Dexamethasone injections - instructions, indications, side effects, reviews. Dexamethasone: instructions, price, analogues and reviews Dexamethasone candles

Dexamethasone is a hormonal medicinal product, which in modern medicine regarded as one of the vital pharmaceuticals belonging to the group of synthetic glucocorticosteroids. Dexamethasone is able to penetrate the tissues of all organs and systems, including the brain and nervous system and affect the entire body. In severe conditions - shock, acute systemic allergies, severe inflammation, pathological immune reactions, the medicine can save a life.

For treatment different type 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, which is produced in the body by the adrenal glands.

Basic forms:

Tablets of 0.5 mg (0.5 mg of the active ingredient) in a pack of 10 units.
Injection solution (0.4%) in 1 ml ampoules containing 4 mg active substance(5 or 25 units per pack). It is used for injection into a muscle, vein (stream or drip), inside the joint, in 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 stabilizing, shaping and transporting dexamethasone to the painful focus, as well as preservatives and additives that facilitate the absorption of the drug.

Each treatment form has its own purposefulness in use, certain indications and contraindications, so you should not treat yourself - only a specialist is able to develop the desired therapy regimen, calculate doses and frequency of use.

The medicine is dispensed by prescription, where the name of the drug in Latin is denoted as Dexamethasoni.

Pharmacological properties and pharmacokinetics

Medicinal properties

The mechanism of the therapeutic action of the drug is based on its ability to create a high concentration of the component in the blood and foci of inflammation, penetrate into all tissues and act at the cellular level.

This allows the active substance to work in the brain and nerve tissues, relieve swelling of the brain, lungs in case of hemorrhage, poisoning, trauma, tumors, removing the patient from a life-threatening state of shock, slow down the course of cancer processes, and eliminate 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, strengthening the protection of cell membranes and blocking 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 mucosal edema respiratory organs, bronchi, restoring the flow of air in case of laryngeal edema or an 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 elimination from the body

The corticosteroid is actively and almost completely absorbed not only after injection, but also after internal administration. Bioavailability or the 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 medicinal substance in blood. With the blood flow, the protein delivers dexamethasone throughout the body, penetrating into the intracellular spaces of tissues.

The largest amount of the 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 along with urine and in small amounts (about 10%) is excreted by the intestines. A small amount of dexamethasone passes into women's milk, which should be taken into account when prescribing the drug to a nursing mother.

Why is the drug prescribed

The action of the drug is used in many diseases of internal organs, systemic, autoimmune pathologies, in diseases of the joints, eyes, skin and in many other areas of medicine.

The list of pathological conditions that require Dexamethasone injections or tablets include:

life-threatening shock conditions of all forms, including pain shock, toxic, cardiogenic, allergic, postoperative, blood transfusion (after blood transfusions);
swelling of brain tissues (with hemorrhage, meningitis, tumors, encephalitis, trauma, surgery);
attack 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, diseases thyroid gland, 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; different kinds myositis;
intractable skin diseases - eczema, various types of dermatitis, psoriasis, toxidermia, Lyell and Stevens-Johnson syndromes, discoid lupus erythematosus, keloid scars (topical application);
eye lesions of an allergic and inflammatory nature: scleritis, corneal ulcer, various types of conjunctivitis (except purulent), uveitis, keratitis, blepharitis, inflammation of the optic nerve, ophthalmopathy against the background of diabetes mellitus;
swelling of the larynx and glottis with acute croup;
inflammation of the joints of various courses: arthritis of various forms, osteoarthritis, polyarthritis, ankylosing spondylitis, bursitis, tendosynovitis and others;
hematopoietic disorders: Addison's disease, lymphoma, agranulocytosis, anemia of various origins, 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 helminthic aggression;
lesions of the esophagus and stomach in case of poisoning with alkalis, acids to suppress inflammation and prevent cicatricial narrowing;
acute renal pathologies - glomerulonephritis, nephrotic syndrome;
malignant processes in the lungs, leukemia, lymphocytic leukemia, multiple myeloma;
nausea and vomiting while taking cytostatics.

Application instruction of Dexamethasone

The treatment regimen with Dexamethasone and the dosage regimen are established only by the attending physician in order to obtain the maximum therapeutic effect with a minimum risk of unwanted side reactions.

Tablets

Usually prescribed for the chronic course of the pathology or after the removal of an acute condition.

The dose is determined for each patient separately, taking into account the nature and severity of the disease, the planned duration of the course, age, drug tolerance and the patient's response.

The usual minimum effective dose for adults per day is 0.5-9 mg. A small dose is taken at a time, a large dose is divided into 3-4 doses. The largest amount of dexamethasone per day should not exceed 10-15 mg.

The average maintenance dose per day is 0.5 - 3 mg.

With long-term use of the drug in a large dose, the drug is combined with food. In this case, between meals, it is desirable to use means that reduce gastric acidity (antacids).

After the patient's condition improves, the dose should be gradually reduced - every 3 days by 0.5 mg to a maintenance dose.

The duration of the course of application ranges from 3 - 5 days to several months.

It is unacceptable to abruptly stop treatment with Dexamethasone, so as not to cause a withdrawal syndrome,

which is expressed in an exacerbation of the underlying disease and painful manifestations of the withdrawal syndrome (weakness, weight loss, vomiting, diarrhea, drop in blood sugar and pressure, muscle pain, fever).

Dosing for children

Juvenile patients are prescribed in accordance with body weight or body area, age and severity of the pathological process.

The approximate children's dose per day is 0.0833 - 0.333 mg per 1 kilogram of the child's body weight. 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 - 4 doses, depending on age.

Injections

Dexamethasone injections for systemic diseases are given into the muscle, or administered intravenously, which is preferable in life-threatening situations when the risk to the patient's life is high. The solution immediately enters the bloodstream, providing a rapid therapeutic effect.

For emergency short-term or single 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, you can enter 3-4 times 4-20 mg. In the acute phase of the pathology, as well as at the beginning of therapy, higher doses of corticosteroid are used. The highest dose is 80 mg, but in critical cases it is higher.

Children's doses for intramuscular injection 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 taking tablets at a maintenance dose.

Drops eye and ear

In acute inflammation, patients over 12 years of age for 48 hours 4-5 times a day drip an ophthalmic solution over the lower eyelid, 1-2 drops. When the degree of inflammation decreases, the treatment is continued for another 4-6 days, reducing the frequency of instillation to 3 times a day.

In chronic processes, the remedy is used twice a day for no longer than 20-40 days.

In case of allergic eye damage, similar doses are used up to 5 times a day for 48 hours, then they gradually reduce the frequency of instillation to 2 times a day and stop treatment for 7 to 12 days.

For patients 6-12 years old, to eliminate inflammatory and allergic phenomena, 1 drop is administered per eyelid up to 4 times a day for no longer than 10 days.

The solution is used from the 8th day after the operation to eliminate cataracts, retinal detachment, strabismus up to 4 times a day for 2 to 4 weeks.

In case of inflammation of the ear (otitis media) of a non-viral nature, 3-4 drops (for children 1-2) are instilled into the sore ear in a warm form three times a day.

The lenses are removed before instillation. You can put them on only after 15 minutes.

Dexamethasone eye ointment

It is used for the same indications as ophthalmic drops in patients from 6 years of age. A strip of ointment 10-15 mm long is carefully placed behind the lower eyelid 3 times a day. The maximum duration of treatment is not more than 20 days.

Use during pregnancy and lactation

In a study on small mammals, it was found that Dexamethasone, like many other hormonal agents, penetrates through the placenta into the tissues of the embryo and can lead to the death of the embryo at early stage and fetal malformations. The class of action of the drug on the fetus is C (according to the FDA).

