Dexamethasone for allergies, dosage in injections for adults. Dexamethasone injections: instructions for use. Instructions for the use of Dexamethasone for children in the form of injections, tablets and drops
Dexamethasone for allergies - common medicine hormonal origin. The drug gives a high therapeutic effect, helps to relieve the symptoms of the disease, tissue swelling. It has anti-inflammatory and anti-shock effects. Convenient to use, as it is available in many forms - tablets of various dosages or injection solutions.
Such a drug has found wide application in the treatment of a large number of pathologies.
But it is more often used for the manifestation of the following diseases:- Obstructive pulmonary disease and bronchial asthma during an exacerbation.
- The onset of anaphylactic shock.
- Quincke's edema.
- Conjunctivitis formation allergic form.
- Acute skin pathologies, expressed by allergic or atopic dermatitis.
- Various gravity edema meninges.
- Infectious pathologies in a complicated form, as well as diseases of the throat, nose and ear of an inflammatory nature.
- With urticaria and other severe allergy symptoms.
With the above diseases, Dexamethasone can be used in various ways. Often, injections are used first, then oral administration... This method allows you to control the flow of hormones into the body and does not cause side effects.
When using Dexamethasone as a treatment for allergic reactions, the instructions for use must be followed. Otherwise, side effects and complications of the disease are possible.
It is very important not to be mistaken with the doses of the drug, therefore it is prescribed under the supervision of a medical specialist. Exactly how much the dosage should be depends on general condition the patient, the severity of the pathology, the presence of complications and the individual characteristics of the organism.
Depending on the form of the drug, there are special instructions:- The oral method of administration is indicated for all people and can be used by both adults and children. The minimum dose is 2-6 mg, the highest 10-15 mg, which is divided into 3 times a day. At the beginning of the application, a small amount of Dexamethasone is drunk 1 time per day during the day. Then, gradually every day, the dose is reduced by 0.5 mg, reaching 4.5. At the end of the drug use, patients are given corticotropin injections. V childhood use the medicine carefully, the dose is less than 1 mg and is set by the attending physician.
- Instructions for the use of internal infusions - Dexamethasone is also widely used intramuscularly, intravenously drip. The dosage of the drug is from 4 to 80 mg, which are administered 3-4 times during the day. The course of treatment with Dexamethasone should be no more than 4 days. The dropper is also used for prophylactic purposes at 0.2-9 mg.
- Medicine for intra-articular use. The drug is used as injections into the affected areas of the body, or soft tissue... The dose ranges from 2 to 8 mg. Allergy injections are given within 3-21 days. The highest dosage should not exceed 80 mg for adults. You can also prick adolescents.
- Instructions for the use of drops. Dexamethasone in this dosage form is used for inflammatory diseases of the nose and throat. The duration of therapy is 2-5 days. Drops are applied at least 3 times a day. They can be assigned to children and adults.
With injections of Dexamethasone and for internal use, it is necessary to consult a medical specialist, since the drug has certain contraindications and side effects.
And its description, containing instructions, helps to determine the right dose.
If used incorrectly, people may experience side effects on the hormonal drug Dexamethasone, while allergies can progress significantly and become complicated due to additional pathologies.
- nervous - accompanied by visual impairment, noted hyperexcitability, depression, stressful situations, confusion of consciousness. Glaucoma may develop;
- cardiovascular - caused by poor heart rate, development chronic pathologies, in jumps blood pressure, lack of potassium in the heart muscle;
- digestive - expressed by nausea, vomiting, pain in the abdomen, possible hiccups, loss of appetite or excessive increase in appetite;
- the endocrine system - if it is violated due to improper use of the drug, patients have sharp fluctuations in weight, irregular periods, poor growth in childhood;
- skin disorders - characterized by rash, itching, redness. The development of dermatitis is possible, therefore, with this allergic disease patients may experience anaphylactic shock, swelling of the face and body.
To avoid undesirable consequences from the use of this hormonal agent, it is necessary to know its contraindications.
Dexamethasone should not be used for kidney and liver diseases, impairment gastrointestinal tract, colitis, ulcers. Heart failure and individual intolerance are also considered contraindications.
Pregnant women and nursing mothers should not use the drug either. In this case, there should be a mandatory consultation with a medical specialist.
from this drug I gained a lot in weight. and back pain remained.
She took it, got an exacerbation of neurodermatitis, from which she could not get rid of it for several years. : (NEVER take hormonal medications on the recommendation of only one doctor, be sure to consult with someone else, preferably even with two, and best of all - on the recommendation. There are VERY few good gynecologists-endocrinologists.
Hormonal drugs have always been treated with caution, after all, this is an interference in the work of the body and what the reaction will be is difficult to imagine.
I will not write about good medicine Dexamethasone or not, since its purpose in my case remains a big question, I'll just tell you about getting to know him.
Dexamethasone was prescribed by a gynecologist-endocrinologist, for a long time I could not get pregnant and the doctor saw the cause of infertility in an increase in male hormones (now I don’t remember which ones).
She said to drink them until I get pregnant, and then (the pregnant woman) come to her.
That's how many times I told myself, you can't blindly trust the doctors, check ten times and then take your medications. But no, my brain turned off and I was led by the words of the gynecologist that after these pills I would immediately become pregnant.
Dexamethasone is a hormone of the adrenal cortex that affects carbohydrate and protein metabolism, has strong anti-allergic and anti-inflammatory properties.
This drug is very often prescribed for those who cannot conceive and are pregnant, although the instructions for use do not say a word about this.
And how many side effects are there. better not to read at all.
Prescribed a meager dosage with the expectation that I will drink for a long time.
I spent 3 months on drink, at first I did not notice any changes, well, I think, the dosage is probably small, while it works.
And then something incredible began to happen to my body, I became a character from a cartoon about an amorous crow (if anyone remembers when a crow fell in love with everyone, even a hare, whose eyes fled in different directions).
After that my condition stabilized for a while, then again everything is great again.
I didn't like inadequate games with my body anymore, after all, this is a hormonal drug and I went to the doctor, at that moment the plate on her door changed from a gynecologist-endocrinologist to just a gynecologist (apparently lowered)!
During a visit to the doctor, she was very surprised that I was still not pregnant and decided to prescribe me other hormones to drink, after which my cycle went off.
As a result, her treatment did not help me in any way, I became pregnant after many years without taking hormonal drugs.
Perhaps this drug really helped someone to become pregnant or carry a child, everything is individual, in my case it turned out to be useless, the wrong diagnosis or the wrong treatment, now you don’t know.
Solution for injection KRKA "Dexamethasone" - Helps relieve inflammation, but a lot of side effects.
- A large number of side effects.
The doctor prescribed dexamethasone to relieve joint inflammation, inject three times a day for 10 days in a row. Immediately upset that the drug is harmonious, described in the instructions, that there can be many side effects. It was necessary, so it was necessary, I started to inject, but I could not stand it for more than 5 days, all the lymph nodes were swollen, the muscles were absolutely painful, they would not touch, in general I felt as if I had been beaten. I threw these injections further away, but they still reminded my body of acquaintance with them.
After long-term treatment with Dexamethasone, I developed steroid diabetes mellitus. Now I sit on Siofor and on the strictest diet. Therefore, I can say one thing - Dexamethasone is a very effective and powerful medicine, but with very serious consequences. Therefore, before you start injecting it or taking it internally, you need to weigh the pros and cons.
When treating pneumonia, dexamethasone was injected for 14 days. The inflammation was removed. I got leukopenia, and as a result, herpes zoster on the leg. constant, excruciating pain. Herpes set itself to itself, after the rashes and pains appeared. The neurologist confirmed the disease, but the late start of treatment led to the manifestation of constant excruciating pain.
Surely many of you at least once in your life have resorted to the help of hormonal drugs. You may have even been prescribed Dexamethasone itself. If so, then many of you will probably agree with me that hormonal drugs, along with their therapeutic effect, also cause a lot of side effects. Moreover, these side effects are very serious. If you look more closely, you will see that Dexamethasone "heals one thing and cripples another." That is why I am never treated with hormones.
Dexamethasone is a terrible thing I drank for two months together with bromocriptine. It contributes to a decrease in immunity, I had a cold on my lip and more than one, my lower abdomen began to hurt, plus I fell ill with the flu. His condition is terrible. it is better to buy something at a higher price and without such side effects.
As for me, a very bad drug. The doctor prescribed me to have menstruation, but it turns out that there is no menstruation and my health has become worse. Dizzy and severe nausea.
Dexamethasone is another drug that is still dripping. Two times 200 ml. every day they pour in, also from a number of antibiotics, but they seem to be more powerful than ceftriaxone. During the infusion, a bitter taste is felt in the mouth, then nausea appears, even up to vomiting. Flatulence and small signals from the gastrointestinal tract, heaviness in the stomach, loss of appetite, headache, insomnia - the doctor associates all these symptoms with the intravenous infusion of Dexamethasone.
Pour in slowly, then the sensations are better, you just have to add a little, the head immediately begins to ache, heart palpitations, a nasty taste of bitterness in the mouth. In addition, I did not notice anything, so I ask the nurse to drip the system slowly. The course of treatment is 7 days, so at least I was told, after which they will try another antibiotic.
I can’t say with confidence that I felt better after the intravenous infusion of Dexamethasone. Maybe the result will be later, or maybe my body does not react to this drug yet. I really hope that I helped, otherwise they promised to prescribe another drug.
- Saved from anaphylactic shock after an antibiotic allergy
- Has led to obesity and metabolic disorders
I want to tell a sad story that happened to me last year. I got an allergic reaction to the antibiotic, and I was sprinkled with some kind of red spots with bubbles inside. In general, the spectacle is not for the faint of heart. In addition, it was hard to breathe (anaphylactic shock began). An ambulance was called for me, the doctor immediately injected desamethasone 0.4% 1 ampoule. It became easier for me to breathe and I was normally taken to the hospital. But that's where it all started. I was given droppers every day and a day 2 times (including daxamethasone) to relieve allergies and skin dermatosis. Prednisolone was also used occasionally. In general, at the end of the treatment on day 10, I began to notice that I was somehow bloated and swelling strongly. I was prescribed other drugs to relieve edema (euphilin). But now I recovered, I was discharged. And I can't fit into clothes. When I went to the hospital I was 80 kg, I am discharged after 10 days already 90. (+10 kg.) To be honest, I cried. It turns out that Dexamethasone in rare cases causes obesity and a violation of carbohydrate-protein metabolism in the body (and they pierced me with 10 ampoules). and together with prednisolone in general inflates a person. I know many such people who have been treated with hormones. It hurts to watch. And the worst thing is that neither diet, nor the gym do not return to shape for a long time. Because there was a metabolic disorder.
Now my weight is frozen at one figure, well, at least it doesn't rise. I do not recommend the drug Dexamethasone, as although it is good for allergies, it has ruined my life a lot.
