in the liver (mainly by conjugation with glucuronic and sulfuric acids) to inactive metabolites. It is excreted by the kidneys (a small part - by the lactating glands). The elimination half-life is 3-5 hours.
Pre- and post-vaccination period (8 weeks before and 2 weeks after vaccination), lymphadenitis after BCG vaccination. Immunodeficiency states (including acquired immunodeficiency syndrome or human immunodeficiency virus (HIV infection).
Gastrointestinal tract diseases: gastric ulcer and 12 duodenal ulcer. esophagitis, gastritis, acute or latent peptic ulcer, recently created intestinal anastomosis, ulcerative colitis with the threat of perforation or abscess formation, diverticulum-
Diseases of the cardiovascular system, including recent myocardial infarction (in patients with acute and subacute myocardial infarction, the spread of the focus of necrosis, slowing of the formation of scar tissue and, as a result, rupture of the heart muscle), decompensated chronic heart failure, arterial hypertension, hyperlipidemia.
Endocrine diseases - diabetes mellitus (including impaired carbohydrate tolerance), thyrotoxicosis, hypothyroidism, Itsenko-Cushing's disease. obesity (stage 1II-1V).
Severe chronic renal and / or liver failure, nephrourolithiasis.
Hypoalbuminemia and conditions predisposing to its occurrence.
Systemic osteoporosis, myasthenia gravis, acute psychosis, polio (except for the form of bulbar encephalitis), open-angle and angle-closure glaucoma, lactation.
Dosage and administration:
The average daily dose is 0.75-9 mg. In severe cases, large doses can be used, divided into 3-4 doses. The maximum daily dose is usually 15 mg. After the therapeutic effect is achieved, the dose is gradually reduced (usually by 0.5 mg in 3 days) to a maintenance dose of 2-4.5 mg / day. The minimum effective dose is 0.5-1 mg / day.
Children (depending on age) are prescribed 83.3-333.3 mcg / kg or 2.5-10 mg / sq. m / day in 3-4 doses.
The duration of the use of dexamethasone depends on the nature of the pathological process and the effectiveness of treatment and ranges from several days to several months or more. Treatment is stopped gradually (at the end, several injections of corticotropin are prescribed).
With bronchial asthma, rheumatoid arthritis, ulcerative colitis - 1.5-3 mg / day, with systemic lupus erythematosus - 2-4.5 mg / day, with oncohematological diseases - 7.5-10 mg.
For the treatment of acute allergic diseases, it is advisable to combine parenteral and oral administration: 1 day - 4-8 mg parenterally, 2 day - inside. 4 mg 3 times a day, 3-4 days - inside. 4 mg 2 times a day, 5. 6 day - 4 mg / day. inside, day 7 - drug withdrawal.
Test with dexamethasone (Liddle test). It is carried out in the form of small and large tests. With a small test, dexamethasone is given to the patient at 0.5 mg every 6 hours for a day (i.e., at 8 a.m., at 14 p.m. and 2 p.m.). Urine for the determination of 17-hydroxycorticosteroids or free cortisol is collected from 8 a.m. to 8 a.m. 2 days before the appointment of dexamethasone and also 2 days at the same time intervals after taking the indicated doses of dexamethasone. These doses of dexamethasone inhibit the formation of corticosteroids in almost all healthy individuals. 6 hours after the last dose of dexamethasone, the plasma cortisol content is below 135-138 nmol / L (less than 4.5-5 μg / 100 ml). Decreased excretion of 17-hydroxycorticosteroids below 3 mg / day. and free cortisol below 54-55 nmol / day (below 19-20 μg / day) excludes hyperfunction of the adrenal cortex. In persons. suffering from a disease or Itsenko-Cushing's syndrome, during a small test, changes in the secretion of corticosteroids are not noted.
When conducting a large test, dexamethasone is prescribed 2 mg every 6 hours for 2 days (i.e. 8 mg of dexamethasone per day). Urine is also collected to determine 17-hydroxycorticosteroids or free cortisol (if necessary, free plasma cortisol is determined).With Itsenko-Cushing's disease, the excretion of 17-hydroxycorticosteroids or free cortisol is reduced by 50% or more, while with adrenal tumors or adrenocorticotropic-ectopated (or corticoliberin -ctopic) syndrome, excretion of corticosteroids does not change. In some patients with adrenocorticotropic-ectopic syndrome, a decrease in corticosteroid excretion is not detected even after taking dexamethasone at a dose of 32 mg / day.
From the endocrine system: decreased glucose tolerance, "steroid" diabetes mellitus or manifestation of latent diabetes mellitus, inhibition of adrenal function, Itsenko-Cushing's syndrome (moon-shaped face, pituitary-type obesity, hirsutism, high blood pressure, dysmenorrhea, amenorrhea, myasthenia gravis, striae). delayed sexual development in children.
From the digestive system: nausea, vomiting, pancreatitis, “steroidal” ulcer of the stomach and duodenum, erosive esophagitis, bleeding and perforation of the gastrointestinal tract, increased or decreased appetite, flatulence, hiccups. In rare cases, increased activity of “liver” transaminases and alkaline phosphatase .
From the cardiovascular system: arrhythmias, bradycardia (up to cardiac arrest), development (in predisposed patients) or increased severity of chronic heart failure, electrocardiographic changes characteristic of hypokalemia, increased blood pressure, hypercoagulation, thrombosis. In patients with acute and subacute myocardial infarction - the spread of the focus of necrosis, slowing the formation of scar tissue, which can lead to rupture of the heart muscle.
From the nervous system: delirium, disorientation, euphoria, hallucinations, manic-depressive psychosis, depression, paranoia, increased intracranial pressure, nervousness or anxiety, insomnia, dizziness, vertigo. cerebellar pseudotumor, headache, cramps.
From the senses: posterior subcapsular cataract, increased intraocular pressure with possible damage to the optic nerve, a tendency to develop secondary bacterial, fungal or viral infections of the eyes, trophic changes in the cornea, exophthalmos.
From the side of metabolism: increased excretion of calcium ions, hypocalcemia. weight gain, negative nitrogen balance (increased protein breakdown), increased sweating.
Caused by Mineralocorticosteroid Activity - fluid and sodium ion retention (peripheral edema), hypernatremia, hypokalemic syndrome (hypokalemia, arrhythmia, myalgia or muscle spasm, unusual weakness and fatigue).
From the musculoskeletal system: deceleration of growth and processes of ossification in children (premature closure of epiphyseal growth zones), osteoporosis (very rarely pathological bone fractures, aseptic necrosis of the head of the humerus and femur), rupture of muscle tendons, steroid myopathy, decrease in muscle mass (atrophy).
From the skin and mucous membranes: delayed wound healing, petechiae, ecchymosis. thinning of the skin, atrophy of the skin and subcutaneous tissue, hyper- or hypopigmentation, "steroid" acne, striae. tendency to develop pyoderma and candidiasis.
Allergic reactions: generalized (skin rash, itching of the skin, anaphylactic shock), local allergic reactions.
Other: the development or exacerbation of infections (the appearance of this side effect is facilitated by the jointly used immunosuppressants and vaccination), leukocyturia. withdrawal syndrome.
Interaction with other drugs
It accelerates the excretion of acetylsalicylic acid, reduces its concentration in the blood (with dexamethasone withdrawal, the concentration of salicylates in the blood increases and the risk of side effects increases).
When used simultaneously with live antiviral vaccines and against the background of other types of immunizations, it increases the risk of virus activation and the development of infections.
Increases the metabolism of isoniazid, mexiletine (especially in "fast acetylators"), which leads to a decrease in their plasma concentrations.
Increases the risk of hepatotoxic effects of paracetamol (induction of "liver" enzymes and the formation of a toxic metabolite of paracetamol).
Increases (with prolonged therapy) the content of folic acid.
Hypokalemia caused by glucocorticosteroids can increase the severity and duration of muscle blockade against muscle relaxants,
In high doses, reduces the effect of somatropin.
Antacids reduce the absorption of glucocorticosteroid drugs.
Dexamethasone reduces the effect of hypoglycemic drugs: enhances the anticoagulant effect of coumarin derivatives.
It attenuates the effect of vitamin D on the absorption of calcium ions in the intestinal lumen. Ergocalciferol and parathyroid hormone inhibit the development of osteopathy caused by glucocorticosteroids.
Reduces the concentration of praziquantsla in the blood.
Cyclosporine (inhibits metabolism) and ketoconazole (reduces clearance) increase toxicity.
Thiazide diuretics, carbonic anhydrase inhibitors. other glucocorticosteroids and amphotericin B increase the risk of hypokalemia. Sodium-containing drugs - edema and high blood pressure.
