Dexamethasone instructions for applying in ampoules of contraindications. Dexamethasone (solution for injection) Instructions for use, contraindications, side effects, reviews

The date: 04.11.2019

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

Dexamethasone is a drug that has anti-inflammatory and immunosuppressive effects. The solution for intravenous and intramuscular administration is a transparent colorless or light yellow liquid.

Latin name: DexameThasone
ATH code: S01Ba01
Active substance: DexameThasone (DexameThasone)
Manufacturer: RUE "BelMEDPreparats" (Republic of Belarus), JSC "Lekhim-Kharkov", PJSC "Pharmak", ZAO FF "Darnitsa" (Ukraine)

Composition

Active substance:

Sodium dexamethasone phosphate (phosphate dexamethasone Danodium salt) in terms of 100% substance - 4.0 mg.

Excipients:

glycerol (distilled glycerin) - 22.5 mg;
dinataria Edetat (Trilon B) - 0.1 mg;
sodium hydrophosphate dodecahydrate (sodium phosphate dubbed 12-aqueous) - 0.8 mg;
water for injection - up to 1 ml.

pharmachologic effect

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

Can interact with specific cytoplasmic receptors:

forms a complex that penetrates the cell core and stimulates the synthesis of mRNA;
the latter induces the formation of proteins, incl. Lipocortin, mediated cell effects. Lipocortine inhibits phospholipase A2, suppresses the release of arachidonic acid and inhibits the biosynthesis of endoperosis, prostaglandins, leukotrienes that contribute to the processes of inflammation, allergies and others.

Eye drops with dexamethasone, also have an anti-allergic, anti-acudative and anti-inflammatory effect.

Pharmacodynamics and pharmacokinetics

The use of dexamethasone allows to increase the sensitivity of the proteins of the outer cell membrane (beta-adrenoreceptors) to endogenous catecholaminams (mediators of intercellular interaction).

Dexamethasone regulates protein metabolism, reducing the synthesis and amplifying in muscle fabric catabolism protein, reducing the number of globulins in the plasma, raising the synthesis of albumin in the liver and kidneys. Effecting the carbohydrate exchange, dexamethasone contributes to the absorption of carbohydrates from the digestive tract, increase the flow into the blood glucose from the liver, the development of hyperglycemia, which in turn activates insulin production. The participation of dexamethasone in water-electrolyte metabolism is manifested in reducing the mineralization of bone tissue, sodium delay and water in the body, reduce calcium suction from the gastrointestinal tract.

The anti-inflammatory and antallergic properties of dexamethasone in their activity are 35 times higher than similar effects of cortisone.

Blood binds (60-70%) with a specific protein - carrier - transcertin. Easily passes through histohematatic barriers (including through the hematorencephalic barrier and placental). In small quantities stands out with breast milk. Metabolized in the liver (mainly by conjugation with glucuronic and sulfuric acids) to inactive metabolites. Exchanged through the kidneys.

Indications for use

Apply Tablets Dexamethasone Instructions recommends in the following cases:

acute and subacute thiosodite (inflammation of the thyroid gland);
hypothyroidism (condition with a rapid disadvantage of thyroid hormones);
progressive ophthalmopathy (increasing the volume of eye tissues) associated with thyrotoxicosis (intoxication of thyroid hormones);
diseases of Addison Burmer (loss of adrenalities of the ability to produce hormones in sufficient quantities);
bronchial asthma;
connecting tissue diseases;
rheumatoid arthritis in the exacerbation phase;
autoimmune hemolytic anemia;
serum disease (immune response to expensive serum proteins);
agranulocytosis (reduction in blood neutrophils);
acute erythrodermia (leather redness);
pEMFIGUS (skin disease, manifested in the form of bubbles in hand, genitalia, mouth, etc.);
acute eczema;
malignant tumors (symptomatic therapy);
brain swelling;
congenital adrenogenital syndrome (hyperfunction of adrenal cortex and increased androgen content in the body).

Dexamethasone in ampoules is used at:

shock of different genes;
asthmatic status;
brain swelling;
severe allergic reactions;
acute hemolytic anemia;
thrombocytopenia;
agranulicitosis;
acute lymphoblastic leukemia (malignant disease, affecting bone marrow, spleen, lymph nodes, forkry gland and other organs);
severe infectious diseases;
acute croup (inflammation of the larynx and the upper respiratory tract);
acute insufficiency of adrenal cortex; Diseases of the joints.

Dexamethasone drops are used in ophthalmological practice when:

unmarried and allergic conjunctivitis (inflammation of the mucous membrane of the eye);
keratitis (inflammation of the cornea of \u200b\u200bthe eye);
keratoconjunctivitis (simultaneous inflammation of the conjunctivities and cornea of \u200b\u200bthe eye) without damage to the epithelium;
irite (inflammation of the iris eye);
iridocyclite (inflammation of the iris and ciliary body); blufarite (inflammation of the edges of the age);
score (inflammation of the deep layers of the schleler of the eye);
episclerite (inflammation of the connective tissue between the conjunctiva and scler); inflammatory processes after injuries of the eye or operations;
sympathetic ophthalmia (inflammatory eye lesions).

Dexamethasone Application Instructions

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

Daily dose of the drug dexamethasone instructions are advised to divide by 2-3 receptions (during either after meals). Supporting small doses should be taken once a day, preferably in the morning.

Dexamethasone in ampoules is designed for intravenous (drip or inkjano), intramuscular, perarticular and intra-articular administration. Recommended daily dose of dexamethasone with such methods of administration - 4-20 mg. Dexamethasone in ampoules is usually used 3-4 times a day for 3-4 days, followed by the transition to the tablet.

Dexamethasone drops are used in ophthalmology: with acute states of 1-2 drops of the drug, they are injected into a conjunctival bag every 1-2 hours, while improving the state - every 4-6 hours.

Chronic processes involve the use of dexamethasone drops 2 times a day. The duration of treatment depends on the clinical course of the disease, therefore dexamethasone drops can be used from several days to four weeks.

Use during pregnancy

The use of dexamethasone during pregnancy is possible only on life indications if the expected benefit of therapy for the mother exceeds the potential risk associated with treatment.
If it is necessary to carry out treatment with a drug during breastfeeding, then breastfeeding should be stopped.

Overdose

Excessive administration of the drug may cause an overdose, which is manifested by the strengthening of side effects, as well as hypercorticism syndrome (Cushing syndrome).