Neutral reviews
- Quickly relieved allergy symptoms
- low price
- A terrible burning sensation after drug administration
The hormonal drug DEXAMETAZONE was prescribed by a physician for me when I had a terrible allergy with swelling of the joints on my hands and knees. Prescribed drugs and intravenous administration calcium gluconate only temporarily relieved the symptoms and in the morning everything started anew.
With just the word "hormonal drug", I decided to first carefully study the instructions and reviews, sometimes it helps to avoid unnecessary purchases of drugs. At the same time I signed up for a dermatologist.
The first thing that confused me was the prescribed dosage. In the instructions for allergies, a much lower dosage was listed, and it was said that usually such a drug was injected with an ambulance in emergency cases with severe edema. And I was prescribed an increased dosage, and even for three days.
But since it was already the 10th day of treatment and I once again woke up with swollen joints, albeit to a lesser extent, I decided to take an injection. The drug cost about 10 rubles.
After the injection, I had a feeling that boiling metal was spreading through my muscles, I had to sit down and wait for this reaction to subside. (the instructions indicate a side effect - burning). I must admit, the next day everything went away and I was just able to be with a dermatologist, who confirmed my fears to me, saying that Dexamethasone was injected in an emergency, it was possible to do without it. In general, he said that he did not welcome this drug, naming some others. I didn't prick him anymore.
The drug certainly helped, but it should be used only in an emergency and only for medical reasons.
Helped with allergies, but could have been dispensed with
“I have quite a long history of problems with a spine. Recently I was at the doctor's office, since it’s not hard to bear with it, he drew out a decametazone. However, it would need a bit for the removal of the inflammation process. After the fifth turn, I noticed that it was noticeably corrected, especially in the area of the belly. One pain in the back was also a little weak. "
I have been injecting dexamethasone from October to the present day. I have post-radiation edema of the brain, and only dexamtesone helps. In courses of 4 weeks, the courses were heavy, with high doses, 8 mg / week-6 mg -4 mg -2 mg, taking breaks if possible. He has a terrible side effect, on the entire endocrine. But if you follow what is written in the instructions - and the instructions say - if you read carefully - follow a certain diet - then it is tolerable. You need to prick in the morning, from 6 to 8.
Avoid carbohydrates and fats, in general, try to follow a low-carb diet. Then the body will not float. Do not eat sugar, chocolate, rolls. Salt is also to a minimum.
He makes me sick, I bear it hard, because the psycho is under pressure, hormonal depression. No appetite. I didn’t get better, I lost weight. The only thing that has acquired "moon-facedness" in 7 months of the courses is the face, but not much.
In general, probably, people have an individual reaction to it. During the break between courses, I donated blood for hormones, I thought that the adrenal glands died from such a hyper-attack of cortisol - no, all hormones are normal.
So, if you have long courses, then stick to a neat diet and do not be afraid of side effects. I am hypotonic, and my hypotension has not gone anywhere. He plants calcium - you can drink calcium D3 and panangin at the same time, because potassium is excreted.
For a two-week course, nothing will happen in the body.
Of course, it is not safe as I think, but what to do when you have to deal with severe allergies ... It can also be the bites of some insects or, as in your case, with food. I was allergic to the medicine, and as a result my whole body was covered with a rash, it was also terrible. But two injections were enough for the allergy to subside. Perhaps someone will write to me that you can do without dexamethasone (I read different reviews on other sites). Well, probably there are other methods, I admit it.
A year and a half ago, my daughter was admitted to the hospital with urticaria. My daughter was 3 years old. She was prescribed a lot of all kinds of injections, including dexamethasone. My daughter seemed to tolerate it well, there were no side effects.
Recently, my daughter discovered a chalazion on upper eyelid, we were also prescribed drops with the content of Dexamethasone - "Tobradex". However, so far the effect is not what I would like.
But all the same I will advise this drug.
After giving birth to a baby and breastfeeding, I started having a "hormonal crisis". To restore the normal balance of hormones, the doctor prescribed me to drink Dexamethasone, and the problems with hormones were really solved. I was especially worried about the questions women's health, but Dexamethasone perfectly helped to get rid of disruptions in menstrual cycle, as well as get rid of the incipient cyst. But, despite the obvious advantages, Dexamtazone also has undesirable side effects. For example, during the appointment, I often had a headache, although I do not suffer from migraines in general, as well as problems with the gastrointestinal tract. Therefore, I would not recommend it, I think you can find another effective medicine.
Positive reviews
Dexamitazone. I read a lot of reviews, but in my history so far this drug shows good indicators. Based nervous breakdown and the chill of the roots of the facial nerve, the corner of my eye dropped, I was still with edema and all kinds of spots. I started taking the drug intravenously with saline, what can I say? Great .. On the 3rd day I turned white, my eyes returned to normal. I am pleased
Saved me from a severe allergic reaction
About two years ago, I helped my sister renovate her house. I got to paint the surfaces with paint. I remember that I did not tolerate the smell of paint very well - there was nausea, the condition was terrible. But as it turned out later, the most unpleasant thing was ahead of me.
By evening, the outer surface of the feet and then just above the ankles were covered with a small itchy rash. I had a herb at home that can be used to treat the skin with itching, I decided to use it, brewed it, insisted and steamed my legs in it. I guess I made a mistake by doing this procedure in very hot water. In the morning, the itching and rash intensified. I went to the dermatovenous dispensary. The doctor, having examined the legs, diagnosed an allergic reaction to chemical preparation and prescribed treatment. However, the next day it became much worse - my legs were swollen so that I could hardly move around the apartment, and even small pimples turned into large blisters. I called the local doctor to the house, it should be noted that she looked very frightened at the sight of my legs, she said that I had erysipelas and sent me to the surgeon, but he, in turn, confirmed the dermatologist's diagnosis of allergy.
By that time, no shoes could fit on my feet, they bought me huge soft men's slippers. I went, of course, with the help of my husband to an allergist friend who diagnosed me with severe urticaria-type allergy. Prescribed oral Dexamethasone tablets and smeared blisters with brilliant green solution. Gradually, my legs returned to normal.
Dexamethasone saved me from a severe allergic reaction. But it must be borne in mind that this drug belongs to hormonal agents, is taken in severe cases, so I made a detailed description of the problem that happened to me, only a doctor should prescribe Dexamethasone.
Good day to all! I have never had problems with barley, ugh ugh, but my husband always suffers from it, not only does he see badly, is short-sighted, but barley gets him too! So he has to run to the clinic, where he is immediately prescribed warming up and prescribed drops of dexamethasone.
I understand that they are not sold without a prescription, at least in our pharmacy. The droplets act very quickly and effectively. Someone advised him to rinse with urine, but he is an intellectual to the marrow of my bones, and he considers urinotherapy in any form to be the most terrible treatment that mankind has just invented. But from what these drops, he does not care, they heal himself perfectly and quickly enough. Three days later, the barley was gone. The father-in-law also uses these drops, since he is a welder and very often his eyes become inflamed, and sometimes there are burns, he is saved only by them.
I read the reviews of the girls, they write a lot of negative things about dexamethasone, they say, there are a lot of side effects and so on. Yes, probably now there are more effective and less harmful hormonal drugs, maybe dexamethasone is used only in Russia. I don't know, I'll tell you about personal experience... My first pregnancy stopped developing at the 9th week, and I had to do curettage. After that, a year of moral suffering. You know, I won't wish it on the enemy. The reason is mixed hyperandrogenism. To give birth has become an obsession. To argue about natural selection (a lot was written on this topic on the then well-known website "Rozhana", which I called a sect 8 years ago) with a woman whose desired child died is cruelty, abomination and blasphemy. I was not going to experiment (that is, get pregnant and wait to see if I can endure this time or not). When I got pregnant for the second time, my doctor immediately prescribed dexamethasone for me. The hormonal background returned to normal, and the drug was gradually canceled.
I endured and gave birth. Therefore, I know that for some, dexamethasone is the only way to give birth. Almost all drugs have side effects, if you start reading them - at least don't live at all. And you have to live and give birth. Of course, time passes, the drugs change, here you need a good doctor - a competent, educated, who develops as a professional, in the know about new methods. And it is imperative that he morally support you, encourage you, say that everything will work out, as my doctor Natasha supported me. And do not delve into negative experiences, neither your own nor someone else's! Only positive and confidence that everything will work out. I wish you all good health.
- Quickly knocks down the temperature
In the summer, the child picked up some kind of virus at sea, and they could not diagnose us, they said that there was some kind of mutation of several viruses. The son coughed, vomited, conjunctivitis appeared and all this was accompanied by a very high fever. And neither antipyretic nor folk methods, as if wiping with water did not give any effect. The temperature did not drop below 38.5, no matter what we did. Several times they called a doctor, made different diagnoses, prescribed antibiotics, but even while taking Sumamed, the temperature was kept. On the fifth day, the child became worse, the temperature rose to 39.5, convulsions began. They called an ambulance, but it turned out that there were only a couple of cars in the resort town and they were all busy, and it was not clear when they would be free. After waiting an hour, they began to call a familiar pediatrician. Despite the fact that it was night, she arrived and after assessing the child's condition, she said that only the hormonal drug Dexamethasone would help. After the injection, literally 10 minutes later, the child stopped trembling, and after another half hour he was already all wet. The temperature dropped to 37.3, in an hour it was already 36. 7. The child was ill for a long time, but there were no such high temperature jumps.
The only thing is that after the injection of dexamethasone it is impossible to get vaccinated for 8 weeks, we transferred it.
Of course, the drug is hormonal, and it is better not to use it, but when no means help bring down the high temperature, an exception can be made, of course, with the approval of the doctor.
Good for knocking down heat
Dexamethasone in drops was prescribed to me by the Ophthalmologist. The drops are very effective. The inflammation subsided very quickly. And there were no troubles during the treatment. I dripped on my own first antibacterial drops in the eyes and there was no improvement, but on these drops it immediately became better!
I am 30 years old, since childhood I have a spring seasonal allergy. And what the parents just didn’t try, and then I myself, and the pills and nose drops, there’s little use. In each pocket there are handkerchiefs, drops, pills, tin is shorter, who knows, he will understand)) And a lot of money was spent on all this. But for 5 years now I have been addicted to dexamethasone. I stab 1 ampoule in / m. All symptoms are gone! The effect lasts 4-7 days, depending on the weather. The price is cheap with awesome action, super! The main thing is not to abuse it.
Last summer I was with my grandmother in the country, sat in the evening with neighbors at the table and a neighbor was bitten by some kind of bzyka. Suddenly, for no apparent reason, the woman becomes ill, begins to choke! Other neighbors came to the rescue, they had ampoules of dexamethasone in their car kit. Thank God I didn't have to go to the hospital. Everything worked out and the neighbor then thanked those neighbors for a long time.