Therefore, Dexamethasone is used during pregnancy only if there is a threat to the life of the mother.

If the pregnant woman received Dexamethasone, after childbirth, monitoring of the baby's health is necessary - since the child may be diagnosed with adrenal dysfunction, which requires immediate intensive treatment.

Since the drug passes into women's milk, lactating mothers need to switch to artificial feeding or stop the drug.

With long-term use of ointment or drops, partial absorption of the drug into the blood occurs. Therefore these dosage forms expectant mothers are allowed to use only after 12 weeks of gestation, in very short courses up to 3 days and in minimal doses.

During lactation, treatment with ointment and drops is acceptable for no longer than 7 to 10 days.

Can I drink alcohol while taking the drug

Treatment with Dexamethasone is incompatible with the use of alcohol, otherwise the consequences of parallel use will be very serious.

There is a high probability of such severe manifestations as:

indomitable diarrhea;
partial loss of vision;
abdominal pain, vomiting;
acute pain at the injection site;
redness of the skin on the chest, urticaria, acne rash on the face;
mucosal ulceration digestive organs;
internal bleeding.

If the patient has a serious alcohol dependence and is not able to give up alcohol for the duration of therapy, other drugs are required.

Drug interactions with other drugs

The combination of Dexamethasone and non-hormonal anti-inflammatory drugs (Aspirin, Paracetamol) increases the likelihood of formation or deepening of ulcers of the digestive organs.

The action of the corticosteroid is reduced with concomitant use:

antacids that reduce the absorption of the treating substance in the stomach;
growth hormone;
drugs from a series of inducers of the CYP3A4 isoenzyme (for example, phenobarbital, phenobarbital, rifabutin, rifampicin, carbamazepine);
aminoglutethimide and ephedrine.

With parallel use, Dexamethasone is capable of:

reduce the therapeutic effect of insulin, hypoglycemic drugs, drugs for high blood pressure, praziquantel and natriuretic diuretics;
enhance the effect of Heparin, Albendazole.
increase the excretion of potassium when combined with diuretics; influence the action of anticoagulants based on coumarin;

Antifungals based on ketoconazole, birth control pills, macrolide antibiotics can prolong the urinary excretion of dexamethasone and increase the frequency and severity of adverse reactions.

The combination of a medication with Thalidomide can provoke the development of Lyell's syndrome, with anticholinergics - glaucoma, with antipsychotics and Azathioprine - cataracts; with cardiac glycosides - arrhythmias.

The combination with anabolic steroids, androgens, contraceptives, estrogens can cause increased facial hair, chest, edema, acne.

The use of antiviral vaccines in parallel with Dexamethasone therapy increases viral aggressiveness against the background of a decrease in immunity.

Contraindications, side effects and overdose

Contraindications

If Dexamethasone is urgently required to save a life, all contraindications (except drug intolerance) and possible adverse reactions are ignored.

For any severe infections, it is permissible to prescribe Dexamethasone injections and tablets only with the simultaneous specific treatment of these diseases.

Contraindications for intra-articular injections:

tendency to bleeding;
intra-articular fracture of the bone;
infection, osteoporosis, instability, joint deformity, bone destruction, ankylosis;
surgery (arthroplasty);
necrosis of the articular bone;
low efficiency after 2 previous injections.

Contraindications for local forms (ointment, drops):

eye damage with a tubercle bacillus, fungus, viruses, including herpes;
glaucoma;
acute suppuration of the structures of the eye (if antibiotic treatment is not carried out);
injury and ulcer of the cornea, the period after the removal of a foreign object;
hole in the eardrum.

Important! Ointment and drops Dexamethasone can reduce the severity of manifestations in the development of bacterial and fungal infection ears and eyes.

Therefore, after clarifying the diagnosis and identifying the infection, the drug should be used with appropriate antimicrobial treatment.

Side effects

A hormonal agent has a profound effect on all body systems. The task of the attending physician is to minimize the risk, frequency and severity of adverse reactions with a high therapeutic effect of the drug.

Undesirable manifestations depend on the duration of the course, dosages, age and condition of the patient.

Basic side effects:

allergic rashes, pruritus, urticaria, swelling on the face, respiratory disorders, bronchospasm, anaphylactic shock;
restlessness, disorientation, depressive, paranoid states or euphoria;
double vision, visual disturbances, pain in the head due to an increase in intracranial pressure, characteristic of a rapid decrease in dose;
insomnia, dizziness;
persistent increase blood pressure;
weakening of the myocardium, arrhythmias;
potassium deficiency and cardiac disorders associated with hypokalemia;
decrease in adrenal function, the development of diabetes mellitus, Itsenko-Cushing's syndrome, excessive hair growth, menstrual cycle disorder, developmental delay in children;
a sharp increase in blood viscosity and thrombosis;
nausea, bouts of vomiting, ulceration of the digestive organs, gastritis, pancreatitis, colitis;
frequent infections against the background of immunosuppression;
osteoporosis, abnormal fractures, joint and muscle pain, femoral head necrosis, tendon rupture;
acne, sweating, dry skin, slow healing of lesions;
swelling of the limbs, weight gain;
a sharp deterioration in vision (with injections in the area of the face, neck and head);
increased pain when injected into the joint;
burning, itching of the mucosa and skin (ointment and drops), with treatment longer than 20 days, allergies, glaucoma and cataracts may develop, and visual function may decrease.

Drivers of transport and workers who require increased concentration should be careful when treating with Dexamethasone, as concentration is disturbed when it is taken.

Overdose

Excessive doses of corticosteroid or long-term treatment can lead to overdose, which manifests itself in an increase in unwanted side effects.

The drug is immediately canceled and the symptoms of an overdose are eliminated with the help of drugs that can relieve certain manifestations.

With long-term therapy, constant monitoring of the development of children is required, periodic examination of the organs of vision, control of intraocular, intracranial pressure, sugar and blood coagulability, functions of the adrenal glands and the hypothalamic-pituitary system.

Dexamethasone analogs

Synonyms - drugs with the same active ingredient as Dexamethasone and a similar therapeutic effect: Dexamethasone-Vial, Dexamethasone-Ferein, eye drops - Dexamethasone Long, Maxidex, Oftan Dexamethasone, Ozurdex.

Analogues with a similar action, but a different composition:

drops with Dexamethasone and other active ingredients: Sofradex, Dexon;
Prednisolone is a corticosteroid drug with a similar but weaker therapeutic effect.

Dexamethasone - instructions for use of the drug is not a manual for self-study. This document contains information that only a person with a medical background can understand and objectively evaluate.

Dexamethasone - pharmacological group

The instructions for use say that dexamethasone (Dexamethasone) is a hormonal drug (pharmacological group - glucocorticosteroids). The drug is obtained synthetically. When introduced into the body, it has an effect similar to the hormones of the adrenal cortex.

The instructions for use of dexamethasone compare it to 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 with fluorine atoms. Some instructions use the name fluoroprednisolone. Based chemical structure, hydrocortisone and dexamethasone have similar properties.

What is dexamethasone tablets used for?

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 administered to the human body than its natural counterparts.

Note! The official instruction does not indicate this, but only a doctor can prescribe dexamethasone, its use and dosage. The drug is 35 times more active than cortisone and 7 times stronger than prednisone!

2 mg of dexamethasone in terms of prednisolone will already be 14 mg, and in terms of hydrocortisone it will be 60 mg of the active substance.