Nonsteroidal anti-inflammatory drugs and ethanol increase the risk of ulceration of the gastrointestinal mucosa, bleeding, in combination with non-steroidal anti-inflammatory drugs for the treatment of arthritis, it is possible to reduce the dose of glucocorticosteroids due to the summation of the therapeutic effect.
Indomethacin, displacing dexamethasone from its association with albumin, increases the risk of side effects.
Amphotericin B and carbonic anhydrase inhibitors increase the risk of osteoporosis.
The therapeutic effect of gluco-corticosteroids is reduced under the influence of phenytoin. barbiturates, ephedrine, theophylline, rifampicin and other inducers of “liver” microsomal enzymes (increase in metabolic rate).
Mitotan and other inhibitors of adrenal cortex function may necessitate an increase in the dose of glucocorticosteroids.
The clearance of glucocorticosteroids is increased against the background of thyroid hormones.
Immunosuppressants increase the risk of infections and lymphomas or other lymphoproliferative disorders caused by the Epstein-Barr virus.
Estrogens (including oral estrogen-containing contraceptives) reduce the clearance of glucocorticosteroids, lengthen the half-life and their therapeutic and toxic effects.
The appearance of hirsutism and acne is facilitated by the simultaneous use of other steroid hormonal drugs - androgens, estrogens, anabolic steroids, and oral contraceptives.
Tricyclic antidepressants can increase the severity of depression caused by glucocorticosteroids (not indicated for the treatment of these side effects).
The risk of developing cataracts is increased when used against other glucocorticosteroids. antipsychotic drugs (antipsychotics), carbamide and azathioprine.
Simultaneous administration with m-anticholinergics (including antihistamines, tricyclic antidepressants), nitrates contributes to the development of increased intraocular pressure.
Prescribing dexamethasone for intercurrent infections, septic conditions and tuberculosis, it is necessary to simultaneously treat with bactericidal antibiotics.
With daily use for 5 months of treatment, atrophy of the adrenal cortex develops.
May mask some symptoms of infections: it is useless to immunize during treatment.
With the sudden abolition of glucocorticosteroids, especially in the case of the previous use of high doses. there is a syndrome of "cancellation" of glucocorticosteroids (not caused by hypocorticism): loss of appetite, nausea, lethargy, generalized musculoskeletal pain, asthenia, and acute adrenal insufficiency may also occur (decrease in blood pressure, arrhythmia, sweating, weakness, oligoanuria, vomiting, abdominal pain, diarrhea, hallucinations, fainting, coma).
After cancellation, a relative insufficiency of the adrenal cortex remains for several months. If stressful situations arise during this period, glucocorticosteroids are prescribed (if indicated) for the time, if necessary in combination with mineralocorticosteroids.
In children during long-term treatment, careful monitoring of the dynamics of growth and development is necessary. Children who were in contact with measles or chicken pox during treatment are given prophylactic immunoglobulins.
During treatment with dexamethasone (especially long-term), it is necessary to observe an oculist, monitor blood pressure and water-electrolyte balance, as well as pictures of peripheral blood and glycemia. In order to reduce side effects, anabolic steroids, antacids can be prescribed. and also increase the intake of potassium ions in the body (diet, potassium preparations). Food should be rich in potassium ions, proteins, vitamins, with a small amount of fat, carbohydrates and salt.
In children during the growth period, glucocorticosteroids should be used only according to absolute indications and iodine by especially careful observation of the attending physician.
The composition of the release form
For the treatment of various types of diseases, Dexamethasone is produced in 4 dosage forms, the therapeutic basis of which is dexamethasone sodium phosphate.
This substance is a synthetic analogue of the natural steroid hormone that the adrenal glands produce in the body.
The main forms:
- Tablets of 0.5 mg (0.5 mg of active ingredient) in a pack of 10 units.
- Injection solution (0.4%) in 1 ml ampoules containing 4 mg of active substance (5 or 25 units per pack). It is used to inject into the muscle, vein (stream or drip), into the joint, into the soft tissues surrounding it, into the fiber of the eyeball.
- Dexamethasone eye drops (ear) 10 ml with an active substance concentration of 0.1% (1 mg in 1 ml).
- Eye ointment - tube 2.5 g.
All forms of the drug as auxiliary components contain substances that are necessary for stabilization, shaping and transportation of dexamethasone to the painful focus, as well as preservatives and additives that facilitate the absorption of the drug.
Each medical form has its purpose in use, certain indications and contraindications, so you should not engage in treatment yourself - only a specialist is able to develop the desired treatment regimen, calculate the dose and frequency of use.
The medicine is prescription, where the name of the drug in Latin is designated as Dexamethasoni.
The mechanism of the therapeutic effect of the drug is based on its ability to create a high concentration of the component in the blood and foci of inflammation, penetrate all tissues and exert an effect at the cellular level.
This allows the active substance to work in the brain and nerve tissues, relieve swelling of the brain, lungs with hemorrhage, poisoning, injuries, and tumors, leading the patient out of a life-threatening state of shock, inhibiting the course of cancer processes, and eliminating the manifestations of acute allergies.
Glucocorticosteroid activates a series of processes that lead to a decrease in the permeability of the walls of blood vessels, strengthen the protection of cell walls and block inflammation at any stage of development.
Suppressing the acute reaction of the immune system to allergens, the drug stops the development of an allergic reaction, including anaphylactic shock, reduces the degree of swelling of the mucous membranes of the respiratory organs, bronchi, restoring air flow during swelling of the larynx or asthmatic attack.
At the same time, the drug inhibits the production of histamine, stopping the pathological manifestations of allergies.
Slows down the formation of cicatricial changes in the tissues of various organs.
Absorption and excretion from the body
The corticosteroid is actively and almost completely absorbed not only after injection, but also after internal administration. The bioavailability or amount of a therapeutic substance reaching the focus of exposure is 77 - 79%, due to which the therapeutic effect of the drug is maximum.
In the blood, 65 - 70% of dexamethasone binds to the transport protein transcortin, which provides a high concentration of the drug in the blood. With blood flow, the protein delivers dexamethasone throughout the body, penetrating into the intracellular spaces of tissues.
The greatest amount of active substance in the blood, providing the maximum therapeutic effect, is observed in the range from 40 to 90 minutes, depending on the method of application.
The active substance is processed by liver enzymes to inactive intermediates. It is removed from the body with urine and in small quantities (about 10%) is excreted by the intestines. A small amount of dexamethasone passes into breast milk, which should be considered when prescribing the drug to a nursing mother.
Characterization of the drug Dexamethasone
Dexamethasone is a hormone containing hormone that is produced by the adrenal cortex. The importance of the hormone is difficult to overestimate. With his participation, processes of protein and carbohydrate metabolism take place.
Due to the wide spectrum of action, the drug is prescribed as an anti-inflammatory, anti-allergic, anti-shock, immunosuppressive, desensitizing, antitoxic agent.
It is characterized by a rapid suspension of the inflammatory process in the body, prevention of the development of edema of the mucous membranes, inhibition of the formation of eosinophilic infiltrate in the submucosal layer.
Dexamethasone is a methylated derivative of fluoroprednisolone. This substance inhibits the production of interleukin (responsible for the course of immune reactions and the process of hematopoiesis) and interferon (protein antagonists of viruses) from lymphocytes, as well as macrophages.
When it enters the stomach, the substance is perfectly absorbed from the digestive tract into the bloodstream, reaching the highest concentration 30 minutes after taking the medicine. It also penetrates well into any tissue, placental and breast milk is no exception. It is excreted through the kidneys and through the intestines. According to the anti-inflammatory effect, this drug is 35 times more active than cortisone and 7 times more than prednisolone.
Dexamethasone is an order forgotten, but the drug has not completely disappeared from medical practice. It is used when the goal is to save lives with justifiable neglect of side effects.
Hormonal drug (glucocorticoid for systemic and topical use). Fluorinated homologue of hydrocortisone.
Dexamethasone is a white or almost white, odorless crystalline powder. Solubility in water (25 ° C): 10 mg / 100 ml, soluble in acetone, ethanol, chloroform. The molecular weight of 392.47.
Dexamethasone sodium phosphate is a white or slightly yellow crystalline powder. Easily soluble in water and very hygroscopic. The molecular weight of 516.41.
Pharmacological action - anti-inflammatory, anti-allergic, immunosuppressive, anti-shock, glucocorticoid. Prevents the release of inflammatory mediators from eosinophils and mast cells.
It inhibits the activity of hyaluronidase, collagenase and proteases, normalizes the functions of the intercellular matrix of cartilage and bone tissue.