Therapy is symptomatic, at the same time requires a decrease in the dose or the abolition of the drug for a while.

Side effects

According to the instructions, dexamethasone may be the cause of the following reactions:

reducing glucose tolerance, inhibition of adrenal function, steroid diabetes, Incenco Cushing syndrome;
hypocalcemia, hypokalemia, hyponatremia, increased calcium excretion, increase body weight, increased sweating;
an increase in intracranial pressure, anxiety, depression, paranoia, dizziness, headache, convulsions;
vomiting, nausea, steroid ulcer, pancreatitis, erosive esophagitis, idiot, meteorism;
bradycardia, arrhythmia, increase blood pressure;
exophthalm, trophic changes of the cornea, a tendency to the development of eye infections, an increase in intraocular pressure, rear subcapsular cataract;
slowing down in children, breaking muscle tendons, osteoporosis, reduced muscle mass, steroid myopathy; Dermatological and allergic reactions.

Contraindications for use

The use of dexamethasone is contraindicated to those patients who have a very increased sensitivity to the components of the drug.

The drug is incompatible with other drugs, as insoluble compounds can form with them.

Injection solution can be mixed in such cases:

only with a solution of glucose 5%;
naCl solution 0.9%.

Form release

In ampoules 1 ml or 2 ml per pack number 10,
In ampoules 1 ml or 2 ml in the contour cellular package No. 5 × 1, No. 5 × 2.

Storage conditions and shelf life

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

Shelf life - 2 years.

Analogs of dexamethasone

Analogs of solution and tablets:

Dexazone
Dexamethasone-Vial,
Decamed,
Meghadeksan,
Dexamethasone Ferrein.

Similar preparations for eye drops:

Dexamethasone Lance,
Dexapos,
Ozdex,
Maxidge,
Dexamethamblong.

The drug MaxiDez, unlike other analogues, has 2 dosage forms: drops and eye ointment. Ointment with dexamethasone can be replaced with ointment hydrocortisone.

One of the strong drugs of the glucocorticosteroid group is dexamethasone. Its main purpose is the regulation of mineral, carbohydrate and protein metabolism. The drug can be produced in various forms: tablets, eye drops and ampoules for injections.

Composition and form of release

The preparation is based on dexamethasone phosphate, 4 mg / ml. This is an active substance providing the therapeutic effect. The medicine refers to the group of corticosteroids that are intended for system use.

In addition to the main, in the composition of the solution there are additional substances:

water for injections;
sodium hydrophosphate;
sodium chloride, etc.

Externally, the solution is a yellowish or colorless transparent liquid, which is packaged in ampoules of glass.

pharmachologic effect

The glucocorticosteroid has a powerful anti-inflammatory effect on the body, reducing and blocking the activity of compounds causing inflammation. It turns out to be anti-inflammatory and counter-applying effect. Dexametosone also takes part in the work of the pituitary and metabolic processes.

Injection can be:

Intravenous.
Local.
Intramuscular.

Local application.The injections supplied to soft tissues or joints are slower than when intravenous. The duration of the effect is saved from three to 21 days.

Intramuscular use.The peak of clinical efficacy with intramuscular injections is reached after 8 hours. Maximum concentration in plasma - after 60 minutes. The duration of exposure is at least 17 days and no more than 28.

Intravenous application.The active substance in this use reaches its peak of plasma concentrations for no more than 5 minutes.

The glucocorticosteroid effect is due to the synthetic hormone of the adrenal cortex, which has the following effect on the body:

anti-inflammatory;
affects glucose exchange;
affects the hypothalamus;
immunosuperpressive.

The main advantages of the use of the drug include such advantages:

relatively low cost;
wide application field;
fast effect effect;
you can apply one-time and supportive.

In addition, the drug has a lot of minuses:

many side effects and contraindications;
restriction on use during pregnancy;
responsible individual selection of dosage;
monitoring condition during reception;
the need to select a minimum dose that would give the therapeutic effect;
hormonal composition.

Indications

List of diseases that require treatment with dexamethasone is quite large, which is associated with the ability of the substance to influence most organism cells.

Among the testimony to the appointment:

rheumatism;
osteoarthritis;
osteochondrosis;
arthritis;
acute form of laryngotracheita in children (stenosis);
severe forms of infectious diseases;
hemolytic anemia in acute form;
bronchial asthma;
brain swelling;
severe allergic reactions (including bronchospasm, dermatosis, swelling of quinque, etc.);
asthmatic status, etc.

Important! The use of dexamethasone as injections should be short-term. It is appointed with urgent and acute states when it is vital.

Contraindications

The injection solution has many contraindications associated with the health status of the patient. The absolute contraindication is the intolerance to the drug.

Among other contraindications:

osteoporosis;
pregnancy (1st trimester);
stomach ulcer;
obesity;
cushing syndrome;
ulcer 12 pans;
increased individual sensitivity to components of the injection solution;
vaccination of live vaccine;
glaucoma;
epilepsy;
severe liver damage;
heart failure;
psychosis;
tuberculosis in active form;
renal failure, etc.

Instructions for use

The medicine can be appointed adults and children regardless of age. The dosage and treatment diagram depends on the severity of the damage and the reaction of the patient for treatment.

The introduction of dexamethasone can be carried out in several ways:

intra-shop;
periarticular;
intravenously drip or stove;
intramuscularly

Treatment schemes

In the treatment of joints, the introduction of the drug is performed directly into the joint and depends on the size of the joint and location. The treatment regimen at the same time implies dams every few days.

Side effect

Glucocorticosteroids have a significant list of possible side effects in terms of volume. The following is most often noted:

anaphylactic reactions;
arterial hypertension;
headache;
growth of intracranial pressure;
problems with sleep;
cushing syndrome;
violations in the work of adrenal glands;
bradycardia;
impotence;
atrophy of the skin;
blood coagulation disorders;
numbness;
scars in those places where injections were carried out;
oppression of adrenal operations, etc.

Features of applications in children

For children, the drug can be appointed from birth only with the extreme necessity of such treatment. During this period, the child must be under constant medical inspection.

During therapy, indicators of the development of the child and its growth should be monitored. In order to prevent violation of growth, if necessary, long-term treatment of children under 14, it is important to do at least a four-day break after a three-day course of treatment.

The medicine refers to hormonal, and can only be appointed by a doctor. For children, the dosage is calculated based on the mass of the body's body.

