Dexamethasone in ampoules: instructions for use

Dexamethasone is a drug that belongs to the group of glucocorticosteroids and is a hormonal agent.

It is widely used in medicine, in its various fields. It is produced in the form of a solution that is used for injections intravenously, intramuscularly and for instillation into the conjunctiva of the eyes.

On this page you will find all information about Dexamethasone: the full instructions for use on this medication, average prices in pharmacies, complete and incomplete analogs of the drug, as well as reviews of people who have already used injections Dexamethasone. Want to leave your opinion? Please write in the comments.

Clinical and pharmacological group

GCS for injection.

Conditions of leave from pharmacies

It is released on prescription.

Price list

How much does Dexamethasone cost? The average price in pharmacies is at the level of100 rubles.

Form of issue and composition

The drug solution, which is sold in pharmacies in ampoules, contains dexamethasone sodium phosphate. This active substance takes 4 or 8 mg.

Auxiliary components are glycerol, disodium phosphate dihydrate, disodium edetate and purified water to obtain a solution of the desired concentration. Dexamethasone solution for internal administration looks like a transparent colorless or yellowish liquid.

Pharmacological effect

Dexamethasone is a homolog of hydrocortisone, a hormone produced by the adrenal cortex.

It interacts with glucocorticoid receptors, regulates the exchange of sodium, potassium, water balance and glucose homeostasis. Stimulates the production of enzyme proteins in the liver, acts on the synthesis of mediators of inflammation and allergies, inhibits their formation. As a result, the drug gives anti-inflammatory, antiallergic, immunosuppressive, anti-shock effect.

When administered intramuscularly, the therapeutic effect is observed after 8 hours, after intravenous infusion is faster. The effect lasts from 3 days to 3 weeks when administered locally, 17 to 28 days after intravenous administration. Dexamethasone has a strong anti-inflammatory and anti-allergic effect. It is 35 times more effective than cortisone.

What is dexamethasone for?

1. In diseases of the gastrointestinal tract: Crohn's disease and ulcerative colitis.
2. With systemic diseases of connective tissue: acute rheumatic carditis; systemic red wolfish lichen.
3. With endocrine disorders: insufficiency of the adrenal gland cortex and their congenital hyperplasia; subacute form of inflammation of the thyroid gland.
4. For rheumatic diseases: bursitis; rheumatoid arthritis; psoriatic and gouty arthritis; osteoarthritis; synovitis; nonspecific tenosynovitis; ankylosing spondylitis; accompanying osteoarthritis of epicondylitis.
5. For allergic diseases: contact and atopic dermatitis; asthmatic status; serum sickness; allergy to food and some medicines; angioedema; allergic rhinitis (seasonal or chronic); bronchial asthma; urticaria associated with blood transfusion.
6. For skin diseases: severe erythema multiforme; pemphigus; exfoliative, bullous herpetiform and severe seborrheic dermatitis; fungoid mycosis; psoriasis.
7. In ophthalmic diseases: optic neuritis; symptomatic ophthalmia; allergic ulcers of the cornea; keratitis; iridocyclitis; irit; uveitis (anterior and posterior); allergic forms of conjunctivitis.
8. In diseases of the respiratory tract: Leffler's syndrome; tuberculosis; sarcoidosis 2nd-3rd degree; aspiration pneumonia; berylliosis.
9. With kidney diseases: renal dysfunction associated with systemic red wolf deprivation; an ideopathic nephrotic syndrome.
10. In malignant diseases: leukemia (acute) in children; lymphoma and leukemia in adults.
11. At a shock: not responding to treatment by classical methods a shock; anaphylactic shock; shock in patients suffering from insufficiency of the adrenal cortex.
12. With hematological diseases: purpura idiopathic thrombocytopenic; erythroblastopenia; anemia is congenital hypoplastic; autoimmune hemolytic anemia; thrombocytopenia secondary.
13. With other indications: trichinosis of the myocardium; trichinosis with neurological signs; tuberculous meningitis.

Contraindications

The use of Dexamethasone is contraindicated in patients with increased sensitivity to the components of the drug.

With caution Dexamethasone is prescribed for:

• diseases of the cardiovascular system;
• endocrine diseases;
• peptic ulcer, gastritis, esophagitis, newly created intestinal anastomosis, diverticulitis;
• parasitic and infectious diseases of various nature;
• immunodeficiency states;
• severe hepatic or renal failure, nephrourolythiasis, hypoalbuminemia;
• glaucoma, poliomyelitis, acute psychosis, systemic osteoporosis.

The use of dexamethasone by pregnant and lactating women, as well as by children, should only occur on the prescription of the doctor after taking into account all possible risks.

