Dexamethasone Description. Dexamethasone: instruction, price, analogues. Dexamethasone is administered intravenously or intramuscularly in acute cases or when it is impossible for oral therapy

10.07.2020 Information

Instructions for medical application Medicinal consumption

Dexametanone

International non-proprietary title

Dexametanone

Dosage form

Injection Solution 4 mg / ml

One ampoule contains

the active substance is 4.37 mg dexamethasame (equivalent to 4.00 mg phosphate dexamethane),

auxiliary substances: glycerin, dynatoryaedetate, sodium hydrophosphate dihydrate, water for injection.

Pharmacotherapeutic group

Corticosteroid tool for systematic generation, glucocorticosteroids.

PBX code H02AB02.

Pharmacological properties

Pharmacokinetics

After intravenous administration, the drug began to start quickly, and after intramuscular administration, the clinical effects in 8 hours. The effect of the drug prolonged and continues 17 to 28 days after intramusculosion and from 3 days to 3 weeks after local application (in the region proceedings). Dose of dexamethasone 0.75 mg is equivalent to a dose of 4 mg of methylprednisolonea of \u200b\u200btriamcinolone, 5 mg of prednisone and prednisolone, 20 mg of hydrocortisone and 25 MGCortizona. In the blood plasma, about 77% of dexamethasone binds to blood proteinamia, and mostly converted to albumin. Only minimality of dexamethasone binds to non-buminic proteins. Dexamethasone is a fat soluble compound. The drug is metabolized in the liver. Small quantities of dexamethasonmetabolized in the kidneys and other organs. The prevailing excretion occurred urine. The half-life (T1 \\ 2) is about 190 minutes.

Pharmacodynamics

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

To date, adequateness of glucocorticoid mechanism has been accumulated, to submit, as it is on the cellular level. There are two clearly defined system-detectors detected in cytoplasm cells. By means of glucocorticoidreceptors, corticosteroids have anti-inflammatory immunosuppressive effects and regulate glucose homeostasis; Throughminexocuticoid receptors, they regulate sodium and potassium metabolism, and the water and electrolyte balance.

Indications for use

Dexamethasone is administered intravenously or substantially in acute cases or if it is impossible to carry out peroral studio.

Primary and secondary replacement therapy (pitpophized)

adrenal insufficiency

Congenital adrenal hyperplasia,

Subacute thyroiditis and heavy shapes-sellent thyroiditis.

Rheumatic fever

Acute rheumlock

Bubble, psoriasis, dermatitis (contact dermatitis by a smell

spring skin, Atopic, exfoliative, bullous

herpetyform, seborrheic, etc.), eczema

Toxidermy, Toxic epidermalnecrolesis (Layella syndrome)

Malignant Exudative Erythema (Stevens-Johnson syndrome)

Allergic reactions to LS and Food-Products

Whey disease, Dosage Exanthema

Urticaria, angioedema swelling

Allergic criny, Polleoz

Diseases threatening vision loss (acute central

chorioretinite, inflammation spectator nerve)

Allergic conditions (conjunctivitis, uveit, sclert, keratitis, iris)

Systemic immune diseases (sarcoidosis, temporal arteritis)

Proliferative change in orbit (endocrine ophthalmopathy,

pseudoovoli)

Sympathetic ophthalmia

Immunosuppressive therapy for the horn of the corneal.

The drug is used systemically or locally (VVID subconjunctive, retrobulbar or parabulbar injections)

Ulcerative colitis

Crohn's disease

Local enteritis

Sarcoidosis (symptomatic)

Acute toxic bronchiolitis

Chronic bronchitis and asthma (exacerbation)

Agranulocytosis, Päyelopathy, anemia (including autoimmune

hemolytic, congenital hypoplastic, erythroblasting)

Idiopathic thrombocytopenic purple

Secondary thrombocytopenia in adults, lymphoma (Hodgkinskaya,

nehodkzhkinskaya)

Leukemia, lympholoikosis (acute, chronic)

Kidney disease autoimmune genesis (W.Ch. acute glomer

lonephritis)

Nephrotic syndrome

Palliative therapy of leukemia and lymphoma

Acute leukemia in children

Hypercalcemia with malignant-based formations

Brain Out of Primary Tumor or Metastasis

wongwall brain, due to craniotomy or head injuries.

Shock of various origins

Shock not responding to standard therapy

Shock in patients with adrenal mining

Anaphylactic shock (intravenous, remove adrenaline)

Description of pharmacological action

Indications for use

Violations from endocrine system: acute lack of adrenal cortex; Surgical interventions, severe injuries or diseases in patients with a well-known or alleged adrenal cortex failure;
- shock of various origin: shock, resistant to standard therapy; anaphylactic shock; shock in patients with insufficiency of adrenal cortex;
- edema of the brain: the edema of the brain, due to the primary or metastatic brain tumors, neurosurgical intervention or cranial injury;
- Malignant diseases: palliative treatment of leukemia and lymphoma in adults, acute leukemia in children, hypercalcemia in patients with malignant tumors In the absence of the possibility of receiving inside;
- exacerbation of chronic obstructive bronchitis and bronchial asthma, asthmatic status;
- Heavy allergic reactions;
- intra-articular administration: In cases of pronounced joint inflammation (except infection), when ineffective ordinary therapy, as well as other states with synovite and effusion (after the aspiration of the synovial fluid);
- Local use (in the area of \u200b\u200bthe lesion) - in cases of fibrous-compacted folliculite, ring-shaped granuloma and sarcoidosis;
- subconjunctive, retrobulberry or parabulbar administration - in cases where there is a danger to vision at inflammatory or allergic diseases Eye, systemic immunodeficiency, proliferative changes in the society, sympathetic ophthalmia and immunosuppressive treatment after the corneal transplantation;
- diagnostic study of adrenal hyperfunction;
- Treatment of diseases in which the use of oral form of dexamethasone is impossible.