Application in pregnant women

Dexamethasone has contraindications to use during pregnancy on the first trimester. With objective need, the medicine can be used in the 2nd and 3rd trimester, given the potential risk for the development of the fetus.

The prolonged use of dexamethasone can adversely affect the intrauterine development of the fetus, lead to such violations as a slowdown in growth, and even become the cause of atrophy of the child's adrenalities and anomalies in the formation of the limbs. If it is necessary to use for the treatment of a dexamethasone woman during breastfeeding, the child is transferred to artificial mixtures of baby food.

Original instructions for use —

Terms of sale

The drug is released in the pharmacy network only by prescription.

Shelf life

Store the drug can be 24 months. After the expiration date, it is impossible to apply it.
Storage conditions:

In an inaccessible children in place.
At room temperature, but not more than 25 degrees.
In the place protected from direct sunlight.

Analogs and price

Name	Manufacturer	Dosage mg / ml	Volume, ml	Number of ampoules, pcs.	Price, r.
Dexametanone	Slovenia	4	1	25	190
	ELLARA (Russia)		2		230
	China		1		100
	India		1		130
Dexazazon	Serbia		1		160
Decamed	Cyprus		2	100	1100

A potent synthetic glucocorticoid is dexamethasone. Instructions for use indicates that the drug contains hormones of adrenal cortex hormones and their synthetic analogues. Why do this medicine prescribed? Dexamethasone is used to regulate protein, carbohydrate and mineral exchange. Patient and doctors confirm that this drug helps in the therapy of inflammatory and systemic diseases, including eyes.

Forms of release and composition

Dexamethasone produced in dosage forms:

Tablets 0.5 mg.
Solution in ampoules for intravenous and intramuscular administration (injections for injections) 4mg / ml.
Drops eye offang 0.1%.
Suspension Eye 0.1%.

The composition of dexamethasone in ampoules: DexameThasone Sodium phosphate (4 mg / ml), glycerin, propylene glycol, Dinatari Edetate, phosphate buffer solution (7.5 pH), methyl and propyl aprichedroxybenzoate, water d / and.

Eye Drops Dexamethasone: DexameThasone Sodium Phosphate (1 mg / ml), Boric Acid, Benzalconium Chloride (Preservative), Sodium Tetraborate, Trilon B, Water D / and.

Pharmacological properties

Dexamethasone has anti-inflammatory, desensitizing (reduces sensitivity to allergens), antiallergic, anti-shock, immunosuppressive (suppresses or reduces immunity) and antitoxic properties.

The use of the drug makes it possible to increase the sensitivity of the proteins of the outer cell membrane (beta-adrenoreceptors) to endogenous catecholamines (mediators of intercellular interaction). The drug regulates protein metabolism, reducing the synthesis and amplifying in muscle fabric catabolism protein, reducing the number of globulins in the plasma, raising albumin synthesis in the liver and kidneys.

Effecting the carbohydrate exchange, dexamethasone, instructions for use reports this, contributes to the suction of carbohydrates from the digestive tract, increase the enhancement of glucose blood from the liver, the development of hyperglycemia, which in turn activates insulin production.

Participation in water-electrolyte exchange is manifested in reducing the mineralization of bone tissue, sodium delay and water in the body, reduce calcium suction from the gastrointestinal tract. Anti-inflammatory and anti-allergic properties of drugs in their activity are 35 times higher than similar effects of cortisone.

From what decxamethasone helps

Indications for use include diseases requiring the introduction of high-speed GCS, as well as cases where oral administration is impossible:

local use (in the area of \u200b\u200bpathological education): keloids, discoomed red lupus, ring-shaped granuloma;
the edema of the brain (with a brain tumor, crank-brain injury, neurosurgical intervention, hemorrhage in the brain, encephalitis, meningitis, radiation lesion);
heavy bronchospasm (aggravation of bronchial asthma, chronic obstructive bronchitis);
sharp heavy dermatoses;
rheumatic diseases;
asthmatic status;
systemic diseases of the connective tissue;
shock (burn, traumatic, operational, toxic) - with the ineffectiveness of vasoconstrictor means, plasma-substituting drugs and other symptomatic therapy;
severe allergic reactions, anaphylactic shock;
endocrine diseases: acute lack of adrenal cortex, primary or secondary insufficiency of adrenal cortex, congenital hyperplasia of adrenal cortex, subacute thyroiditis;
blood diseases: acute hemolytic anemia, agranulocytosis, idiopathic thrombocytopenic purple in adults;
severe infectious diseases (in combination with antibiotics);
malignant diseases: palliative treatment of leukemia and lymphoma in adult patients; acute leukemia in children; Hypercalcemia in patients suffering from malignant tumors, with the impossibility of oral treatment.

What is prescribed dexamethasone in ophthalmologic practice:

allergic conjunctivitis;
keratoconjunctivitis without damage to the epithelium;
curls;
blufarite;
keratitis;
inflammatory process after injuries of the eye and operational interventions;
iridocyclitis;
immunosuppressive treatment after the corneal transplantation;
irit;
sympathetic ophthalmia;
blefarkonjunctivitis;
episclerite.

Instructions for use

The dosing mode of dexamethasone is individual and depends on the testimony, state of the patient and its reaction to therapy.

Application of solution

The drug is introduced intravenously slowly inkjet or drip (with acute and urgent states); intramuscularly; Local (in pathological education) is also possible. In order to prepare a solution for intravenous drip infusion (dropper), an isotonic sodium solution of chloride or a 5% solution of dextrose should be used.

In the acute period under various diseases and at the beginning of therapy, dexamethasone is used in higher doses. During the day, it is possible to introduce from 4 to 20 mg of the solution 3-4 times. Use for 3-4 days with a subsequent transition to tablets.

Doses of drug dexamethasone for children (injections intramuscularly)

The dose of the drug during substitution therapy (in case of insufficiency of adrenal cortex) is 0.0233 mg / kg of body weight or 0.67 mg / m2 of body surface area, divided by 3 doses, every 3rd day or 0.00776 - 0.01165 mg / kg body weight or 0.233 - 0.335 mg / m2 Body surface area daily.

When the effect is reached, the dose is reduced to supporting or before discontinuation. The duration of parenteral use is usually 3-4 days, then go to the supporting therapy with dexamethasone in tablets. The long-term use of high doses of the drug requires a gradual reduction in the dose in order to prevent the development of acute insufficiency of adrenal cortex.