Reduces capillary permeability, stabilizes cell membranes, including lysosomal, inhibits the release of cytokines (interleukins 1 and 2, gamma interferon) from lymphocytes and macrophages. Affects all phases of inflammation, the antiproliferative effect is due to the inhibition of the migration of monocytes into the inflammatory focus and proliferation of fibroblasts.
After intravenous administration, maximum plasma concentrations of dexamethasone phosphate are achieved in just 5 minutes, and after intramuscular administration - in 1 hour. When applied topically in the form of injections into joints or soft tissues, absorption is slower. The action of drugs begins quickly after intravenous administration.
With intramuscular administration, the clinical effect is observed 8 hours after administration. The drug acts for a long time: from 17 to 28 days after intramuscular injection and from 3 days to 3 weeks after topical application. The biological half-life of dexamethasone is 24-72 hours. In plasma and synovial fluid, dexamethasone phosphate is rapidly converted to dexamethasone.
In blood plasma, approximately 77% of dexamethasone binds to proteins, mainly albumin. Only a small amount of dexamethasone binds to other plasma proteins. Dexamethasone is a fat-soluble substance, so it penetrates into the inter- and intracellular space.
It has an effect in the central nervous system (hypothalamus, pituitary gland) by binding to membrane receptors. In peripheral tissues, it binds and acts through cytoplasmic receptors.
Dexamethasone breaks down at its site of action, i.e. in a cage. Dexamethasone is metabolized primarily in the liver. A small amount of dexamethasone is metabolized in the kidneys and other tissues. The main route of elimination are the kidneys.
Dexamethasone is a synthetic hormone of the adrenal cortex (corticosteroid), which has a glucocorticoid effect. It has anti-inflammatory and immunosuppressive effects, and also affects energy metabolism, glucose metabolism and (due to negative feedback) on the secretion of the activation factor of the hypothalamus and trophic hormone adenohypophysis.
The mechanism of action of glucocorticoids is still not fully understood. There are now a sufficient number of reports on the mechanism of action of glucocorticoids to confirm that they act at the cellular level. In the cytoplasm of cells, there are two well-defined receptor systems.
Due to binding to glucocorticoid receptors, corticoids have an anti-inflammatory and immunosuppressive effect and regulate glucose metabolism, and due to binding to mineralocorticoid receptors, they regulate sodium, potassium metabolism and water-electrolyte balance.
Glucocorticoids dissolve in lipids and easily penetrate target cells through the cell membrane. The binding of the hormone to the receptor leads to a change in the conformation of the receptor, contributing to an increase in its affinity for DNA.
The hormone / receptor complex enters the cell nucleus and binds to the regulatory center of the DNA molecule, which is also called the glucocorticoid response element (GRE). An activated receptor associated with GRE or with specific genes regulates the transcription of m-RNA, which can be increased or decreased.
The newly formed m-RNA is transported to the ribosome, after which the formation of new proteins occurs. Depending on the target cells and the processes that take place in the cells, protein synthesis can be enhanced (for example, the formation of tyrosine transaminase in liver cells) or reduced (for example, the formation of IL-2 in lymphocytes). Since glucocorticoid receptors are found in all types of tissues, it can be considered that glucocorticoids act on most cells of the body.
Hypersensitivity (for short-term systemic use for health reasons is the only contraindication).
For systemic use (parenteral and oral). Systemic mycoses, parasitic and infectious diseases of a viral or bacterial nature (currently without appropriate chemotherapy or recently transferred, including recent contact with the patient), including herpes simplex, herpes zoster (viraemic phase), chickenpox, measles, amoebiasis, strongyloidosis (established or suspected), active forms of tuberculosis.
Immunodeficiency conditions (including AIDS or HIV infection), the period before and after prophylactic vaccinations (especially antivirals), systemic osteoporosis, myastenia gravis, gastrointestinal tract diseases (including peptic ulcer of the stomach and duodenum, esophagitis, gastritis acute or latent peptic ulcer, recently created intestinal anastomosis, ulcerative colitis with the threat of perforation or abscess formation, diverticulitis).
Diseases of the cardiovascular system, including recent myocardial infarction, congestive heart failure, arterial hypertension, diabetes mellitus, acute renal and / or liver failure, psychosis.
For intraarticular administration. Unstable joints, previous arthroplasty, pathological bleeding (endogenous or caused by the use of anticoagulants), articular fracture of the bone, infected foci of lesions of the joints, periarticular soft tissues and intervertebral spaces, pronounced periarticular osteoporosis.
Eye forms. Viral, fungal and tuberculous lesions of the eyes, including keratitis caused by Herpes simplex, viral conjunctivitis, acute purulent eye infection (in the absence of antibiotic therapy), violation of the integrity of the corneal epithelium, trachoma, glaucoma. Ear forms. Perforation of the eardrum.
Pregnancy and lactation
The use of corticosteroids during pregnancy is possible if the expected effect of therapy exceeds the potential risk to the fetus (adequate and strictly controlled safety studies have not been conducted).
Women of childbearing age should be warned of the potential risk to the fetus (corticosteroids pass through the placenta). It is necessary to carefully monitor newborns whose mothers received corticosteroids during pregnancy (the development of adrenal insufficiency in the fetus and newborn is possible).
Teratogenicity of dexamethasone in mice and rabbits has been shown after local ophthalmic applications of multiple therapeutic doses.
In mice, corticosteroids cause fetal resorption and a specific disorder — the development of a cleft palate in offspring. In rabbits, corticosteroids cause fetal resorption and multiple disorders, including abnormalities in the development of the head, ear, limbs, palate, etc. The FDA category of action on the fetus is C.
Nursing women are advised to stop either breastfeeding or the use of drugs, especially in high doses (corticosteroids penetrate breast milk and can inhibit growth, production of endogenous corticosteroids and cause unwanted effects in the newborn).
It should be borne in mind that with topical use of glucocorticoids, systemic absorption occurs.
If the overdose is not correct due to a delay in the tissue fluid structures, gastrointestinal lesions of an erosive and ulcerative nature, exacerbations and bleeding may occur, accompanied by vomiting, hiccups, and bloating. A reaction to the hypersensitivity of the drug in the form of urticaria, dermatitis, angioedema may occur.
In patients who have recently suffered a heart attack, heart failure, cardiac arrest, heart failure, and many other heart complications can be triggered.
Behavioral changes often occur, such as a state of euphoria, sleep loss, psychosis, depressive behavior, and paranoia. Hallucinations are frequent; for people with schizophrenia and epilepsy, exacerbations are dangerous.
Arterial and ocular pressure can “jump up”, cataracts, glaucoma can develop, infections of the organs of vision are provoked. At high doses, burning sensation, tissue necrosis, and swelling are felt. Side effects of dexamethasone with iv use are often expressed by arrhythmia, seizures and sudden flushing of the face.
When a medicine is injected into the joint, there is often a sensation of increased pain. Intracranial administration is often fraught with nosebleed.
A sudden cessation or reduction in the previous dose is dangerous for those people who have been sitting on Dexamethasone for a long time. Adrenal insufficiency may occur, resulting in a sharp drop in pressure and death.
In the event that the patient has any pronounced adverse reactions of the body, the drug should be discontinued
Release form and packaging
There are 4 options for the form of production of Dexamethasone:
- in tablets of 0.5 mg (the entire contents of the tablet is the active component), in a pack of 10 tablets,
- in ampoules Dexamethasone with a volume of 1 or 2 ml - a solution for injection (active component - 4 mg), in a package - 5, 10 or 25 ampoules,
- in bottles (drops in the eyes or ears), 10 ml (1 mg of the active ingredient per 1 ml of solution),
- in tubes (ointment for eyes) 2.5 g each
The list of pathological conditions in which injection or Dexamethasone tablets are required includes:
- life-threatening shock conditions of all forms, including pain shock, toxic, cardiogenic, allergic, postoperative, blood transfusion (after blood transfusions),
- swelling of brain tissue (with hemorrhage, meningitis, tumor, encephalitis, trauma, surgery),
- an attack of bronchial asthma or long-term asthmatic status,
- lung pathology: berylliosis, tuberculosis, alveolitis, pneumonia, Leffler's syndrome (resistant to other medicines),
- allergic reactions: urticaria, Quincke's edema, hay fever, allergy to drugs and products, serum sickness,
- endocrine disorders - adrenal insufficiency, thyroid disease, thyrotoxic crisis, thyroiditis, adrenogenital syndrome,
- autoimmune diseases - rheumatic heart disease, multiple sclerosis, systemic lupus erythematosus, pemphigus, scleroderma, systemic vasculitis,
- pain with inflammation of the reproductive organs, including prostatitis, various types of myositis,
- intractable skin diseases - eczema, dermatitis of various types, psoriasis, toxidermia, Lyell and Stevens-Johnson syndromes, discoid lupus erythematosus, keloid scars (local application),
- allergic and inflammatory eye damage: scleritis, corneal ulcer, various types of conjunctivitis (except purulent), uveitis, keratitis, blepharitis, inflammation of the optic nerve, ophthalmopathy against diabetes mellitus,
- swelling of the larynx and glottis with acute croup,
- inflammation of the joints of various types: arthritis of various forms, osteoarthritis, polyarthritis, ankylosing spondylitis, bursitis, tendosynovitis and others,
- hematopoiesis: Addison’s disease, lymphoma, agranulocytosis, anemia of different origin, thrombocytopenia,
- critical conditions in case of damage to the gastrointestinal system: enteritis, including granulomatous, hepatitis and hepatic coma, ulcerative colitis,
- allergic-toxic reaction with massive helminth aggression,
- damage to the esophagus and stomach during poisoning with alkalis, acids to suppress inflammation and prevent scarring,
- acute renal pathology - glomerulonephritis, nephrotic syndrome,
- malignant processes in the lungs, leukemia, lymphocytic leukemia, myeloma,
- nausea and vomiting with cytostatics.