Form release

solution for intravenous and intramuscular administration 4 mg / ml; Dark glass ampoule 1 ml pack cardboard 5;

Solution for intravenous and intramuscular administration 4 mg / ml; Dark glass ampoule 1 ml pack cardboard 25;

Solution for intravenous and intramuscular administration 4 mg / ml; Dark glass ampoule 2 ml pack cardboard 25;

Solution for intravenous and intramuscular administration 4 mg / ml; Dark glass ampoule 2 ml pack cardboard 5;

Solution for intravenous and intramuscular administration 4 mg / ml; Dark glass ampoule 1 ml pack cardboard 10;

Solution for intravenous and intramuscular administration 4 mg / ml; Dark glass ampoule 1 ml pack cardboard 15;

Solution for intravenous and intramuscular administration 4 mg / ml; Dark glass ampoule 1 ml pack cardboard 20;

Solution for intravenous and intramuscular administration 4 mg / ml; Dark glass ampoule 2 ml pack cardboard 10;

Solution for intravenous and intramuscular administration 4 mg / ml; Dark glass ampoule 2 ml pack cardboard 15;

Solution for intravenous and intramuscular administration 4 mg / ml; Dark glass ampoule 2 ml pack cardboard 20;

Solution for intravenous and intramuscular administration 4 mg / ml; bottle (bottle) dark glass 1 ml pack cardboard 5;

Solution for intravenous and intramuscular administration 4 mg / ml; bottle (bottle) of dark glass 1 ml pack cardboard 15;

Solution for intravenous and intramuscular administration 4 mg / ml; bottle (bottle) dark glass 1 ml pack cardboard 25;

Solution for intravenous and intramuscular administration 4 mg / ml; bottle (bottle) dark glass 1 ml pack cardboard 10;

Solution for intravenous and intramuscular administration 4 mg / ml; bottle (bottle) of dark glass 1 ml pack cardboard 20;

Solution for intravenous and intramuscular administration 4 mg / ml; bottle (bottle) dark glass 2 ml pack cardboard 5;

Solution for intravenous and intramuscular administration 4 mg / ml; bottle (bottle) dark glass 2 ml pack cardboard 10;

Solution for intravenous and intramuscular administration 4 mg / ml; bottle (bottle) dark glass 2 ml pack cardboard 15;

Solution for intravenous and intramuscular administration 4 mg / ml; bottle (bottle) dark glass 2 ml pack cardboard 20;

Solution for intravenous and intramuscular administration 4 mg / ml; bottle (bottle) dark glass 2 ml tutu cardboard 25;

Solution for intravenous and intramuscular administration 4 mg / ml; ampoule 1 ml with a knife of ampumen tutu cardboard 10;

Solution for intravenous and intramuscular administration 4 mg / ml; ampoule 1 ml with a knife of ampules Packaging Contour plastic (pallets) 5Packet cardboard 1;

Solution for intravenous and intramuscular administration 4 mg / ml; ampoule 1 ml with a knife of ampules Packaging Contour plastic (pallets) 5Packet cardboard 2;

Solution for intravenous and intramuscular administration 4 mg / ml; ampoule 1 ml with a knife of ampules Packaging Contour plastic (pallets) 10Pachka cardboard 1;

Solution for intravenous and intramuscular administration 4 mg / ml; ampoule 1 ml with a knife of ampules Packaging Contour plastic (pallets) 10Packet cardboard 2;

Pharmacodynamics

GKS. long action For systemic use. It has a pronounced anti-inflammatory, anti-allergic and desensitizing effect, has immunosuppressive activity.
Dexamethasone (like other GCS) acts at the cellular level through two receptor systems in cellular cytoplasm. Binding to glucocorticoid receptors, the GCS has an anti-inflammatory and immunosuppressive effect and regulate glucose homeostasis. Binding to mineralocorticoid GCS receptors regulate sodium, potassium exchange and water balance.
After in / in administration, the action is developing quickly, after the introduction of the clinical effect is achieved after 8 hours. The effect of the drug prolonged and continues from 17 to 28 days after the introduction and from 3 days to 3 weeks after local administration (in the lesion region ).
Dose of dexamethasone 750 μg is equivalent to a dose of 4 mg of methylprednisolone and triamcinolone, 5 mg of prednisone and prednisolone, 20 mg of hydrocortisone and 25 mg of cortisone.

Pharmacokinetics

Distribution and metabolism
Binding of plasma proteins (mainly with albumin) is 72%. Only the minimum amount of dexamethasone binds to non-albumin proteins. Dexamethasone is a fat soluble compound. Originally metabolized in the liver. A small amount of dexamethasone is metabolized in the kidneys and other organs.
Election
Displays mainly with urine.

Use during pregnancy

The use of dexamethasone during pregnancy is possible only on life indications if the expected benefit of therapy for the mother exceeds the potential risk associated with treatment.
Since the influence of the drug is possible on the growth of the child and on the secretion of endogenous GKS during the use of dexamethasone, breastfeeding should be stopped.

Contraindications for use

Osteoporosis;
- acute viral, bacterial and systemic fungal infections (when there is no appropriate treatment);
- Cushing syndrome;
- lactation period (breastfeeding);
- idiopathic thrombocytopenic purpura (for per / m administration);
- for use in ophthalmology: viral and fungal diseases eye, acute form purulent eye infection in the absence of specific therapy, cornea diseases combined with epithelium defects, trachoma, glaucoma;
- Increased sensitivity to dexamethane and other components of the drug.
Relative contraindications: chronic renal failure, liver cirrhosis or chronic hepatitis, acute psychosis.

Side effects

The purpose of glucocorticoids parenterally or in the form of local injections reduces the risk of systemic side effects. However, the risk of developing systemic and local side effects to some extent exists and increases with long therapy and with an increase in the frequency of injections.
With fast / in the introduction in high doses: generalized anaphylaxis, redness of the face or cheeks, interruptions in the work of the heart, convulsions.
From the CNS and peripheral nervous system: Rarely mental disorders, such as delirium (confusion, excitement, anxiety), disorientation, euphoria, hallucinations, manic-depressive episodes, depression or paranoia, glaucoma, cataract, an increase in intraocular pressure and exophthalm.
Local reactions: redness, swelling, pain or other signs of inflammation or allergic reaction at the injection site are less frequent by-phenomena. For long use At the injection site, stria, tenders, skin atrophy or subcutaneous tissue can be observed.
Others: rarely - generalized allergic skin reaction, sudden blindness, burning sensation, feeling of numbness, pain or tingling at the injection site or next to it.