Despite the fact that Dexamethasone is a hormonal drug, which is why many do not recommend using it, I can only give him ten out of ten. Even hormones do not pose such a danger and do not cause as much inconvenience as allergies.
Since childhood, I have had eczema on my hands in, perhaps, its worst form. Everything looked as if there was no skin at all. We tried all kinds of remedies, but only Celestoderm, an ointment whose main component is dexamethasone, helped me, and for the first time in several years I saw normal skin on my hands. Since then, I have been clogging the skin manifestations of allergy with hormones, since dermatologists and allergists threw up their hands, they say, hereditary, and nothing can be done. True, now I have found a more effective hormone - mometasone, and I mainly use it.
I recently had allergic conjunctivitis. At first I thought that conjunctivitis was ordinary - I used Albucid and Tetracycline. Two weeks suffered - the situation only worsened. Then, due to the characteristic itching, I realized that it was an allergy. I bought Dexamethasone eye drops at the pharmacy, which cost about 50 rubles, I dripped for two days, in the morning and in the evening, and my two-week problem disappeared like a hand.
So there are situations when salvation is only in hormones and without them there is no way.
Despite the fact that I have been using them periodically for 15 years now, I have not noticed any side effects. The main thing is not to abuse it. Ointment smear with a thin layer and on a small area.
"Dexamethasone" for allergies: dosage, reviews
Allergic reactions can be triggered by a variety of irritants. Some people cannot stand the flowering of certain plants, others cannot be in the same room with animals. Both drug and food allergies occur quite unexpectedly and sharply. Modern pharmacological companies offer you to purchase various remedies to eliminate unpleasant symptoms. One of these is Dexamethasone. For allergies, this drug is used by many patients, despite the wide range of analogues. Today's article will tell you about the use of antihistamine medication.
Description and characteristics
The drug "Dexamethasone" refers to antihistamines of hormonal origin. The active ingredient of the drug is sodium phosphate dexamethasone. Depending on the form of release of the drug, there may be additional components in it. You can buy the drug "Dexamethasone" (for allergies) at the pharmacy. The manufacturer offers injections, eye drops or tablets of your choice. Depending on the type and severity of the pathology, the appropriate form is selected.
The glucocorticoid is relatively inexpensive. Drops will cost you no more than 100 rudders, tablets can be purchased for 50 rubles. Ampoules in the amount of 25 pieces cost no more than 200 rubles. Despite this affordable price, it is important to remember that "Dexamethasone" in case of allergies should be prescribed by a doctor. You should not self-medicate, which, moreover, is not always correct.
"Dexamethasone" for allergies: purpose and contraindications
A hormonal antihistamine is prescribed to treat allergic reactions when the use of other medications is impossible or ineffective. Most often, "Dexamethasone" is used in the development of an acute severe condition, for example, Quincke's edema, anaphylactic shock, bronchospasm. The planned use of this medication is prescribed when it is necessary to remove a person from a serious condition. In the future, doctors recommend switching to the use of conventional antihistamines. The main indications for the use of the drug will be the following situations:
- allergy in the form of shock, edema, bronchospasm;
- hemolytic anemia, thrombocytopenia;
- acute croup, adrenal insufficiency;
- dermatitis, erythema, lichen and urticaria;
- allergic conjunctivitis, iritis, inflammation of the optic nerve.
The drug is also used in complex therapy for the treatment of various kinds of inflammatory processes: arthritis, bursitis, bronchitis, blood diseases, and so on. Do not use "Dexamethasone" for allergies in the following cases:
- with hypertension and diabetes mellitus;
- if a person has a stomach ulcer and kidney failure;
- during pregnancy and lactation;
- with fungal and purulent eye lesions (for drops);
- with hypersensitivity.
The use of tablets
It is important to use "Dexamethasone" correctly for allergies. The dosage of the drug is prescribed individually in each case. If the doctor does not give separate recommendations, then you need to take the medicine according to the instructions. For an adult, the minimum daily dose is 1-2 tablets (0.5-1 mg of active ingredient). If necessary, the portion is increased, but it should not exceed 30 tablets (15 mg) per day. The prescribed dose is divided into several doses (from 2 to 4).
When relief occurs, the dose of the drug is reduced every three days by 0.5 mg. In this case, it is necessary to assess the patient's condition. The tablets are not used in children under 12 years of age. If such therapy is necessary, another form of drug release is chosen.
Using eye drops
This form of the drug can be used to treat children from 6 years of age. Before use, be sure to shake the bottle.
- Children from 6 to 12 years old are recommended to inject 1 drop up to three times a day.
- Adult patients and children after 12 years of age are prescribed 2 drops up to 5 times a day. After two days, the frequency of use is reduced to 2-3 times.
Medication therapy lasts about 7 days. If necessary, this period can be extended up to 10 days. In the postoperative period and for chronic allergies, the medicine is used for up to one month, but in a lower dosage.
"Dexamethasone" for allergies intramuscularly: dosage
Dexamethasone injections are used in especially dangerous situations when it is impossible to hesitate. Most often they are used in hospitals and ambulance paramedics. How to correctly administer Dexamethasone for allergies intramuscularly? During manipulation, it is important to follow all aseptic rules: use only disposable syringes, wipe the skin with sterile alcohol wipes, wash your hands before injecting. The dosage of the drug can be from 1 to 5 ampoules per day. The medicine is used as follows:
- in shock, 5 ampoules at once, and then the portion is calculated in accordance with the body weight;
- during cerebral edema 2-3 ampoules into a vein, and after 1 injection with a break of 6 hours.
For children, a medication is used from birth, but only in case of emergency. The dose of the drug "Dexamethasone" depends on the baby's body weight. With allergies, how much to prick a child who weighs 10 kilograms? Intramuscularly, such a patient is injected with 0.25 mg of the drug per day. Frequency rate of application - 3 times a day (the portion must be divided).
The action of the medication
How does Dexamethasone work for allergies? The medication acts on the adrenal cortex. It has anti-inflammatory and antihistamine effects. The medicine interferes with the production of eosinophils. It inhibits the work of inflammatory mediators. It also has an immunosuppressive effect. The corticosteroid affects the metabolism, it eliminates proteins that contribute to the development of allergy symptoms.
The effect of using the medication lasts about three days. Active substance excreted by the kidneys. Important: the medicine suppresses the effectiveness of vitamin D. In this regard, with prolonged use, a lack of calcium in the body may be detected.
Reviews of the drug
There are very different opinions about the described medicine. Most consumers say the drug saved their lives. Indeed, the drug in the form of injections is used in emergency situations when it is impossible to hesitate. The tool works quickly and efficiently.
Positive reviews are also left about the Dexamethasone tablets. Consumers say the drug cannot be withdrawn at once. It is necessary to gradually reduce its dosage. How to do it correctly - your doctor will tell you. Often, taking pills ends with an injection. Also, patients are often prescribed to continue therapy with other antihistamines.
There are practically no negative reviews about this tool. If you follow the recommendations of a specialist and do not use the medication yourself, then they will not appear. The instructions for use say that the medicine has many side effects. But if you follow all the rules and take into account contraindications, then they can be avoided.
Finally…
You already know that the drug "Dexamethasone" is used exclusively in emergency cases for allergies. Dosage, reviews of the drug and the method of its use were considered in detail. If you suddenly find yourself in such a situation where the use of "Dexamethasone" is required, then consult a doctor. In an emergency, call an ambulance. You should not self-medicate and, without a doctor's recommendation, use any medicine, including this one. Good luck!
Dexamethasone /
pharmachologic effect
Glucocorticosteroid (GCS) - a methylated derivative of fluoroprednisolone, inhibits the release of interleukin-1 and interleukin-2, interferon gamma from lymphocytes and macrophages. It has anti-inflammatory, anti-allergic, desensitizing, anti-shock, anti-toxic and immunosuppressive effects.
Suppresses the release of adrenocorticotropic hormone (ACTH) and beta-lipotropin by the pituitary gland, but does not reduce the content of circulating beta-endorphin. Inhibits secretion thyroid-stimulating hormone(TSH) and follicle stimulating hormone (FSH).
Increases the excitability of the central nervous system(Central nervous system), reduces the number of lymphocytes and eosinophils, increases - erythrocytes (stimulates the production of erythropoietins).
Interacts with specific cytoplasmic receptors, forms a complex that penetrates the cell nucleus, stimulates the synthesis of mRNA, which induces the formation of proteins, incl. lipocortin, which mediate cellular effects. Lipocortin inhibits phospholipase A2, inhibits the release of arachidonic acid and inhibits the synthesis of endoperoxides, Pg, leukotrienes, which promote inflammation, allergies, etc.
Protein metabolism: reduces the amount of protein in plasma (due to globulins) with an increase in the albumin / globulin ratio, increases the synthesis of albumin in the liver and kidneys; enhances protein catabolism in muscle tissue.
Lipid metabolism: increases the synthesis of higher fatty acids and triglycerides (TG), redistributes fat (accumulation of fat mainly in the shoulder girdle, face, abdomen), leads to the development of hypercholesterolemia.
Carbohydrate metabolism: increases the absorption of carbohydrates from the gastrointestinal tract (GIT); increases the activity of glucose-6-phosphatase, leading to an increase in the flow of glucose from the liver into the blood; increases activity
phosphoenolpyruvate carboxylases and the synthesis of aminotransferases leading to the activation of gluconeogenesis.
Water-electrolyte exchange: detains Na + and water in the body, stimulates the excretion of K + (MCS activity), reduces the absorption of Ca2 + from the gastrointestinal tract, "flushes" Ca2 + from the bones, increases the excretion of Ca2 + by the kidneys.
The anti-inflammatory effect is associated with inhibition of the release of inflammatory mediators by eosinophils; inducing the formation of lipocortin and reducing the number of mast cells that produce hyaluronic acid; with a decrease in capillary permeability; stabilization of cell membranes and membranes of organelles (especially lysosomal).
The antiallergic effect develops as a result of suppression of the synthesis and secretion of allergy mediators, inhibition of the release of histamine and other biologically active substances from sensitized mast cells and basophils, a decrease in the number of circulating basophils, suppression of the development of lymphoid and connective tissue, a decrease in the number of T- and B-lymphocytes, mast cells, a decrease in the sensitivity of effector cells to allergy mediators, inhibition of antibody production, changes in the body's immune response.
In chronic obstructive pulmonary disease (COPD), the action is based mainly on inhibition of inflammatory processes, inhibition of the development or prevention of edema of the mucous membranes, inhibition of eosinophilic infiltration of the submucous layer of the bronchial epithelium, deposition of circulating immune complexes in the mucous membrane of the bronchi, as well as inhibition of erosion and desquamation ... Increases the sensitivity of beta-adrenergic receptors of the bronchi of small and medium caliber to endogenous catecholamines and exogenous sympathomimetics, reduces the viscosity of mucus by inhibiting or reducing its production.