Why is dexamethasone prescribed in injections and tablets?
Indications for the use of Dexamethasone are systemically treatable corticosteroids diseases (if necessary, the drug can be used as an addition to the main therapy). The solution is administered intravenously and intramuscularly in cases where oral administration or local treatment is ineffective or impossible.
The drug Dexamethasone (injections and tablets) is indicated for rheumatic and allergic diseases, cerebral edema, shock of various origins, certain kidney diseases, autoimmune disorders, respiratory tract diseases, blood diseases, acute severe dermatoses, IBD, during HRT (for example, with adenohypophysis / adrenal gland insufficiency).
What is dexamethasone eye drops prescribed for?
In ophthalmic practice, the use of corticosteroids is advisable for allergic and non-purulent conjunctivitis, iridocyclitis, shave, keratitis, keratoconjunctivitis without damaging the integrity of the corneal epithelium, blepharoconjunctivitis, sclerite, blepharitis, episclerate, sympathetic ophthalmia, as well as for stopping inflammation after surgery or eye injury.
Dexamethasone intoxication usually occurs with prolonged (several weeks) administration of elevated doses. If dexamethasone is taken once, an overdose does not occur. And in such a situation, it is enough to stop taking the medicine or adjust the intake. If this is not done, then symptoms of toxemia with dexamethasone will appear, characterized by:
- disruptions in the central nervous system: hallucinations, psychosis, loss of consciousness,
- disruptions in the activities of CVS: heart failure, increased blood pressure, heart rate,
- intracranial pressure, convulsions,
- allergic reactions
- nausea and vomiting.
It is good if signs of excessive medication have been detected within half an hour. It is immediately necessary to call an ambulance crew and take a number of measures to provide first aid.
Home help. The algorithm of actions is standard. Among them:
- the reception of a large amount of clean and slightly salty water (4 glasses),
- provoking a gag reflex,
- taking absorbent drugs (atoxil, enterosgel).
Stationary measures. In the clinic, symptomatic treatment is mainly performed, the role of which is to stabilize and restore the functions of the internal organs and all systems.
There is no antidote to the medication. Hemodialysis in this case does not bring effect. In the case of the development of Cushing's syndrome, aminoglutetimide is prescribed.
More often, when an overdose of dexamethasone occurs, consequences in the form of the development of Cushing's syndrome are possible. Its early symptoms are characterized by phenomena such as:
- local obesity
- change in quantitative indicators of glucose in the bloodstream,
- the appearance of striae (stretch strips on the skin),
- slow wound healing
- local deposition of melanin,
- hirsutism in women, impotence in men,
- high blood pressure
- frequent headaches
- depressive state
- disturbance of the phases of sleep.
This medication is strong enough. Therefore, in order to avoid the consequences of an overdose, one should strictly adhere to medical recommendations, do not resort to self-medication, take into account the presence of chronic diseases.
It is limited for use in: peptic ulcers of the gastrointestinal tract, peptic ulcer of the stomach and duodenum, esophagitis, gastritis, intestinal anastomosis (in the nearest history), congestive heart failure, arterial hypertension, thrombosis, diabetes mellitus, osteoporosis, osteocorosis, Itenko / or liver failure, psychosis, convulsive conditions, myasthenia gravis, open-angle glaucoma, AIDS, pregnancy, breast-feeding.
With prolonged treatment (more than 3 weeks) in high doses (more than 1 mg of Dexamethasone per day) for the prevention of secondary adrenal insufficiency, Dexamethasone is withdrawn gradually.
This condition can last for several months, so if stress occurs (including against the background of general anesthesia, surgery or injury), an increase in dose or the introduction of Dexamethasone is necessary.
Topical application of Dexamethasone can lead to systemic effects. With intra-articular administration, it is necessary to exclude local infectious processes (septic arthritis). Frequent intra-articular administration can lead to damage to articular tissues and osteonecrosis. Patients are not recommended to overload the joints (despite the decrease in symptoms, the inflammatory processes in the joint continue).
Particular attention, before the start of the treatment process with Dexamethasone injections, should be drawn to the fact that reactions of the body of an allergic nature are possible, all measures taken will avoid serious complications.
The medicine should be withdrawn gradually, the dose cannot be sharply reduced, since the body will react in its own way with dizziness, drowsiness, pain in the area of bones, joints and muscles. Temperature, runny nose, conjunctivitis may be triggered.
In the postoperative period, for patients who are under stress during the period of therapeutic exposure, it is necessary to slightly increase the dose size, or replace it with drugs such as cortisone or hydrocortisone.
Close medical attention is required by those who have osteoporosis, both types of diabetes mellitus, tuberculosis disease, gastrointestinal tract pathologies, and elderly people. They require increased attention and strictly observed doses of the drug.
If treatment continues for a long time, it is necessary to monitor the level of potassium in the blood serum.
If the patient is in a state of severe stress (due to trauma, surgery or a serious illness) during therapy, the dose of dexamethasone needs to be increased, and if this happens during treatment discontinuation, hydrocortisone or cortisone should be used.
Patients who have been injected with dexamethasone for a long time and who experience severe stress after discontinuation of therapy should be reinstated with dexamethasone, since the resulting adrenal insufficiency can last for several months after discontinuation of treatment.
Treatment with dexamethasone or natural glucocorticoids may mask the symptoms of an existing or new infection, as well as symptoms of intestinal perforation. Dexamethasone can exacerbate systemic fungal infection, latent amoebiasis, and pulmonary tuberculosis.
Caution and medical supervision are recommended for patients with osteoporosis, with arterial hypertension, heart failure, tuberculosis, glaucoma, liver or kidney failure, diabetes mellitus, active peptic ulcer, recent intestinal anastomosis, ulcerative colitis and epilepsy.
Special care is required for patients in the first weeks after myocardial infarction, patients with thromboembolism, severe myasthenia gravis, hypothyroidism, psychosis or psychoneurosis, as well as elderly patients.
During treatment, exacerbation of diabetes mellitus or a transition from the latent phase to the clinical manifestations of diabetes mellitus may be observed.
Caution should be exercised when prescribing against the background of ulcerative colitis, intestinal diverticulitis, hypoalbuminemia. Appointment in case of intercurrent infections, tuberculosis, septic conditions requires preliminary and then simultaneous antibacterial therapy.
GCS may increase susceptibility or mask the symptoms of infectious diseases. Chicken pox, measles, etc.infections can be more severe and even fatal in non-immunized individuals. Immunosuppression often develops with prolonged use of corticosteroids, but can also occur with short-term treatment.
Against the background of concomitant tuberculosis, it is necessary to conduct adequate antimycobacterial chemotherapy. The simultaneous use of dexamethasone in high doses with inactivated viral or bacterial vaccines may not give the desired result.
Immunization against the background of replacement therapy with corticosteroids is permissible. It is necessary to take into account the increased action in case of hypothyroidism and cirrhosis of the liver, aggravation of psychotic symptoms and emotional lability with their high initial level, masking of some symptoms of infection, the likelihood of persisting for several months (up to 1 year) of relative adrenal insufficiency after discontinuation of Dexamethasone (especially in case of prolonged use )
With a long course, they carefully monitor the growth and development of children, systematically conduct an ophthalmological examination, monitor the condition of the hypothalamic-pituitary-adrenal system, and blood glucose level.