Method of application and dose

In / m and in / in introduction
The drug is introduced in / m, in / in (inkjano or drip) with glucose or saline. Do not mix dexamethasone with other drugs in the same syringe or bottle for infusion. The recommended initial middle dose for V / B or V / M of administration is 0.5-9 mg / or, if necessary, more. 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 transfer to the supporting therapy of the oral form of the drug.
Coffee Introduction and Local Use
When intra-articular administration, the recommended dose is from 0.4 mg to 4 mg once. Intra-articular injections can be repeated in 3-4 months; The drug can be added to a maximum of 3-4 times in the same joint for a year; The drug can be simultaneously administered in 2 joints. More frequent use can damage the cartilage of the joint.
The dose of the drug depends on the size of the affected joint. Usually, 2-4 mg of dexamethasone is introduced into large joints, in small joints - 0.8-1 mg. Doses of dexamethasone, which are introduced into the synovial bag, are 2-3 mg; Doses that are entered into the vagina of the tendon are 0.4-1 mg; Doses that are introduced into the tendon make up 1-2 mg.
Dose of dexamethasone for administration to the area of \u200b\u200bthe damage is equal to the intra-articular dose. The drug can be simultaneously introducing a maximum of 2 areas of lesion.
To introduce into soft tissues around the joint, it is recommended to apply a dose from 2 to 6 mg.
Doses for children with per / m administration
When conducting substitution therapy (in case of insufficiency of adrenal cortex), the dose is - at 23.3 μg / kg (670 μg / m2) for 3 injections every third day, or daily at 7.76-11.65 μg / kg (233-335 μg / m2). With other indications, the recommended dose is from 27.76 to 166.65 μg / kg every 12-24 hours.

Overdose

Symptoms: In the case of the use of the drug in high doses for several weeks, the majority of the side effects listed above the side effects and syndrome of Cushing is possible.
Treatment: a reduction in the dose or temporary cancellation of the drug, the conduct of symptomatic therapy. There is no special antidote. Hemodialysis is not effective.

Interactions with other drugs

The effectiveness of dexamethasone decreases with simultaneous reception of rifampicin, carbamazepine, phenobarbital, phenyotine (diphenylhydantoin), prison, ephedrine or aminogllutetimide.
Dexamethasone reduces the effectiveness of hypoglycemic drugs, antihypertensive agents, anticulate drugs of the kumarine series, prazicvantel and sodium.
Dexamethasone increases the activity of heparin, albendazole and kaliuretics.
The simultaneous use of dexamethasone and GCS in high doses or agonists of β2-adrenoreceptors increases the risk of hypokalemia. In patients with hypokalemia, there are higher arrhythmogenicity and toxicity of cardiac glycosides.
With the simultaneous use of oral contraceptives, the half-life of GCS may increase, which leads to an increase in their action and an increase in the number of side effects.
The simultaneous use of riteodine and dexamethasone is contraindicated, because may result in death.
The simultaneous purpose of dexamethasone and methoclopramid, diphenhydramine, strokerazine or perzetronamine or branite, efficiently for the prevention of nausea and vomiting caused by chemotherapy using cisplatin, cyclophosphamide, methotrexate, fluorouration.

Special guidelines when taking

With caution to apply in patients with arterial hypertension, heart failure, diabetes, epilepsy, thromboembolia, severe miastenia and glaucoma.
The GCS action is enhanced in patients with cirrhosis of the liver or hypothyroidism.
Dexamethazone treatment can mask signs of an existing or new infection. Dexamethasone can cause aggravation of systemic fungal infection, latent amebiasis, lung tuberculosis.
During the period of treatment with dexamethasone, vibrant vaccination is contraindicated virus Vaccine. Immunization of the killed viral or bacterial vaccine does not cause expected to produce antibodies and does not have expected prophylactic effects. Usually, dexamethasone is not prescribed for 8 weeks before and within 2 weeks after vaccination.
Care should be taken in the treatment of patients after surgical intervention or bone fractures, since dexamethasone can slow down the healing of the wound and the process of forming the bone corner.
The treatment of dexamethasone in children can be carried out only in absolute indications.

Storage conditions

List B.: At a temperature not higher than 25 ° C (Do not freeze).

Shelf life

Belonging to ATX classification:

** Drug reference is intended exclusively for informational purposes. For more information, please contact the manufacturer's annotation. Do not self-medicate; Before starting the use of the drug, dexamethasone you should consult a doctor. EUROLAB is not responsible for the consequences caused by the use of information posted on the portal. Any information on the site does not replace the Consultation of the doctor and cannot serve as a guarantee of a positive effect. drug.

Are you interested in drug dexamethasone? Do you want to know more detailed information or do you need a doctor inspection? Or do you need an inspection? You can make an appointment to the doctor - Clinic Euro.lab always at your service! Top doctors will consider you, they will advise required help And make a diagnosis. you also can call a doctor. Clinic Euro.lab Opened for you around the clock.

** Attention! The information presented in this reference book is intended for medical professionals and should not be the basis for self-treatment. Description of the drug Dexamethasone is given for reference and is not intended to appoint treatment without the participation of a doctor. Patients need a specialist consultation!

If you are interested in any other medicines and medicines, their descriptions and instructions for use, information about the composition and form of release, indications for use and side effects, methods of application, prices and reviews about drugs or you have any Other questions and suggestions - email us, we will definitely try to help you.

Hormonal preparations have a multidirectional action. They not only normalize the work of the endocrine system, but also stabilize the functioning separate organs and systems. An example of such a medicine is dexamethasone (injections) - for what and how not all patients are appointed.

Dexamethasone (injections) - what are you prescribed for?