Pills

Oral administration of tablets involves the purpose of 1-9 mg of the drug per day at the initial stage of treatment, followed by a decrease in the daily dose to 0.5-3 mg with supporting therapy.

Daily dose of the drug dexamethasone instruction recommends dividing 2-3 receptions (after or during meals). Supporting small doses should be taken once a day, preferably in the morning.

Eye drops dexametazone

Eye drops are designed for local applications. With strong inflammation in the first day-two treatment in the conjunctival bag, they bury 1-2 cap. Every 2 hours. Next, the intervals between the instillations are lengthened to 4-6 hours.

To prevent the development of inflammation in the first 24 hours after injury or surgery, the patient bursts 4 r. / Day. 1-2 drops, then the treatment continues in the same dose, but with less multiple applications (usually the procedure is repeated 3 r. / day). The course lasts 14 days.

Alternatively, drops can be used with dexamethasone ointment. It is squeezed with a 1-1.5-centimeter strip and laid out for the lower eyelid. The multiplicity of procedures is 2-3 throughout the day. You can combine the use of ointments and drops (for example, droplets during the day, and ointment - before bedtime).

For the treatment of otitis, the drug is injected into the auditory passage of the patient's ear 2-3 r. / Day. 3-4 drops.

Children from 6 to 12 years old with allergic inflammatory states: 1 drop 2-3 times a day for 7-10 days, if necessary, treatment continues after 10 hours of control of the corneal status.

Side effect

Usually dexamethasone is well tolerated. It has low mineralocorticoid activity, i.e. Its influence on water-electrolyte exchange is small. As a rule, low and medium doses do not cause sodium delays and water in the body, an increased excretion of potassium. The following side effects are described:

breaking muscle tendons;
exophthalm;
slow down wound healing;
steroid ulcer of the stomach and duodenum;
sudden loss of view (with parenteral administration in the head, neck, nasal shells, scalp skin, it is possible to deposition of the drug crystals in the eye vessels);
nausea, vomiting;
hypocalcemia;
improving body weight;
thrombosis;
a tendency to the development of secondary bacterial, fungal or viral eye infections;
hypercoagulation;
an increase in blood pressure;
dizziness;
nervousness or anxiety;
anaphylactic shock;
paranoia;
steroid eels;
delay in sexual development in children;
gastrointestinal bleeding and perforation of the wall of the gastrointestinal tract;
bradycardia (right up to the heart stop);
indigestion;
convulsions;
inhibition of adrenal function;
skin rash;
erosive esophagitis;
euphoria;
trophic corneal changes;
steroid diabetes or manifestation of latent diabetes;
affective insanity;
negative nitrogen balance (increased disintegration of proteins);
osteoporosis (very rarely - pathological fractures of bones, aseptic necrosis of the head of the shoulder and femur);
slowdown in the growth and processes of ossification in children (premature closure of epiphyseal growth zones);
hallucinations;
insomnia;
reduction of glucose tolerance;
a tendency to the development of pyodermia and candidiasis;
increased sweating;
fluid delay and sodium (peripheral swelling);
pancreatitis;
arrhythmias;
itsenko Cushing syndrome (moon-shaped face, the obesity of the pituitary type, girsutism, an increase in blood pressure, dysmenorrhea, amenorrhea, muscular weakness, strry);
flatulence;
local allergic reactions;
depression;
an increase in intracranial pressure;
an increase in intraocular pressure with possible damage to the optic nerve;
increase or decrease in appetite;
strya;
headache.

Contraindications

According to the instructions, dexamethasone patients with increased sensitivity to the components of the drug are not prescribed. With caution apply with:

Tablets: during the treatment and breastfeeding, do not apply.

Pregnancy injections apply only on life indications (especially in 1 trimester).

Interaction

The drug is incompatible with other drugs, as insoluble compounds can form with them.

The injection solution can be mixed only with a solution of glucose 5% and a solution of NaCl 0.9%.

Analogs of the drug dexametan

Full analogues on the active substance:

Dexamethasone phosphate.
Dexamethamblong.
Dexaven.
Dexamethasone sodium phosphate.
Dexapos.
Dexamed.
Deckon.
Maxidge.
Forthectin.
Decadron.
Dexafar.
Offanta dexamethasone.
Dexamethasone buffus (nicomed; -Bethlek; -vial; -Lens; -fenein).
Dexazone.

Price

In pharmacies, the price of dexamethasone, tablets (Moscow) is 45 rubles. Buy injections can be for 200 rubles. This is the price of 25 ampoules 1 ml. Eye drops 0.1% are implemented for 57 rubles per 10 ml.

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GKS for injection

Active substance

Dexamethasone phosphate (in the form of sodium salt) (DexameThasone)

Release form, composition and packaging

Injection Transparent, colorless or pale yellow.

Auxiliary substances: methylparaben, propylparaben, sodium metabisulfite, Dinatari Edetat, sodium hydroxide, water d / and.

2 ml - dark glass ampoules (25) - cardboard boxes.
2 ml - dark glass vials (25) - cardboard boxes.

pharmachologic effect

Synthetic glucocorticoid (GKS), methylated fluoroprednisolone derivative. It has an anti-inflammatory, immunosuppressive effect, increases the sensitivity of beta-adrenoreceptors to endogenous catecholaminam.

Interact with specific cytoplasmic receptors (receptors for GCS are in all tissues, especially there are many of them in the liver) with the formation of a complex inducing proteins (including enzymes that regulate vital processes in cells.)

Protein exchange: Reduces the number of globulins B, increases the synthesis of albumin on the liver and kidney (with an increase in albumin / globulin coefficient), reduces the synthesis and enhances the catabolism of the protein in muscle tissue.

Lipid sharing: increases the synthesis of higher fatty acids and triglycerides, the fat redistributes (fat accumulation occurs mainly in the field of shoulder belt, facial, belly) leads to the development of hypercholesterolemia.

Carbohydrate: Increases carbohydrate absorption from the gastrointestinal tract; increases the activity of glucose-6-phosphatase (increasing the flow from the liver into blood); Increases the activity of phosphoenolpiruwatkarboxylase and the synthesis of aminotransferase (activation of gluconeogenesis); Promotes the development of hyperglycemia.

Water-electrolyte exchange: delays Na + and water in the body, stimulates the removal of K + (mineralocorticoid activity), reduces the absorption of Ca + from the gastrointestinal tract, reduces the mineralization of bone tissue.