Discontinue therapy only gradually. It is recommended to be careful when carrying out any kind of operations, the occurrence of infectious diseases, injuries, avoid immunization, eliminate the use of alcoholic beverages.
In children, in order to avoid overdose, dose calculation is based on the surface area of the body. In case of contact with patients with measles, chickenpox and other infections, concomitant preventive therapy is prescribed.
In rare cases, patients receiving parenteral corticosteroids may experience anaphylactoid reactions. Prior to administration, appropriate precautions should be taken in patients, especially if the patient has a history of allergy to any drug.
Corticosteroids can aggravate the course of systemic fungal infections and, therefore, should not be used in the presence of such infections. Corticosteroids can activate latent amoebiasis. Therefore, it is recommended to exclude latent or active amoebiasis before starting corticosteroid therapy.
Medium and high doses of cortisone or hydrocortisone can cause high blood pressure, salt and water retention, and increased potassium excretion. However, it may be necessary to limit salt and potassium. All corticosteroids increase calcium excretion.
Use corticosteroids with great caution in patients with recent myocardial infarction because of the risk of rupture of the ventricular wall. Corticosteroids should be used with caution in patients with herpes simplex eye infection, because of the risk of corneal perforation.
Aspirin should be used with caution in combination with corticosteroids because of the risk of hypoprothrombinemia. In some patients, steroids can increase or decrease sperm motility and sperm count.
- muscle loss
- pathological fractures of long tubular bones,
- vertebral compression fractures,
- aseptic necrosis of the head of the femur and humerus.
Influence on the ability to drive a car and other potentially dangerous mechanisms. During treatment, you should not drive vehicles and engage in potentially hazardous activities that require increased attention and speed of psychomotor reactions.
Side Effects of Dexamethasone
The frequency of occurrence and severity of side effects of Dexamethasone depend on the dosage of the drug, the duration of the drug, the possibility of using taking into account the circadian rhythm.
Systemic side effects of Dexamethasone:
- on the part of the sensory organs and NS - delirium, euphoria, depressive / manic episode, disorientation, hallucinations, increased ICP with stagnant disc syndrome(non-inflammatory edema)optic nerve (benign intracranial hypertension, the development of which is a consequence of a rapid decrease in the dosage of the drug (usually in children) and is accompanied by visual impairment and headaches) vertigosleep disturbances, headache, dizziness, loss of vision (with the introduction of the solution in the region of the nasal concha, head, neck, scalp), cataractwith localization of opacities in the back of the lens, glaucomahypertension of the eye with the likelihood of damage to the optic nerve, the development of a secondary viral / fungal infection of the eye, steroid exophthalmos,
- from the CCC -arterial hypertension, myocardial dystrophycharacteristic for hypokalemia ECG changes, hypercoagulation, thrombosis, with a predisposition - the development of heart failure, with parenteral use - flushing of the head,
- from the digestive system - nausea, hiccups, vomiting, pancreatitiserosive and ulcerative lesions of the digestive canal, increase / decrease in appetite, erosive esophagitis,
- metabolic disorders - peripheral edema due to water retention and Na +, nitrogen deficiency, hypocalcemia, hypokalemiaweight gain
- endocrine disorders - hyper- or hypocorticism syndrome, manifestation latent(hidden) diabetes mellitussteroid diabetes, growth retardation in children, irregular menstruation, hirsutism,
- from the locomotor system - joint or muscle pain, back pain, steroid myopathy, tendon rupture, osteoporosis, muscle weakness, decreased muscle mass, with intra-articular injection of the solution, an increase in the intensity of pain in the joint is possible,
- from the skin - striae, ecchymosis and petechiae, steroid acne, thinning of the skin, increased sweating, poor wound healing,
- hypersensitivity reactions - hives, skin rashes, shortness of breath, stridor, swelling of the face, anaphylactic shock.
Also possible: a decrease in the function of the immune system, activation of infectious diseases, withdrawal syndrome (general weakness, lethargy, nausea, anorexia, abdominal pain).
Local reactions during the administration of the solution: numbness, burning, paresthesia, pain, infection at the injection site, scarring at the injection site, hypo- or hyperpigmentation. With intramuscular administration, the process of atrophy of the subcutaneous tissue and skin may begin.
Reactions to the use of ophthalmic forms: prolonged (more than 3 consecutive weeks) the use of eye drops may be accompanied by an increase in intraocular pressure, the formation of glaucoma with damage to the fibers of the optic nerve,posterior subcapsular (cupped) cataract, visual impairment (for example, loss of its fields), thinning / perforation of the cornea, the spread of infection (bacterial or herpetic).
With increased sensitivity to benzalkonium chloride or dexamethasoneare possible blepharitis and conjunctivitis.
Local reactions are manifested by burning and itching of the skin, irritation, dermatitis.
Terms of issue, storage and sale
Release form - Solution for injections 4 mg / ml 1 ml. 1 ml in a clear glass ampoule with a break ring or with a break point. Self-adhesive labels are glued onto the ampoules.
10 ampoules together with "Dexamethasone in ampoules instructions for use" are placed in a pack with a corrugated cardboard partition.
Either 5 ampoules with a kink ring or with a kink point are inserted into the blister strip packaging from a polymer film. 2 contour cell packs with ampoules together with instructions for medical use in the state and Russian languages are put in a pack of cardboard.
Storage conditions - Store at a temperature not exceeding 25 ºС. Keep ampoules in an outer packaging to protect from the effects of light. Keep out of the reach of children! Shelf life is 2 years.Do not use the drug after the expiration date indicated on the package. Pharmacy Vacation Terms - Prescription.
Manufacturer - PJSC Farmak, Ukraine, 04080, Kiev, st. Frunze, 63. The owner of the registration certificate is PJSC Farmak, Ukraine.
Properties of the drug and its use
The substance Dexamethasone is a synthetic analogue of the secretion of the adrenal cortex, which is normally produced in humans, and has the following effects on the body:
- It reacts with a receptor protein, which allows the substance to penetrate directly into the nuclei of membrane cells.
- It activates a number of metabolic processes by inhibiting the enzyme phospholipase.
- It blocks mediators of inflammatory processes in the immune system.
- It inhibits the production of enzymes that affect protein breakdown, thereby improving the metabolism of bone and cartilage.
- Reduces white blood cell production.
- Reduces vascular permeability, thereby preventing the spread of inflammatory processes.
As a result of these properties, the substance Dexamethasone has a powerful anti-allergic, anti-inflammatory, anti-shock, immunosuppressive effect.
Dexamethasone in ampoules is used for systemic treatment of pathologies, in cases where local therapy and internal medication have not yielded any results, or their use is impossible.
Dexamethasone regulates protein metabolism, reducing synthesis and enhancing protein catabolism in muscle tissue, reducing the number of globulins in plasma, increasing the synthesis of albumin in the liver and kidneys
Dexamethasone injections can be purchased for 35-60 rubles, or replaced with their analogues, among which Oftan Dexamethasone, Maxidex, Metazon, Dexazone
Most often, dexamethasone injections are used to relieve allergic reactions, as well as for the treatment of joint diseases. The description of the drug indicates the following conditions and diseases in which Dexamethasone is used:
- The development of acute adrenocortical insufficiency,
- Rheumatic pathology,
- Intestinal diseases of unknown nature,
- Shock conditions
- Acute forms of thrombocytopenia, hemolytic anemia, severe diseases of an infectious nature,
- Skin pathologies: eczema, psoriasis, dermatitis,
- Bursitis, shoulder-scapular periarthritis, osteoarthrosis, osteochondrosis,
- Laryngotracheitis in acute children,
- Multiple sclerosis,
- Swelling of the brain with traumatic brain injuries, meningitis, tumors, hemorrhages, radiation injuries, neurosurgical interventions, encephalitis.
Dexamethasone in injections is used in the development of acute and emergency conditions, when human life depends on the effectiveness and speed of the drug. The drug is usually used in a short course taking into account vital signs.
Dexamethasone injections: instructions for use
Methods of administration of Dexamethasone: iv, i / m, topically.
The daily dose is equivalent to 1 / 3-01 / 2 of the dose for per os administration and varies from 0.5 to 24 mg. Her child should be 2 introduction. Treatment is carried out in a minimally effective dose and as short a course as possible. The drug is canceled gradually. With prolonged use, the highest dose is 0.5 mg / day.
Injections are prescribed for emergency conditions, as well as in cases where oral administration is not possible. In urgent conditions, the introduction of higher doses of the drug (4-20 mg) is allowed, and the dose is repeated until the desired therapeutic effect is achieved. The daily dose in rare cases exceeds 80 mg.