Dexamethasone refers to K. hormonal drugs. This medicine is a synthetic analogue of adrenal hormones. Use it in case of insufficient work of these glands and with other pathological conditions. If we refer to the instructions of the drug dexamethasone, injection, the readings for use there are specified as follows:

diseases of the joints, muscles (, myositis);
brain swelling;
dermatosis;
liver diseases;
pathology of the visual apparatus;
oncological diseases;
blood diseases.

Dexamethasone (injections) - for what are adults prescribed?

The spectrum of disorders under which the drug is used. The injections of dexamethasone intramuscularly help to quickly stop an allergic reaction, developed by the edema of the brain. Doctors talk about the positive effect of treating severe infectious diseases when dexamethasone is used with the antibiotic. This drug It has a systematic impact on the body. Talking to patients about dexamethasone, injections, for which the drug is prescribed, doctors point to the next effect of the drug:

eliminate shock;

lifting inflammation;
regulation of metabolism;
reduction of allegorical reaction;
reducing the toxic effect on the body in the infectious process.

Dexamethasone (injections) - for what are you prescribed for children?

Dexamethasone, injections, children are rarely prescribed. Thus, the drug can be used in vaccination with live vaccines if the child has a predisposition to the development of allergies. As part complex therapy The medicine is used in the syndrome of Itsenko-Cushing - the disease, accompanied by impaired adrenal operations. Children are not prescribed by violation of the blood coagulation system. Among the main pathologies at which the use of dexamethasone is shown:

severe skin lesions, dermatosis;
crohn's disease;
hemolytic anemia;
glomerulonephritis.

Talking about such dosage formAs dexamethasone, injections, for which the drug is prescribed, it is necessary to note the possibility of local injection of the drug. Injections are often held in the neoplasm in soft tissues, joint and even in the eye. In rare cases, with a pronounced and resistant hypothermia, dexamethasone is used in the composition of a lithic mixture (administered with the analgine and dipherrol).

Dexamethasone (injections) - for what is prescribed for pregnant women?

When entering the child, the drug is used with caution. It helps the body of the future mother to deal with increased content In the blood of androgen - men's hormones that can provoke miscarriage. Under the action of dexamethasone there is a decrease in testosterone synthesis. The drug can be used throughout the period of gestation.

In each case, experts define individually the need to use the drug. When dexamethasone is prescribed, injections, the testimony for the use of medication during pregnancy is always associated with the threat of interrupting gestation. The drug is used carefully: its components penetrate through a placental barrier, so they can influence the fruit.

Dexamethasone (injections) - for what is prescribed oncoboles?

Often in the list of prescribes of patients with oncology, there is a dexamethasone, a solution for injection. It is used in a tumor-like process in the brain as a drug of complex therapy. It allows you to improve general state Patient: Remove swelling, reduce inflammation. The systematic use of the drug helps to normalize intracranial pressure, save the patient from strong, prolonged headaches. Dosage, multiplicity and duration of therapy are established individually, taking into account the stage of the pathological process.

Injection of dexamethasone and diclofenac together

The drug for injection dexamethasone in some cases can be applied along with another drug - diclofenac. This medication has a pronounced anti-inflammatory and painkillers and is actively used in inflammatory processes of various localization. To strengthen its effect, doctors can assign simultaneously with diclofenas and dexamethasone. Such a combination of drugs is recommended for use with:

treatment of osteochondrosis, rheumatoid arthritis;
inflammation of joints, soft tissues with severe pain syndrome;
neuralgias, neuritis;
painful sensations against the background of radiculitis, spondylitrite.

The decision on the feasibility of such therapy takes the doctor. Dosage, the multiplicity of administration is established individually, on the basis of the general health of the patient, clinical picture Diseases. More often, doctors use the following proportion: 75 mg of diclofenac preparation and 4 mg of dexamethasone.

How to breed dexamethasone for injections?

For the correct administration of the drug dexamethasone (injection), the instruction states about the need for preliminary dilution of the drug. As a solvent, saline is often used - 0.9% sodium chloride. Also allowed to breed the drug glucose. However, in this case, it is necessary to take into account exchange processes in organism. In case of individual diseases, dexamethasone injections (for which they are prescribed above) are not bred by glucose (diabetes mellitus, for example).

Dexamethasone Injection - Dosage

Finding out what effect on the body is injecting dexamethasone, for which the drug is prescribed, it is necessary to designate the dispensing features of the drug. It is worth noting that all appointments exercise exclusively by the doctor: it calculates the dosage, the frequency of administration of the drug and the duration of therapy. These parameters are completely dependent on the nature of the pathology, the stage of the disease and the clinical picture.

So, adult dexamethasone is prescribed as follows:

for urgent states - intravenously, slowly in the dosage of 4-20 mg, up to 4 times a day (maximum one-time dose of 80 mg);
to maintain the functions of the body, in the composition of complex therapy - 0.2-9 mg of the drug per day;
with a shock - intravenous 20 mg of dexamethasone once, then at the rate of 3 mg / kg of weight for 24 hours;
with a brain edema - 10 mg intravenously, then 4 mg every 6 hours.

Children are prescribed to children. Calculation of the dosage - 0.02776-0.16665 mg / kg. Indication to the use of the drug is the lack of adrenal cortex. In this case, dexamethasone is used as:

0.0233 mg / kg (0.67 / mg / m2) per day with an interval of 3 days;
with daily reception - 0.00776-0.01165 mg / kg per day.

"Dexamethasone" refer to drugs that may in some cases save lives. Such a hormonal remedy effectively copes with an anaphylactic reaction, bronchospasm, toxic shock and many other hazardous states. Not everyone knows when he is prescribed to children, in what form it is used, which side reactions can be called in childhood And what could be the consequences of exceeding its dosage.

Form release

"Dexamethasone" is produced in such forms.

Pills

They are small, round flat form And often white. In one package they are contained 10 , 20 pieces or more.

Eye drops

They are represented by plastic bottles by 5 , 10 ml Colorless transparent solution.