The anti-shock and antitoxic effect is associated with an increase in blood pressure (due to an increase in the concentration of circulating catecholamines and restoration of the sensitivity of adrenergic receptors to them, as well as vasoconstriction), a decrease in the permeability of the vascular wall, membrane-protective properties, activation of liver enzymes involved in the metabolism of endo- and xenobiotics.
The immunosuppressive effect is due to inhibition of the release of cytokines (interleukin1, interleukin2; interferon gamma) from lymphocytes and macrophages.
Suppresses the synthesis and secretion of ACTH, and secondarily - the synthesis of endogenous GCS. It inhibits connective tissue reactions during the inflammatory process and reduces the possibility of scar tissue formation.
In terms of the strength of glucocorticosteroid activity, 0.5 mg of dexamethasone corresponds to approximately 3.5 mg of prednisone (or prednisolone), 15 mg of hydrocortisone, or 17.5 mg of cortisone.
Dexamethasone is rapidly and almost completely absorbed after oral administration. The bioavailability of dexamethasone tablets is approximately 80%. C max in blood plasma and the maximum effect after oral administration is achieved in 1-2 hours; after taking a single dose, the effect persists for about 2.75 days.
In blood plasma, approximately 77% of dexamethasone binds to proteins, mainly albumin. A small amount of dexamethasone binds to non-albumin proteins. Dexamethasone is a fat-soluble substance that can penetrate into extra- and intracellular spaces. In the central nervous system (hypothalamus, pituitary gland), its effects are due to binding to membrane receptors. In peripheral tissues, it binds to cytoplasmic receptors. Its disintegration takes place in the place of its action, i.e. in a cage. It is metabolized mainly in the liver to the formation of inactive metabolites. It is excreted by the kidneys.
Indications for the use of the drug
From the side endocrine system: replacement therapy of primary and secondary (pituitary) adrenal insufficiency, congenital adrenal hyperplasia, subacute thyroiditis and severe forms of postradiation thyroiditis. Rheumatic diseases: rheumatoid arthritis (including juvenile chronic arthritis) and extra-articular lesions in rheumatoid arthritis(lungs, heart, eyes, cutaneous vasculitis).
Systemic connective tissue diseases, vasculitis and amyloidosis (as part of combination therapy): systemic lupus erythematosus (treatment of polyserositis and lesions internal organs), Sjogren's syndrome (treatment of lesions of the lungs, kidneys and brain), systemic sclerosis (treatment of myositis, pericarditis and alveolitis), polymyositis, dermatomyositis, systemic vasculitis, amyloidosis (replacement therapy for adrenal insufficiency), scleroderma.
Skin diseases: pemphigoid, bullous dermatitis, dermatitis herpetiformis, exfoliative dermatitis, exudative erythema (severe), erythema nodosum, seborrheic dermatitis (severe), psoriasis (severe), lichen, fungoid mycoses, angioedema, bronchial asthma, contact dermatitis, atopic dermatitis, serum sickness, allergic rhinitis drug disease (hypersensitivity to drugs), urticaria after blood transfusion, systemic immune diseases (sarcoidosis, temporal arteritis).
Eye diseases: proliferative changes in the orbit (endocrine ophthalmopathy, pseudotumors), sympathetic ophthalmia, immunosuppressive therapy in corneal transplantation.
Diseases of the gastrointestinal tract: ulcerative colitis (severe exacerbations), Crohn's disease (severe exacerbations), chronic autoimmune hepatitis, rejection reaction after liver transplantation.
Blood diseases: congenital or acquired acute pure aplastic anemia, autoimmune hemolytic anemia, secondary thrombocytopenia in adults, erythroblastopenia, acute lymphoblastic leukemia (induction therapy), myelodysplastic syndrome, angioimmunoblastic malignant T-cell lymphoma (in combination with cytostatics) (in combination with cytostatics) , anemia after myelofibrosis with myeloid metaplasia or lymphoplasmacytoid immunocytoma, systemic histiocytosis (systemic process).
Kidney disease: primary and secondary glomerulonephritis (Goodpasture syndrome), kidney damage in systemic connective tissue diseases (systemic lupus erythematosus, Sjogren's syndrome), systemic vasculitis (usually in combination with cyclophosphamide), glomerulonephritis in polyarteritis nodosa, Churg-Strauss syndrome, Wegener's granulomatosis Genokha, mixed cryoglobulinemia, kidney damage in Takayasu's arteritis, interstitial nephritis, immunosuppressive therapy after kidney transplantation, induction of diuresis or reduction of proteinemia in idiopathic nephrotic syndrome (without uremia) and in kidney damage associated with systemic lupus erythematosus.
Malignant diseases: palliative therapy of leukemia and lymphoma in adults, acute leukemia in children, hypercalcemia in malignant neoplasms.
Other indications: tuberculous meningitis with subarachnoid blockade (in combination with adequate anti-tuberculosis therapy), trichinosis with neurological or myocardial manifestations.
Doses are set individually for each patient, depending on the nature of the disease, the expected duration of treatment, drug tolerance and the patient's response to the therapy.
Regular supportive dose - from 0.5 mg to 3 mg / day.
Minimally effective the daily dose is 0.5-1 mg.
The daily dose can be divided into 2-4 doses.
After achieving a therapeutic effect, the dose is gradually reduced (usually by 0.5 mg every 3 days until a maintenance dose is reached).
With long-term use of high doses inside, the drug is recommended to be taken with meals, and in the intervals between meals, it is necessary to take antacids. The duration of the use of dexamethasone depends on the nature of the pathological process and the effectiveness of treatment and ranges from several days to several months or more. Treatment is stopped gradually (at the end, several injections of corticotropin are prescribed).
At bronchial asthma, rheumatoid arthritis, ulcerative colitis - 1.5-3 mg / day;
At systemic lupus erythematosus- 2-4.5 mg / day;
At oncohematological diseases- 7.5-10 mg.
Dosing in children
Children (depending on age) are prescribed 2.5-10 mg / m 2 body surface area / day, dividing the daily dose into 3-4 doses.
Diagnostic tests for hyperfunction of the adrenal cortex
Short 1mg Dexamethasone Test: 1 mg dexamethasone orally at 11.00; blood sampling for determination of serum cortisol at 8.00 the next day.
Special 2-day test with 2 mg dexamethasone: 2 mg dexamethasone by mouth every 6 hours for 2 days; 24-hour urine is collected to determine the concentration of 17-hydroxycorticosteroids.
Classification of the incidence of side effects (WHO): very often> 1/10, often from> 1/100 to 1/1000 to 1/10000 to
Dexamethasone
Forms of issue
Dexamethasone instruction
Dexamethasone is a synthetic glucocorticosteroid. It is produced in several dosage forms at once: solution for intravenous and intramuscular administration, eye drops, tablets. In terms of glucocorticoid activity, it is 25 times higher than hydrocortisone, 7 times - prednisolone. Inhibits the activity of white blood cells and resident mononuclear phagocytes. Prevents the migration of the former to the inflammatory focus. It stabilizes the lysosomal membranes, thereby reducing the level of proteases in the inflammatory focus. Levels the effect of histamine on the walls of the capillaries, thereby reducing their permeability. Inhibits the proliferative activity of fibroblasts and suppresses collagen synthesis. Reduces the intensity of the formation of inflammatory mediators - prostaglandins and leukotrienes. Inhibits the release of cyclooxygenase-2. Promotes the migration of leukocytes from the blood to the lymph. In direct interaction with blood vessels, it exhibits a vasoconstrictor effect. Effect on protein metabolism: reduces the content of globulins in the serum, stimulates the formation of albumin in the kidneys and liver, activates catabolic processes in skeletal muscles. Influence on fat metabolism: promotes the formation of fatty acids, redistributes adipose tissue from the extremities to the abdomen, face, shoulder girdle, increases the level of lipids in the blood. Influence at carbohydrate metabolism: promotes absorption of carbohydrates from the gastrointestinal tract, increases blood glucose levels. At submaximal doses, it makes brain tissue more excitable and increases the risk of seizures. With systemic use, it exhibits anti-inflammatory, antiallergic effects, suppresses immunity and excessive cell proliferation. Local forms of the drug exhibit anti-inflammatory, anti-allergic effects, reduce the intensity of exudate flow into the inflammation focus (due to the vasoconstrictor effect).
It is metabolized by microsomal liver enzymes. The half-life is 2-3 hours. Eliminated by the kidneys.
Bacterial, viral and fungal infections require constant medical monitoring of the condition of the patient taking Dexamethasone. Severe forms of infectious diseases can only be taken in combination with specific therapy. Diseases and conditions in which the drug should also be taken with caution are: immunodeficiency diseases, BCG vaccination, diseases of the gastrointestinal tract (stomach and duodenal ulcer, inflammation of the esophageal mucosa, inflammation of the diverticulum, etc.), cardiovascular pathology, endocrine diseases. Before starting drug therapy with the use of Dexamethasone, it is necessary to monitor blood counts, glucose and electrolytes in the blood. With a sharp discontinuation of the drug (especially if it was taken in submaximal doses), rebound syndrome often develops, the manifestations of which are nausea, loss of appetite, musculoskeletal pain, chronic fatigue. While taking the drug, it is necessary to monitor blood pressure, water-salt balance, and also be observed by an ophthalmologist.
When combined with certain medications, Dexamethasone can cause a number of unwanted side effects. So, taking it together with azathioprine or antipsychotic drugs can provoke cataracts, and with anticholinergics - glaucoma. In combination with oral contraceptives, testosterone preparations, female sex hormones, anabolic steroids Dexamethasone can cause acne, increased male hair growth. In combination with non-steroidal anti-inflammatory drugs, taking the drug increases the risk of erosive and ulcerative lesions of the gastrointestinal tract.
All about the drug Dexamethasone for allergies and not only
Dexamethasone is a drug against inflammation, allergies, shock conditions. It is also a desensitizing and immunosuppressive drug.
This medicine belongs to hormonal drugs, namely glucocorticosteroid hormones. Most often used against allergies, in which inflammation, weakening of the immune system or shock reactions are already observed.
General information about the drug
Currently, there are 3 forms of release of this drug:
- solution in ampoules;
- eye drops (the drug is also called "Oftan dexamethasone");
- pills.
The base is the substance of the same name, dexamethasonum. Its share in the solution for injection is ½ of the total composition. The auxiliary components are:
- Glycerol. Has the ability to decompose inorganic alkalis and salts, disaccharides and monosaccharides. Available for absorption by mucous membranes. Absorbs excess water from the body, that is, it is a hygroscopic substance. Shows bactericidal properties.
- Disodium edit. The substance is not absorbed by the body on its own, which means it does not stay in it. Also, like glycerin, it has a hygroscopic function. In an independent form, the permissible rate entering the body is 2.5 mg / kg of body weight. In this case, the substance itself is an allergen, but when used correctly, it helps to remove calcium and iron from the body.
