Content
For diseases endocrine system Doctors use the drug Dexamethasone in ampoules, the effect of which is to influence the metabolism of carbohydrates and proteins in the body. This strong medicine, contains hormones, so it should be used with caution and under supervision. Find out when treatment with drug ampoules is used, how to give injections correctly, whether there is a risk side effects.
What is Dexamethasone
For diseases of the endocrine system and brain, doctors can prescribe Dexamethasone injections. This drug is a hormonal drug and contains a substance from the group of glucocorticosteroids secreted by the adrenal cortex. It has a strong effect on carbohydrate-protein metabolism, so the medicine is prescribed to children only for absolute indications due to the risk of disorders. Once inside, the active substance begins to act very quickly, providing anti-stress, anti-inflammatory and anti-allergic effects.
Dexamethasone acts inside cells. The medicine regulates sodium and potassium metabolism, water balance, glucose levels, increases synthesis fatty acids. The anti-shock, immunoregulatory effect develops eight hours after intramuscular injection of ampoules, the effect lasts from several hours to four weeks.
Compound
The drug solution, which is sold in pharmacies in ampoules, contains dexamethasone sodium phosphate. This active substance takes 4 or 8 mg. The auxiliary components are glycerin, disodium phosphate dihydrate, disodium edetate and purified water to obtain a solution of the desired concentration. Dexamethasone solution for internal administration appears as a clear, colorless or yellowish liquid.
pharmachologic effect
Dexamethasone is used as systemic drug long acting, have a desensitizing effect and have immunosuppressive activity. The main fat-soluble substance of the drug binds to albumin proteins and accumulates in the liver, kidneys and other organs. The compound is excreted from the body in urine.
What is it prescribed for?
Injections intramuscularly, intravenously or intraarticularly are prescribed for the following indications:
- dysfunction of the endocrine system – acute insufficiency of the adrenal cortex, surgical interventions, severe injuries;
- shock – resistant to therapy, anaphylactic;
- cerebral edema caused by metastases, tumors, neurosurgical interventions, traumatic brain injuries;
- oncology – leukemia, lymphoma, leukemia, hypercalcemia;
- exacerbation of obstructive bronchitis, bronchial asthma;
- severe allergies;
- joint inflammation;
- fibrous compacted folliculitis, granuloma annulare, sarcoidosis;
- eye diseases of an inflammatory or allergic nature, treatment after corneal transplantation.
Instructions for Dexamethasone in ampoules
The drug is available in the form of tablets, injection ampoules and eye drops. Injection solutions have a dosage of 4 mg active substance per 1 ml, presented in a package of 10 pieces. Each test tube is made from clear glass. Another form of release of Dexamethasone ampoules contains five injection units inside a contoured blister pack made of polymer film, two pieces in a cardboard box.
The instructions for use of the drug urge caution in patients with arterial hypertension, heart failure, glaucoma, epilepsy, myasthenia gravis and thromboembolism. There are other restrictions:
- the effect of the drug may increase liver cirrhosis and hypothyroidism;
- treatment can mask infectious signs, aggravate systemic fungal diseases, latent amoebiasis, pulmonary tuberculosis;
- during therapy, vaccination with live viruses is contraindicated due to the lack of expected antibody production, preventive action;
- cannot be used eight weeks before and two weeks after vaccinations;
- Not recommended for use in treatment after surgery or bone fracture.
- the medicine slows down the healing and formation of callus;
- The drug is stored for two years at temperatures up to 25 degrees, it cannot be frozen;
- specific conditions for dispensing from a pharmacy - by prescription.
During pregnancy
When carrying a child, Dexamethasone therapy is possible, but only if the benefit of treatment to the mother outweighs the risk to the fetus. The doctor prescribes the drug for health reasons, so he has the right to prescribe the medicine to a pregnant woman. You cannot use the medicine during breastfeeding, because the active substance passes into the milk and negatively affects the health and development of the child.
For children
Dexamethasone for inhalation can be used by children using a nebulizer. Such safe way use eliminates the risk of burns to the laryngeal mucosa. For the procedure, you will need to prepare a solution - dilute 1 ml of ampoule in 6 ml of saline solution. IN pure form It is prohibited to use the medicine. The product is diluted strictly before inhalation, the amount is 3-4 ml. The course of therapy with Dexamethasone ampoules lasts a week, procedures can be carried out up to four times a day.
There are a number of rules for using inhalations:
- do not let your child eat an hour before the procedure;
- Make sure that the baby is not active half an hour before inhalation, so that breathing, heartbeat and body temperature will return to normal;
- inject the inhalation solution into the nebulizer, then use the mouthpiece or put a mask on the child;
- the child should sit in front of the nebulizer and inhale the vapor for 5-10 minutes;
- For infants, inhalations are performed while lying down in their sleep: put a mask on the sleeping child;
- the baby should breathe calmly, evenly, shallowly - deep breaths lead to spasms and coughing;
- Monitor your child's slow exhalations until his lungs are completely empty.
How much can you use
Depending on the patient’s medical history, the doctor prescribes a course of using Dexamethasone ampoules. If the effect is achieved, the dosage of the medicine is reduced. Ampoules should not be used for a long time, because there is a risk of developing acute adrenal insufficiency. The approximate duration of the course of treatment is up to four days, then the patient takes tablets as maintenance treatment.
How to prick
Dexamethasone is administered intravenously, intramuscularly or intraarticularly. The first two methods involve jet injection or administration through a dropper with glucose or saline. It is forbidden to mix Dexamethasone intramuscularly with other medications in the same syringe. The initial dose is 0.5-9 mg, in just one day it is allowed to be administered into soft fabrics up to 20 mg of medication in 3-4 doses.
For intra-articular use, the dose of the active substance from the ampoule is 0.4-4 mg once, the course is repeated after 3-4 months. The drug can be administered into one joint no more than four times a year; only two joints can be treated at a time. If you use Dexamethasone more often, according to reviews, there is a risk of damaging the cartilage. The dose of the drug depends on the size of the joint - up to 4 mg for large ones, up to 1 mg for small ones.