Application in pregnancy and lactation

Dexamethasone in the form of tablets and drops during pregnancy and lactation is prohibited. If during breastfeeding there is a need for treatment with Dexamethasone, the child is transferred to artificial mixtures.

Dexamethasone injections during pregnancy are made only for vital indications. For example, a drug can be prescribed in the case when the immune system begins to perceive the embryo, as a foreign body. Dexamethasone suppresses immune activity, which helps to eliminate the threat of miscarriage and keep the pregnancy.

Instructions for use

The instructions for use indicate that the dosing regimen is individual and depends on the indications, the patient's condition and his reaction to therapy.

1. The drug is administered iv in a slow stream or drip (with acute and urgent conditions); in / m; possibly also local (in pathological education) introduction. To prepare a solution for intravenous drip infusion, an isotonic solution of sodium chloride or a 5% dextrose solution should be used.
2. In an acute period with various diseases and at the beginning of therapy, Dexamethasone is used in higher doses. During the day, you can inject 4 to 20 mg of Dexamethasone 3-4 times.

Doses of the drug for children (IM):

• The dose of the drug during replacement therapy (with adrenal cortex insufficiency) is 0.0233 mg / kg body weight or 0.67 mg / m2 surface area body, divided into 3 doses, every 3rd day or 0.00776 - 0.01165 mg / kg body weight or 0.233 - 0.335 mg / m2 body surface area daily. For other indications, the recommended dose is from 0.02776 to 0.16665 mg / kg body weight or 0.833 to 5 mg / m2 body surface area every 12-24 hours.
• When the effect is achieved, the dose is reduced to a maintenance dose or until the treatment is discontinued. The duration of parenteral use is usually 3-4 days, then switch to maintenance therapy with dexamethasone in tablets.

Long-term use of high doses of the drug requires a gradual dose reduction in order to prevent the development of acute adrenocortical insufficiency.

Side effects

Against the background of treatment with Dexamethasone in the form of injections, the following side effects can be observed in patients:

1. From the skin and mucous membranes: delayed healing of wounds, petechiae, ecchymosis, thinning of the skin, hyper- or hypopigmentation, steroid acne, striae, propensity to develop pyoderma and candidiasis;
2. From the sense organs: posterior subcapsular cataract, increased intraocular pressure with possible damage to the optic nerve, propensity to develop secondary bacterial, fungal or viral eye infections, trophic corneal changes, exophthalmos, sudden loss of vision (when parenteral administration in the area of ​​the head, neck, nasal concha, scalp may precipitate crystals of the drug in the vessels of the eye);
3. From the side of metabolism: increased excretion of calcium, hypocalcemia, weight gain, negative nitrogen balance (increased protein breakdown), increased sweating. Due to mineralocorticoid activity - fluid retention and sodium (peripheral edema), gipsarnturnemia, hypokalemic syndrome (hypokalemia, arrhythmia, myalgia or muscle spasm, unusual weakness and fatigue);
4. From the endocrine system: a decrease in glucose tolerance, steroid diabetes mellitus or manifestation of latent diabetes mellitus, oppression of adrenal function, Isenko-Cushing syndrome (luniform face, obesity of the pituitary type, hirsutism, increased blood pressure, dysmenorrhea, amenorrhea, muscle weakness, striae), delay in sexual development in children;
5. From the side of cardiovascularsystem: arrhythmias, bradycardia (up to cardiac arrest); development (in predisposed patients) or increased severity of heart failure, changes in the electrocardiogram, 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;
6. From the side of the musculoskeletal system: slowing growth and ossification processes in children (premature closure of epiphyseal growth zones), osteoporosis (very rarely - pathological fractures bones, aseptic necrosis of the head of the humerus and thigh bone), rupture of the tendons of muscles, steroid myopathy, decrease in muscle mass (atrophy). Dexamethasone instructions for use;
7. From the nervous system: delirium, disorientation, euphoria, hallucinations, manic-depressive psychosis, depression, paranoia, increased intracranial pressure, nervousness or anxiety, insomnia, dizziness, vertigo, pseudotumor cerebellum, headache, convulsions.
8. From the digestive system: nausea, vomiting, pancreatitis, steroid ulcer of the stomach and duodenum, erosive esophagitis, gastrointestinal bleeding and perforation of the wall of the gastrointestinal tract, increase or decrease in appetite, digestive disorders, flatulence, hiccough. In rare cases - increased activity of hepatic transaminases and alkaline phosphatase;

Overdose

With too active use of Dexamethasone for several weeks, an overdose is possible, which is manifested by the symptoms listed among the side effects.