Forms of release of dexamethasone

The substance Dixamethasone is a poorly soluble powder with a crystalline structure, white or yellowish in color, without a pronounced odor. According to the instructions for use, the most common form of release is a solution for parenteral administration. Methods of administration: into a vein, into a muscle, into a joint, into periarticular tissues. Subcutaneously, dexamethasone is used in veterinary medicine.

In the pharmacy network, you can buy dexamethasone in the following pharmaceutical forms:

Dexamethasone tablets at a dosage of 0.5 mg of the active substance.
Solution for injections, in ampoules of 4 mg and 8 mg.
Eye drops in solution or suspension, concentration 0.1%.
Spray Dexocort with dexamethasone (and neomycin) for the treatment of dermatological pathologies.

Accumulating information from the instructions for the use of dexamethasone for various dosage forms, the drug is produced by several domestic manufacturers, the German Bayer AG and Weimer Pharma, Polish pharmacists, Slovenia Krka and a pharmaceutical company in Thailand. The price depends on the manufacturer and the form of release. Estimated cost is from 60 to 100 rubles per pack of ampoules.

pharmachologic effect

Indications for use are listed in the instructions for use of the drug. The use of dexamethasone varies depending on the pathology. Deksametazon, when administered orally, acts at the cellular level, causing cytoplasmic receptors to respond.

Since there are transmembrane receptors in all organs and tissues, the synthetic glucocorticosteroid acts systemically.

Instructions for use Desoximetasone contains information that the drug effectively eliminates:

inflammatory processes in organs and tissues, including the liver, kidneys, eyes, skin;
acts as an immunosuppressant;
suppresses allergic reactions;
brings the patient out of shock;
promotes the elimination of toxins in case of poisoning;
removes excess fluid from the body.

In general, dexamethasone and its analogues change the metabolism of the body in all systems, which is why it is so important to follow the instructions. When taken orally or injected, the drug is quickly and completely absorbed by the body.

Note! Instructions for use warns not only about the strong effect of dexamethasone on the body, but also about the effect of prolongation. Wrong dosage will cause side effects.

The half-life (half-life) of the active substance is from one and a half to two and a half days. The drug Dexametazole is processed in the liver, excreted from the body through the urinary system.

lipid metabolism

The use of dexamethasone (or its analogues) provokes the stimulation of the formation of triglycerides and fatty acids. In this case, triglycerol concentrates the deposition of subcutaneous fat in the upper body. The patient acquires a characteristic appearance, a person "who sits on hormones." The patient has an increase in the shoulder girdle, face and abdomen. Hands and feet, as a rule, gain weight slightly, but are prone to swelling.

Note! The use of the drug without clear instructions from the attending physician is fraught with an increase in the content of bad cholesterol in the blood. This, in turn, threatens with vascular complications in the legs, ischemic disease heart, development of hypertension.

carbohydrate metabolism

The use of Dexamethasone enhances the absorption of carbohydrates from the intestines. At the same time, it stimulates the entry of glucose reserves from the liver into the blood, which increases the blood glucose content, reaching hyperglycemia.

Dexamethasone - intramuscular injections

Protein metabolism

According to the instructions, in terms of the effect on protein metabolism in the body, the use of dexamethasone shifts the globulin-albumin balance towards the predominance of albumin in the blood. Increases the intensity of protein breakdown in muscle tissue, while reducing the formation of complex protein molecules (globulins). Stimulates the synthesis of albumin in the liver and kidneys.

Water-salt balance

Taking Dexamethasone, even if the instructions are followed, can contribute to the retention of sodium and water ions in the body. Glucocorticosteroid flushes out potassium. Weakens bones by preventing the absorption of calcium from food. With prolonged use of dexamethasone, patients have an edematous appearance, pronounced pastosity of tissues.

Thus, stimulation of the absorption of carbohydrates, a change in the water-salt balance when taking dexomethasone, leads to the accumulation of adipose tissue (Itsenko-Cushing's syndrome) and the development of osteoporosis. These two prescription effects are the most common contraindication to long-term therapy.

Note! The effect of dexamethasone on metabolism is dose-dependent (method of administration, dosage, duration of treatment). When following the instructions for taking the drug, it is expressed to a minimal extent.

The instruction warns that the use of the drug in children is fraught with a slowdown in their growth. This is due to the ability of glucocorticosteroids to enhance the decay processes in the tissues of the body. Affected may be: bone, connective, muscle, adipose tissue, as well as the dermis.

The anti-inflammatory effect is explained by the ability of dexamethasone to stop the production of inflammatory mediators. Initiates the production of more lipocartin. Taking the drug prevents the destruction of lysosomes, which is especially important in inflammatory joint pathologies. In the treatment of arthritis, the instruction recommends the use of lotions, compresses with a solution of dexamethasone. The local form of application effectively relieves inflammation, constricts blood vessels in the area of action of the solution or ointment.

Note! The success of anti-inflammatory therapy with dexamethasone depends on complex treatment.

In parallel, the patient is prescribed a course of antimicrobial therapy (for example, Ciprofloxacin), antibiotics (for example, Tobramycin, Ciprofloxacin hydrochloride for pneumonia, Gentamicin in gynecology). Women with inflammatory diseases Stizon.

The immunosuppressive effect is explained by the ability of dexamethasone to suppress the activity of lymphocytes and macrophages.

The antiallergic effect consists of the complex action of the drug on the body. Reduces the manifestations of allergies by inhibiting the production of histamines, the anti-inflammatory effect that Dexamethasoni has on the composition of the blood.

The instruction warns that in high doses, dexamethasone has an exciting effect on the brain, increasing the activity of the synapse. This may manifest as an epileptic seizure or convulsive syndrome. You need to monitor the condition and blood counts.

Indications for use - instructions for dexamethasone

The use of glucocorticosteroids is indicated for a number of diseases. According to the instructions, dexamethasone is used: inside in tablet form; injection (intravenously, droppers, intramuscular injections); locally locally (applications, compresses, rubbing).

Appointment in tablets is done for the following diseases:

Pathologies in the work of the thyroid gland - hypothyroidism, thyroiditis in an acute and smoothed form. Eye disease caused by thyrotoxicosis.
Inflammatory diseases of the joints.
endocrine disorders.
Bronchial asthma in the acute stage, severe bronchitis with an asthmatic component, pneumonia, Hobl.
Blood diseases, hematopoietic disorders.
Dermatosis, eczema.
Oncological pathologies. Here, dexamethasone is indicated in the complex of supportive treatment when the disease is in the last stages of development (palliative therapy).

How to take in tablets? The instruction indicates that oral dexamethasone is used as a continuation of treatment, with the abolition of injections or droppers.

Dexamethasone solution is prescribed in the form of intramuscular injections, intravenous drip in severe conditions that require immediate or extremely intensive medical care.

Inject the drug in the following cases:

Shock conditions of various etiologies (for example, with trauma).
Severe allergic reactions: anaphylactic shock, Quincke's edema, dermatosis, eczema with a large affected area.
Cerebral edema caused by: traumatic injury (including surgical intervention); infection (meningitis, encephalitis); hemorrhage, etc.
As part of the complex treatment of severe infections, including tuberculosis.
Respiratory disorders, status asthmaticus.
Hormonal insufficiency with poor adrenal function.
Joint pathologies of inflammatory, traumatic, autoimmune origin.
Acute states of neurological etiology.
Oncopathology.

The instructions also indicate the use of dexamethasone not only in pure form, but also as part of complex topical preparations. Indications for use may be in dentistry, in ophthalmic treatment, in the treatment of ENT organs.