Side effects
Dexamethasone ampoules contain a steroid hormone, so there is a risk of side effects:
- anaphylaxis;
- facial redness due to blood flow into the vessels;
- heart failure;
- convulsions;
- confusion, agitation, restlessness;
- disorientation, paranoia, depression, euphoria;
- hallucinations, glaucoma, cataracts;
- increase intraocular pressure;
- allergic reactions on the skin, stretch marks, tendon ruptures, atrophy of subcutaneous tissue;
- occurrence of disorders gastrointestinal tract;
- development of sudden blindness, burning numbness, pain at the injection site.
Contraindications
Instructions for use of Dexamethasone ampoules highlight the following contraindications:
- osteoporosis;
- acute viral infections, bacterial or fungal diseases;
- lactation;
- eye lesions, purulent infection, defects of the cornea, epithelium, trachoma, glaucoma;
- state of sensitivity to the composition of the drug;
- chronic renal failure, liver cirrhosis, development of hepatitis, acute psychosis.
Overdose
If you use Dexamethasone too actively for several weeks, an overdose is possible, which is manifested by the symptoms listed among the side effects. Treatment is carried out according to the manifested factors, and consists of reducing the dose or temporarily discontinuing the drug. In case of overdose, there is no special antidote; hemodialysis is not effective.
Interaction
Instructions for use of Dexamethasone highlight the following drug interactions:
- phenobarbital, ephedrine reduce the effectiveness of the drug;
- Dexamethasone reduces the effectiveness of hypoglycemic, anticoagulant, and antihypertensive medications;
- taking with other glucocorticosteroids leads to an increased risk of hypokalemia;
- when used with oral contraceptives, the half-life of Dexamethasone increases;
- Ritodrine should not be used concomitantly with the drug in question due to the risk fatal outcome;
- the ability to enhance the effect of antibiotics;
- To prevent nausea and vomiting after chemotherapy, it is recommended to use Dexamtheazone and Metoclopramide, Diphenhydramine, Prochlorperazine, Ondansetron, Granisetron simultaneously.
Analogs
Based on the active substance and indications for use, the following analogues of Dexamethasone are distinguished:
- Vero-Dexamethasone;
- Dexaven;
- Dexamethasone-Betalek;
- Decadron;
- Dexamed;
- Dexazone;
- Dexamethasone Vial;
- Maxidex;
- Dexamethasonelong;
- Dexapos;
- Dexon;
- Dexafar;
- Megadexane;
- Fortecortin;
- Oftan Dexamethasone.
Price of Dexamethasone in ampoules
The medicine can be bought inexpensively in an online store or ordered from the pharmacy department catalog. The price of Dexamethasone in ampoules depends on the level of the pharmacy and the format. approximate cost indicated in the table:
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Dexamethasone injections reviews chondrosis
Attention! The information presented in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only qualified doctor can make a diagnosis and make treatment recommendations based on individual characteristics specific patient.
Found an error in the text? Select it, press Ctrl + Enter and we will fix everything!Dexamethasone is a drug that is classified as a glucocorticosteroid and is essentially hormonal drug. Its use in medicine is quite widespread. Dexamethasone is available in tablet forms or ointments, solutions for intramuscular and intravenous injections In addition, it is included in many eye drops.
Pharmacology
Dexamethasone is a synthetic analogue that is normally produced by the adrenal cortex. It affects glucocorticoid receptors, controls potassium, sodium, glucose and water metabolism, affects the production enzyme proteins and mediators inflammation (reduces the formation of the latter). Due to this, the drug gives pronounced anti-shock, anti-inflammatory, immunosuppressive and anti-allergic effects.
When administered intramuscularly, the effect appears within eight hours; when administered intravenously, it occurs much faster. Saved Effect from three days to three weeks or up to twenty-eight days with intravenous infusion.
The effects of dexamethasone are thirty-five times more pronounced than those of.
Composition and forms
The active substance in all forms is dexamethasone sodium phosphate. In addition to it, the drug contains additional components: water, phosphate solution, glycerin and sodium edetate.
The release forms of the drug are as follows:
- Ophthalmic suspension;
- Oftan (eye drops) 0.1%;
- Dexamethasone solution for injection (ampoules with solution for intravenous or intramuscular infusion) 4 mg/1 ml;
- Tablets 0.5 milligrams.
What is it prescribed for?
Diseases that require introduction fast-acting corticosteroids, or when taking tablet forms is impossible:
- Shocks of various origins (toxic, surgical, burn or traumatic). If other symptomatic therapy (plasma substitutes, vasoconstrictors and others) is ineffective;
- Anaphylactic shock or other severe manifestations of allergies;
- Blood diseases (thrombocytopenic purpura, agranulocytosis or hemolytic anemia);
- Endocrine pathologies (insufficiency of the adrenal cortex, secondary or primary, congenital hyperplasia of the adrenal cortex, subacute thyroiditis);
- For keloids, SLE, granuloma annulare, locally (that is, injection into the area of formation);
- Rheumatic diseases;
- In ophthalmology (parabulbar, retrobulbar or subconjunctival administration): for sympathetic ophthalmia, eye injuries and operations, episcleritis, scleritis, blepharoconjunctivitis, blepharitis, iridocyclitis, iritis, keratoconjunctivitis, keratitis, allergic conjunctivitis, corneal transplantation;
- Severe acute dermatoses;
- Malignant pathologies: lymphomas and leukemia (as palliative treatment), leukemia, hypercalcemia in tumors;
- Severe infections (in combination with antibiotics);
- Brain edema (due to tumors, head injury, neurosurgical operations, strokes, radiation injury, meningitis, encephalitis);
- Systemic connective tissue diseases;
- Severe bronchospasm, status asthmaticus.
Dexamethasone: tablets, instructions for use
Indications to the use of dexamethasone tablets are:
Indications for use of eye drops
Dexamethasone solution for injection - indications
- Hemolytic anemia;
- Acute adrenal insufficiency;
- Asthmatic status;
- Brain swelling;
- Severe infections;
- Various shocks;
- Joint diseases;
- Thrombocytopenia;
- Severe allergies;
- Acute croup;
- Agranulocytosis;
- Lymphoblastic leukemia.
Contraindications
If it is needed short-term use of the drug in connection with vital signs, then the only contraindication would be hypersensitivity to dexamethasone or additional components of the drug.
Intra-articular injections contraindicated at:
Intravenous/intramuscular injections are contraindicated in:
- Active tuberculosis;
- Liver diseases (hepatitis or cirrhosis);
- Acute psychosis;
- Acute infections;
- Thrombocytopenic purpura.