- Sodium hydrogen phosphate dihydrate. Its main function is to maintain acid-base balance blood. It independently performs the role of a laxative, but in this the drug is only an auxiliary agent.
Together with water for injection, these components make up the second half of the total mass of the drug.
The drug in tablet form has the following composition: the active ingredient is dexamethasone, lactose monohydrate, talc, colloidal silicon dioxide, povidone, corn starch, magnesium stearate.
Drops composition: disodium editate, sodium tetraborate, boric acid, water for injections.
How does it affect the body
This drug inhibits the activity of leukocytes and tissue macrophages. Stops the movement of leukocytes to the sites of inflammation. Suppresses the ability of macrophages to phagocytosis. Reduces the concentration of proteolytic enzymes at the site of inflammation. By producing histamine, it reduces the permeability of capillary vessels. Stops collagen formation and fibroblast activity. Plays the role of a vasoconstrictor in direct contact with blood vessels. Stimulates the activity of gluconeogenesis enzymes.
By increasing blood glucose levels, it promotes the production of insulin. In high concentration, it lowers the threshold of convulsive readiness. With systematic use, it has the following therapeutic actions: anti-inflammatory, antiallergic, immunosuppressive and antiproliferative. As an anti-inflammatory, this drug is 30 times more potent than hydrocortisone. However, it does not have mineralocorticoid activity.
The medicine is absorbed immediately after application. Bioavailability in the form of injections is 90%, in tablet form 80%. Due to the intake of one dosage of the drug, the effect lasts for almost 3 days. Getting into the plasma, 77% of the drug is bound to proteins. Only a small percentage is associated with non-albumin proteins. The final decomposition of the drug is carried out in the cell, that is, in the place of direct action. The metabolic site is the liver. The drug is excreted through the kidneys.
Dexamethasone is a synthesized analogue of natural glucocorticosteroids, which, in turn, regulate metabolic processes in the body. It is one of the most effective anti-allergic medicines. It quickly suppresses allergic reactions and inflammatory processes, relieves swelling, pain, peeling, itching, etc. Activation of the neurotransmitter - adrenaline plays an anti-shock role in the use of this drug.
Indications and contraindications
it medication is prescribed for the treatment of the following conditions:
Contraindications include:
- the period of pregnancy (especially the first 3 months);
- baby feeding interval breast milk;
- an increased rate of cortisol in the body;
- low platelet count in the patient's blood;
- aggravated infections (viral, fungal, bacterial);
- joint diseases (ankylosis, osteoporosis and others) and arthroplasty;
- the period after the vaccination;
- thinning of bone tissue.
In the most extreme cases and desperate situations, doctors allow the use of the medicine by patients with:
- different types of insufficiency (heart, liver, kidneys);
- high blood pressure;
- epilepsy;
- high risk of blood clots;
- diabetes mellitus;
- muscle weakness;
- aggravated psychosis.
Instructions for the use of Dexamethasone for allergies
This is a potent drug, which means that before using it, it is imperative to consult with specialists. The drug is prescribed only as directed by a doctor.
In case of a serious allergic reaction or exacerbation of chronic allergy, a course of treatment is prescribed according to the following scheme (combination of injections and pills):
The article was written based on materials from the sites: otzov-mf.ru, fb.ru, xn - 80avnr.xn - p1ai, protabletky.ru, allergia.life.
Dexamethasone is a glucocorticosteroid of synthetic origin, which is similar to a substance secreted by the human adrenal cortex. The hormonal drug penetrates the central nervous system, has anti-inflammatory and immunosuppressive effects. It is based on a substance - dexamethasone phosphate. Produced in different forms ah, has the widest range of applications. For the first time, the tool became known in 1957.
Release form and composition
Dexamethasone is produced in different forms:
- Pills. The concentration of the active substance is 0.5 mg. Additionally, the composition includes magnesium stearate, anhydrous colloidal silicon dioxide, MCC, lactose monohydrate, sodium croscarmellose. Form - round flat, color - white, surface - risk and chamfer. Packing: one pack contains 10 tablets.
- Injection. The content of the active substance in 1 ml is 4 mg, auxiliary components: disodium edetate, glycerin, water, phosphate-buffered solution, propylene glycol, methyl-, propyl parahydroxybenzoate. Packing: in one package of 5, 25 ampoules.
- Eye drops(additionally used for the ears). 1 ml of liquid contains 1 mg of active substance. Other components: boric acid, Trilon B, sodium tetraborate, benzalkonium chloride, water.
- Eye ointment. Ingredients: dexamethasone - 0.1%, liquid anhydrous lanolin, petrolatum, propyl parahydroxybenzoate, methyl parahydroxybenzoate. White ointment without a specific odor, packaged in aluminum tubes of 3.5 grams.
pharmachologic effect
Dexamethasone has the following properties:
- immunosuppressive;
- antitoxic;
- anti-inflammatory;
- anti-shock;
- desensitizing;
- antiallergic;
- antiexudative.
The active substance increases the susceptibility of beta-adrenergic receptors in relation to endogenous catecholamines.
Pharmacodynamics
Dexamethasone phosphate interacts with receptors for GCS, which are present in all tissues (specific cytoplasmic receptors), resulting in the formation of complexes that induce protein synthesis to regulate vital processes in the body. Thus, the following pharmacodynamic features are noted:
- In protein metabolism: in the blood plasma, the concentration of globulins decreases, the production and catabolism of proteins in muscle tissues decreases, and the synthesis of albumin in the kidneys and liver increases.
- In carbohydrate metabolism:
- the level of absorption of carbohydrates from the digestive tract increases;
- the rate of penetration of glucose into the blood increases (glucose-6-phosphatase is activated);
- the production of aminotransferases is accelerated;
- phosphoenolpyruvate carboxylases are activated.
- accelerates the synthesis of triglycerides, fatty acids of higher purpose;
- fat is mobilized from the subcutaneous tissue of the legs and arms.
- water and Na + are retained;
- reduced absorption of calcium from the gastrointestinal tract;
- mineralocorticoid activity is stimulated.
- eosinophils and mast cells stop the release of inflammatory mediators;
- the formation of lipocortins is induced;
- the number of mast cells decreases;
- decreases vascular permeability;
- the membranes of organelles and cells are stabilized;
- the production of prostaglandins with the involvement of arachidonic acid is inhibited;
- the resistance of membranes to negative influences increases.
- the proliferation of lymphocytes is inhibited;
- the migration of B cells is suppressed;
- the interaction of lymphocytes B and T decreases;
- the process of release of cytokines is inhibited;
- the synthesis of antibodies decreases.
- the proliferation of connective and lymphoid tissue is suppressed;
- the production and secretion of allergic mediators slows down;
- the sensitivity of allergy mediators and effector cells decreases;
- the rate of release of biologically active substances is inhibited;
- the process of antibody formation is inhibited;
- the immune response changes;
- the number of basophils that circulate decreases.
Pharmacokinetics
Pharmacokinetic features:
- The active substance binds in the blood fluid with transcortin (a specific carrier protein) by a maximum of 70%, easily overcoming histohematogenous barriers.
- Metabolization occurs in the liver through conjugation with sulfuric and glucuronic acid, as a result of which the metabolites become inactive.
- Excretion is carried out by the kidneys through the urine by 80-90%, by the intestines through the feces - by 10%.
- The minimum elimination half-life from the plasma part of the blood is 3 hours, the maximum is 5.
- The bioavailability level is 78-79%.
Indications for use
Dexamethasone tablets are taken in the following cases:
- bronchial asthma;
- Addison-Birmer syndrome;
- thyrotoxicosis, hypothyroidism, thyroiditis;
- rheumatoid arthritis;
- hemolytic autoimmune anemia;
- thrombocytopenia;
- hypoplasia, aplasia in hematopoiesis;
- serum disease;
- agranulocytosis;
- eczema, pemphigus, erythroderma;
- congenital adrenogenital syndrome;
- oncological neoplasms (to eliminate the gag reflex);
- edema of the brain.
Indications for the use of the injection solution:
- insufficiency of the adrenal cortex in acute form;
- brain tumor, cerebral hemorrhage, meningitis, encephalitis, radiation injury, traumatic brain injury and other diseases accompanied by cerebral edema;
- shocks;
- severe allergies - Quincke's swelling, anaphylactic shock, bronchospasm, etc.;
- asthmatic status;
- infectious pathologies with a severe course;
- lymphoblastic leukemia, thrombocytopenia, agranulocytosis;
- croup in the stage of exacerbation;
- discoid lupus erythematosus;
- keloids;
- ring-shaped granuloma;
- joint diseases - arthritis, periarthritis, styloiditis, osteoarthritis, epicondylitis, bursitis, osteochondrosis, tendovaginitis.
Eye drops and ointment are used in such cases:
- conjunctivitis allergic and non-purulent;
- iritis;
- keratitis;
- iridocyclitis;
- blepharitis;
- scleritis;
- blepharoconjunctivitis;
- injury to the visual apparatus;
- corneal transplant;
- episcleritis;
- keratoconjunctivitis.
Rules for the use of different forms of the drug:
- The tablets are taken orally, that is, inside. At the initial stages, the maximum dosage is prescribed (from 1 to 9 mg), after which the dose is reduced. The daily rate is divided into 2 or 3 doses. It is recommended to take tablets during meals or after meals with water.
- Injection solutions are administered intramuscularly, intravenously (by jet or drip method), intra-articular, peri-articular. The average daily dosage ranges from 4 to 20 mg. The number of daily procedures is 2-4 times. The maximum course of therapy is 4 days, after which the patient is transferred from injections to tablets. Injections are prescribed when emergency, severe course of the disease and in the case when the patient is not able to take pills. The solution can be used as inhalation for diseases of the respiratory system. For this, Dexamethasone is dissolved in saline.
- Eye drops. At chronic course diseases, it is enough to drip 1-2 drops twice a day, with an exacerbated condition - every 2 hours, after which the interval decreases until the introduction of drops after 4 hours.
- Eye ointment. It is applied to the affected areas of the skin and mucous membranes 2-4 times a day.
How Dexamethasone is used, depending on the diseases (most common):
- Dexamethasone for allergies. In case of a fatal emergency, an injection solution is used. It is administered intramuscularly and intravenously. The dosage is calculated individually, depending on the degree of damage. For uncomplicated allergic reactions, tablets are prescribed, which are taken 3-4 times a day. The daily norm is from 7 to 15 mg for an adult and a maximum of 2 mg for a child. If the allergy affects the visual apparatus, drops and ointment are used. Additionally, funds are injected into the nose and ears, if present allergic symptoms in these bodies.
- Dexamethasone for oncology. The drug does not treat malignant tumors, but it helps to cope with the symptoms that appear - swelling, high intracranial pressure, focal signs. In this case, pills are prescribed, but more often injections, which involve 3-time administration at a dosage of 2 mg. The tablets are normally taken up to 10 mg.