In ophthalmology, for inflammatory, degenerative diseases, eye injuries (including operating rooms), dexamethasone is prescribed in the form of drops. This may be a special solution of dexamethasone without additives or as part of a multicomponent drug.

Locally externally dexamethasone (ointment, solution, aerosol) is indicated for lupus erythematosus, severe dermatosis (including granulomatous), eczema, keloid formations.

Dexamethasone contraindications

In the instructions for the use of dexamethasone, contraindications are divided into absolute and relative. To the absolute, when dexamethasone is forbidden to use even for a short course, is the individual intolerance to the drug.

The description of the drug contains a list of relative contraindications.

Dexamethasone should not be prescribed for the following conditions and pathologies:

glaucoma;
obesity stage 3;
viral lesions, including: herpes, HIV;
systemic mycoses;
helminthic invasion;
inflammatory diseases (without the use of antibiotics in the complex);
diseases gastrointestinal tract(colitis, peptic ulcer, enteritis);
a recent history of a heart attack;
diabetes;
pathologies of the liver, kidneys, which are expressed in a sharp decrease in the efficiency of these organs;
osteoporosis;
inflammation of the lymph nodes;
some forms of mental pathologies;
polio;
pregnancy.

Note! The reaction of the body to the introduction of a potent corticosteroid cannot be predicted. According to the instructions, the use of dexamethasone requires an individual approach, especially with regard to dosage and duration of treatment.

Pregnancy is a relative contraindication. The instruction allows the use of dexamethasone in cases where the risk of its negative effect on the fetus is offset by the serious condition of the mother.

Breastfeeding is a contraindication for the use of dexamethasone and its analogues. According to the instructions, HB should be discontinued if effective therapy is not possible without dexamethasone. To maintain the lactation process, express milk until the end of treatment.

Dosage

About how to dose dexamethasone, the instruction clearly indicates only that the dosage is selected individually. Treatment with corticosteroids begins with a low dose, the middle of therapy is an intensive course, the final stage is a gradual decrease in dosage

Note! The introduction of a synthetic hormone into the body will inevitably provoke a slowdown in the production of its own corticosteroid analogues. The unjustified use of a potent hormonal medication can undermine your health.

V official instructions according to the use of dexamethasone, the classic dosing regimen for the drug in injections looks like this:

the beginning of therapy - from 2 to 4 mg of the drug per day;
in the zone of therapeutic effect (2-3 days of treatment) - the maximum dosage;
the final stage of treatment is a gradual decrease in the daily dose to 0.5 mg.

The instruction warns that the initial intake of doxymethasone orally at the maximum dose can provoke a hormonal shock in the patient. The same effect occurs with a sharp withdrawal of the drug.

According to the instructions, not only the dosage varies, but also the form of application of dexamethasone. At the intensive stage of therapy, Dexomethosone is injected into a vein by jet, drip or intramuscular injection. For maintenance therapy, it is enough to take pills.

In the treatment of joints, dexamethasone is injected locally, directly into the affected joint.

Instructions for treatment are as follows:

from 0.2 to 8 mg of dexamethasone is injected into the joint once every 3 days;
full course - 3 weeks.

Children are dosed with doxymethasone according to their age. The minimum allowed to use per day is 0.25 mg, the maximum is 2.5 mg of the active substance per day.

Note! The dosage varies not only from age or individual reactions, but also from his diagnosis, anamnesis. For children, the daily dose is divided into 3-4 doses.

Instructions for the ophthalmic use of drugs with dexamethasone:

the initial stage of treatment - 1-2 drops every 1-2 hours;
after the development of a stable therapeutic effect - the time period is increased to 4-6 hours.

The duration of the use of drugs with dexamethasone varies depending on the severity of the condition. According to the instructions no more than 3 weeks.

In dermatology, the use of drugs containing dexamethasone, according to the instructions for the relevant medications.

Note! Uncontrolled use of hormonal drugs in allergic skin reactions leads to an exacerbation of the disease. One of the consequences of non-compliance with the instructions is tissue necrosis.

Side effects of dexamethasone

Since dexamethasone is a potent hormonal drug, its use can adversely affect any of the body's systems. Side effects can be called systemic, since the work of the whole organism is disrupted.

Endocrine system:

Itsenko-Cushing's syndrome;
increased glucose levels, diabetes;
impaired production of adrenal hormones;
in children - growth retardation;
adolescents have delayed puberty.

Disorders in the metabolic system:

decrease in the level of calcium, potassium;
increase in sodium content;
increased protein breakdown processes, increased sweating.

The cardiovascular system:

violation of the heart rhythm with a predominance of bradycardia (in severe cases, cardiac arrest);
increased arterial parameters, blood clotting, vascular thrombosis;
in patients with a heart attack - delayed scarring, necrosis, rupture of the heart;

Musculoskeletal system:

amyotrophy;
osteoporosis;
myopathy.

Neurology and psyche:

hallucinations, euphoria, depression, nervousness, insomnia;
convulsions, epileptic seizures;
headaches, disorientation, memory lapses.

Digestive system:

nausea, vomiting;
ulcer perforation;
acute colitis;
inflammation of the esophagus;
inflammation of the pancreas.

The instruction to the drug indicates possible changes in the sense organs. Organic damage to the eyes, the development of inflammatory processes, decreased visual acuity.

Due to metabolic disorders pathological changes in internal organs, the use of dexamethasone not according to the instructions is fraught with the following manifestations:

acne;
striae;
change in pigmentation;
inflammatory processes.

On the part of dermatological complications, the use of dexamethasone can lead to allergic reactions in the form of dermatitis, eczema, and various types of rashes.

Note! To reduce the effect of the side effects of dexamethasone and its analogues on the body, during the use of glucocorticosteroids, a concomitant drug is prescribed. symptomatic therapy.

For example, according to the instructions for stabilizing the work digestive system prescribed omeprazole.

A balanced diet is very important with dexamethasone. Food should be rich in proteins, be easy to digest. Preference should be given to foods rich in potassium. Dairy products are important because the body requires an increased amount of calcium. Salt should be kept to a minimum. However, it should not be completely excluded from the diet.

Dexamethasone analogues and price

Similar drugs, then what can replace dexamethasone, are usually not indicated in the instructions for use. The use of generic drugs is possible according to the instructions for dexamethasone, since the active substance in these medicines is one. Exact information on dosage and use is indicated in the annotation to the drug.

List of drugs with different trade names, but with one active ingredient - dexamethasone:

Decadron
Dexa-Allvoran
Supertendin
Fortecourt
Dexacort
Sondex
Dexabene
Detazone
Maxidex

Table of drugs that are analogues of dexamethasone. Their use is regulated by separate instructions, since having a similar effect, the preparations contain other active hormonal substances.

Drug (trade name)	Release form	Price in rubles (approximate)
Methylprednisolone (Metipred)	tablets solution for injection, vial	190
Naphthyzine Dioxidine	compound nasal drops	60
Methylprednisolone aceponate (Advantan)	ointment emulsion	1219
Fluocinolone acetonide (Sinaflan)	ointment	96
Triamcinolone (Ftorocort, Kenalog)	ointment tablets	260
Betamethasone (Diprospan, Akriderm)	amp, solution cream, ointment	580
Desonide (Desoven)	cream, gel	from 350
Alclomethasone (Afloderm)	cream	370
beclomethasone	metered dose aerosol for inhalation	292
Clobetasol (Dermovate)	ointment	435
Fluticasone	spray can nasal spray	800
Hydrocortisone (cortisol)	solution suspension for intraarticular injections ointment, gel ointment, eye suspension	155
Dexamethasone Ferein	solution, ampoules	—
Prednisolone	solution tablets	48
Dexa Gentamicin	eye ointment	140

The instruction indicates that all drugs with doxymethasone cannot be used without a doctor's prescription. When buying, the pharmacist will need to present a prescription in Latin.