For children during periods of active growth, corticosteroids are prescribed strictly according to absolute(vital) indicators.
Toxic and therapeutic actions
drug are decreasing barbiturates, phenytoin, rifampicin, amidoglutethimide, ephedrine, rifabutin, somatotropin, antacids, and rise- oral contraceptives. Joint reception with cyclosporine can cause seizures in children.
Increased risks of hypokalemia and arrhythmia are possible when combined corticosteroids and diuretics, cardiac glycosides. Edema and hypertension may occur with the combined use of dexamethasone and dietary supplements containing sodium. Severe hypokalemia, osteoporosis and heart failure - with amphotericin B, carbonic anhydrase inhibitors; ulcers and bleeding in the gastrointestinal tract - with NSAIDs.
Simultaneous use GCS with antiviral live vaccines can lead to activation of viruses and, as a result, the development of infection.
Dexamethasone weakens insulin and antidiabetic drugs, diuretics and coumarins, in addition, taking the drug reduces the tolerance of glycosides, reduces the concentration of praziquantel and salicylates, and reduces glucose levels.
Due to the fact that dexamethasone increases the clearance of salicylates, after its discontinuation the dose of salicylates is reduced. Concomitant use with indomethacin may result in a false negative result in the dexamethasone suppression test.
Doses and methods of use
Injection forms of the drug (dexamethasone injections) are required for retrobulbar, periarticular, intraarticular, intramuscular and intravenous administration. Dosages at the same time, they are purely individual and are prescribed in accordance with the indications, the patient’s condition and his response to treatment.
To prepare solutions for drip intravenous infusion will require five percent dextrose or isotonic. High doses of the drug can be administered until the condition stabilizes (that is, no more than 72 hours).
For adult patients in emergency or acute conditions, slow intravenous, jet or drip administration of the drug is recommended; intramuscular administration of four to twenty milligrams up to four times per day is also possible. United single dose (maximum) no more than eighty milligrams. Maintenance - up to nine milligrams/day. The course of such therapy is usually four days, after which the patient is transferred to dexamethasone tablets. For children, the drug is prescribed every twelve to twenty-four hours intramuscularly at a dose of 0.166 mg/kg.
- Tendons - up to one milligram;
- Nerve nodes (ganglia) - up to two milligrams;
- Small joints up to one milligram;
- Joint capsules - up to three milligrams;
- Large joints - up to four milligrams;
- Soft tissues - up to six milligrams.
If necessary a drug can be re-prescribed after a period of three days to three weeks, a single dose in this case is no more than eighty milligrams/day. In shock conditions adult patients twenty milligrams are administered at once, and then throughout the day with a continuous infusion of three milligrams/kilogram or up to 6 mg per kg intravenously once, or forty milligrams every six hours intravenously.
In the presence of cerebral edema, dexamethasone (for adults) is prescribed ten mg intravenously, then four mg four times a day until symptoms disappear, after four days the dosage is reduced and therapy is stopped on the fifth to seventh day.
For children with adrenal insufficiency, the daily dosage is 0.0233 milligrams/kg, this amount is divided into three doses and administered intramuscularly every 72 hours or daily - up to 0.01165 per kg per day.
In the case of acute allergic processes or exacerbations of chronic allergies, dexamethasone is used as follows:
- 1 day - injection solution 1-2 ml intramuscular injection or dexamethasone tablets 0.75 mg;
- 2-4 days - four tablets divided into two doses;
- 5-6 days - one tablet daily;
- Day 7 - no therapy;
- Day 8 - the patient is monitored.
Side effects
Typically dexamethasone well tolerated. The drug has low mineralocorticoid activity, that is, the drug has little effect on the exchange of water and electrolytes.
More often, medium and low dosages of the drug do not lead to fluid and sodium retention, don't bring to enhance potassium excretion.
The following side effects are possible:
- Regarding the sensory organs: subcapsular posterior cataract, increased intraocular pressure, increased risk attachment of fungal, viral, bacterial infections eyes, changes in the trophism of the cornea, exophthalmos, sudden loss of vision (crystals of dexamethasone can be deposited in the vessels of the eyes if it is injected into the neck, head, nose, scalp);
- Regarding the skin and mucous membranes: stretch marks, acne, pigmentation disorders, thinning of the skin, ecchymosis, petechiae, slow wound healing, candidiasis, pyoderma;
- Regarding the endocrine system: Itsenko-Cushing syndrome, diabetes mellitus, decreased glucose tolerance, impaired puberty, adrenal suppression;
- Regarding metabolism: increased calcium excretion, hypokalemic syndrome, peripheral edema, increased protein breakdown, increased body weight, hypocalcemia;
- Regarding the musculoskeletal system: slowing of ossification and growth, osteoprorosis, tendon ruptures, steroid myopathy, muscle atrophy;
- Regarding blood vessels and the heart: thrombosis, arrhythmias, hypercoagulation, bradycardia, increased pressure, heart failure, in case of heart attacks - growth of the lesion and slowing down of scarring, as a result, myocardial ruptures;
- Regarding the gastrointestinal tract: hiccups, nausea, flatulence, vomiting, appetite disturbances, pancreatitis, esophagitis, bleeding;
- Regarding nervous system: convulsions, delirium, headaches, disorientation, cerebellar pseudotumors, euphoria, vertigo, hallucinations, psychosis, anxiety, paranoia, depression;
- Allergic manifestations: itching, rash, local manifestations, anaphylactic shock;
- Local manifestations in the case of parenteral administration: tingling, pain, numbness, burning, infections, less often - necrosis, with intramuscular infusion: atrophy (especially of the deltoid muscle) of the subcutaneous tissue and skin;
- Among others: withdrawal syndrome, infections, leukocyturia, blood transfusion to the face.
Prices
Below are approximate prices for various forms of the drug:
- Dexamethasone eye drops about 82 rubles;
- Dexamethasone injection solution - 144 rubles;
- Dexamethasone tablets -45 rub. for ten pieces;
- Eye drops 0.1% with dexamethasone - 34 rubles;
- Dexamethasone ampoules 1ml/4 mg -202 rub. for twenty-five grand.
Dexamethasone is an antiallergic, anti-inflammatory, immunosuppressive drug. It has well-defined antifibroblastogenic and antiexudative properties. Available in pharmacies according to prescription.