- The drug for urticaria, which is a sign of an allergic reaction. Dexamethasone has a powerful anti-allergic effect. A corticosteroid improves liver function by speeding up metabolic processes, as a result of which harmful toxic substances and allergens are removed as quickly as possible. This leads to a decrease in the manifestation of symptoms, in particular, urticaria. For treatment, tablets and injections are used, the dosage is selected at the individual level, but it should not exceed 5 mg.
- Dexamethasone for osteochondrosis. This disease is characterized by inflammatory processes that provoke pain syndrome, stiffness of movements. Due to the chemical processes that occur when using dexamethasone phosphate, inflammation is stopped, and with it pain. With a mild course, a tablet form is prescribed, with a severe one - an injection. The daily dosage is from 4 to 20 mg, the number of procedures per day is 4 times. Feature - if the drug is injected into the joint, maximum dose is 4 mg.
- Dexamethasone for asthma. An asthma attack is characterized by swelling respiratory tract, inflammatory process, shortness of breath. It occurs most often against the background of allergic reactions. Glucocorticosteroid helps to eliminate unpleasant symptoms, eliminate the allergen from the body, thereby reducing secretory activity. During an acute attack, it is recommended to use pills and injections at the same time. In a chronic course, it is enough to drink the tablet form three times a day with a daily dosage of 3-15 mg.
- Remedy for otitis media. The disease occurs against the background of inflammatory processes, which Dexamethasone is actively fighting with. The active substance, by binding to cytoplasmic receptors, creates a complex that penetrates the cell nucleus. After this, biochemical processes take place that eliminate inflammation. In acute otitis media, 2-3 drops of Dexamethasone eye drops are injected into the auricles every two hours. After normalization of the condition, you can drip 1-2 drops three times a day. A prerequisite is to close the ear canal with a cotton swab for 30-40 minutes after the procedure.
- Dexamethasone at a temperature. The drug can lower body temperature, but at the same time increase blood pressure. In addition, Dexamethasone slightly suppresses the immune system, so it is inappropriate to use it as an antipyretic agent. The exceptions are cases in which the drug is prescribed for the main indications.
- To open up the lungs. Dexamethasone is undesirable to use during gestation, but a hormonal steroid is necessary to open the lungs of an unborn child. It is injected in the 3 nm trimester of pregnancy. The dosage is prescribed by the doctor, the procedure is carried out by a specialist.
- Use of the drug in gynecology. Dexamethasone is recommended by medicine for infertility. This is due to the fact that the active substance restores the concentration of adrenal hormones, prevents hyperandrogenism, reduces the amount of male hormones in female body and prevents premature birth, miscarriages. That is why the drug can be taken when planning pregnancy and infertility. The minimum dosage is ¼ tablets per day.
The prescribing of the drug should be dealt with by the attending physician after a comprehensive examination. It is strictly forbidden to independently change the dosage and duration of the course - this will lead to negative consequences.
Contraindications
The main direct contraindication to the use of Dexamethasone is an allergic reaction to one of the components that make up the composition.
It is forbidden to use the drug for intra-articular administration in the following conditions:
- increased bleeding;
- instability of the articular system;
- fractures;
- after arthroplasty;
- infection;
- periarticular osteoporosis.
Do not use eye drops and ointments in such cases:
- infection of the visual apparatus with viruses, fungi, tubercle bacillus;
- glaucoma;
- the presence of trachoma;
- damage to the epithelium in the cornea.
If drops are used to treat otitis media and other ear pathologies, damage (violation of the integrity) of the eardrum is prohibited.
Dexamethasone is prescribed with caution for such pathological abnormalities:
- ulcerative lesion of the duodenum and stomach, gastritis, esophagitis, diverticulitis, colitis non-specific type;
- smallpox, measles, herpes, amebiasis;
- heart failure, heart attack, stroke, hyperlipidemia;
- arterial hypertension;
- thyrotoxicosis, Itsenko-Cushing's syndrome, hypothyroidism;
- obesity stages 3 and 4;
- cirrhosis of the liver, nephrourolithiasis, nephrotic syndrome;
- period of pregnancy.
Side effects of Dexamethasone
Dexamethasone is tolerated by the body quite normally, but in some cases, side reactions occur. This is due to exceeding the dosage and duration of the course, uncontrolled intake, the presence of contraindications. What can happen:
- Endocrine system: hirsutism, pituitary obesity, changes in facial contours, dysmenorrhea, decreased glucose tolerance, suppression of adrenal function. These complications occur in very rare cases.
- Digestive system: hiccups, nausea and vomiting, change in appetite (decrease or increase), flatulence. Sometimes diseases occur - esophagitis, perforation of the gastrointestinal tract, bleeding, pancreatitis, steroid-type ulcer.
- Cardiovascular system: bradycardia or arrhythmia (slow or increased heart rate), increased blood pressure. Complications - progression of heart failure, hypokalemia, hypercoagulability, rupture of the heart muscle (after myocardial infarction), death.
- Nervous system: disorientation, hallucinations, delirium, euphoric state, depression, psychosis, nervousness, insomnia, headache, convulsions, dizziness, high intracranial pressure, vertigo, increased anxiety, paranoia.
- Musculoskeletal system: tendon rupture, slow bone growth in children, osteoporosis, tissue necrosis in the head of the femur and humerus, steroid myopathy, muscle atrophy.
- Skin and mucous membranes: slow regeneration of damaged tissues (non-healing of wounds), hypo- or hyperpigmentation, the occurrence of acne, thinning of the epidermis, petechiae, development of stretch marks (stretch marks), ecchymosis. If an allergic reaction occurs, the skin becomes covered with a rash, hyperemia, urticaria, etc., in rare cases, anaphylactic shock occurs.
- Sense organs: decreased visual acuity and hearing, high intraocular pressure, exophthalmos, trophic damage to the cornea. Posterior cataract.
- Metabolism: calcium deficiency, water and sodium retention, against the background of which there is peripheral edema, rapid weight gain, muscle spasms, fatigue and weakness (due to hypokalemia).
- Local damage - in the areas where the drug is injected: dumbness, tingling, burning, itching, redness, pain, scarring, necrosis and skin atrophy.
Overdose
If you take the drug according to the norm prescribed by the doctor, an overdose is excluded. But it can occur with excessively prolonged use of Dexamethasone. In this case, the above-described adverse reactions occur, up to the death of the patient.
Interaction
When using the drug, it is necessary to take into account some facts of the interaction of dexamethasone phosphate with other substances:
- The negative effect occurs with the simultaneous use of Dexamethasone with antipsychotic and anticholinergics. In the first case, cataract develops, in the second - glaucoma.
- The active substance significantly reduces the concentration of insulin-based drugs. It is undesirable to take the drug together with hypoglycemic dosage forms.
- Acne and hirsutism occurs when taken together with estrogenic, androgenic, anabolic-steroid drugs, as well as hormonal contraceptives.
- Diuretics, taken together with a glucocorticosteroid, promote the rapid elimination of nutrients.
- Non-steroidal anti-inflammatory drugs are incompatible with hormonal agents, as the risk of ulcers and erosions in the digestive tract increases.
- Dexamethasone weakens the anticoagulant effect, therefore it is undesirable to use the corresponding drugs together.
- It is not recommended to combine a corticosteroid with cardiac glycosides, as the tolerance of the latter worsens.
- The level of exposure to dexamethasone phosphate decreases when taken simultaneously with carbamazepine, aminoglutemimmide, ephedrine, barbiturates, phenytoin, rifampicin.
- The effect of imatinib and praziquantel decreases when used together with dexamethasone.
- Itraconazole enhances the effectiveness of the hormonal agent.
- Methotrexate with Dexamethasone increases hepatotoxicity.
Dexamethasone analogs
Dexamethasone has a lot similar drugs, which have the same or a different mechanism of action, composition. But there are special dosage forms which are compared with Dexamethasone most often.
What is Dexamethasone or Prednisolone better?
Prednisolone refers to a glucocorticosteroid that is often prescribed. The drug is based on the active substance of the same name, has an average duration of action. Dexamethasone - the maximum, about 6-7 times more (for the analogue 36 hours, for the second 96). This is due to the fact that this medication is subject to fluoridation.
The drugs have the same indications, but a different mechanism of action. When taking Prednisolone, a large amount of potassium and calcium is excreted from the body, so you will have to additionally take these microelements. With prolonged therapy, it is more advisable to use an analogue, since Dexamethasone in this case leads to undesirable effects.
What is Dexamethasone or Diprospan better?
The drugs are included in a single group of hormonal agents, having a slightly different effect, since the substance of the same name is in the composition of Dexamethasone, and Diprospan consists of betamethasone. The analogue is produced only in the form of an injection solution, while Dexamethasone in drops, tablets, injections, eye ointments... The funds are direct analogs, as they have the same indications and effectiveness. Therefore, if necessary, they are replaced with each other (if there are contraindications, allergies, etc.).
What is dexamethasone or metipred better?
Metipred contains sodium succinic methylprednisolone, therefore it is used for a long course of treatment and in case of emergency. Dexamethasone is indicated for short course and urgent emergency care... This is due to the fact that the analog has a much smaller list of side reactions, but acts more slowly. When carrying a child, preference should be given to Metypred - it is less toxic to the unborn child. In other cases, the choice of the drug is based on individual indicators - the course of the disease, the characteristics of the body, etc.
What is dexamethasone or hydrocortisone better?
Hydrocortisone is considered the most commonly used steroid, which is produced in the widest range - in the form of powder, tablets, injections, creams, ointments. Based on hydrocortisone acetate. Both drugs have a similar mechanism of action, but Hydrocortisone is made not from a synthetic substance, but from a natural one, so the analogue has a high price. Based on the feedback from doctors and consumers, Hydrocortisone is more often used for a long course of therapy, it is used during pregnancy and lactation.
Alcohol compatibility
The glucocorticosteroid drug is strictly forbidden to be taken together with alcoholic beverages... This is due to the fact that ethanol, binding with dexamethasone phosphate, has a negative effect:
- allergic reaction;
- redness of the chest;
- acne formation;
- unstoppable diarrhea;
- decreased visual acuity;
- pain syndromes in the abdomen;
- the formation of ulcers in the organs of the gastrointestinal tract;
- internal bleeding.
Dexamethasone during pregnancy
Dexamethasone phosphate is undesirable to use during pregnancy, but the drug can be prescribed when the benefits for the expectant mother significantly exceed the harmful effects on the fetus. During gestation, the dosage should be minimal. The woman must be constantly monitored. The active substance easily penetrates the placental barrier, concentrating in the blood serum of the fetus.
What negative consequences may arise:
- placental insufficiency;
- slowing down the development of the embryo;
- oligohydramnios;
- intrauterine fetal death;
- insufficiency of the adrenal glands in a born baby or an excess of leukocytes.
Dexamethasone also penetrates into breast milk, therefore, it is contraindicated to use the drug during lactation.