Ampoule storage conditions: at room temperature, in original packaging. Store no more than 5 years from the date of issue.

Video

INN: Dexamethasone

Manufacturer: Krka, d.d., Novo Mesto

Anatomical-therapeutic-chemical classification: Dexamethasone

Registration number in the Republic of Kazakhstan: No. RK-LS-5 No. 003394

Registration period: 05.08.2016 - 05.08.2021

Instruction

Tradename

Dexamethasone

International non-proprietary name

Dexamethasone

Dosage form

Solution for injection, 4 mg/ml

Compound

One ampoule contains

active substance- dexamethasone sodium phosphate 4.37 mg (equivalent to dexamethasone phosphate 4.00 mg),

vexcipients: glycerin, disodium edetate, sodium hydrogen phosphate dihydrate, water for injection.

Description

Clear, colorless to light yellow solution

Pharmacotherapeutic group

Corticosteroids for systemic use. Glucocorticosteroids. Dexamethasone.

ATX code H02AB02

Pharmacological properties

Pharmacokinetics

After intravenous administration, the drug begins to act quickly, and after intramuscular administration, the clinical effect is achieved after 8 hours. The action of the drug is prolonged and lasts from 17 to 28 days after intramuscular injection and from 3 days to 3 weeks after local application (in the affected area). A dose of 0.75 mg dexamethasone is equivalent to a dose of 4 mg methylprednisolone and triamcinolone, 5 mg prednisone and prednisolone, 20 mg hydrocortisone, and 25 mg cortisone. In plasma, about 77% of dexamethasone binds to plasma proteins, and the majority is converted to albumin. Only a minimal amount of dexamethasone binds to non-albumin proteins. Dexamethasone is a fat soluble compound. The drug is initially metabolized in the liver. Small amounts of dexamethasone are metabolized in the kidneys and other organs. The predominant excretion occurs through the urine. The half-life (T1 \ 2) is about 190 minutes.

Pharmacodynamics

Dexamethasone is a synthetic adrenal hormone (corticosteroid) with glucocorticoid action. The drug has a pronounced anti-inflammatory, anti-allergic and desensitizing effect, has immunosuppressive activity.

To date, enough information has been accumulated on the mechanism of action of glucocorticoids to imagine how they act at the cellular level. There are two well-defined receptor systems found in the cytoplasm of cells. Through glucocorticoid receptors, corticosteroids exert anti-inflammatory and immunosuppressive effects and regulate glucose homeostasis; through mineralocorticoid receptors, they regulate sodium and potassium metabolism, as well as water and electrolyte balance.

Indications for use

Dexamethasone is administered intravenously or intramuscularly in acute cases or when oral therapy is not possible:

replacement therapy for primary and secondary (pituitary) adrenal insufficiency

congenital adrenal hyperplasia

subacute thyroiditis and severe forms of postradiation thyroiditis

rheumatic fever

acute rheumatic heart disease

pemphigus, psoriasis, dermatitis (contact dermatitis affecting a large surface of the skin, atopic, exfoliative, bullous herpetiform, seborrheic, etc.), eczema

toxidermia, toxic epidermal necrolysis (Lyell's syndrome)

malignant exudative erythema (Stevens-Johnson syndrome)

allergic reactions to drugs and food

serum sickness, drug exanthema

urticaria, angioedema

allergic rhinitis, hay fever

diseases that threaten the loss of vision (acute central chorioretinitis, inflammation of the optic nerve)

allergic conditions (conjunctivitis, uveitis, scleritis, keratitis, iritis)

systemic immune diseases (sarcoidosis, temporal arteritis)

proliferative changes in the orbit (endocrine ophthalmopathy, pseudotumors)

sympathetic ophthalmia

immunosuppressive therapy in corneal transplantation

The drug is used systemically or locally (in the form of subconjunctival, retrobulbar or parabulbar injections):

ulcerative colitis

Crohn's disease

local enteritis

sarcoidosis (symptomatic)

acute toxic bronchiolitis

chronic bronchitis and asthma (exacerbations)

agranulocytosis, panmyelopathy, anemia (including autoimmune hemolytic, congenital hypoplastic, erythroblastopenia)

idiopathic thrombocytopenic purpura

secondary thrombocytopenia in adults, lymphoma (Hodgkin's, non-Hodgkin's)

leukemia, lymphocytic leukemia (acute, chronic)

kidney disease of autoimmune origin (including acute glomerulonephritis)

nephrotic syndrome

palliative care for leukemia and lymphoma in adults

acute leukemia in children

hypercalcemia in malignant neoplasms

cerebral edema due to primary tumors or metastases to the brain, due to craniotomy or head trauma.

Shock of various origins

shock not responding to standard therapy

shock in patients with adrenal insufficiency

anaphylactic shock (intravenously, after the introduction of adrenaline)

Other indications

Indications for intra-articular administration of dexamethasone or injection into soft tissues:

rheumatoid arthritis (severe inflammation in a single joint)

ankylosing spondylitis (when inflamed joints do not respond to standard therapy)

psoriatic arthritis (oligoarticular lesion and tendosynovitis)

monoarthritis (after removal of intra-articular fluid)

osteoarthritis (only in the presence of exudate and synovitis)

extra-articular rheumatism (epicondylitis, tendosynovitis, bursitis)

Local administration (injections into the lesion):

hypertrophic, inflamed, and infiltrated lesions of lichen, psoriasis, granuloma annulare, sclerosing folliculitis, discoid lupus, and cutaneous sarcoidosis

localized alopecia

Dosage and administration

Doses are set individually for each patient, depending on the nature of the disease, the expected duration of treatment, the tolerability of corticosteroids and the patient's response to therapy.

Parenteral application

The solution for injection is administered intravenously or intramuscularly, as well as in the form of intravenous infusions (with glucose or saline).

The recommended average initial daily dose for intravenous or intramuscular administration varies from 0.5 mg to 9 mg and, if necessary, more. The initial dose of dexamethasone should be used until the clinical effect is achieved; then the dose is gradually reduced to the minimum effective. During the day, you can enter from 4 to 20 mg of Dexamethasone 3-4 times. The duration of parenteral administration is usually 3-4 days, then they switch to maintenance therapy with the oral form of the drug.

Local administration

The recommended single dose of dexamethasone for intra-articular administration is from 0.4 mg to 4 mg. Intra-articular injection can be repeated after 3-4 months. Injections into the same joint can only be done 3-4 times in a lifetime, and injections into more than two joints at the same time should not be made. More frequent administration of dexamethasone can lead to damage to intra-articular cartilage and bone necrosis. The dose depends on the size of the affected joint. The usual dose of dexamethasone is 2 mg to 4 mg for large joints and 0.8 mg to 1 mg for small joints.

The usual dose of dexamethasone for intraarticular capsule is 2 mg to 3 mg, for the introduction into the tendon sheath - from 0.4 mg to 1 mg, and for tendons - from 1 mg to 2 mg.

When administered to limited lesions, the same doses of dexamethasone are used as for intra-articular administration. The drug can be administered simultaneously, at most, in two foci.

Dosing in children

When administered intramuscularly, the dose for replacement therapy is 0.02 mg / kg of body weight or 0.67 mg / m2 of body surface area, which is divided into 3 injections with an interval of 2 days, or from 0.008 mg to 0.01 mg / kg of body weight or from 0.2 mg up to 0.3 mg/m2 body surface area daily. For other indications, the recommended dose is 0.02 mg to 0.1 mg/kg body weight, or 0.8 mg to 5 mg/m2 body surface area, every 12 to 24 hours.