Upon reaching the necessary results, treatment is continued at a dose of 2-4 mg, gradually reducing it until the drug is completely discontinued.
In order to maintain a lasting effect, injections are indicated with an interval of 3-4 hours. The introduction of Dexamethasone iv is also allowed by the method of prolonged drip infusion.
After the completion of the acute phase of the disease, the patient is transferred to the drug inside.
In the muscle in the same place you can enter no more than 2 ml of the drug.
The treatment regimen depends on the indications:
- in shock - 2-6 mg / kg iv in bolus, repeated injections every 2-6 hours or as a long-term infusion using a dose of 3 mg / kg / day .. GCS is prescribed as an adjunct to the main anti-shock therapy. The introduction of these doses is permissible exclusively in conditions that threaten the life of the patient, and, as a rule, this period lasts up to 72 hours.
- At cerebral edema (OGM) treatment begins with a dose of 10 mg (iv), then - until symptoms are relieved (within 12-24 hours) - 4 mg is administered every 6 hours. After 2-4 days, the dose is reduced and the administration of Dexamethasone is stopped for 5-7 days. At oncological diseasesmaintenance therapy may be required - 2 mg IV or IM 2 or 3 r / day.
- In acute OBM, the patient needs short-term intensive care. The loading dose of the medicine for an adult is 50 mg, for a child weighing up to 35 kg - 20 mg (injected into a vein). After this, the dose is gradually reduced while increasing the intervals between injections of the drug.
- At allergies (in particular, with exacerbation of chronic diseases of an allergic nature and in acute self-limiting reactions), parenteral administration is combined with oral administration of the drug. Allergy injections are done only on the first day, injecting 4 to 8 mg of Dexamethasone into the patient's vein. For 2-3 days, 2 times take 1 mg of the drug inside, for 4-5 days - 2 times 0.5 mg, for 6-7 days - 0.5 mg (once). On day 8, evaluate the effectiveness of treatment.
In cases of immediate asthmatic status requiring intravenous administration of corticosteroids, the combination “Eufillin and Dexamethasone ”: GCS reduces the release of mediators (heparin, histamine, serotonin) from the cell, protects tissues from destructive processes, prevents the formation of arachidonic acid metabolites, and Eufillin reduces blood vessel resistance, relieves bronchospasminhibits platelet aggregation and dilates coronary vessels.
Dmitry, 51 years old, Rostov-on-Don “A medicine that has been used for many years. Old but golden. I personally treat them with pain in the joints and spine. The doctor sometimes puts blockades with him, it helps a lot. But, they can’t be treated for a long time, because the pressure in the eyes rises only when it’s absolutely unbearable to walk. ”
Olga - doctor, 48 years old, Chelyabinsk “Well-proven medicine. How many years have I been using it. Excellent relieves the symptoms of psoriasis, eczema in severe degrees and forms. The main thing is that this drug is effective and inexpensive. The only thing I regret about is that older people endure its components quite hard. ”
Marina, 35 years old, Moscow “I was pleasantly surprised when I started using Dexamethasone. I am an allergic person with experience. The effect came literally immediately after the injection. The swelling and redness from the face are gone. The doctor said that you can’t use for a long time, it’s a pity, the medicine is cool and not at all expensive, and this is very important for ordinary people. ”
The use of dexamethasone in ampoules for inhalation
Inhalation of Dexamethasone is indicated for acute inflammatory diseases of the respiratory tract (for example, bronchitis or laryngitisas well as bronchial obstruction).
Inhalations with Dexamethasone for children should be done 3 r. / Day., Mixing 0.5 ml of the drug with 2-3 ml of saline. As a rule, treatment is continued from 3 to 7 days.
You can dilute the drug in saline in a ratio of 1: 6, and then apply 3-4 ml of the finished solution for inhalation.
Dexamethasone tablets: instructions for use
The dose for oral administration is selected individually depending on the type of disease, the activity of its course and the nature of the patient's response to the prescribed treatment.
The average daily dose is from 0.75 to 9 mg. With severe illnesses, the dose can be increased, while it is divided into several doses. The highest dose is 15 mg / day.
The optimal dosage for children is selected depending on age, and usually ranges from 2.5 to 10 mg / m2 / day. It is necessary to divide it into 3 or 4 doses.
The duration of the course is determined by the nature of the pathological process and the patient's response to treatment. In some cases, taking Dexamethasone is continued for several months.
A test with Dexamethasone is carried out in the form of small and large tests.
A small test involves the appointment of a patient with 0.5 mg of Dexamethasone 4 times a day at regular intervals (6 hours). Urine to determine free cortisol should be collected from 8:00 to 8:00 of the second day before the appointment of the drug and at the same time intervals after taking the necessary dose.
At hypercorticism syndrome changes in the secretion of corticosteroids are not observed.
A large test involves the appointment of 2 mg 1 time in 6 hours for 48 hours. Diagnose hypercorticism syndrome allows lower free cortisol and 17-ACS by 50 (or more) percent.
In patients with ACTH-ectopic syndrome and adrenal tumors GCS excretion rates are not changed. In some cases, when ACTH-ectopic syndromethey do not change even when taking 32 mg of Dexamethasone per day.
Dexamethasone eye drops: instructions for use
Eye drops are for topical use. With severe inflammation in the first day or two of treatment, 1-2 drops are instilled into the conjunctival sac. every 2 hours. Further, the intervals between instillations are extended to 4-6 hours.
To prevent the development of inflammation in the first 24 hours after an injury or surgery, the patient is instilled 4 r. / Day. 1-2 drops, then the treatment is continued in the same dose, but with a lower frequency of applications (usually the procedure is repeated 3 r. / Day.). The course lasts 14 days.
As an alternative to drops, an ointment with Dexamethasone can be used. It is squeezed out by a 1-1.5-centimeter strip and laid for the lower eyelid. The multiplicity of procedures is 2-3 during the day. You can combine the use of ointments and drops (for example, drops in the afternoon, and ointment - before bedtime).
For treatment otitis the drug is injected into the ear canal of the affected ear 2-3 p. / day. 3-4 drops.
Instructions for use Dexamethasone
Oral administration of Dexamethasone in the form of tablets involves the appointment of 1-9 mg of the drug per day at the initial stage of treatment, followed by a decrease in the daily dose to 0.5-3 mg with maintenance therapy.
The daily dose of Dexamethasone is recommended to be divided into 2-3 doses (after or with food). Maintenance small doses should be taken once a day, preferably in the morning.
Dexamethasone in ampoules is intended for intravenous (drip or stream), intramuscular, periarticular and intraarticular administration. The recommended daily dose of Dexamethasone with such methods of administration is 4-20 mg. Dexamethasone in ampoules is usually used 3-4 times a day for 3-4 days, followed by switching to tablets.
Drops of dexamethasone are used in ophthalmology: in acute conditions, 1-2 drops of the drug are instilled into the conjunctival sac every 1-2 hours, with improvement, every 4-6 hours.
Chronic processes suggest the use of dexamethasone drops 2 times a day. The duration of treatment depends on the clinical course of the disease, so Dexamethasone drops can be used from several days to four weeks.
Dexamethasone in Veterinary Medicine
In veterinary medicine, the drug is used as an active anti-shock, antiallergenic and anti-inflammatory.
Why are cats and dogs prescribed Dexamethasone? The drug is used to treat shock conditions, injuries, arthritis, bursitis,allergic diseases, edematous diseasepoisoning ketosisand acute mastitis.
The therapeutic dose for dogs and cats is 0.1-1 ml (depending on the size of the animal and indications).
Reception of Dexamethasone provokes a shift in metabolism towards anabolism, which against the background of the use of even a small dose anabolic steroids can accelerate muscle gain and make it more significant.
In addition, suppressing secretioncatabolic hormones, the drug helps to increase endurance, accelerates the recovery of an athlete after training, suppresses pain and inflammation in case of damage to ligaments and joints.
Since GCS belong to the group of stress hormones, their use in sports is allowed only for short courses.
What is dexamethasone
The drug belongs to the category of synthetic glucocorticoids. Available in tablets, eye drops, ampoules. The trade and international nonproprietary name (INN) in the register of medicines (RLS) are the same - Dexamethasone (dexametazon). The medicine is intended to regulate carbohydrate, protein and mineral metabolism. For the pharmacodynamics of tablets, the following actions are characteristic:
Dexamethasone - instructions for use
There are different patterns of using a hormonal drug based on which disease you want to defeat with its help. The doctor should tell you how to take Dexamethasone in tablets correctly, after making an accurate diagnosis. General recommendations:
- The initial dose of tablets for an adult for a day is 0.5-9 mg.