Ampoules with mortar for enclosures in the muscle or vein

One ampoule such medication contains 1-2 ml A transparent solution that is often colorless, but maybe a little yellowish. One box includes 5 or 10 ampoule

Structure

Main component Any form of medication is represented by dexamethazone in the form of sodium phosphate. This compound is contained in 1 ml of solution for injections at a dose of 4 mg, and in one tablet - in an amount of 500 μg (0.5 mg). The concentration of such a substance in the eye drops is 0.1%, which corresponds to 1 mg per 1 ml solution.

In addition to the active compound, sterile water, sodium hydrophosphate, dinatarium and glycerol are sterile water. Eye drops include additional ingredients such as benzalconium chloride, edestat of dynatory, water, sodium tetrahydrate and boric acid. The auxiliary additives of the tablet form are lactose, corn starch, colloidal silicon dioxide, talc, talc and magnesium stearate.

Operating principle

Indications

Injections of "dexamethasone" intramuscularly or intravenously prescribed in acute cases or in situations where the reception is impossible. In other cases, use a tablet form.

The drug is effective:

With anaphylactic shock or other severe allergies.
With the edema of the brain, the cause of which is injured, as well as operation, meningitis, tumor process and other factors.
In case of lack of adrenal cortex.
With toxic, burn or traumatic shock.
With severe bronchospasm or asthmatic status.
With rheumatic or systemic diseases.

With severe forms of dermatosis.
In case of crown disease or ulcerative colitis.
With hemolytic anemia and other blood diseases.
When glomerulonephritis.
With severe infections.
With leukemia and other neoplasms.

Injection shape can also be used locally, for example, to enter into the pathological formation of soft tissues, into the joint or in the eye fabric. For emergency decrease in body temperature, a lithic mixture is used with "Dexamethasone"whose components are "Analgin" and "DIMEDROL".

Eye drops are used for keratitis, conjunctivitis, iris, behave and other diseases of the organ of vision. Inhalations with "dexamethasone" are appointed by doctors in obstructive bronchitis, a casst, false croup (stenosis of the larynx). The drug is poured into the nebulizer along with physical and conduct a procedure for 5-10 minutes.

How old are allowed to take?

If the use of "dexamethasone" has serious indications, such a medicine can be appointed at any age, even a 10-month or one-year-old child. At the same time, treatment with such a hormonal means should be only under medical supervision (both children up to a year and a child's child). Giving the drug to children without appointing a doctor is unacceptable.

Contraindications

Any form of "dexamethasone" does not apply with increased sensitivity to substances in its composition. Drug is contraindicated in acute viral, fungal or bacterial infection. Eye drops can not be applied when damaged the integrity of the cornea.

Crims and tablets are not prescribed during vaccination (when using living vaccines) and in the syndrome of Itsenko-Cushing. Injections are prohibited in serious problems with hemostasis, and tablets due to lactose content are not prescribed with violations of carbohydrate metabolism.

Caution in the appointment of the drug require patients with arterial hypertension, tuberculosis, renal failure, epilepsy, ulcerative disease, hypothyroidism, liver failure and some other pathologies. If a child has some kind chronic illnessThe question of the appointment of "dexamethasone" should be solved by a specialist individually.

Side effects

Treatment of "dexamethasone" can provoke:

Cataract or glaucoma.
Disturbance of the heart - for example, bradycardia, heart failure or extrasystole.
Increase body weight, hyperglycemia, water delay and other exchange violations.
Increase blood pressure.
Weakness or muscle atrophy.
Mental disorders.
Slowing wound healing, skin thinning, appearance of stretch marks and acne.
Reducing the level of lymphocytes, eosinophils, platelets or monocytes.

In addition, a local reaction may occur for a medicine - for example, burning during an injection or redness of the skin after injection. If you cancel the drug sharply, this will lead to the development of cancellation syndrome, manifesting a decrease in blood pressure, nausea, headache and other negative symptoms.

Instructions for applying dexamethasone
The composition of the drug dexametazone
Indications of the drug dexametazone
Conditions for storage of drug dexamethasone
The shelf life of the drug dexamethasone

ATX code: Hormones for systemic use (excluding sex hormones and insulins) (H)\u003e Corticosteroids for system use (H02)\u003e Corticosteroids for system use (H02A)\u003e Glucocorticoids (H02ab)\u003e DexameThasone (H02AB02)

Release form, composition and packaging

pR D / INJEKTS. 4 mg / 1 ml: AMP. 5, 10 or 25 pcs.
Reg. No: RK-LS-5-No. 020631 from 11.06.2014 - Existing

Injection Colorless or weakly brown, transparent.

Excipients: Water d / and, creatinine, sodium citrate, dynatory of edestate dihydrate, sodium hydroxide solution 1 M.

1 ml - dark glass ampoules (5) - Packaging Cell contour (1) - Cardboard packaging.
1 ml - Dark Glass Ampoules (5) - Packaging Cell Contour (2) - Cardboard Packaging.
1 ml - dark glass ampoules (5) - Packaging cell contour (5) - cardboard packaging.

Description of the medicinal preparation Dexametanone Created in 2014 on the basis of the instructions posted on the official website of the Ministry of Health of the Republic of Kazakhstan. Renewal date: 08/25/2014

pharmachologic effect

Synthetic glucocorticoid preparation. It has a pronounced anti-inflammatory, anti-allergic and desensitizing effect, has immunosuppressive activity. Slightly detains sodium and water in the body. These effects are associated with the oppression of the release of inflammatory mediators by eosinophils; induction of lipocortion formations and a decrease in the number of fat cells producing hyaluronic acid; with a decrease in permeability of capillaries; inhibition of cyclooxygenase activity (mainly COF-2) and prostaglandin synthesis; Stabilization of cell membranes (especially lysosomal). The immunosuppressive effect is due to the braking of the release of cytokines (interleukin-I, II, gamma interferon) from lymphocytes and macrophages. The main effect on the metabolism is associated with the catabolism of proteins, an increase in glucongenesis in the liver and a decrease in glucose recycling by peripheral tissues. The drug suppresses vitamin D activity, which leads to a decrease in calcium suction and an increase in its removal from the body. Dexamethasone suppresses the synthesis and secretion of the adrenocorticotropic hormone and the secondary - synthesis of endogenous glucocorticoids. A feature of the drug is a significant oppression of the functions of the pituitary and complete absence of mineralocorticoid activity.