The anti-inflammatory effect is associated with the oppression of release of eosinophils and fat cells of inflammation mediators; induction of lipocortion formation and reducing the number of fat cells producing hyaluronic acid; with a decrease in permeability of capillaries; Stabilization of cell membranes (especially lysosomal) and organelle membranes. Acts on all stages of the inflammatory process: inhibits the synthesis of prostaglandins (PG) at the level of arachidonic acid (lipocortine inhibits phospholipase A2, suppresses the liberation of arachidonic acid and inhibits the biosynthesis of endoperosis, leukotrienes, contributing to the processes of inflammation, allergies, etc.), synthesis of "pro-inflammatory cytokines" ( Interleukin 1, factor of necrosis of the Alpha tumor, etc.); Increases the stability of the cell membrane to the action of various damaging factors.

The immunosuppressive effect is due to the resulting lymphoid tissue involution, the inhibition of lymphocyte proliferation (especially T-lymphocytes), suppressing the migration of B cells and the interaction of T- and limfocytes, the braking of the release of cytokines (interleukin-1, 2; gamma interferon) from lymphocytes and macrophages and a decrease in antibody formation.

The antiallergic effect develops as a result of a decrease in the synthesis and secretion of allergy mediators, inhibition of release of the release of sensitized fat cells and basophils of histamine and other biologically active substances, reducing the number of circulating basophils, t- and deformphocytes, fat cells; suppressing the development of lymphoid and connective tissue, reducing the sensitivity of effector cells to allergy mediators, inhibition of antibody formation, changes in the immune response of the body.

With obstructive diseases of the respiratory tract, the action is due mainly to the braking of inflammatory processes, the prevention or decrease in the severity of edema of mucous membranes, a decrease in the eosinophilic infiltration of the submembrance layer of the epithelium of the bronchi and sediments in the mucous membranes of the circulating immune complexes, as well as the braking of erosion and deskvamation of the mucous membrane. Increases the sensitivity of beta-adrenoreceptors of bronchi small and medium caliber to endogenous catecholamps and exogenous sympathomimetics, reduces the viscosity of the mucus by reducing its products.

Suppresses the synthesis and secretion of ACTH and the secondary - synthesis of endogenous GKS.

Inhibits the connective tissue reactions during the inflammatory process and reduces the possibility of forming scar tissue.

Action feature is a significant inhibition of the pituitary function and almost complete absence of mineralocorticosteroid activity.

Doses 1-1.5 mg / day depress the function of the adrenal cortex; The biological half-life - 32-72 h (the duration of the oppression of the hypothalamus-pituitary-hypophy-cortical substance of the adrenal glands).

Approximately 3.5 mg of prednisone (or), 15 mg of hydrocortisone or 17.5 mg of cortisone correspond to 0.5 mg of dexamethasone.

Pharmacokinetics

Blood binds (60-70%) with a specific protein-transceiver - transcertine. Easily passes through histohematic barriers (including through hematophephalic and placental).

Metabolized in the liver (mainly by conjugation with glucuronic and sulfuric acids) to inactive metabolites.

Excreted by kidneys (small part - lactating glands). T 1/2 dexamethasone from plasma - 3-5 h.

Indications

Diseases requiring the introduction of high-speed GCS, as well as cases where oral administration is impossible:

- endocrine diseases: acute insufficiency of adrenal cortex, primary or secondary insufficiency of adrenal cortex, congenital hyperplasia of adrenal cortex, subacute thyroiditis;

- shock (burn, traumatic, operational, toxic) - with the ineffectiveness of vasoconstrictor means, plasma-substituting drugs and other symptomatic therapy;

- edema of the brain (with a brain tumor, cranial and brain injury, neurosurgical intervention, hemorrhage in the brain, encephalitis, meningitis, radiation lesion);

- asthmatic status; Heavy bronchospasm (aggravation of bronchial asthma, chronic obstructive bronchitis);

- severe allergic reactions, anaphylactic shock;

- rheumatic diseases;

- systemic connecting tissue diseases;

- sharp heavy dermatoses;

- malignant diseases: palliative treatment of leukemia and lymphoma in adult patients; acute leukemia in children; hypercalcemia in patients suffering from malignant tumors, with impossibility of oral treatment;

- blood diseases: acute hemolytic anemia, agranulocytosis, idiopathic thrombocytopenic purpura in adults;

- severe infectious diseases (in combination with antibiotics);

- in ophthalmologic practice (subconjunctive, retrobulbar or parabulbar administration): allergic conjunctivitis, keratitis, keratoconjunctivitis without damage to the epithelium, irrit, iridocyclite, blepharitis, blepharoconjunctivitis, scarce, episclerite, inflammatory process after eye injury and surgery, sympathetic ophthalmia, immunosuppressive treatment after corneal transplantation;

- Local use (in the area of \u200b\u200bpathological education): keloids, discoomed red lupus, ring-shaped granuloma.

Contraindications

For short-term use on life indications, the only contraindication is increased sensitivity to dexamethane or components of the drug.

FROM caution The drug should be prescribed under the following diseases and states:

- Diseases of the tract - ulcerative ulcer of the stomach and duodenum, esophagitis, gastritis, acute or latent peptic ulcer, recently created intestinal anastomosis, nonspecific ulcerative colitis with a threat of perforation or abscess, diverticulitis;

- pre- and post accuming period (8 weeks before and 2 weeks after vaccination), lymphadenitis after the BCG vaccination;

- immunodeficiency states (including AIDS or HIV infection);

- diseases of the cardiovascular system (incl. Recently suffered myocardial infarction - in patients with acute and subacted myocardial infarction possible, the focus of necrosis is possible, slowing down the formation of scar tissue and, as a result, is the gap of the heart muscle), severe chronic heart failure, arterial hypertension, hyperlipidemia);

- endocrine diseases - diabetes mellitus (including violation of the tolerance for carbohydrates), thyrotoxicosis, hypothyroidism, the disease of Izeno-Custine, obesity (III-IV Art.)

- severe chronic renal and / or liver failure, nephrowolithiasis;

- hypoalbuminemia and states predisposing to its occurrence;

- systemic osteoporosis, Miasthenia gravis, acute psychosis, poliomyelitis (except for the shape of the bulbar encephalitis), open and closed-coronal glaucoma;

- Pregnancy.