Terms of sale
The drug Dexamethasone is dispensed mainly by prescription, in which it is indicated Latin name- Rp: Sol. Dexamethasoni phosphatis.
Storage conditions
It is recommended to store the product in any form of release at a temperature not higher than + 20-25 degrees. After opening the ampoule, the solution is stored in the refrigerator for 24 hours. Opened drops and ointment can be stored for no more than a month. Keep children away from the medicine, exclude direct sunlight, do not freeze.
Shelf life
The expiration date depends on the form of release and the manufacturer. On average, these are the following indicators:
- eye drops - 24-36 months;
- injection solution - 2-3 years;
- tablets - 48 months;
- ointment - 3 years.
Manufacturer
Dexamethasone is produced in different countries:
- Russia: KhFK Akrikhin, Bryntsalov, Vector, Vicher-Pharm, Vostok, DalHimPharm.
- Germany: Weimer Pharma GmbH, Bayer AG.
- Poland: Warsaw pharmaceutical plant "Polfa".
- Thailand: General Drag House.
Dexamethasone is a medication that must be administered with caution. To do this, before admission, the patient must undergo a comprehensive examination to identify diseases and conditions included in the list of contraindications. During therapy, the patient is obliged to visit the attending doctor to monitor the state of health and the dynamics of treatment. These are prerequisites for achieving a successful result.
Bibliography:
- Anatomical Therapeutic Chemical Classification (ATX);
- Nosological classification (ICD-10);
- Official instruction from the manufacturer.
The mechanism of action of the human immune system can be compared to the work of an antivirus. She constantly scans the cells of the body for the presence of foreign bodies. When a "foreign antigen" is detected, the immune bodies remember information about it and no longer allow it to enter the body. The reactions that occur when the allergen is removed can be very violent. Their manifestation requires the prompt administration of a drug that relieves severe symptoms. For example, Dexamethasone for allergies acts quickly and effectively.
Operating principle
The drug enters the body through intravenous infusion and intramuscular injections... In addition to injections, there are tablets and drops of Dexamethasone, but they act more slowly and are not suitable as emergency measures.
After an intravenous injection, the effect of the drug begins instantly. In the blood, the drug enters into a compound with glucocorticosteroid receptors - special proteins that are found in all tissues of the body, penetrating into their nucleus.
The compound reduces the permeability of the vessel walls and inhibits the production of prostaglandins and histamines. Under the influence of Dexamethasone, the activity of mast cells, macrophages, lymphocytes decreases and the release of proteins responsible for the immune system (cytokines) slows down.
All this suppresses the activity of the immune system. The mechanism of action of Dexamethasone provides an anti-shock, anti-inflammatory, immunosuppressive effect.
Indications for use
Prescribing Dexamethasone is common practice for surgeons and therapists. The spectrum of diseases in the treatment of which a synthetic analogue of hydrocortisone is used is wide. This is also facilitated by various dosage forms of the drug.
For allergic reactions, Dexamethasone is used: drops, tablets and injections. This makes it possible to use it for different manifestations of the disease. Dexamethasone for allergies is prescribed for:
- Quincke's edema;
- anaphylactic shock;
- urticaria, atopic and allergic dermatitis, eczema;
- bronchial asthma and obstructive bronchitis with bronchospasm;
- allergic conjunctivitis;
- hay fever and allergic rhinitis.
special instructions
Dexamethasone is a strong hormonal drug. If the rules of admission are not followed, it can harm the body. It should be taken as directed and under the supervision of a physician. The doctor will accurately calculate the dosage of the drug required for one dose and determine the duration of the course.
Most often, treatment begins with injections, and by the end of the course they switch to pills. This scheme allows you to avoid unwanted reactions to the drug and control what dose of Dexamethasone has entered the body.
Do not use the drug for chronic alcoholism. The ban is due to the fact that the medicine is not combined with alcohol.
While taking the medication, doctors recommend reducing to the minimum acceptable level eating carbohydrates and salt. It is advisable to enrich the menu with foods high in vitamins and microelements. The diet should be dominated by protein foods.
Allergies in children
Allergies often appear during childhood. Sometimes its manifestations require serious treatment. Conventional antihistamines are not enough.
Glucocorticosteroids can delay the growth and physical development of a child. Therefore, during treatment with Dexamethasone, especially when it lasts a long time, periodic comparative assessment the physical condition of the baby.
Before and after the vaccination, they refuse to treat the child with Dexamethasone. 2 months before the expected date of vaccination and 2 weeks after it, the drug is administered only for vital indications.
If a small patient has had contact with patients with measles and chickenpox, immunoprophylaxis is additionally prescribed. This is done to prevent the development of infections.
When, due to allergies, a child has a stuffy nose, difficulty breathing, the mucous membranes of the nose become inflamed and swollen, it is possible to prescribe an injection solution in the form of drops. This application quickly eliminates swelling and inflammation. The medicine works faster than if it were injected into the muscle.
Pregnancy and allergies
During pregnancy, Dexamethasone is used with extreme caution. It is best to avoid taking the drug in the first trimester. At this time, all systems and organs of the future man are laid and formed.
Before prescribing a drug, the doctor weighs its potential benefits and the harm it can cause to the fetus. Application is possible only if the therapeutic effect of the hormonal agent outweighs the possible danger to the embryo.
In the third trimester of pregnancy, Dexamethasone can cause the development of atrophic processes in the fetal adrenal cortex. It is highly likely that the baby will need treatment right after birth.
Treatment with Dexamethasone during lactation is unacceptable. Together with milk, the drug enters the child's body. When the use of the drug cannot be avoided, breastfeeding is stopped.
Overdose and side effects
In cases where injecting Dexamethasone is the only way to save the patient's life, doctors do not take into account contraindications and side effects. The only thing that can interfere with the introduction of the drug is an allergy to Dexamethasone.
When the case is not so urgent, before prescribing the medicine, the doctor finds out if the patient has any diseases in which his intake is undesirable or prohibited.
With great care, Dexamethasone is prescribed for tuberculosis and other infections of bacterial and viral origin. The medicine suppresses the immune system, so its use in such cases is undesirable.
Artificial hydrocortisone is also avoided when treating the elderly.
In addition to a large list of contraindications, Dexamethasone can negatively affect the gastrointestinal tract, nervous and cardiovascular systems, and respiratory organs.
From the side of the nervous system, the following are possible:
- dizziness and headaches;
- exacerbations mental illness, hallucinations;
- insomnia;
- convulsions;
- increased intraocular and intracranial pressure.
From the gastrointestinal tract, nausea and vomiting, internal bleeding, pancreatitis may occur.
Undesirable consequences from the heart and blood vessels can take the form:
- increased blood pressure and hypertensive crisis;
- violation heart rate(arrhythmia, bradycardia);
- changes in blood composition and thrombosis.
In addition, Dexamethasone can lead to:
- gaining excess weight;
- diabetes mellitus;
- decrease in the general tone of the body;
- tendon ruptures;
- osteoporosis;
- muscle weakness.
An overdose of Dexamethasone enhances the manifestation of side effects of the drug. It is treated symptomatically. If the patient took pills, doctors recommend taking enterosorbents. Even the usual activated carbon will do.
Catad_pgroup Systemic corticosteroids
Catad_pgroup Preparations for ophthalmology
Dexamethasone for injection - instructions for use
INSTRUCTIONS for medical use of the drug
The name of the medicinal product:
Trade name of the drug:
DexamethasoneInternational non-proprietary name:
dexamethasoneDosage form:
injectionComposition
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-aqueous) - 0.8 mg
water for injection - up to 1 ml
Pharmacotherapeutic group:
glucocorticosteroidATX code:
Н02АВ02Description:
transparent colorless or light yellow liquid.pharmachologic effect
Synthetic glucocorticosteroid is a methylated derivative of fluoroprednisolone. It has anti-inflammatory, anti-allergic, desensitizing, anti-shock, anti-toxic and immunosuppressive effects.Interacts with specific cytoplasmic receptors and forms a complex that penetrates the cell nucleus and stimulates the synthesis of mRNA; 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.
Protein metabolism: reduces the amount of protein in the plasma (due to globulins) with an increase in the albumin / globulin ratio, increases the synthesis of albumin in the liver and kidneys; enhances protein catabolism in muscle tissue.
Lipid metabolism: increases the synthesis of higher fatty acids and triglycerides, redistributes fat (fat accumulation mainly in the shoulder girdle, face, abdomen), leads to the development of hypercholesterolemia.
Carbohydrate metabolism: increases the absorption of carbohydrates from the gastrointestinal tract; increases the activity of glucose-6-phosphatase, leading to an increase in the flow of glucose from the liver into the blood; increases the activity of phosphoenolpyruvate carboxylase and the synthesis of aminotransferases, leading to the activation of gluconeogenesis.
Antagonistic action in relation to vitamin D: "washing out" of calcium from the bones and increasing its renal excretion.
The anti-inflammatory effect is associated with inhibition of the release of inflammatory mediators by eosinophils; inducing the formation of lipocortins and reducing the number of mast cells that produce hyaluronic acid; with a decrease in capillary permeability; stabilization of cell membranes and membranes of organelles (especially lysosomal).
The antiallergic effect is due to a decrease in the number of circulating eosinophils, which leads to a decrease in the release of immediate allergy mediators; reduces the effect of allergy mediators on effector cells.
The immunosuppressive effect is due to inhibition of the release of cytokines (interleukin1 and interleukin2, interferon gamma) from lymphocytes and macrophages.
Suppresses the synthesis and secretion of adrenocorticotropic hormone and, secondarily, the synthesis of endogenous glucocorticosteroids. A feature of the action is a significant inhibition of the function of the pituitary gland and an almost complete absence of mineralocorticosteroid activity.
Doses of 1-1.5 mg / day inhibit the function of the adrenal cortex; biological half-life - 32-72 hours (duration of inhibition of the hypothalamus-pituitary-adrenal cortex).
In terms of the strength of glucocorticosteroid activity, 0.5 mg of dexamethasone corresponds to approximately 3.5 mg of prednisone (or prednisolone), 15 mg of hydrocortisone, or 17.5 mg of cortisone.
Pharmacokinetics
In the blood, it binds (60-70%) with a specific protein - a carrier - transcortin. Easily passes through the histohematological barriers (including through the blood-brain barrier and placental). A small amount is excreted in breast milk. It is metabolized in the liver (mainly by conjugation with glucuronic and sulfuric acids) to inactive metabolites. It is excreted by the kidneys.