Pharmacokinetics

Dexamethasone phosphate refers to long-acting glucocorticosteroids. After the introduction, the injection is quickly absorbed from the injection site and is distributed in tissues with blood flow. About 80% of the drug are associated with blood plasma proteins. It penetrates well through the hematostephalic and other histohematic barriers. C Max dexamethasone in the liquor is observed 4 hours after B / in the introduction and is 15-20% of the blood plasma concentration. After a / in administration, a specific effect manifests itself after 2 hours and lasts for 6-24 hours. Dexamethasone is metabolized in the liver significantly slower than cortisone. T 1/2 of blood plasma - about 3-4.5 hours. About 80% of the administered dexamethasone is eliminated by the kidneys in the form of a glucuronide for 24 hours.

Indications for use

shock of various genes (anaphylactic, post-trap, postoperative, cardiogenic, hemotransfusion, etc.);
the edema of the brain (with brain tumors, cranial and brain injury, neurosurgical operations, brain hemorrhage, meningitis, encephalitis, radiation lesions);
asthmatic status;
heavy allergic reactions (swelling of quinque, bronchospasm, dermatosis, acute anaphylactic reaction to medications, serum transfusion, pyrogenic reactions);
acute hemolytic anemia;
thrombocytopenia;
agranulocytosis;
acute lymphoblastic leukemia;
severe infectious diseases (in combination with antibiotics);
acute insufficiency of adrenal cortex;
diseases of the joints (shoulder-painting periatritis, epicondylitis, bursitis, tendovaginitis, osteochondrosis, arthritis various etiology, osteoarthritis);
rheumatoid diseases;
collagenoses.

Dexamethasone, an injection solution, 4 mg / ml, is used in acute and urgent states in which parenteral administration is vital. The drug is intended for short-term application for life indications.

Dosing mode

The dosing mode is individual and depends on the testimony, the severity of the disease and the patient's reaction to therapy. The drug is introduced in / m, in / squeezedly, or drip, periarticular or intra-articular administration is also possible. In order to prepare a solution for in / in drip infusion, an isotonic solution of sodium chloride should be used, a 5% glucose solution or a ringer solution.

Adultsv / B, V / m is introduced from 4 to 20 mg 3-4 times / day. The maximum daily dose is 80 mg. With sharply dangerous situations, high dosages may be needed. The duration of parenteral use is 3-4 days, then transfer to the supporting therapy of the oral form of the drug. When the effect is reached, the dose is reduced over several days before the maintenance dose (an average of 3-6 mg / day, depending on the severity of the disease) or to the cessation of treatment with continuous patient observation. Fast V / in the introduction of massive doses of glucocorticoids can cause a cardiovascular collapse:

injection produce slowly, within a few minutes.

Brain swelling (adult):the initial dose of 8-16 mg intravenously, subsequently 5 mg in / in or in / m every 6 hours before the satisfactory result is reached. With surgical operations on the brain, these dosages may be needed a few more days after surgery. After that, the dosage should gradually decrease. Continuous treatment can counteract the increase in intracranial pressure associated with the brain tumor.

Children prescribe in / m. The dose of the drug is usually from 0.2 mg / kg / day to 0.4 mg / kg / day. Treatment should be reduced to minimal doses in the shortest period of time.
When the dose, the dose depends on the degree of inflammation, size and arrangement of the affected area. The drug is introduced once every 3-5 days (for a synovial bag) and once every 2-3 weeks (for joint).

In Odini, it is not more than 3-4 times at the same time in two joints at the same time. The most frequent administration of dexamethasone can damage the articular cartilage. Casting injections should be carried out in strict sterile conditions.

Side effects

Usually dexamethasone is well tolerated. It has low mineralocorticoid activity:

his influence on water-electrolyte exchange Nightly. As a rule, low and medium doses of dexamethasone do not cause sodium delays and water in the body, an increased excretion of potassium.

With a single introduction:

nausea, vomiting;
arrhythmias, bradycardia, right up to a heart stop;
arterial hypotension, collapse (especially with the rapid introduction of large doses of the drug);
reduction of glucose tolerance;
reduced immunity.

With prolonged therapy:

steroid diabetes or manifestation of latent diabetes mellitus, inhibition of adrenal functions, Itsenko-Cushing syndrome, sexual development delay in children, violation of the function of sex hormones (violation menstrual cycle, amenorrhea, girsutism, impotence);
pancreatitis, steroid ulcer of the stomach and duodenum, erosive esophagitis, gastrointestinal bleeding and perforation of the tract walls, raising or decreased appetite, disruption of digestion, meteorism, hurry, harmful cases - increasing the activity of hepatic transaminases and alkaline phosphatase, hepatomegaly;
myocardial dystrophy, development or enhancing the severity of heart failure, changes on the electrocardiogram characteristic of hypokalemia, increased blood pressure, hypercoagulation, thrombosis. In patients with sharp and subacted myocardial infarction - the spread of the focus of necrosis, slowing down the formation of scar tissue, which can lead to a rupture of the heart muscle;
delium, disorientation, hallucinations, manico-depressive psychosis, depression, paranoia, an increase in intracranial pressure with an elevation nerve (pseudo-turn of the brain - more often in children, usually after too rapid dose reduction, symptoms - headache, worsening visual acuity or bias in the eyes) , exacerbation of epilepsy, mental dependence, anxiety, sleep disorders, dizziness, headache, convulsions, amnesia, cognitive disorders;
an increase in intraocular pressure, glaucoma, the swelling of the optic nerve, the rear subcapsular cataract, thinning of the cornea or sclera, exacerbacterial, fungal or viral diseases, exophthalm, a sudden loss of vision (with parenteral administration, it is possible to deposit the drug crystals in the eye vessels);
increased elimination of calcium, hypocalcemia, increase in body weight, negative nitrate balance, increased sweating;
liquid delay and sodium (peripheral edema), hypernatremia, hypokalemic alkalosis;
the slowdown in the growth and processes of ossification in children (premature closure of epiphyseal growth zones), osteoporosis (very rarely pathological fractures of bones, aseptic necrosis heads of the shoulder and femur), the gap of the muscle tendons, proximal myopathy, reduced muscle mass (atrophy). Strengthening pain in the joint, swelling of the joint, painless destruction of the joint, arthropathy Charcot (with intravantic administration);
slowed healing of wounds, petechia, ekkimosis, thinning of skin, hyper- or hypopigmentation, steroid eels, strlicy, tendency to the development of pyodermia and candidiasis;
hypersensitivity, including anaphylactic shock, local allergic reactions - skin rash, itching. Transient burning or tingling in the crotch area after in / in the injection of large doses of corticosteroid phosphates.