Diseases for which dexamethasone is used
- Addison's disease.
- Adrenal insufficiency.
- Thyroiditis.
- Hypothyroidism.
- Adrenogenital syndrome.
- Tumor hypercalcemia.
- Spicy rheumatoid arthritis.
- Collagenoses.
- Inflammatory and degenerative joint diseases.
- Bronchial asthma of infectious-allergic nature.
- Brain swelling.
- Asthmatic status.
- Myositis.
- Hepatitis.
- Non-specific ulcerative colitis.
- Severe respiratory diseases.
- Hepatitis.
- Anemia.
- Lymphoma.
- Leukemia.
- Agranulocytosis.
- Lymphocytic leukemia.
- Plasmacytoma.
- Infectious diseases in severe form.
- Inflammatory and allergic processes in the eyes.
- Inflammation of the posterior segment and anterior part of the eye.
- Chemical damage to the eyes.
- Eye burns.
- Sympathetic uveitis.
- Recovery period after eye surgery.
- Bronchial asthma.
Instructions for use of dexamethasone
Orally, eye drops, intramuscular, intravenous, retrobulbar, periarticular, intra-articular. The drug should be stopped gradually, otherwise “withdrawal syndrome” may occur.
Types of dexamethasone
Tablets, eye drops, injection solution.
Dexamethasone dosage
For adults
Injections
- Spicy and emergency conditions: 3-4 times a day, a single dose is 4-20 mg, intramuscularly or intravenously. In case of complications, you can increase the single dose to 80 mg. For maintenance treatment, 0.2-9 mg of the drug is administered per day. After 3-4 days, the injections are replaced with tablets.
- Intra-articular, periarticular (introduction into soft tissue): 0.2-6 mg. At least 3 days should pass between administrations.
- Shock state: single administration of 20 mg intravenously. For maintenance treatment, 3 mg per 1 kg of body weight. The drug is administered continuously over 24 hours.
- Cerebral edema: single dose 10 mg intravenously. Until symptoms are completely eliminated, 4 mg is administered intramuscularly at intervals of 6 hours. 2-4 days after the start of treatment, the dose is gradually reduced.
Eye drops
- Acute inflammation: 4-5 times a day, 1-2 drops at a time. Repeat for 2 days. When it starts to appear therapeutic effect, instill the drug 3-4 times a day.
- Chronic inflammation: 2 times a day, instill 1-2 drops. Take the drug for no longer than 4 weeks.
- Care after injuries and operations: 2-4 times a day, instill 1-2 drops.
Inside
Regular daily dose drug 2-3 mg. In severe cases, if there is an urgent need, you can increase the dose to 4-6 mg. For maintenance therapy, 0.5-1 mg per day is administered. The daily dose is distributed into 2-3 doses.
For children
Injections
- Acute and emergency conditions: 0.02776-0.16665 mg per 1 kg of body weight. There should be 12-24 hours between doses. Intramuscularly.
- Adrenal cortex insufficiency: the daily dose is 0.233-0.335 mg per m2 of body area.
Eye drops (ages 6-12 years)
Inflammatory, allergic processes: 2-3 times a day, 1 drop. The course lasts 7-10 days, if necessary it can be continued.
Inside
Depending on the age and nature of the disease, the daily dose is 0.25-2 mg. Distributed into 3-4 doses.
Side effects of dexamethasone
- When using eye drops: short-term tearing and burning, possible disturbance of intraocular pressure. With long-term use - corneal perforation, posterior capsular cataract.
- Ulcerative-erosive lesions of the gastrointestinal tract.
- Loss of potassium, calcium.
- Nausea, vomiting.
- Muscle weakness.
- Water and sodium retention.
- Atony of the gastrointestinal tract.
- Hemorrhagic pancreatitis.
- Osteoporosis.
- Myopathy.
- Bradycardia.
- Arrhythmia.
- Osteoporosis.
- Myopathy.
- Myocardial infarction.
- Itsenko-Cushing syndrome.
- Myocardial dystrophy.
- Hyperlipoproteinemia.
- Hyperglycemia.
- Headache.
- Dizziness.
- Increased intracranial pressure.
- Cramps.
- Skin thinning, pigmentation changes.
- Mood changes.
- “Withdrawal syndrome” when abruptly stopping the drug.
- Allergic reaction.
- Thromboembolism, thrombosis.
- Kidney disorders.
- Violation of the secretion of sex hormones.
- Pancreatitis.
- Delayed healing of wounds.
- Obesity.
Dexamethasone contraindications
- Hypersensitivity.
- For eye drops: fungal, viral, acute purulent diseases, glaucoma, trachoma, damaged corneal epithelium.
- Infection in the joints and soft tissues located near the joints.
- Active tuberculosis.
- Amebic infection.
- Systemic mycosis.
- Preventive vaccinations.
Dexamethasone during pregnancy
During pregnancy, the drug should be taken only when absolutely necessary, when its use is more important than the potential danger to the fetus. During lactation, while taking the drug, it is recommended to avoid breastfeeding.
Dexamethasone is a drug that belongs to the group of corticosteroids. There are quite a lot of pathologies that require the use of this drug.
It is sometimes used to treat even infants, but only in cases where it is necessary to take urgent measures that will save the child’s life (for example, with, or when other medications have not had the desired therapeutic effect. In this case, it is necessary to constantly be under the supervision of a doctor.
Features of the drug
The medicine is available in several dosage forms: in the form of injections, tablets and drops. For children, Dexamethasone is usually prescribed in injection or tablet form.
The active ingredient is dexamethasone phosphate. With regard to additional ingredients of the drug, it must be said that the composition of the drug depends on its form:
- The composition of the injection form contains 4 mg of active substance per 1 ml of solution, and a small amount of glycerin, propylene glycol, phosphate buffer solution, and water are observed as accompanying components.
- In tablet form contains 0.5 mg of active substance, as well as lactose, silicon and residual amounts of magnesium stearate.
- In eye drops contains the main active ingredient weighing 1 mg per milliliter of solution, as well as small amounts boric acid, sodium tetraborate, water and preservatives.
Active substance is able to pass into cells and increase the synthesis of ribonucleic acid. Due to the inhibition of phospholipase, the production of arachidonic acids is increased, as well as the biosynthesis of endoperoxide, mediators of the inflammatory allergic reaction and pain syndrome.