- Maintenance dose - 0.5-3 mg per day.
- The maximum daily dose is 10-15 mg.
- If Dexamethasone tablets have a therapeutic effect, the dose is gradually reduced by 0.5 mg every three days to a maintenance minimum.
- The drug should be drunk 2-4 times a day with meals.
- In case of an overdose of tablets, you should immediately consult a doctor.
- Be sure to specify what kind of interaction with other drugs prescribed for Dexamethasone will not cause harm when taken together.
As a rule, for some types of cancer, Dexamethasone can be prescribed to improve the general condition of the patient, as part of complex therapy. Pills have relatively few side effects. With oncology, dexamethasone should be taken at 7.5-10 mg per day. Drinking tablets is allowed only as directed by a doctor. It is preferable for a period of admission to be hospitalized in an oncology clinic.
Sometimes, with this disease, a drug is prescribed, but not in tablets. Dexamethasone for bronchitis and exacerbations of bronchial asthma is used in ampoules by inhalation. It helps prevent bronchospasm, relieve severe coughing attacks. 0.5 ml of the drug is diluted in 2-3 ml of saline. Inhalation with the drug is done for adults and children three times a day for a week. This can significantly alleviate the patient’s condition in a relatively short period of time.
The drug is prescribed for many eye diseases, but not in tablets, but in drops. with conjunctivitis and other acute inflammations, treatment lasts two days. 1-2 drops are instilled into the eyes 4-5 times a day. If the disease is chronic, then the course of treatment lasts from three to six weeks. In this case, 1-2 drops of Dexamethasone are instilled into the eyes twice a day. If the medicine enters the cornea, a burning sensation is possible, which quickly passes, but this phenomenon is not considered side-effect.
Depending on the diagnosis, 83-333 mcg of the drug is prescribed per day. The instruction of Dexamethasone recommends that treatment be carried out only according to strict indications and the entire period strictly control the processes of development and growth of the child, because pills at any time can provoke their slowdown and even complete cessation. Therapy should be stopped gradually, reducing the dosage every three days for the gradual elimination of hormones.
Similar effects are exerted by drugs similar in properties:
- Oftan Dexamethasone,
- Dexamethasone long,
You can buy the drug only subject to a doctor’s prescription. You can buy Dexamethasone at any pharmacy. In addition, tablets are presented at affordable prices in the catalogs of specialized online stores that sell drugs. How much Dexamethasone costs depends on the form of release, the number of tablets, and the manufacturer. The price of a blister for 10 pieces in Moscow varies from 18 to 45 rubles.
Dosage for children
Young patients are prescribed in accordance with body weight or body area, age and severity of the pathological process.
Estimated daily dose of children 0.0833 - 0.333 mg per 1 kilogram of body weight of the child. Thus, according to the calculation, a child weighing 25 kg can receive a maximum of 0.333 x 25 = 8.36 mg of the drug per day, divided into 3-4 doses. The minimum dose that will give a therapeutic effect for a small patient with such a weight is 0.0833 x 25 = 2.08 mg.
More precisely, the children's dose is calculated according to the surface area of the child’s body at the rate of 0.0025 - 0.0001 mg per 1 square meter per day in 3 to 4 doses, depending on age.
In systemic diseases, dexamethasone injections are done inside the muscles, or injected intravenously, which is preferable in life-threatening situations when the patient’s life is at high risk. The solution immediately enters the bloodstream, providing a quick therapeutic effect.
For emergency short-term or one-time use of the drug, only intolerance to any of the substances in the composition of Dexamethasone is considered a contraindication. In critical situations, the side effects of the drug are neglected.
Adults with acute and emergency conditions per day can be administered 3-4 times 4 to 20 mg each. In the acute phase of the pathology, as well as at the beginning of therapy, higher doses of the corticosteroid are used. The highest dose is 80 mg, but in critical cases it is higher.
Children's doses for intramuscular administration are calculated by the weight of the child at the rate of 0.02776 - 0.16665 mg per kilogram of body weight after 12-24 hours.
The duration of injection with a gradual dose reduction usually does not exceed 3-4 days, after which the patient is transferred to the administration of tablets in a maintenance dose.
Eye and ear drops
In acute inflammation, patients older than 12 years of age receive 48 ml of ophthalmic solution for 1 to 2 drops 4 to 5 times a day for 48 hours. When the degree of inflammation decreases, treatment is continued for another 4-6 days, reducing the frequency of instillation up to 3 times a day.
In chronic processes, the drug is used twice a day for no longer than 20 to 40 days.
In case of allergic eye damage, similar doses are used up to 5 times a day for 48 hours, then - gradually lower the frequency of instillation to 2 times a day and cancellation of treatment for 7-12 days.
Patients 6 to 12 years of age to eliminate inflammatory and allergic phenomena are administered 1 drop per eyelid up to 4 times a day for no longer than 10 days.
The solution is used from 8 days after cataract surgery, retinal detachment, strabismus up to 4 times a day for 2 to 4 weeks.
With inflammation of the ear (otitis media) of a non-viral nature, 3-4 drops are dropped into a sore ear in a warm form (for children 1-2) three times a day.
Lenses are removed before instilling. You can wear them only after 15 minutes.
General directions for use
According to the instructions, Dexamethasone injections can be given to both adults and children who are one year old. If you use the hormone intravenously, it is best to pre-mix it with glucose or saline. Also, doctors can prescribe injecting the drug intramuscularly.What should be the dosage of “Dexamethasone”?
Injections are prescribed three or four times a day, four to twenty milligrams at a time. The main thing is that the daily norm does not exceed eighty milligrams of the drug. In some cases, when it comes to the life of the patient, this dosage may be increased. However, only the attending physician should increase (or lower) the hormone intake rate.
How long should I use the injection? The optimal course of treatment, according to the recommendations of specialists, should not exceed three to four days. If the drug helps, and it is necessary to continue treatment, then doctors can prescribe “Dexamethasone” in tablets. As you improve, you should lower the accepted daily allowance to the minimum. Only a doctor has the right to cancel a drug.
With the introduction of the solution into the muscle, the procedure must be carried out carefully and slowly, otherwise the development of various complications can be provoked. Patients and nurses often mention this in their reviews of Dexamethasone.
Action and composition
The active substance of the drug is dexamethasone phosphate disodium salt, water for injection, glycerol, trilon B, sodium hydrogen phosphate dodecahydrate are used as auxiliary components. Dexamethasone solution is a clear, colorless liquid (sometimes with a light yellow tint).
The pharmacological effect of dexamethasone is due to the ability of glucocorticoids to interact with cytoplasmic receptors of cells, as a result of which the synthesis of messenger RNA starts. As a result, the formation of protein substances is induced, the synthesis of prostaglandins and other inflammatory mediators is suppressed. The drug affects protein, lipid and carbohydrate metabolism, has anti-inflammatory, anti-toxic and anti-shock effects, eliminates signs of allergic reactions.
In pharmacies, you can buy Dexamethasone in ampoules of 1 and 2 ml, which are packed in cardboard boxes of 5, 10 or 25 pieces. 1 ml of solution contains 4 mg of active substance. The price of a Russian-made Dexamethasone ampoule in a dosage of 4 mg averages 5–7 rubles.
Dexamethasone Pharmacological Group
The instructions for use say that dexamethasone (Dexamethasone) is a hormonal drug (the pharmacological group is glucocorticosteroids). The medicine is obtained synthetically. When introduced into the body, it has an effect similar to the hormones of the adrenal cortex.
Dexamethasone injections in ampoules
Instructions for use of dexamethasone compares it with hydrocortisone (cortisol), a hormone that is produced by the body. By its nature, dexamethasone is a homologue of hydrocortisone - it has a similar structure and structure, but the composition of its molecule is supplemented by fluorine atoms. In some instructions, the name fluoroprednisolone is used. Based on the chemical structure, hydrocortisone and dexamethasone have similar properties.
Why use dexamethasone tablets
However, the instructions for the drug indicate that the use of dexamethasone is recommended in smaller quantities, in comparison with other medicines in this group. Dexamethasone is significantly more effective when introduced into the human body than its natural prototypes.
2 mg of dexamethasone in terms of prednisone will be already 14 mg, and in terms of hydrocortisone it will be 60 mg of the active substance.
How to inject the drug intramuscularly instruction
Intramuscular and intravenous administration of the contents of the ampoule requires special care and patience, because the medication is administered slowly, and in the case of droppers, the drip method should be used. Otherwise, with rapid administration, cardiovascular collapse may occur.