Local with parenteral administration:

burning, numbness, pain, tingling at the place of administration, infection at the injection site, rarely - necrosis of the surrounding tissues, the formation of scars at the injection site; Atrophy of the skin and subcutaneous tissue at a per / m administration (the introduction into the deltoid muscle is especially dangerous);
development or exacerbation of infections (promoted by immunosuppressants and vaccination), leukocytosis, leukocyturia, blood tides to face, cancellation syndrome, risk of thrombosis and infections.

Contraindications for use

increased sensitivity to dexamethasone or auxiliary components of the drug;
system infection, if not used specific antibacterial therapy;
For periarticular or intra-articular administration:previous arthollasty, pathological bleeding (endogenous or caused by the use of anticoagulants), intra-articular bone fracture, infectious (septic) inflammatory process in the joint and periarticular infections (including in history), as well as the general infection, bacteremia, systemic fungal infection, pronounced by the occasional osteoporosis, the absence of signs of inflammation in the joint ("dry" joint, for example, with osteoarthritis without synovitis), pronounced bone destruction and joint deformation (sharp narrowing of the joint gap, ankylosis), the unstability of the joint as an outcome of arthritis, Aseptic necrosis of bone epiphysis forming, infection at the injection site (for example, septic arthritis due to gonorrhea, tuberculosis).

In children during the growth period, glucocorticosteroids should be used only in absolute indications and under particularly thorough observation of the doctor.

Carefully

Special attention is required when considering the use of systemic corticosteroids in patients with the following diseases and states, the patient's frequency monitoring is necessary:

Application in pregnancy and breastfeeding

During pregnancy (especially in the first trimester) and during breastfeeding, the drug is prescribed only if the expected therapeutic effect will exceed the potential risk on the fruit and child. With prolonged treatment during pregnancy, the possibility of violation of the fetal growth processes is not excluded. In the case of the application in recent months of pregnancy, there is a danger of the development of adrenal cortex atrophy from the fetus, which may later require substantive therapy in the newborn.

special instructions

In post-marketing research, very rare cases of the development of tumor lysis syndrome in patients with hemoblastosis after using dexamethasone alone or in combination with other chemotherapeutic means are reported. Patients with a high risk of development of lysis syndrome tumors must be under close control and appropriate precautions should be applied.

Patients and / or guardians should be warned regarding the possibility of developing serious side effects from the psyche. Symptoms usually manifest themselves within a few days or weeks after the start of treatment. The risk of data side effects is higher when using high doses / systematic exposure, although the level of the level does not allow to predict the offensive, the severity or duration of the reaction. Most reactions disappear after a reduction in the dose or cancellation of the drug, although sometimes specific treatment is necessary. Patients and / or guardians should consult a doctor if psychological symptoms are bothering, in particular depression, suicidal thoughts, although such reactions are registered not often. Special attention requires the use of systemic corticosteroids in patients with existing or existing heavy affective disorders, which include depressive, manic-depressive psychosis, previous steroid psychosis - treatment is carried out only on life indications.

After the parenteral purpose of glucocorticoids, serious anaphylactic reactions may be observed, such as larynx swelling, urticaria, bronchospasm, more often in patients with allergies in history. In the occurrence of anaphylactic reactions, it is necessary to carry out the following measures: urgently in / in slow administration 0.1-0.5 ml of adrenaline (solution 1: 1000:

0.1-0.5 mg of adrenaline depending on the body weight), in / in the introduction of aminoophyllinnoxinophyllin and if it is necessary to-certificate breathing.

Side effects can be reduced when the minimum effective doses are prescribed in a short time and by administering daily dose Single in the morning. It is necessary to tate the dose more often depending on the activity of the disease.

Patients with brain injuries or stroke should not be prescribed glucocorticoids, as it will not benefit and can even be harmful.

In diabetes mellitus, tuberculosis, bacterial and amoebic dysentery, arterial hypertension, thromboembolis, cardiac and renal failure, non-specific ulcerative colitis, diverticulite, recently educated intestinal anastomose, apply dexamethasone is needed very carefully and with adequate treatment of the underlying disease.

With a sudden abolition of the drug, especially in the case of high doses, there is a syndrome of glucocorticosteroids:

anorexia, nausea, inhibition, generalized muscular and skeletal pains, general weakness. Sust fast decline Doses after prolonged treatment can lead to acute adrenal insufficiency, arterial hypotension, death. After the discharge of the drug for several months, the relative failure of the adrenal cortex may be maintained. If in this period there are stressful situations, temporarily glucocorticoids are prescribed, and, if necessary, mineralocorticoids.

Before the use of the drug, it is desirable to conduct a patient examination for the presence of ulcerative pathology of the gastrointestinal tract. Patients with predisposition to the development of this pathology must be appointed with the preventive purpose of antacid funds.

During treatment with the drug, the patient must adhere to a diet with rich in potassium, proteins, vitamins, with a reduced content of fats, carbohydrates and sodium.