As a result of the action of the drug, there is a decrease in the amount of protease, hyaluronidase and collagenase in small quantities or with complete absence, which leads to the following:
- Improving the functioning of bone and cartilage tissues.
- Reduced permeability of the capillary bed.
- Correcting the stabilization of cell membranes.
- Retention of water and sodium in the body.
- Increased protein catabolism, glucose utilization, and increased glycogen release from the liver.
When taking the tablet form of Dexamethasone for children, almost complete absorption of the drug into the blood from the stomach is observed. At the same time, the percentage of binding to blood proteins is not too high, it reaches on average no more than 80%, and bioavailability is no more than 70%. The active substance can act inside cells.
The effect may appear within a few minutes from the moment of administration, but the maximum effect is achieved on average after 2 hours. The duration of the therapeutic effect of the drug can be 3 days.
When using the injection form, the effect of the drug can occur much faster. This is largely due to the lack of time required for the drug to be absorbed. The medicine penetrates the blood-brain barrier, thereby affecting the organs of the central nervous system.
The drug is excreted in the urine through the urinary system.
Dexamethasone is incompatible with other medications.
Indications and contraindications
Dexamethasone can be used for various pathologies, but due to possible side effects, as well as the presence of a large number of contraindications, including childhood, it is not used so often. Basically, its use is justified only in cases where there is a threat to life. And childhood is no exception.
Among the indications in which there is an acute threat to life are:
- Anaphylactic shock, manifested by a sharp drop blood pressure, disruption of the heart and other vital organs.
- Severe allergic reaction in the form.
- Brain swelling as a result of a traumatic brain injury, infectious process, the presence of a tumor process in the skull area.
- Toxic condition associated with a massive burn, a consequence of painful or traumatic shock, acute blood loss.
- Acute failure adrenal apparatus.
Dexamethasone in children is also used for the following: chronic diseases:
- severe course, clinical manifestations of severe bronchospasm;
- severe autoimmune pathologies such as rheumatoid arthritis or systemic lupus erythematosus;
- expressed;
- Crohn's disease or ulcerative colitis with severe dysfunction of the digestive tract;
- hemolytic anemia or other pathologies of the blood system;
- glomerulonephritis;
- severe infectious processes;
- malignant lesions.
Among the contraindications, in which even acute processes will not be an indication for the use of this drug, the following should be highlighted:
- increased sensitivity of the body to the components of the drug;
- allergy to dexamethasone;
- acute diseases that can be caused by bacterial, viral, and fungal infections;
- condition associated with direct vaccination, especially after BCG vaccination;
- pathologies of the cornea, accompanied by a violation of its integrity;
- Itsenko-Cushing syndrome;
- inflammatory diseases of the digestive tract, especially associated with the presence of erosive and ulcerative defects (gastritis, gastric or duodenal ulcers);
- tuberculosis and other chronic infectious processes;
- pathologies of the nervous system, accompanied by seizures, epilepsy;
- diseases of the endocrine system, especially thyroid gland(hypothyroidism or thyroiditis).
Dexamethasone should be taken with caution in case of liver dysfunction.
To treat severe nasal congestion and difficulty breathing in children due to allergies, Dexamethasone drops are sometimes prescribed for instillation into the nose. This unusual application The drug relieves swelling well, eliminates inflammation, and facilitates the baby’s breathing.
Possible side effects
Side effects are a common problem when using Dexamethasone in children. Among the most common reactions are:
- Allergic reaction in response to the administration of the drug, which most often takes the form of urticaria, eczema or rashes of various types.
- Nervous system dysfunction, such as headache, dizziness, neuropathy, etc.
- Damage to the digestive tract. May manifest as the appearance or complication of pancreatitis, gastritis, as well as peptic ulcer stomach and duodenum.
- In children, improper or prolonged use of Dexamethasone can lead to slowing down the growth of both the whole organism and individual systems . That is why babies taking Dexamethasone develop acquired heart defects, serious disorders in the functioning of internal organs, underdevelopment or delayed development of the gonads and organs of the reproductive system.
- The appearance of a specific appearance associated with increased body weight, water retention in the body, and muscle atrophy.
- Mental disorders.
- Change skin with their depletion and the appearance of stretch marks and cicatricial changes.
- Development of cataracts and glaucoma.
Instructions for the use of Dexamethasone for children in the form of injections, tablets and drops
The dosage of the drug in children and not only should be calculated only by a specialist, based on pathological condition the patient, the severity of the process, as well as the patient’s age and body weight.
The method of administration and dose of Dexamethasone for children depends on the form of the drug and indications.
Using injection form The doctor’s prescription for the drug may be as follows: in the event of an acute condition that is urgent, the calculation is based on 0.02 mg per 1 kg of body weight. In some cases, the dosage can be increased to 0.16 mg per 1 kg. In this case, it is necessary to take into account the dosage regimen and frequency of administration. The minimum duration between administrations is 12 hours. In some cases, a single injection of Dexamethasone is used intramuscularly or intravenously. In case of acute adrenal insufficiency, it is permissible to increase the dosage to 0.2-0.3 mg per kilogram of body weight until the condition stabilizes.
In tablet form for inflammatory, allergic or other chronic pathologies, Dexamethasone, dosage 0.25 mg, is divided into three or four doses per day. The maximum daily dosage can reach 2 mg.
In the form of eye drops Dexamethasone is allowed to be taken in one drop up to 3 times a day. The duration of therapy can be up to a week. In the case of a severe or chronic process, an individual increase in the duration of use of this drug is possible.
Drug in liquid form in ampoules are often used for inhalation in children with inflammation respiratory tract(for example, with bronchitis, laryngitis, bronchial obstruction). For children, the following dosage is used: 0.5 ml of the drug is mixed with 2-3 ml of saline solution. Inhalations are done 3 times a day for 3-7 days.
How much does it cost and how to store it
The price of Dexamethasone depends not only on the type of pharmacy and manufacturer, but also on the dosage form. The average cost of the tablet form is about 50 rubles. Injection form can reach a price of about 200 rubles. The cost of eye drops is about 70 rubles. The drug is dispensed from the pharmacy only with a doctor's prescription.
The drug can be stored in the form of tablets and injections for five years from the date of manufacture, and the shelf life for drops is three years, but only if the bottle is sealed. Once opened, the drops must be used within 3 weeks.