An adult is administered only from four to twenty milligrams three times a day.The maximum possible dose is eighty milligrams. But, if the situation threatens the patient's life, then it is allowed to administer a larger amount of medicine. As a rule, the medication is used parenterally for three to four days, after which they switch to oral use of the drug. As soon as a positive effect is achieved, the dosage should be reduced to three to six milligrams per day.
In the case of cerebral edema at the initial stage, no more than sixteen milligrams are used for the purpose of treatment. After every six hours, they inject five milligrams intramuscularly until a positive result is visible.
For babies, the drug is administered only intramuscularly, while the dosage is selected according to the weight of the baby. Thus, you will need about 0.3 mg. per day per kilogram.
The therapeutic effect of intramuscular administration of Dexamethasone occurs only after eight hours, while with the intravenous effect occurs literally in ten minutes.
★ Treatment of ALLERGIES. First aid. The reasons for the occurrence. Nutrition for allergies.
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Dexamethasone injections for what purpose
Dexamethasone refers to hormonal drugs. This medicine is a synthetic analogue of the adrenal hormones. Use it with insufficient work of these glands and with other pathological conditions. If you refer to the instructions for the drug Dexamethasone, injection, indications for use there are indicated the following:
- diseases of joints, muscles (arthritis, myositis),
- cerebral edema,
- kidney disease
- liver disease
- pathology of the visual apparatus,
- oncological diseases,
- bronchial asthma,
- blood diseases.
Dexamethasone (injections) - why is it prescribed for adults?
The range of disorders in which the drug is used is wide. Intramuscular injections of Dexamethasone help quickly stop the allergic reaction that has developed brain edema. Doctors talk about the positive effect of treating severe infectious diseases when Dexamethasone is used along with an antibiotic. This drug has a systemic effect on the body. Telling patients about Dexamethasone, injections, for which the drug is prescribed, doctors indicate the following effect of the drug:
- removal of inflammation,
- metabolic regulation
- decrease in allegorical reaction,
- reduction of toxic effects on the body during the infectious process.
Dexamethasone (injections) - what is prescribed for children?
Dexamethasone, injection, children are rarely prescribed. So, the drug can be used for vaccination with live vaccines, if the child has a predisposition to the development of allergies. As part of complex therapy, the medicine is used for Itsenko-Cushing's syndrome - a disease accompanied by impaired adrenal gland function. Injections are not prescribed for children in case of disruption of the blood coagulation system. Among the main pathologies in which the use of Dexamethasone is indicated:
- severe skin lesions, dermatoses,
- Crohn's disease,
- hemolytic anemia,
Talking about such a dosage form as Dexamethasone, injections, for which the drug is prescribed, it is necessary to note the possibility of local administration of the drug. Injections are often carried out in the neoplasm in the soft tissues, joint and even in the eye. In rare cases, with severe and persistent hypothermia, Dexamethasone is used as part of the lytic mixture (administered with Analgin and Diphenhydramine).
Dexamethasone (injections) - what is prescribed for pregnant women?
When carrying a child, the drug is used with caution. It helps the body of the expectant mother to fight the increased blood levels of androgens - male hormones that can provoke a miscarriage
Under the influence of Dexamethasone, there is a decrease in testosterone synthesis.The drug can be used throughout the gestation period.
In each case, specialists individually determine the need for the use of the drug. When dexamethasone is prescribed, injections, indications for the use of the drug during pregnancy are always associated with the threat of interruption of gestation
The drug is used carefully: its components penetrate the placental barrier, therefore, it can affect the fetus.
Dexamethasone (injections) - why is it prescribed for cancer patients?
Often in the list of appointments of patients with oncology there is Dexamethasone, a solution for injection. Use it in the tumor process in the brain as a drug of complex therapy. It allows you to improve the general condition of the patient: relieve swelling, reduce inflammation. The systematic use of the drug helps to normalize intracranial pressure, relieve the patient of severe, prolonged headaches. Dosage, frequency and duration of therapy are set individually, taking into account the stage of the pathological process.
Which is better - prednisone or dexamethasone?
Prednisone Is a synthetic analogue hydrocortisone, which is considered a standard remedy with an average duration of action and is most often used in clinical practice.
Compared to hydrocortisoneits glucocorticoid activity is 4 times higher, however, according to mineralocorticoid activity prednisone inferior hydrocortisone.
Dexamethasone is a long-acting corticosteroids. Unlike the analogue, the drug is fluorinated. Glucocorticoid activity of the drug is 7 times higher, which prednisone. However, it does not have a mineralocorticoid effect.
To a greater extent than other corticosteroids, it provokes depression of the hypothalamic-pituitary-adrenal axis, causes severe disturbances in calcium, lipid and carbohydrate metabolism, has a psychostimulating effect, and therefore is not recommended for prolonged use.
Dexamethasone during pregnancy and pregnancy planning
Tablets: during treatment and lactation are not used.
Drops: during pregnancy are not recommended, if used during lactation, breast-feeding should be discontinued.
Injections during pregnancy are used only for health reasons (especially in the 1st trimester).
When planning pregnancy, Dexamethasone can be used in situations where the reason for the inability to conceive / bear the baby is hyperandrogenism. During pregnancy, it is most often prescribed for threatened miscarriage, when the immune system perceives the embryo as a foreign body (the drug helps to suppress immune activity).
Reviews of Dexamethasone during pregnancy allow us to conclude that although the drug is in some cases the only chance to become pregnant and maintain a pregnancy, its use is almost always associated with certain inconveniences.
After all, Dexamethasone - what is it? A powerful hormonal drug. Therefore, almost all women taking it noted a change in body weight, hormonal disorders, a tendency to depression.
Dexamethasone price, where to buy
The price of Dexamethasone in ampoules of 4 mg - from 9 UAH. Drops for eyes can be bought from 12 UAH. The price of Dexamethasone in tablets is from 14 UAH.
In Russian pharmacies for dexamethasone eye drops, the price starts from 65-79 rubles. Injections are sold for 34-55 rubles. for packing No. 5, the price of tablets - from 30 rubles. Ophthalmic ointment with dexamethasone can be bought from 140 rubles.
|Age||Introduction||Dose mg||Quantity once a day||Treatment features|
|Adults||Intravenously or intramuscularly||4 – 20||3 — 4||Not more than 80 mg per day, parenterally - up to 4 days, later - oral therapy. The dose varies depending on the condition.|
|Children||Intramuscularly||The dosage is calculated depending on the body weight of the child. Usually it is 0.2 - 0.4 mg per 1 kg of body weight per day.|
In the treatment of joints, the drug is administered directly to the joint and depends on the size of the joint and location. The treatment regimen involves an injection every few days.
Use in pregnant women
Dexamethasone has a contraindication for use during pregnancy in the first trimester. If there is an objective need, the medicine can be used in the 2nd and 3rd trimester, taking into account the potential risk for the development of the fetus.
Prolonged use of Dexamethasone can adversely affect fetal development, lead to disorders such as stunted growth, and even cause atrophy of the adrenal cortex and abnormalities in limb formation. If dexamethasone is needed to treat a woman during breastfeeding, the child is transferred to artificial infant formula.
Original instructions for use - Download
Advantages and disadvantages
Reviews of doctors about the use of Dexamethasone indicate that the danger of hormonal drugs is somewhat exaggerated, and their use is very effective in the treatment of allergic conditions, cerebral edema, joint damage.
The main advantages of Dexamethasone injections are:
- Wide range of action,
- Low price
- Pronounced positive and quick effect,
- The possibility of using the drug in complex therapy.
The disadvantages of Dexamethasone injections include:
- Limited use during pregnancy,
- The need for control during the period of use of the drug,
- A large list of side effects
- The need to select the lowest possible dosage.
To avoid the negative effects of the drug Dexamethasone, it is enough to take into account the presence or absence of contraindications, and select the dosage taking into account the age, weight, and results of the patient’s tests.
On the video: Dexamethasone injections - reviews, chondrosis.
Dexamethasone for children
When the question arises about the baby’s life and urgent intervention is required, dexamethasone for children is prescribed. The drug is used in case of:
- laryngeal edema - false croup,
- severe chronic diseases - asthma, bronchitis, atypical dermatitis,
- rheumatoid arthritis,
- acute allergies
- connective tissue diseases
- respiratory failure in newborns.
Dexamethasone is used under the strict supervision of a pediatrician who prescribes a dose and dosage regimen. This is due to the effect of the drug on the growth process of the child. Use it in the form of injections, tablets, eye drops, ointment is prescribed, starting from 6 years. The ampoule solution, which is used for inhalation, receives good reviews. The drug removes:
- allergic cough
- coughing fits