As a result of the suppression of the dexamethasone of the inflammatory reaction and the immune function, susceptibility to infection increases. If a patient has intercurrent infections, the septic state treatment with dexamethasone must be combined with antibacterial therapy.

A chickenpox may result in mortal outcome in patients with immunosuppression. Patients who have not suffered a wind oil can be avoided to avoid close personal contact with sick chickenpox or a herpes slimming, and in case of contact, apply for urgent medical help.

patients should be taken care and avoid contact with sick cortel and immediately seek medical help if the contact occurs.

Live vaccines should not be prescribed to persons with a weakened immune response. Immune response to other vaccines can be reduced.

If the treatment of dexamethasone is carried out in 8 weeks milked 2 weeks after active immunization (vaccination), then a decrease or loss of immunization effect may be observed (suppresses antibodies).

Use in pediatrics

In children during the growth period, glucocorticosteroids should be used only on life indications and under particularly careful observation of the doctor. During long-term treatment, it is necessary to carefully monitor the dynamics of growth and development. To prevent violation of growth processes with long-term treatment of children under the age of 14, it is desirable every 3 days to make a 4-day break in treatment.

Premature newborns:

the available data indicate the development of long side effects from the nervous system after early treatment (<96 ч) недоношенных детей с хроническими заболеваниями легких в начальной дозе 0.25 мг/кг 2 раза/сут.

Recent studies have assumed the relationship between the use of dexamethasone in premature babies and the development of children's cerebral paralysis. In this regard, an individual approach to the appointment of the drug is needed, given the assessment of "risk / benefit".

Use in older people

General side effects of systemic corticosteroids can be associated with more serious consequences in old age, especially osteoporosis, hypertension, hypokalemia, diabetes, susceptibility to infection and skin thinning.

Features of the influence of the drug on the ability to control vehicles or potentially hazardous mechanisms

Since dexamethasone can cause dizziness and headache, when driving vehicles or working with other mechanisms, it is recommended to refrain from driving a car and control other potentially hazardous mechanisms.

Medicinal interaction

Pharmaceutical incompatibility of dexamethasone with others in / in the injected drugs is possible - it is recommended to be administered separately from other drugs (in / in bolus, or through another dropper, as a second solution). When mixing a solution of dexamethasone, a sediment is formed with heparin.

Simultaneous purpose of dexamethasone with:

Inductors of hepatic microsomal enzymes(barbiturates, carbamazepine, prison, rifabutin, rifampicin, phenytoin, phenylbutazone, theophylline, ephedrine, barbiturates) It is possible to weaken the effects of dexamethasone due to the increase in its elimination from the body;
diuretics(especially tiazide and carboanhydrase inhibitors) and amphotericin B. - may result in increased removal of potassium from the body and increase the risk of developing heart failure;
sodium-containing drugs - to the development of edema and increased blood pressure;
cardiac glycosides -their portability deteriorates and the likelihood of the development of ventricular extrasytoly increases (due to the caused hypokalemia);
Indirect anticoagulants- weakens (less often enhanced) their action (dose correction is required);
anticoagulants and thrombolitics- rises the risk of developing bleeding from an ulcers in the gastrointestinal tract;
ethanol and npvp - the risk of erosive-peptic lesions in the gastrointestinal tract and the development of bleeding is increasing (in combination with NSAIDs in the treatment of arthritis it is possible to reduce the dose of glucocorticosteroids due to the summation of the therapeutic effect). Indomethacin, ousting dexamethasone due to albumin, increases the risk of developing its side effects;
Paracetamol- the risk of hepatotoxicity is increasing (induction of hepatic enzymes and the formation of toxic paracetamol metabolite);
acetylsalicylic acid- accelerates its excretion and reduces blood concentration. When taking corticosteroids, the kidney clearance of salicylate increases, therefore the abolition of corticosterides can lead to body intoxication by salicylate;
insulin and oral hypoglycemic drugs, hypotensive drugs - their effectiveness decreases;
vitamin D -it decreases its effect on the suction of CA 2+ in the intestine;
somatotropic hormone - reduces the effectiveness of the latter;
M-cholinoblocators (including antihistamines and tricyclic antidepressants) and nitrates - contributes to an increase in intraocular pressure;
isoniazid and Mexylethine - increases their metabolism (especially in "slow" acetylastors), which leads to a decrease in their plasma concentrations.

Carboangeerase and "loop" diuretics inhibitors can increase the risk of osteoporosis.

ACTH enhances dexamethasone action.

Ergocalciferol and pararathgamon prevent the development of osteopathy caused by dexamethasone.

Cyclosporine and ketoconazole, slowing down the metabolism of dexamethasone, can in some cases increase its toxicity, increases the risk of developing cramps in children.

The simultaneous purpose of androgens and steroidal anabolic preparations with dexamethasone contributes to the development of peripheral edema, hirsutism, the appearance of acne.

Estrogens and oral estrogen-containing contraceptives reduce dexamethasone clearance, which can be accompanied by an increase in the severity of its action.

Mitanka and other inhibitors of the adrenal cortex functions can determine the need to increase the dose of dexamethasone.

With simultaneous use with alive antiviral vaccines and against the background of other types of immunization increases the risk of activating viruses and the development of infections.

Antipsychotic means (neuroleptics) and azathioprine increase the risk of cataracts when appointing dexamethasone.

With simultaneous use with antihydride preparations, decreases, and with thyroid hormones - the clearance of dexamethasone increases.

With simultaneous use with drugs that increase the metabolic clearance of glucocorticoids (ephedrine and aminogllutetimide), it is possible to reduce or inhibition of dexamethasone effects; with carbamazepine - it is possible to reduce the action of dexamethasone; With Imatinib, it is possible to reduce the concentration of immatureba in the blood plasma due to the induction of its metabolism and an increase in the elimination of the body.

With simultaneous use with antipsychotic means, buccarbore, astatoid caused the risk of cataracts.

With simultaneous use with methotrexate, hepatotoxicity is possible; With a praziquantel - it is possible to reduce the concentration of the prazicvantel in the blood.

Immununopressants and cytostatics reinforce the effect of dexamethasone.