Optimal temperature regime should not exceed 25 degrees Celsius. It is necessary to protect the drug from exposure to sunlight.
Release form: Liquid dosage forms. Injection.
General characteristics. Compound:
Active substance:
dexamethasone sodium phosphate;1 ml of solution contains 4 mg of dexamethasone sodium phosphate in terms of dry matter;Excipients: propylene glycol, glycerin, disodium edetate, phosphate buffer solution pH 7.5, methyl parahydroxybenzoate (E 218), propyl parahydroxybenzoate (E 216), water for injection. Basic physical and chemical properties: transparent colorless liquid.
Pharmacological properties:
Pharmacodynamics.
Dexamethasone is a synthetic glucocorticoid drug whose molecule contains a fluorine atom. It has a pronounced anti-inflammatory, anti-allergic and desensitizing, anti-shock and immunosuppressive effect. Slightly retains sodium and water in the body.The main effect on metabolism is associated with protein catabolism, increased gluconeogenesis in the liver and decreased glucose utilization by peripheral tissues.
Dexamethasone inhibits the synthesis and secretion of ACTH and, secondarily, the synthesis of endogenous
glucocorticoids. A peculiarity of the drug’s action is the absence of mineralocorticoid activity.
Pharmacokinetics.
Dexamethasone is a long-acting glucocorticoid.Bioavailability - more than 90%.
The plasma half-life is approximately 3 - 4.5 hours.
The biological half-life is 36 - 72 hours.
Plasma protein binding - up to 80%.
In the cerebrospinal fluid, the maximum concentrations of dexamethasone are detected 4 hours after intravenous administration(approximately 15-20% plasma concentration). Decrease
the concentration of dexamethasone in the cerebrospinal fluid occurs very slowly (approximately 2/3 of
maximum concentrations can be detected even after 24 hours).
Dexamethasone is metabolized in the liver much more slowly than cortisol, forming
a small amount of 6-hydroxy- and 20-dihydroxymethasone. Almost 80% of the administered dose
excreted by the kidneys, mainly in the form of glucuronide, within 24 hours.
Indications for use:
Treatment of diseases that can be treated systemic treatment glucocorticoids (if necessary as an additional treatment to the main one), if local treatment or oral administration is impossible or ineffective:
Rheumatic diseases.
Shock of various origins (anaphylactic, post-traumatic, post-operative, cardiogenic).
Brain edema (due to tumor disease, traumatic brain injury, neurosurgical intervention, cerebral hemorrhage, encephalitis, meningitis, radiation injury).
Systemic diseases connective tissue.
Allergic diseases (allergic rhinitis, acute anaphylactic reaction on medicines).
Diseases of the respiratory tract (pulmonary fibrosis).
Inflammatory diseases intestines (ulcerative ileitis/colitis).
Some (nephrotic syndrome).
Acute severe dermatoses (pemphigus vulgaris,).
Blood diseases (immunohemolytic, thrombocytopenic purpura).
Replacement therapy: primary adrenal insufficiency (Addison's disease); insufficiency of the anterior lobe of the pituitary gland (Sheehan syndrome); .
Important! Get acquainted with the treatment, ,
Directions for use and dosage:
Doses are determined individually, depending on the disease of the individual patient, the intended period of treatment, tolerability of corticoids and the body's response.
The injection solution can be administered intravenously (by injection or infusion with 5% glucose solution or 0.9% sodium chloride solution), intramuscularly or locally (by intra-articular injection or injection into the lesion on the skin or into the soft tissue infiltrate ). It must be remembered that when administered intra-articularly, the drug cannot be administered into labile and infected joints, unstable joints (due to arthritis, necrosis), deformed joints (narrowing of the joint space, ankylosis). It should be remembered that with intra-articular administration, in addition to local effects (anti-inflammatory, antiallergic, antiexudative effects), systemic effects (immunosuppressive and antiproliferative effects) can be added.
The recommended average initial daily dose for intravenous or intramuscular administration varies from 0.5 to 9 mg per day, the dose is increased if necessary. Initial doses of the drug should be used until a clinical response occurs, and then the dose should be gradually reduced to the lowest clinically possible effective dose. If a clinical response is not achieved when using dexamethasone, then the drug should be stopped and switched to other glucocorticosteroids. When high doses are prescribed for several days, the drug is not abruptly discontinued, but the dose is gradually reduced over the next few days or a longer period.
For intra-articular administration, recommended doses range from 0.4 mg to 4 mg. The dose depends on the size of the affected joint. Typically 2-4 mg is injected into large joints and 0.8-1 mg into small joints. The frequency of use usually ranges from one administration every 3-5 days to one administration every 2-3 weeks. Frequent intra-articular injection may damage articular cartilage. Intra-articular injection can be done simultaneously in no more than 2 joints.
The dose of dexamethasone injected into the bursa is usually 2-3 mg, the dose injected into the tendon sheath is 0.4-1 mg, and the dose injected into the ganglia is 1 to 2 mg.
The dose of dexamethasone administered to the lesion site is equal to the intra-articular dose. Dexamethasone can be administered in parallel to no more than two lesions.
Doses of 2 to 6 mg of dexamethasone are recommended for administration into soft tissues (near the joint).
For the treatment of cerebral edema - 10 mg intravenously at the first administration, then 4 mg intramuscularly once every 6 hours until symptoms disappear. The dose can be reduced after 2-4 days with gradual withdrawal over 5-7 days after elimination of cerebral edema. When a therapeutic effect is achieved, it is recommended to switch from parenteral administration to oral administration of the drug.
For the treatment of shock - 20 mg intravenously at first administration, then 3 mg/kg over 24 hours as a continuous intravenous infusion or 2-6 mg/kg as a single intravenous injection, or 40 mg initially, then repeated intravenous injections every 4 -6 hours while symptoms of shock are observed. A single intravenous dose of 1 mg/kg is also possible. Shock therapy must be discontinued as soon as the patient’s condition has stabilized; treatment usually lasts no more than 2-3 days.
For allergic diseases - intramuscularly 4-8 mg at the first administration. Further treatment is carried out with oral medications.
Doses for children. Recommended dose for replacement therapy is 0.02 mg/kg body weight or 0.67 mg/m2 body surface area per day in three injections. For all other indications, the initial dose range is 0.02-0.3 mg/kg/day in 3-4 injections (0.6-9.0 mg/m2 body surface area/day).