Side effects

decreased glucose tolerance, "steroidal" diabetes mellitus, or manifestation of latent diabetes mellitus

Itsenko-Cushing's syndrome, weight gain

hiccups, nausea, vomiting, increased or decreased appetite, flatulence, increased activity of "liver" transaminases and alkaline phosphatase, pancreatitis

"steroid" gastric ulcer and duodenum, erosive zophagitis, bleeding and perforation of the gastrointestinal tract

arrhythmias, bradycardia (up to cardiac arrest), development (in predisposed patients) or increased severity of chronic heart failure, increased blood pressure

hypercoagulation, thrombosis

delirium, disorientation, euphoria, hallucinations, manic-depressive psychosis, depression, paranoia

increased intracranial pressure, nervousness, anxiety, insomnia, headache, dizziness, convulsions, vertigo

pseudotumor of the cerebellum

sudden loss of vision (with parenteral administration, crystals of the drug may be deposited in the vessels of the eye), posterior subcapsular cataract, increased intraocular pressure with possible damage to the optic nerve, trophic changes in the cornea, exophthalmos, the development of secondary bacterial, fungal or viral infections eye

negative nitrogen balance (increased protein breakdown), hyperlipoproteinemia

increased sweating

fluid and sodium retention (peripheral edema), hyperkalemia syndrome (hypokalemia, arrhythmia, myalgia or muscle spasm, unusual weakness and fatigue)

growth retardation and ossification processes in children (premature closure of the epiphyseal growth zones)

increased excretion of calcium, osteoporosis, pathological bone fractures, aseptic necrosis of the head of the humerus and femur, tendon rupture

"steroid" myopathy, muscle atrophy

delayed wound healing, a tendency to develop pyoderma and candidiasis

petechiae, ecchymosis, thinning of the skin, hyper- or hypopigmentation,

steroid acne, striae

generalized and local allergic reactions

decreased immunity, development or exacerbation of infections

leukocyturia

violation of the secretion of sex hormones (violation menstrual cycle, hirsutism, impotence, delayed sexual development in children

withdrawal syndrome

burning, numbness, pain, paresthesias and infections, necrosis of surrounding tissues, scarring at the injection site, atrophy of the skin and subcutaneous tissue when administered intramuscularly (injection into the deltoid muscle is especially dangerous), arrhythmias, flushing of blood to the face, convulsions (with intravenous introduction), collapse (with the rapid introduction of large doses)

Contraindications

hypersensitivity to the active substance or auxiliary components of the drug

peptic ulcer of the stomach and duodenum

osteoporosis

acute viral, bacterial and systemic fungal infections (when appropriate therapy is not used)

Cushing's syndrome

pregnancy and lactation

kidney failure

cirrhosis of the liver or chronic hepatitis

acute psychoses

intramuscular injection is contraindicated in patients with severe disorders of hemostasis (idiopathic thrombocytopenic

for use in ophthalmic practice: viral and fungal eye diseases

acute form of purulent eye infection in the absence of a specific

therapy, corneal diseases associated with epithelial defects, trachoma, glaucoma

active tuberculosis

Drug Interactions

The effectiveness of dexamethasone is reduced when taken concomitantly rifampicin, carbamazepine, phenobarbitone, phenytoin (diphenylhydantoin), primidone, ephedrine, or aminoglutethimide. Dexamethasone reduces the therapeutic effect hypoglycemic drugs, antihypertensive drugs, praziquantel and natriuretics; dexamethasone increases activity heparin, albendazole and kaliuretics. Dexamethasone may change the action coumarin anticoagulants.

Simultaneous use of dexamethasone and high doses glucocorticoids or agonists 2-receptor increases the risk of developing hypokalemia. Higher arrhythmogenicity and toxicity of cardiac glycosides is noted in patients suffering from hypokalemia.

With the simultaneous use of oral contraceptives, the half-life of glucocorticoids may increase, which leads to an increase in their action and an increase in the number of side effects.

The simultaneous use of ritodrine and dexamethasone during labor is contraindicated, since this can lead to the death of the mother due to pulmonary edema.

Co-administration of dexamethasone and metoclopramide, diphenhydramine, prochlorperazine, or 5-HT3 receptor antagonists (serotonin or 5-hydroxytryptamine type 3 receptors), such as ondansetron or granisetron, is effective in preventing nausea and vomiting caused by chemotherapy with cisplatin, cyclophosphamide, methotrexate, fluorouracil .

special instructions

Application in pediatrics

Children during long-term treatment it is necessary to carefully monitor the dynamics of growth and development. In children during the period of growth, glucocorticosteroids should be used only for health reasons and under the most careful supervision of a physician. To prevent disruption of growth processes during long-term treatment of children under the age of 14 years, it is advisable to take a 4-day break in treatment every 3 days.

Children who are in contact with measles patients during treatment chickenpox prescribe specific immunoglobulins.

With diabetes mellitus, tuberculosis, bacterial and amoebic dysentery, arterial hypertension, thromboembolism, cardiac and kidney failure, ulcerative colitis, diverticulitis, recently formed intestinal anastomosis, Dexamethasone should be used very carefully and subject to the possibility of adequate treatment of the underlying disease. If the patient had a history of psychosis, then treatment with glucocorticosteroids is carried out only for health reasons.

With the sudden withdrawal of the drug, especially in the case of high doses, there is a withdrawal syndrome of glucocorticosteroids: anorexia, nausea, lethargy, generalized musculoskeletal pain, general weakness. After discontinuation of the drug for several months, relative insufficiency of the adrenal cortex may persist. If stressful situations arise during this period, temporarily glucocorticoids are prescribed, and if necessary, mineralocorticoids.

Before starting the use of the drug, it is desirable to examine the patient for the presence of ulcerative pathology of the gastrointestinal tract. Patients with a predisposition to the development of this pathology should be prescribed with preventive purpose antacids.

During treatment with the drug, the patient should follow a diet rich in potassium, protein, vitamins, with a reduced content of fats, carbohydrates and sodium.

If the patient has intercurrent infections, a septic condition, treatment with Dexamethasone should be combined with antibiotic therapy.

If treatment with Dexamethasone is carried out for 8 weeks before and 2 weeks after active immunization (vaccination), then in this case the effect of immunization will be reduced or completely neutralized.

Patients with severe traumatic brain injury and impaired cerebral circulation according to the ischemic type, it is necessary to prescribe glucocorticoids with caution.

Features of influenceon the ability to manage vehicle or potentially dangerous mechanisms

Because Dexamethasone can cause dizziness and headache, when driving vehicles or working with other mechanisms, it is recommended to refrain from driving a car and operating other potentially dangerous mechanisms.

Overdose

Symptoms: possible aggravation of side effects.

Treatment: should be canceled and symptomatic therapy prescribed. There is no specific antidote.

After the disappearance of symptoms of an overdose, the drug is resumed.

Release formand packaging

1 ml in dark glass ampoules with a white dot and a green ring for opening the ampoules. A self-adhesive label is attached to the ampoule.

Dexamethasone ampoules 4 mg, 1 ml, 25 pcs. - the average price is 185 rubles.

Dexamethasone is a drug that has anti-inflammatory and immunosuppressive effects. Solution for intravenous and intramuscular injection, is a clear, colorless or light yellow liquid.