Dosage

Dosing mode is individual and depends on the indications, the state of the patient and its reaction to therapy. The drug is introduced into / in slowly inkjet or drip (with acute and urgent states); per / m; Local (in pathological education) is also possible. In order to prepare a solution for in / in drip infusion, an isotonic solution should be used or a 5% dextrose solution.

In the acute period under various diseases and at the beginning of therapy, dexamethasone is used in higher doses. During the day, you can enter from 4 to 20 mg of dexamethasone 3-4 times.

Dose drug for children (in / m):

The dose of the drug during substitution therapy (in case of insufficiency of the adrenal cortex) is 0.0233 mg / kg of body weight or 0.67 mg / m 2 of the body surface area, divided by 3 doses, every 3rd day or 0.00776 - 0.01165 mg / kg body weight or 0.233 - 0.335 mg / m 2 body surface area daily. With other indications, the recommended dose is from 0.02776 to 0.16665 mg / kg of body weight or 0.833 - 5 mg / m 2 of the body surface area every 12-24 hours.

The long-term use of high doses of the drug requires a gradual reduction in the dose in order to prevent the development of acute insufficiency of adrenal cortex.

Side effects

Usually dexamethasone is well tolerated. It has low mineralocorticoid activity, i.e. Its influence on water-electrolyte exchange is small. As a rule, low and medium doses of dexamethasone do not cause sodium delays and water in the body, an increased excretion of potassium. The following side effects are described:

From the endocrine system:reducing glucose tolerance, steroid diabetes or manifestation of latent diabetes mellitus, inhibition of adrenal functions, Izsenko-Cushing syndrome (moon-like face, hypophized type obesity, girsutism, enhancement of blood pressure, dysmenorrhea, amenorrhea, muscle weakness, strry), latency of sexual development Children.

From the digestive system:nausea, vomiting, pancreatitis, steroid ulcer of the stomach and duodenum, erosive esophagitis, gastrointestinal bleeding and perforation of the walls of the gastrointestinal tract, an increase or decrease in appetite, disruption of digestion, flatulence, ICOT. In rare cases - an increase in the activity of hepatic transaminases and alkaline phosphatase.

From the side of the cardiovascular system:arrhythmias, bradycardia (up to a heart stop); Development (in predisposed patients) or strengthening the severity of heart failure, changes on the electrocardiogram characteristic of hypokalemia, an increase in blood pressure, hypercoagulation, thrombosis. In patients with acute and subacted myocardial infarction - the spread of the focus of necrosis, slowing down the formation of scar tissue, which can lead to the rupture of the heart muscle.

From the nervous system:delium, disorientation, euphoria, hallucinations, manic-depressive psychosis, depression, paranoia, increasing intracranial pressure, nervousness or anxiety, insomnia, dizziness, vertigo, pseudogo cerebellum, headache, convulsions.

From the senses:rear subcapsular cataract, an increase in intraocular pressure with possible damage to the optic nerve, a tendency to the development of secondary bacterial, fungal or viral eye infections, trophic changes of the cornea, exophthalm, sudden loss of vision (with parenteral administration in the head, neck, nasal shells, the skin of the head is possible Deposition of drug crystals in eye vessels).

From the metabolism:increased excretion of calcium, hypocalcemia, body weight increase, negative nitrate balance (increased protein decay), increased sweating.

Conditioned mineralocorticoid activity- Liquid delay and sodium (peripheral edema), plasternatrhythmia, hypocalaminessindrome (hypokalemia, arrhythmia, myalgia or muscle spasm, unusual weakness and fatigue).

From the musculoskeletal system:the slowdown in the growth and processes of ossification in children (premature closure of epiphyseal growth zones), osteoporosis (very rarely pathological fractures of bones, aseptic necrosis of the head of the shoulder and femur), the gap of the muscle tendons, steroid myopathy, a decrease in muscle mass (atrophy).

From the side of the skin and mucous membranes:slowed healing of wounds, petechia, ekkimosis, skin thinning, hyper- or hypopigmentation, steroid eels, strry, tendency to the development of pyodermia and candidiasis.

Allergic reactions:skin rash, itching, anaphylactic shock, local allergic reactions.

Local with parenteral administration:burning, numbness, pain, tingling at the place of administration, infection at the injection site, rarely - necrosis of the surrounding tissues, the formation of scars at the injection site; Atrophy of the skin and subcutaneous tissue at a per / m administration (the introduction into the deltoid muscle is especially dangerous).

Others:the development or aggravation of infections (jointly used immunosuppressants and vaccination and vaccination), leukocyturia, "tides" of blood to the face, "cancellation" syndrome contribute to the appearance of this side effect.

Overdose

It is possible to strengthen the side phenomena described above.

It is necessary to reduce the dose of dexamethasone. Treatment is symptomatic.

Medicinal interaction

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

Simultaneous purpose of dexamethasone with:

- Inductors of hepatic microsomal enzymes(phenobarbital, rifampicin, phenytoin, theophylline, ephedrine) leads to a decrease in its concentration;

— diuretics(especially tiazide and carboanhydrase inhibitors) and amphotericin in - It may lead to an increase in the elimination of the K + organism and an increase in the risk of developing heart failure;

— with sodium-containing drugs- to the development of edema and an increase in blood pressure;

— cardiac glycosides -their portability deteriorates and the likelihood of the development of ventricular extrasytoly increases (due to the caused hypokalemia);

— indirect anticoaguppy- weakens (less often enhanced) their action (dose correction is required);

— anticoagulants and thrombolitics -rises the risk of developing bleeding from ulcers in the gastrointestinal tract;

— ethanol and npvp - the risk of erosive-ulcer lesions in the gastrointestinal tract and the development of bleeding is increasing (in combination with NSAIDs in the treatment of arthritis it is possible to reduce the dose of glucocorticosteroids due to the summation of the therapeutic effect);

— paracetamol- the risk of hepatotoxicity is increasing (induction of hepatic enzymes and the formation of toxic paracetamol metabolite);

— - accelerates its elimination and reduces blood concentration (when dexamethasone cancels, the level of salicylates in the blood increases and the risk of developing side effects) is increasing);

— insulin and oral hypoglycemic drugs, hypotensive means -their effectiveness decreases;

— vitamin D -it decreases its effect on the suction of CA 2+ in the intestine;

— somatotropic hormone -reduces the effectiveness of the latter, and with praziquantel -its concentration;

— M-cholinoblocators(including antihistamines and tricyclic antidepressants) and nitrates -contributes to an increase in intraocular pressure;

— isoniazid and Mexylethine- increases their metabolism (especially in "slow" acetylastors), which leads to a decrease in their plasma concentrations.