Treatment is made according to the manifested factors, is to reduce the dose or the temporary withdrawal of the drug. When an overdose is not a particular antidote, hemodialysis is not effective.

special instructions

1. Patients with abnormalities in the work of the liver Dexamethasone prescribe with extreme caution.
2. In order to reduce the risk of side effects, the patient should follow a diet with high potassium content. Food should be rich in protein, carbohydrate intake and salt should be somewhat reduced.
3. During the treatment with Dexamethasone, patients should constantly monitor the arterial pressure, the state of the organs of vision, water-electrolyte balance and clinical picture of blood.
4. Treatment with the drug can not be stopped abruptly, because in this case the risk of withdrawal syndrome increases, which is accompanied by an increase in primary symptoms of the disease and suppression of adrenal function.
5. Patients with diabetes should constantly monitor blood glucose levels and, if necessary, adjust the daily dose of hypoglycemic drugs.
6. When using the drug in pediatric practice, you should closely monitor the dynamics of child growth, since prolonged use of the drug in large doses can lead to inhibition of the patient's growth.

Drug Interactions

Instructions for use Dexamethasone distinguishes the following drug interactions:

1. Possibility to strengthen the action of antibiotics;
2. Phenobarbital, ephedrine reduce the effectiveness of the drug;
3. Admission with other glucocorticosteroids leads to an increased risk of hypokalemia;
4. When used with oral contraceptives, the half-life of Dexamethasone increases;
5. Ritodrin is not allowed to be used concomitantly with the drug in question due to the risk of death;
6. Dexamethasone lowers the effectiveness of hypoglycemic, anticoagulant, antihypertensive medications;
7. for the prevention of nausea and vomiting after chemotherapy, it is recommended to apply simultaneously Dexamteazone and Metoclopramide, Diphenhydramine, Prochlorperazine, Ondansetron, Granisetron.

Reviews

We picked up some people's comments about the drug Dexamethasone:

1. Catherine. I have arthritis of the shoulder joint. The doctor prescribed this medicine - she promised that it would cure. Has made 3 nyxes, in 2 months the pain has returned, even more strongly. The weight gain was 15 kg for 8 months. Diet, fitness, exercise machines only slow down weight gain. Because of this medicine, I turned from a slender woman into a quail. The endocrinologist said that I can only accept myself as I am. Former harmony will not return. Never take this medication.
2. Ulyana. For a long time I can not get pregnant due to problems with the ovaries. Constantly I am flied, this time the doctor has appointed or nominated to me a hormonal agent Dexamethazonum. You should drink 1/2 tablet before bedtime for a month. After a week of treatment, appetite was gone, nausea appeared, but I quickly gained weight. For all the time of therapy I added 5 kilograms. But all this is not so essential, the main thing is that the drug helps me solve the main problem. I hope for a positive result.
3. Victoria. The drug was taken from the middle of May to the end of September. But since it is a hormonal drug, and taking one tablet a day is considered a small dosage, it began to gain weight. And only parts of the body grew (belly and neck). As a result, the husband scored 10 kg. In addition, taking the drug increases the feeling of hunger. From tablets had to be abandoned. Thanks to sports and proper nutrition, weight returned to normal, and the problem with allergies was solved thanks to the Avamis spray, which is less harmful to the body.
4. Alexey. My wife was stabbed with Dexamethasone for 35 weeks. The indication was an increase in the antibody titer. They made only 3 injections with an interval of 6 hours. My wife gave birth in time to a healthy son, so I do not see anything wrong with this drug, if it is applied correctly (in a hospital or under the supervision of a doctor).

Advantages and disadvantages

The main advantages of Dexamethasone are:

1. The possibility of using the drug in various convenient forms. The agent in the injection form has the fastest effect.
2. Low cost of the drug, as the packaging will cost 200 rubles.
3. A rapid and pronounced positive effect after administration of the drug.
4. Wide range of effects.
5. The possibility of using the drug as a single dosage, and with a support.

It is also important to take into account the shortcomings of the medicine, which are not so few:

1. Necessity of control of the drug intake.
2. A large list of adverse reactions.
3. Limited possibility of prescribing during breastfeeding and during pregnancy.
4. The need to choose the lowest possible dosage of the drug.
5. Absence of dosage forms in the form of ointments and gels, which would be useful when joint pathologies.

Analogues

Dexamethasone has quite a few structural analogues containing the same active substance. These include:

• Dexaven;
• Dexazone;
• Dexamed;
• Dexafar;
• Maxidex;
• Dexamethasone-Nycomed;
• Dexamethasone-Ferein;
• Fortecortin, etc.

Before using analogues, consult your doctor.

Storage conditions and shelf life

Keep away from children. Optimum storage temperature for droplets and solution is up to 15 ° C (it is forbidden to freeze solutions), for tablets - up to 25 ° C.

Shelf life 2 years.

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