Latin name: Dexamethasone
ATX code: S01BA01
Active substance: Dexamethasone (Dexamethasone)
Manufacturer: RUE “Belmedpreparaty” (Republic of Belarus), JSC “Lekhim-Kharkov”, PJSC “Farmak”, CJSC FF “Darnitsa” (Ukraine)

Compound

Active substance:

Dexamethasone sodium phosphate (dexamethasone phosphate disodium salt) in terms of 100% substance - 4.0 mg.

Excipients:

glycerol (distilled glycerin) - 22.5 mg;
disodium edetate (trilon B) - 0.1 mg;
sodium hydrogen phosphate dodecahydrate (sodium phosphate disubstituted 12-water) - 0.8 mg;
water for injection - up to 1 ml.

pharmachologic effect

Dexamethasone is a hormonal drug with anti-allergic, anti-inflammatory, immunosuppressive, desensitizing, antitoxic, anti-shock activity.

Able to interact with specific cytoplasmic receptors:

forms a complex that penetrates the cell nucleus and stimulates mRNA synthesis;
the latter induces the formation of proteins, incl. lipocortin mediating cellular effects. Lipocortin inhibits phospholipase A2, inhibits the release of arachidonic acid and inhibits the biosynthesis of endoperoxides, prostaglandins, leukotrienes, which promote inflammation, allergies, and others.

Dexamethasone eye drops also have anti-allergic, anti-exudative and anti-inflammatory effects.

Pharmacodynamics and pharmacokinetics

The use of Dexamethasone makes it possible to increase the sensitivity of the proteins of the outer cell membrane (beta-adrenergic receptors) to endogenous catecholamines (mediators of intercellular interaction).

Dexamethasone regulates protein metabolism, reducing synthesis and increasing protein catabolism in muscle tissue, reducing the amount of globulins in plasma, and increasing albumin synthesis in the liver and kidneys. Influencing carbohydrate metabolism Dexamethasone promotes the absorption of carbohydrates from the digestive tract, increases the flow of glucose into the blood from the liver, the development of hyperglycemia, which in turn activates the production of insulin. The participation of Dexamethasone in water-electrolyte metabolism is manifested in a decrease in mineralization bone tissue, sodium and water retention in the body, a decrease in calcium absorption from the gastrointestinal tract.

The anti-inflammatory and anti-allergic properties of Dexamethasone are 35 times more active than those of cortisone.

In the blood, it binds (60-70%) to a specific protein - the carrier - transcortin. Easily passes through histohematic barriers (including through the blood-brain barrier and placental). It is excreted in a small amount from breast milk. Metabolized in the liver (mainly by conjugation with glucuronic and sulfuric acids) to inactive metabolites. Excreted through the kidneys.

Indications for use

The instruction recommends using Dexamethasone tablets in the following cases:

acute and subacute thyroiditis (inflammation of the thyroid gland);
hypothyroidism (a condition with a persistent lack of thyroid hormones);
progressive ophthalmopathy (an increase in the volume of eye tissues) associated with thyrotoxicosis (intoxication with thyroid hormones);
Addison-Birmer disease (loss of the ability of the adrenal glands to produce hormones in sufficient quantities);
bronchial asthma;
connective tissue diseases;
rheumatoid arthritis in the acute phase;
autoimmune hemolytic anemia;
serum sickness (immune reaction to foreign serum proteins);
agranulocytosis (decrease in the level of neutrophils in the blood);
acute erythroderma (redness of the skin);
pemphigus (skin disease that manifests itself in the form of blisters on the hands, genitals, mouth, etc.);
acute eczema;
malignant tumors (symptomatic therapy);
cerebral edema;
congenital adrenogenital syndrome (hyperfunction of the adrenal cortex and increased levels of androgens in the body).

Dexamethasone in ampoules is used for:

shock of various origins;
asthmatic status;
cerebral edema;
severe allergic reactions;
acute hemolytic anemia;
thrombocytopenia;
agranulocytosis;
acute lymphoblastic leukemia (a malignant disease that affects the bone marrow, spleen, The lymph nodes, thymus and other organs);
severe infectious diseases;
acute croup (inflammation of the larynx and upper respiratory tract);
acute insufficiency of the adrenal cortex; joint diseases.

Dexamethasone drops are used in ophthalmic practice for:

non-purulent and allergic conjunctivitis (inflammation of the mucous membrane of the eye);
keratitis (inflammation of the cornea of the eye);
keratoconjunctivitis (simultaneous inflammation of the conjunctiva and cornea of the eye) without damage to the epithelium;
iritis (inflammation of the iris);
iridocyclitis (inflammation of the iris and ciliary body); blepharitis (inflammation of the edges of the eyelids);
scleritis (inflammation of the deep layers of the sclera of the eye);
episcleritis (inflammation of the connective tissue between the conjunctiva and the sclera); inflammatory processes after eye injuries or operations;
sympathetic ophthalmia (inflammatory lesions of the eye).

Application instruction of Dexamethasone

At the initial stage of treatment, the use of Dexamethasone (orally) in the form of tablets is preferred at 10-15 mg of the drug per day, followed by a decrease in the daily dose to 2-4.5 mg with maintenance therapy.

The daily dose of Dexamethasone is recommended to be divided into 2-3 doses (during or after meals). Maintenance small doses should be taken once a day, preferably in the morning.

Dexamethasone in ampoules is intended for intravenous (drip or jet), intramuscular, periarticular and intraarticular administration. The recommended daily dose of Dexamethasone for these routes 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.

Dexamethasone drops are used in ophthalmology: in acute conditions, 1-2 drops of the drug are instilled into conjunctival sac every 1-2 hours, with improvement - every 4-6 hours.

Chronic processes involve 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.

Use during pregnancy

The use of Dexamethasone during pregnancy is possible only for health reasons, if the expected benefit of therapy for the mother outweighs the potential risk associated with treatment.
If it is necessary to carry out drug treatment during breastfeeding then breastfeeding should be discontinued.

Overdose

Excessive administration of the drug can cause an overdose, which is manifested by increased side effects, as well as hypercortisolism syndrome (Cushing's Syndrome).

Therapy is symptomatic, at the same time a dose reduction or drug withdrawal is required for a while.

Side effects

According to the instructions, Dexamethasone can cause the following reactions:

decreased glucose tolerance, suppression of adrenal function, steroid diabetes mellitus, Itsenko-Cushing's syndrome;
hypocalcemia, hypokalemia, hyponatremia, increased calcium excretion, weight gain, increased sweating;
increased intracranial pressure, anxiety, depression, paranoia, dizziness, headache, convulsions;
vomiting, nausea, steroid ulcer, pancreatitis, erosive esophagitis, hiccups, flatulence;
bradycardia, arrhythmias, increased blood pressure;
exophthalmos, trophic changes in the cornea, a tendency to develop eye infections, increased intraocular pressure, posterior subcapsular cataract;
deceleration of ossification in children, rupture of muscle tendons, osteoporosis, decreased muscle mass, steroid myopathy; dermatological and allergic reactions.

Contraindications for use

The use of Dexamethasone is contraindicated in those patients who have a very hypersensitivity to the components of the drug.

The drug is incompatible with other medicines, since it can form insoluble compounds with them.

The solution for injection can be mixed in such cases:

only with 5% glucose solution;
NaCl solution 0.9%.

Release form

In ampoules of 1 ml or 2 ml in package No. 10,
In ampoules of 1 ml or 2 ml in blisters No. 5×1, No. 5×2.

Storage conditions and shelf life

In a place protected from light at a temperature not exceeding 25 ° C.
Keep out of the reach of children.

Shelf life - 2 years.