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

Indomethacin, ousting dexamethasone due to albumin, increases the risk of developing its side effects.

ACTH enhances dexamethasone action.

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

Cyclosporine and ketoconazole, slowing down dexamethasone metabolism, can in some cases increase its toxicity.

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

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

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

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

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

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

special instructions

During treatment with dexamethasone (especially long), observation of the eyepiece, control of the blood pressure and state of the water and electrolyte balance, as well as the pattern of peripheral blood and blood glucose levels is necessary.

In order to reduce side effects, antacids can be prescribed, and also to increase the admission to + in the body (diet, potassium preparations). Food should be rich in squirrels, vitamins, with limiting the content of fats, carbohydrates and cooking salts.

The effect of the drug is enhanced in patients with hypothyroidism and cirrhosis of the liver. The drug can strengthen existing emotional instability or psychotic disorders. When specifying psychosis, a history of dexamethasone in high doses is prescribed under the strict control of the doctor.

With caution, it should be used in acute and subacted myocardial infarction - it is possible to spread the focus of necrosis, slowing down the formation of scar tissue and the gap of the heart muscle.

In stressful situations during supportive treatment (for example, surgical operations, injury or infectious diseases), a dose correction should be corrected due to the increase in glucocorticosteroid need. It should be carefully observed for patients during the year after the end of long-term therapy with dexamethasone due to the possible development of the relative failure of the adrenal cortex in stressful situations.

With a sudden cancellation, especially in the case of the preceding use of high doses, the development of the "Cancellation" syndrome (anorexia, nausea, inhibition, generalized muscular-skeletal pain, general weakness), as well as the aggravation of the disease, was assigned to the dexamethasone.

During treatment with dexamethasone, vaccination should not be carried out in connection with the decline in its effectiveness (immune response).

Assigning dexamethasone at intercurrent infections, septic conditions and tuberculosis, it is necessary to simultaneously carry out antibiotics of bactericidal action.

In children during long-term treatment, dexamethasone needs careful monitoring of growth and development dynamics. Children, which during the treatment period were in contact with sick cute or chickenpasses, prophylactically prescribe specific immunoglobulins.

Due to the weak mineralocorticoid effect for substitution therapy with adrenal insufficiency, dexamethasone is used in combination with mineralocorticoids.

In patients with diabetes mellitus, the content of blood glucose should be monitored and corrected therapy if necessary.

X-ray control over the bone-articular system (spinal shots, brushes) are shown.

In patients with latent infectious diseases of the kidneys and urinary tract, dexamethasone is able to cause leukocyturia, which may have a diagnostic value.

Dexamethasone increases the content of metabolites of 11- and 17-oxytocorticosteroids.

Pregnancy and lactation

When pregnancy (especially in the first trimester), the drug can be applied only when the expected therapeutic effect exceeds the potential risk to the fetus. With long-term therapy during pregnancy, the possibility of breach of fetal growth is not excluded. In the case of use at the end of pregnancy, there is a danger of atrophy of the adrenal cortex at the fetus, which may require substitution therapy in a newborn.

If it is necessary to carry out treatment with a drug during breastfeeding, then breastfeeding should be stopped.

Childcare

In children during the growth period, GCS should be applied only in absolute indications and under particularly thorough observation of the attending physician.

Dexamethasone is a drug belonging to the glucocorticosteroid group and is a hormonal agent.

It is widely used in medicine, in different areas. It produces in the form of a solution, which is used for injections intravenously, intramuscularly and for instillation in the conjunctival of the eyes.

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

Clinical and Pharmacological Group

GKS for injections.

Conditions of vacation from pharmacies

Recommended by a doctor's prescription.

Prices

How much is dexamethasone? The average price in pharmacies is at the level of 100 rubles.

Release form and composition

A medication solution that is sold in pharmacies in ampoules contains dexamethasone sodium phosphate. This active substance takes 4 or 8 mg.

The auxiliary components are glycerin, dihydrate dynatium phosphate, dynatory edctate and purified water to obtain the solution of the desired concentration. The dexamethasone solution for internal administration looks like a transparent colorless or yellowish liquid.

Pharmacological effect

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

It interacts with glucocorticoid receptors, regulates sodium, potassium metabolism, water balance and glucose homeostasis. Stimulates the production of enzyme proteins in the liver, acts on the synthesis of mediators of inflammation and allergies, oppress their education. As a result, the remedy provides anti-inflammatory, anti-allergic, immunospressive, anti-shock effect.

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

What are they prescribed dexamethasone?

In case of gastrointestinal diseases: and ulcerative colitis.
With systemic diseases of the connective tissue: acute rheumatic trint; .
In endocrine disorders: the insufficiency of the bark of the adrenal glands and their congenital hyperplasia; Prostulating the shape of inflammation of the thyroid gland.
With rheumatic diseases: Bursit; ; psoriatic and gouty arthritis; osteoarthritis; Sinovit; nonspecifice tendosinitis; Ankylosing spondylitis; Accompanying osteoarthritis epicondylitis.
With allergic diseases: contact and atopic; asthmatic status; serum disease; Allergies to food and some medicines; angioedema edema; (seasonal or chronic); ; related to blood transfusion.
With skin diseases: severe multiform erythema; pemphigus; exfoliative, bullous herpesiform and severe seborrheic dermatitis; Fungoid mycosis; .
With eye diseases: neuritis of the optic nerve; symptomatic ophthalmia; Allergic corneal ulcers; keratitis; iridocyclitis; Irit; uveitis (front and rear); Allergic forms.
With respiratory diseases: Lefeler syndrome; ; Sarcoidosis of the 2nd-3 degree; aspiration pneumonia; Berilliosis.
For kidney diseases: impaired kidney function, associated with systemic red wolf deprived; Ideopatic nephrotic syndrome.
For malignant diseases: leukemia (acute) in children; Lymphoma and leukemia in adults.
With a shock: non-treated with classical shock methods; anaphylactic shock; Shock in patients suffering from insufficiency of the adrenal gland bark.
In hematological diseases: Purple idiopathic thrombocytopenic; erythroblasting; anemia congenital hypoplastic; autoimmune hemolytic anemia; Thrombocytopenia secondary.
With other testimony: myocardial trichinosis; trichinosis with neurological signs; Tuberculous meningitis.