Indications for use:
The drug is used for diseases requiring the introduction of a fast-acting glucocorticosteroid, as well as in cases where oral administration of the drug is not possible:Endocrine diseases (acute insufficiency of the adrenal cortex, primary or secondary insufficiency of the adrenal cortex, congenital hyperplasia of the adrenal cortex, subacute thyroiditis);
- shock resistant to standard therapy; anaphylactic shock;
- cerebral edema (with a brain tumor, traumatic brain injury, neurosurgical intervention, cerebral hemorrhage, encephalitis, meningitis, radiation injury);
- asthmatic status; severe bronchospasm (exacerbation bronchial asthma, chronic obstructive bronchitis);
- severe allergic reactions;
- rheumatic diseases;
- systemic connective tissue diseases;
- acute severe dermatoses;
- malignant diseases(palliative treatment of leukemia and lymphoma in adult patients; acute leukemia in children; hypercalcemia in patients with malignant tumors, when oral treatment is impossible);
- diagnostic study of adrenal hyperfunction;
- blood diseases (acute hemolytic anemias, agranulocytosis, idiopathic thrombocytopenic purpura in adults);
- severe infectious diseases (in combination with antibiotics);
- intra-articular and intra-synovial administration: arthritis different etiology, osteoarthritis, acute and subacute bursitis, acute tendovaginitis, epicondylitis, synovitis;
- local application (in the field of pathological education): keloids, discoid lupus erythematosus, annular granuloma.
Contraindications for use:
For short-term use for "vital" indications, the only contraindication is hypersensitivity.For intra-articular administration: previous arthroplasty, 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 general infection, pronounced periarticular osteoporosis, no signs of inflammation in the joint (the so-called "dry" joint, for example, in osteoarthritis without synovitis), pronounced bone destruction and deformation of the joint (sharp narrowing of the joint space, ankylosis), joint instability as an outcome of arthritis, aseptic necrosis of the joint forming epiphyses of bones.
Post-vaccination period (period lasting 8 weeks before and 2 weeks after vaccination), lymphadenitis after BCG vaccinations... Immunodeficiency states (including AIDS or HIV infection).
Diseases of the gastrointestinal tract (peptic ulcer and 12 duodenal ulcer, esophagitis, gastritis, acute or latent peptic ulcer, recently created intestinal anastomosis, ulcerative colitis with the threat of perforation or abscess formation, diverticulitis).
Diseases of the cardiovascular system, incl. recent myocardial infarction (in patients with acute and subacute myocardial infarction, the spread of the necrosis focus, slowing of the formation of scar tissue and, as a result, rupture of the heart muscle is possible), decompensated chronic heart failure, arterial hypertension, hyperlipidemia.
Endocrine diseases - diabetes mellitus (including impaired carbohydrate tolerance), thyrotoxicosis, hypothyroidism, Itsenko-Cushing's disease.
Severe chronic renal and / or hepatic failure, nephrourolithiasis. Hypoalbuminemia and conditions predisposing to its occurrence.
Systemic osteoporosis, myasthenia gravis, acute psychosis, obesity (III-IV grade), poliomyelitis (except for the form of bulbar encephalitis), open and closed angle glaucoma, pregnancy, lactation.
For intra-articular administration: general serious condition the patient, the ineffectiveness (or short duration) of the action of 2 previous injections (taking into account the individual properties of the glucocorticosteroids used).
Method of administration and dosage:
Intra-articular, in the lesion focus - 0.2-6 mg, with a repetition of 1 every 3 days or 3 weeks.Intramuscularly or intravenously - 0.5-9 mg / day.
For the treatment of cerebral edema - 10 mg in the first injection, then 4 mg intramuscularly every 6 hours until the symptoms disappear. The dose can be reduced after 2-4 days with a gradual cancellation within 5-7 days after the elimination of cerebral edema. The maintenance dose is 2 mg 3 times / day.
For the treatment of shock - intravenously 20 mg in the first injection, then 3 mg / kg over 24 hours in the form of intravenous infusion or intravenous stream - from 2 to 6 mg / kg in the form of a single injection or 40 mg in the form of a single injection, given every 2 6 hours; intravenous administration of 1 mg / kg as a single dose is possible. Shock therapy should be canceled as soon as the patient's condition stabilizes, the usual duration is no more than 2-3 days.
Allergic diseases - intramuscularly in the first injection of 4-8 mg. Further treatment is carried out with oral dosage forms.
In case of nausea and vomiting, during chemotherapy - intravenously 8-20 mg 5-15 minutes before the chemotherapy session. Further chemotherapy should be given with oral dosage forms.
For the treatment of respiratory distress syndrome in newborns - intramuscularly 4 injections of 5 mg every 12 hours for two days.
The maximum daily dose is 80 mg.
For children: for the treatment of adrenal insufficiency - intramuscularly at 23 μg / kg (0.67 mg / sq. M) every 3 days, or 7.8-12 μg / kg (0.23-0.34 mg / sq. M.) m / day), or 28-170 μg / kg (0.83-5 mg / sq. m) every 12-24 hours.
Precautions for use
Children who are in contact with patients with measles or chickenpox, prophylactically prescribe special immunoglobulins.In children during the growth period, glucocorticosteroids should be used only for absolute indications and under the close supervision of a physician.
It should be borne in mind that in patients with hypothyroidism, the clearance of glucocorticosteroids decreases, and in patients with thyrotoxicosis, it increases.
Overdose
Symptoms: increased blood pressure, edema, peptic ulcer, hyperglycemia, impaired consciousness.Treatment: symptomatic, no specific antidote.
Side effect
The frequency of development and the severity of side effects depend on the duration of use, the size of the dose used and the possibility of observing the circadian rhythm of the appointment.From the side of metabolism: retention of sodium and water in the body; hypokalemia; hypokalemic alcoholosis; negative nitrogen balance caused by increased protein catabolism, increased appetite, weight gain.
On the part of the cardiovascular system: a higher risk of thrombus formation (especially in immobilized patients), arrhythmias, increased blood pressure, development or worsening of chronic heart failure, myocardial dystrophy, steroid vasculitis.
From the musculoskeletal system: muscle weakness, steroid myopathy, decrease in muscle mass, osteoporosis, compression fractures of the vertebrae, aseptic necrosis of the femoral head and humerus, pathological fractures of long bones.
From the digestive system: nausea, vomiting, erosive and ulcerative lesions of the gastrointestinal tract (which can cause perforations and bleeding), hepatomegaly, pancreatitis, ulcerative esophagitis.
Dermatological reactions: thinning and fragility of the skin, petechiae and subcutaneous hemorrhages, ecchymosis, striae, steroid acne, delayed wound healing, increased sweating.
From the side of the central nervous system: increased fatigue, dizziness, headache, mental disorders, seizures and false symptoms of a brain tumor (increased intracranial pressure with congestive optic nerve head).
From the endocrine system: decreased glucose tolerance, "steroid" diabetes mellitus or manifestation of latent diabetes mellitus, suppression of adrenal function, Itsenko-Cushing's syndrome (moon face, pituitary obesity, hirsutism, increased blood pressure, dysmenorrhea, amenorrhea, myasthenia gravis, striae), delayed sexual development in children.
On the part of the organs of vision: posterior subcapsular cataract, enhancement intraocular pressure, exophthalmos.
Side effects associated with immunosuppressive effects: more frequent occurrence of infections and aggravation of the severity of their course.
Others: allergic reactions.
Local reactions (at the injection site): hyperpigmentation and leukoderma, atrophy of the subcutaneous tissue and skin, aseptic abscess, hyperemia at the injection site, arthropathy.
Interaction with other medicinal products
Concomitant use with phenobarbital, rifampicin, phenytoin or ephedrine can accelerate the biotransformation of dexamethasone, thereby weakening its effect. Hormonal contraceptives enhance the effect of dexamethasone.Simultaneous use with diuretics (especially "loop") can lead to increased excretion of potassium from the body.
With simultaneous administration with cardiac glycosides, the possibility of cardiac arrhythmias increases.
Dexamethasone weakens (less often enhances) the effect of coumarin derivatives, which requires a dose adjustment.
Dexamethasone enhances side effect non-steroidal anti-inflammatory drugs, especially their effect on the gastrointestinal tract (increased risk of erosive and ulcerative lesions and bleeding from the gastrointestinal tract). In addition, it reduces the concentration of non-steroidal anti-inflammatory drugs in the blood serum and thus their effectiveness.
Carbonic anhydrase inhibitors: increase the risk of hypernatremia, edema, hypokalemia, osteoporosis.
Reduces the effectiveness of insulin and oral hypoglycemic drugs, antihypertensive drugs.
Antacids weaken the effect of dexamethasone.
In combination with paracetamol, it increases the risk of developing hepatotoxicity, due to the induction of liver enzymes and the formation of a toxic metabolite of paracetamol.
The simultaneous use of androgens, steroid anabolic steroids contributes to the appearance of edema, hirsutism and acne; estrogens, oral contraceptives - leads to a decrease in clearance, an increase in the toxic effects of dexameatazone.
The risk of developing cataracts increases when antipsychotics (neuroleptics) and azathioprine are used against the background of dexamethasone.
Simultaneous administration with M-anticholinergics (including antihistamines, tricyclic antidepressants) and nitrates promotes the development of glaucoma.
When used simultaneously with live antiviral vaccines and against the background of other types of immunizations, it increases the risk of virus activation and the development of infections.
Amphotericin B increases the risk of heart failure.
In combination with anticoagulants and thrombolytics, the risk of developing gastrointestinal ulcers and bleeding increases.
Reduces the concentration of salicylates in plasma (increases the excretion of salicylates).
Increases the metabolism of mexiletine, reducing its concentration in plasma.
Possibilities and features of the use of the drug during pregnancy
(especially in the first trimester), the drug can be used only when the expected therapeutic effect outweighs the potential risk to the fetus. With prolonged therapy during pregnancy, the possibility of impaired fetal growth is not excluded. If used at the end of pregnancy, there is a risk of atrophy of the adrenal cortex in the fetus, which may require replacement therapy in the newborn.If it is necessary to carry out drug treatment during breastfeeding, then breastfeeding should be discontinued.
The effect of the drug on the ability to drive vehicles, mechanisms
Administration is not recommended during treatment vehicles, as well as engaging in activities that require the speed of psychomotor reactions and precise movements.Release form:
Solution for injection 4 mg / ml.
1 ml in neutral glass ampoules.
10 ampoules, together with instructions for use and a knife for opening ampoules or an ampoule scarifier, are placed in a cardboard box.
5 ampoules in a blister made of polyvinyl chloride film.
1 or 2 blister packs, together with instructions for use and a knife for opening ampoules or an ampoule scarifier, are placed in a cardboard box.
When using ampoules with notches, rings and break points, it is allowed not to insert an ampoule scarifier or a knife for opening ampoules.
Shelf life:
2 years. Do not use after the expiration date printed on the package.Storage conditions:
In a dark place at a temperature of 5 to 25 ° C.Keep out of the reach of children.
Terms of dispensing from pharmacies:
Dispensed by prescription.Name, address of the manufacturer and address of the place of manufacture of the medicinal product / organization accepting claims
JSC "DALKHIMFARM", 680001, Russian Federation, Khabarovsk Territory, Khabarovsk, st. Tashkent, 22.