A dose of 0.75 mg of dexamethasone is equivalent to a dose of 4 mg of methylprednisolone and triamcinolone, or 5 mg of prednisolone, or 20 mg of hydrocortisone, or 25 mg of cortisone, or 0.75 mg of betamethasone.
Adverse reactions. From the endocrine system: increased appetite, weight gain, steroid diabetes, decreased tolerance to carbohydrates, hyperglycemia, depression of the hypothalamic-pituitary-adrenal system, impaired secretion of sex hormones (menstrual irregularities, amenorrhea, hirsutism, impotence), premature epiphyseal closure, growth retardation in newborns, children and adolescents, cortical palsy in premature infants, Cushing's syndrome;
from the outside immune system: increased risk of occurrence or exacerbation of fungal, viral or bacterial infections, decreased immune response, development of opportunistic infections, decreased reactivity to vaccinations and skin tests, delayed wound healing, regression of lymphoid tissue, leukocytosis;
from the central nervous system: dizziness, headache, affective disorders(irritability, euphoria, depression, mood lability, suicidal thoughts), psychotic reactions (including mania, hallucinations, psychosis and exacerbation of schizophrenia), anxiety, sleep disturbances, cognitive dysfunction, including confusion and amnesia, as well as neuritis, neuropathy, paresthesia, hyperkinesia, convulsions. In children, the drug can cause paralysis of the cerebral cortex. The drug may cause physical dependence;
from the digestive system: dyspepsia, nausea, vomiting, bloating, peptic ulcer with numerous perforations and hemorrhages, perforation of the small and large intestines, ulcerative esophagitis, hemorrhagic pancreatitis, atony of the digestive tract, candidiasis;
from the liver and biliary tract: increased levels of liver enzymes, hepatomegaly;
on the metabolic side: sodium and water retention, increased potassium excretion, hypokalemic alkalosis, negative nitrogen balance;
from the organs of vision: increased intraocular pressure, glaucoma, papilloedema, posterior subcapsular cataract, thinning of the cornea or sclera, exophthalmos, retinopathy, exacerbation of ophthalmic viral or fungal diseases, retrolental fibroplasia;
from the outside of cardio-vascular system: syncope, bradycardia, tachycardia, angina attack, increase in heart size, myocardial rupture as a complication of myocardial infarction, polytropic ventricular extrasystole, edema, arterial hypertension, increased intracranial and intraocular pressure, congestive heart failure;
from the blood system: purpura, eosinophilia, thrombocytopenia, non-thrombocytopenic purpura, increased risk of thrombosis, thrombophlebitis;
from the respiratory system: pulmonary edema, thromboembolism, bronchospasm;
dermatological reactions: increased sweating, acne, inhibition of regenerative and reparative functions of the skin, thinning of the skin, erythema, petechiae, stretch marks, skin atrophy, ecchymosis, telangiectasia, hyper- and hypopigmentation of the skin, sterile abscess, impaired distribution of subcutaneous tissue;
reactions at the injection site: redness and tingling of the skin, painless destruction of the joint, which symptomatically resembles neurogenic arthropathy (Charcot's joint);
from the musculoskeletal system: osteoporosis, fractures tubular bones or ridges, avascular osteonecrosis, tendon ruptures, muscle weakness, muscle atrophy, proximal myopathy;
allergic reactions: hypersensitivity reactions, angioedema, urticaria, allergic dermatitis, anaphylactic shock.
Signs of glucocorticoid withdrawal syndrome.
In patients who long time treated with dexamethasone, when the dose is reduced too quickly, a withdrawal syndrome may occur and, as a result, cases of adrenal insufficiency, hypotension or death may occur.
In some cases, signs of withdrawal may be similar to signs of worsening or relapse of the disease for which the patient was being treated.
If severe adverse reactions occur, treatment should be discontinued.
Features of application:
Use during pregnancy or breastfeeding.
It can be used during pregnancy, especially in the first trimester, only for health reasons.
Breastfeeding during treatment with the drug is not allowed.
Children. Children are prescribed the drug only in absolute terms, intramuscularly at 0.01 - 0.02 mg/kg every 12 - 24 hours. During treatment with dexamethasone, careful monitoring of the growth and development of children is necessary.
Features of application. During parenteral treatment with corticosteroids, hypersensitivity reactions may occur in isolated cases, so it is necessary to take appropriate measures before starting treatment with dexamethasone, taking into account the possibility (especially in patients with a history of allergic reactions to any other drugs) of allergic reactions.
In patients who are treated with dexamethasone for a long time, when treatment is stopped, a withdrawal syndrome (without visible signs of adrenal insufficiency) may occur with symptoms: elevated temperature, runny nose, redness of the conjunctiva, drowsiness or irritability, muscle and joint pain, weight loss, general weakness, convulsions. Therefore, the dose of dexamethasone should be reduced gradually. Sudden discontinuation may be fatal.
If the patient is under unusual stress (due to injury, surgery, or serious illness) during therapy or during discontinuation of dexamethasone therapy, the dose should be increased or hydrocortisone or cortisone used.
Patients who have been using dexamethasone for a long time and experience severe stress after stopping therapy should restart their dexamethasone dosage as the resulting adrenal insufficiency may continue for several months after stopping treatment.
Treatment with dexamethasone or natural corticosteroids may mask symptoms of existing or new infection, as well as symptoms of intestinal perforation.
Dexamethasone can cause an exacerbation of systemic fungal infection, latent and pulmonary.
Patients with active pulmonary tuberculosis should receive dexamethasone (together with anti-tuberculosis drugs) only for rapid or diffuse pulmonary tuberculosis. Patients with inactive pulmonary tuberculosis who are being treated with dexamethasone or patients who respond to tuberculin should receive chemical and prophylactic agents.
Caution and medical supervision are recommended for patients with arterial hypertension, heart failure, tuberculosis, glaucoma, hepatic or renal failure, active peptic ulcer, recent intestinal anastomosis, and epilepsy. Special care is required for patients during the first weeks after myocardial infarction, patients with thromboembolism, myasthenia gravis, hypothyroidism, psychosis or psychoneurosis, as well as elderly patients.
Exacerbation may occur during treatment with dexamethasone. diabetes mellitus or transition from the latent phase to clinical manifestations diabetes
At long-term treatment With dexamethasone, serum potassium levels should be monitored.