Contraindications

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

The use of dexamethasone with pregnant and nursing women, as well as children should occur only to the appointment of a doctor after taking into account all possible risks.

Application during pregnancy and lactation

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

Injections of dexamethasone during pregnancy are made only on life indications. For example, the drug can assign in the case when the immune system begins to perceive the embryo as a foreign body. Dexamethasone suppresses immune activity, which makes it possible to eliminate the threat of miscarriage and preserve pregnancy.

Instructions for use

In the instructions for use, it is indicated that the dosing mode is individual and depends on the indications, the state of the patient and its reaction to therapy.

The drug is introduced into / in slowly inkjet or drip (with acute and urgent states); per / m; Local (in pathological education) is also possible. In order to prepare a solution for in / in drip infusion, an isotonic solution of sodium chloride or a 5% solution of dextrose should be used.
In the acute period under various diseases and at the beginning of therapy, dexamethasone is used in higher doses. During the day, you can enter from 4 to 20 mg of dexamethasone 3-4 times.

Doses of the drug for children (in / m):

The dose of the drug during substitution therapy (in case of insufficiency of adrenal cortex) is 0.0233 mg / kg of body weight or 0.67 mg / m2 of body surface area, divided by 3 doses, every 3rd day or 0.00776 - 0.01165 mg / kg body weight or 0.233 - 0.335 mg / m2 Body surface area daily. Under other indications, the recommended dose is from 0.02776 to 0.16665 mg / kg of body weight or 0.833 - 5 mg / m2 of the body surface area every 12-24 hours.
When the effect is reached, the dose is reduced to supporting or before discontinuation. The duration of parenteral use is usually 3-4 days, then go to the supporting therapy with dexamethasone in tablets.

The long-term use of high doses of the drug requires a gradual reduction in the dose in order to prevent the development of acute insufficiency of adrenal cortex.

Side effects

Against the background of treatment with decxamethasone in the form of injections in patients, the following side effects may be developed:

From the side of the skin and mucous membranes: Slowed healing of wounds, petechia, ekkimosis, skin thinning, hyper- or hypopigmentation, steroid acne, strlicy, tendency to the development of pyodermia and candidiasis;
From the senses: rear subcapsular cataract, increase intraocular pressure with possible damage to the optic nerve, tendency to the development of secondary bacterial, fungal or viral infections, trophic changes of the cornea, exophthalm, sudden loss of vision (with parenteral administration in the head, neck, nasal shells, head It is possible to deposition of the drug crystals in the vessels of the eye);
From the metabolism: Increased calcium removal, hypocalcemia, body weight increase, negative nitrogenous balance (increased protein decay), high sweating. Conditioned by mineralocorticoid activity - fluid delay and sodium (peripheral edema), plasternatrhythmia, hypocalaminessindrome (hypokalemia, arrhythmia, myalgia or muscle spasm, unusual weakness and fatigue);
From the endocrine system: Reducing glucose tolerance, steroid diabetes mellitus or manifestation of latent diabetes mellitus, oppression of adrenal functions, Izsenko-Cushing syndrome (moon-shaped face, hypophized obesity, hirsutism, enhancement of blood pressure, dysmenorrhea, amenorrhea, muscle weakness, strry), penal delay in children;
From cardiovascular Systems: arrhythmias, bradycardia (up to a heart stop); Development (in predisposed patients) or strengthening the severity of heart failure, changes on the electrocardiogram characteristic of hypokalemia, an increase in blood pressure, hypercoagulation, thrombosis. In patients with sharp and subacted myocardial infarction - the spread of the focus of necrosis, slowing down the formation of scar tissue, which can lead to a rupture of the heart muscle;
From the musculoskeletal system: slowdown in the growth and processes of ossification in children (premature closure of epiphyseal growth zones), osteoporosis (very rarely pathological bone fractures, the aseptic necrosis of the head of the shoulder and femur), the gap of the muscle tendons, steroid myopathy, reduced muscle mass (atrophy). Dexamethasone instructions for use;
From the nervous system: Delia, disorientation, euphoria, hallucinations, manico-depressive psychosis, depression, paranoia, increase in intracranial pressure, nervousness or anxiety, insomnia, dizziness, vertigo, pseudogo cerebellum, headache, cramps.
From the digestive system: nausea, vomiting, pancreatitis, steroid ulcer of the stomach and duodenal intestine, erosive esophagitis, gastrointestinal bleeding and perforation of the walls of the gastrointestinal tract, increase or decrease in appetite, digestion disruption, meteorism, okota. In rare cases - an increase in the activity of hepatic transaminases and alkaline phosphatase;

Overdose

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

Treatment is made according to the factors manifested, is to reduce the dose or temporary cancellation of the drug. With overdose there is no special antidote, hemodialysis is not effective.

special instructions

Patients with deviations in the work of the liver decxamethasone are prescribed with special caution.
In order to reduce the risk of side effects development, the patient must comply with a diet with a high content of potassium. Food should be rich in proteins, carbohydrate and salt consumption should be slightly reduced.
During the treatment period, dexamethasone patients should constantly monitor the indicators of blood pressure, the condition of the organs of vision, water-electrolyte balance and clinical picture of the blood.
Treatment with the drug should not be discontinued, since in this case the risk of cancellation syndrome - a state, which is accompanied by an increase in the primary symptoms of the disease and the oppression of adrenal functions.
Patients with diabetes mellitus should constantly monitor the level of glucose in the blood and, if necessary, adjust the daily dose of hypoglycemic drugs.
When using the drug in pediatric practice, it should be closely following the child's growth dynamics, since the long-term use of the drug in large doses can lead to the oppression of the patient's growth.

Medicinal interaction

The instructions for the use of dexamethasone allocates the following drug interactions:

The ability to strengthen the effect of antibiotics;
Phenobarbital, ephedrine reduce the effectiveness of the means;
Reception with other glucocorticosteroids leads to increasing risk of hypokalemia;
When used with oral contraceptives, the half-life of dexamethasone increases;
Ryodrin is forbidden to apply simultaneously with the drug under consideration due to the risk of fatal outcome;
Dexamethasone reduces the effectiveness of hypoglycemic, antoslude, antihypertensive medicines;
for the prevention of nausea and vomiting after chemotherapy, it is recommended to use at the same time dexamteiazone and metoclopramide, diphenhydramine, oklorperazine, ondannetron, rhineetron.