Dexamethasone analogs

Analogues of solution and tablets:

Dexazon,
Dexamethasone-Vial,
Dexamed,
Megadexan,
Dexamethasone-Ferrein.

Similar preparations for eye drops:

Dexamethasone-LANS,
Dexapos,
Ozurdex,
Maxidex,
Dexamethasone long.

The drug Maxidez, unlike other analogues, has 2 dosage forms: drops and eye ointment. Dexamethasone ointment can be replaced with Hydrocortisone ointment.

Dexamethasone is one of the drugs that, if not properly treated, can cause serious complications. Before using the drug, it is necessary to study the properties, features of the application and possible side effects.

Pharmacological form and main properties

Dexamethasone is an injection solution that is widely used in pharmacology. The active substance is dexamethasone phosphate, auxiliary: glycerin, disodium edetate, sodium hydrogen phosphate dihydrate, water. The drug is able to have anti-shock, anti-allergic and anti-toxic effects. It is produced in ampoules of 5 mg. The cost varies from 25 to 500 rubles.

The main properties of the drug:

Dexamethasone can be combined with antibiotics to enhance the medicinal effect.

Dexametzone can replace the intake of other antiallergic drugs.

Approximate dosage: 0.5 mg corresponds to 3.5 mg of Prednisolone, 17.5 mg of Cortisone or 15 mg of Hydrocortisone.

Indications for admission

For some diseases, taking medication in tablets is difficult or impossible at all. The patient can only tolerate Dexamethasone injections, for which intramuscular injections are prescribed. Indications for this method of drug administration will be:

To obtain a therapeutic effect as soon as possible, the drug is administered intravenously. This is necessary if:

transient development of shock (traumatic, burn, toxic);
cerebral edema with intracranial hemorrhage or traumatic brain injury;
severe course of allergies;
acute renal failure;
severe pain in the back, in the neck and thoracic region: possible
acute leukemia;
acute form of lung disease;
severe infectious diseases.

It is also possible to use the drug solution locally: it is applied to keloid scars and pathological skin rashes.

Contraindications for taking Dexamethasone

Unconditional contraindication - individual hypersensitivity to the drug. Also, injections are prescribed with caution in pathological conditions:

It is undesirable to take the drug for mental pathologies, in particular, for acute psychosis. Dexamethasone can exacerbate symptoms, provoke the appearance of hallucinations. Also, the action of Dexamethasone can increase the manifestation of depression and anxiety.

Instructions for use and dosage

The dosage is selected individually depending on the severity of the course of the disease. When administered through a dropper, Dexamethasone is administered slowly, drip or jet. Daily dose for adults: from 4 to 20 mg, the number of procedures is 3-4. You can administer the drug intravenously for 3-4 days, after which the patient is transferred to the oral form (medication in tablets). During the acute period, doses may be higher and reach 100-150 mg of the drug per day. After achieving a therapeutic effect, the dose is reduced to a maintenance dose or treatment is stopped.

The drug does not cause water and sodium retention in the body; special drinking regimen during treatment is not required. But after the introduction of a dropper, the patient may feel a headache, slight dizziness and nausea. In order for the unpleasant symptoms to go away, it is recommended not to get up immediately after the procedure, but to wait 10-15 minutes.

If the drug needs to be injected, the needle is not inserted under the skin, but into muscle tissue. It has great importance How to administer Dexamethasone intramuscularly: quickly or slowly. With a sharp hit of Dexamethasone in the tissue at the puncture site, a hematoma may appear. To avoid this, the drug should be administered gradually, monitoring the patient's condition. An allergic reaction to the action of the drug may appear within 5-10 minutes, therefore, after the injection of the patient, it is necessary to observe 10-15 minutes.

Side effects

Most patients do not experience side effects from taking Dexamethasone. But some patients may experience side effects different systems organs:

During the administration of the drug, local reactions may occur: tingling, numbness, burning. After healing, a scar may form at the injection site. Rarely, necrosis of the surrounding tissue occurs. This can be avoided by observing the rules for administering the drug: disinfection of the puncture site and slow administration of the drug.

The use of Dexamethasone during the development of an infection leads to an exacerbation of symptoms and slows down treatment!

With intravenous administration of the drug, patients with hypersensitivity may suffer from flushing of the face, cramps of the limbs and arrhythmias.

Taking during pregnancy

The drug is not recommended during pregnancy, especially during the first trimester. Dexamethasone can slow down the growth of the fetus, increase the risk of pregnancy fading. It should be used only in a situation where the therapeutic effect is more important than the potential risks. To understand why Dexamethasone injections are prescribed for pregnant women, it is necessary to assess the severity of the woman's condition. The drug is prescribed for:

Dexamethasone is prescribed to pregnant women who have elevated levels of male hormones. The drug stabilizes the level of production of ketosteroids and allows you to bear the child. If a woman started premature birth, Dexamethasone will suppress contractions and the pregnancy will continue.

The drug can have the greatest negative effect in the third trimester. It can cause atrophy of the adrenal cortex in the fetus. In this case, additional therapy of the newborn will be required. During breastfeeding, the drug is prohibited. If long-term treatment is necessary, breastfeeding should be abandoned.

Special instructions for long-term use

Before starting treatment and after it is necessary to do general analysis blood. During the period of treatment with Dexamethasone, the patient should be under the supervision of an ophthalmologist, monitor blood pressure, calcium and glucose levels in the blood. When side effects the patient should increase the intake of calcium in the body.

To do this, you need to add high-protein foods to the menu, and monitor how many carbohydrates the patient consumes per day.

Sudden withdrawal of the drug, especially at high doses of the drug, can provoke the appearance of a withdrawal syndrome.

A patient with withdrawal syndrome has nausea, pain in the extremities, loss of appetite. He becomes lethargic, distracted, suffers from general weakness. Sometimes taking Dexamethasone provokes the body's immune response if the immune system recognizes it as a toxic substance. In this case, you need to increase the rate of water consumption to 2-2.5 liters per day in order to quickly remove Dexamethaone from the body.

For children, long-term use of Dexamethasone is contraindicated, it is associated with a slowdown in development and growth. The fragility of bones increases, the risk of fracture increases. If a child during the period of treatment is in contact with patients with chickenpox, he needs prophylactic immunoglobulins.

Interaction with other drugs

The simultaneous use of several drugs can both enhance their effect and speed up treatment, and cause complications. Dexamethasone in combination with other drugs increases the risk of side effects. Patients may experience various symptoms when taken with:

When a patient takes another drug for a long time, Dexamethasone is usually started with a minimum dose. If side effects occur, the reception is stopped. In this case, it is advisable to prescribe to the patient an analogue of the drug that has a similar therapeutic effect.

Analogues and substitutes

Replacement of the drug may be necessary if the patient has intolerance to the main or auxiliary active substances. The analogue is selected from the same group of drugs. The form of release is also often changed: tablets or ointment are prescribed instead of injections.

Dexamethasone analogs may also have side effects. They are observed immediately after administration or a few days after the accumulation of the active substance in the body. In case of a severe allergic reaction, the use should be stopped immediately.

What else is worth knowing?

Once in the body, Dexamethasone is not completely absorbed. Only 60-70% of the active substance binds to transocrtin, a carrier protein. The drug easily penetrates tissues, including through the placental barrier. Metabolism occurs in the liver, the remains of the substance are excreted from the body by the kidneys. The decay and half-life takes 3-5 hours.

Dexamethasone is a drug that has proven itself as a remedy fast action against allergies and inflammatory diseases articular tissue. It is not addictive, injections do not cause any particular pain. Compliance with the instructions reduces the risk of side effects and accelerates the action of the drug.