Vaccination with live vaccine is contraindicated during treatment with dexamethasone. Vaccination with a non-live viral or bacterial vaccine does not lead to the expected development of antibodies and does not provide the expected protective effect.
Dexamethasone is not prescribed 8 weeks before vaccination and is not started earlier than 2 weeks after vaccination.
Patients who have been treated for a long time with high doses of dexamethasone and have never had measles should avoid contact with infected persons; in case of accidental contact, prophylactic treatment with immunoglobulin is recommended.
Caution is advised in patients recovering from surgery or because dexamethasone may slow wound healing and bone formation.
The effect of glucocorticosteroids is enhanced in patients with liver cirrhosis or hypothyroidism.
Intra-articular administration of dexamethasone may lead to local or systemic effects. Frequent use may cause damage to cartilage or bone.
Before intra-articular injection, synovial fluid should be removed from the joint and examined (check for infection). Injecting corticosteroids into infected joints should be avoided. If a joint infection develops after the injection, appropriate antibiotic therapy should be started.
Patients should avoid physical activity on the affected joints until the inflammation is resolved.
Injection of dexamethasone into unstable joints should be avoided.
Corticoids may interfere with the results of allergy skin tests.
Children and adolescents should be treated with dexamethasone only when clearly needed. During treatment with dexamethasone, careful monitoring of the growth and development of children and adolescents is necessary.
Patients with fluid and electrolyte imbalance should be careful when taking dexamethasone, because medium and large doses of glucocorticosteroids can cause salt and water retention in the body, as well as increased potassium excretion. In these cases, limiting salt intake and additional potassium intake is indicated. All corticosteroids increase the process of calcium excretion, as a result of which the secretion of mineralcorticoids may be impaired. Therefore, additional administration of salt and/or mineralcorticoids is indicated. When long-term corticosteroid therapy is discontinued possible development withdrawal syndrome, accompanied by an increase in body temperature, pain in muscles and joints, and general malaise. These symptoms can also appear in patients without signs of adrenal insufficiency.
Immunization with live vaccines is contraindicated in persons using immunosuppressive doses of corticosteroids. In cases of immunization of such patients with inactivated viral or bacterial vaccines, the response of serum antibodies may be reduced.
In active forms of tuberculosis, the use of dexamethasone should be limited to cases of fulminant or disseminated forms of the disease, in which corticosteroids are used in parallel with specific therapy.
Patients with latent forms of tuberculosis or positive tuberculin reactions for whom corticosteroids are indicated should be under constant medical supervision to avoid relapses.
Corticosteroids should be prescribed with caution to patients with herpes simplex because their use can lead to corneal perforation. Long-term use of corticosteroids can lead to the development of posterior subcapsular, with possible damage optic nerve, and also increase the risk of secondary viral or fungal eye infections.
The drug is contraindicated in patients in whom the intra-articular administration of corticosteroids has significantly increased pain, accompanied by swelling and further limitation of joint mobility, fever and general malaise (these symptoms indicate the occurrence). In case of development of septic arthritis and when the diagnosis is confirmed, it is necessary to prescribe the appropriate antibacterial therapy. Injecting corticosteroids directly into the site of infection should be avoided. It is necessary to carefully examine any intra-articular fluid to exclude a septic process. Corticosteroids cannot be injected into labile joints. Frequent intra-articular injections can injure joint tissue. Excessive loads on damaged joints until they disappear completely are contraindicated for patients. inflammatory process, even when symptomatic improvement occurs.
The drug is prescribed with caution to infectious patients, especially with chickenpox and measles, because these diseases become more severe when using dexamethasone. Therefore, persons who have not suffered from these diseases should
Care should be taken to avoid infection as much as possible. In case of contact with sick people, you should immediately consult a doctor.
The ability to influence the reaction rate when driving a vehicle or working with other mechanisms. No data.
Interaction with other drugs:
Concurrent use of dexamethasone and non-steroidal anti-inflammatory drugs increases the risk gastrointestinal bleeding and the formation of ulcers.
The effectiveness of dexamethasone is reduced if rifampicin, carbamazepine, phenobarbitone, phenytoin (diphenylhydantoin), primidone, ephedrine or aminoglutethimide are taken in parallel, so the dose of dexamethasone in such combinations must be increased.
The combined use of dexamethasone and drugs that inhibit CYP 3A4 enzyme activity, such as ketoconazole, macrolide antibiotics, may cause an increase in the concentration of dexamethasone in serum and plasma.
Dexamethasone is a moderate inducer of CYP 3A4. Concomitant use with drugs that are metabolized by CYP 3A4, such as indinavir, erythromycin, may increase their clearance.
Ketoconazole may inhibit adrenal synthesis of glucocorticoids. Thus, due to decreased concentrations of dexamethasone, adrenal insufficiency may occur.
Dexamethasone reduces the therapeutic effect of drugs against diabetes mellitus, arterial hypertension, coumarin anticoagulants, praziquantel and natriuretics (therefore, the dose of these drugs should be increased).
Dexamethasone increases the activity of heparin, albendazole and kaliuretics (the dose of these drugs should be reduced if necessary).
Dexamethasone may alter the effect of coumarin anticoagulants, so the prothrombin time should be checked more frequently when using this combination of drugs.
Concurrent use of dexamethasone and high doses of glucocorticosteroids or β2-adrenergic agonists increases the risk of hypokalemia. In patients with hypokalemia, cardiac glycosides contribute more to rhythm disturbances and have greater toxicity.
Glucocorticosteroids increase the renal clearance of salicylates, so it is sometimes difficult to obtain therapeutic serum concentrations of salicylates. Caution should be exercised in patients who are gradually reducing the dose of a corticosteroid, as this may result in increased serum salicylate concentrations and toxicity.
If oral contraceptives are used concomitantly, the half-life of glucocorticoids may increase, which will enhance their biological effects and may increase the risk of side effects.
Concomitant use of ritordin and dexamethasone is contraindicated as it may lead to pulmonary edema. Reported fatal outcome women in labor during childbirth due to the development of this condition.
Concomitant use of dexamethasone and thalidomide may cause toxic epidermal necrolysis.
With the simultaneous use of dexamethasone with amphotericin B and drugs that remove potassium from the body (diuretics), hypokalemia is observed, which can lead to heart failure.
Concomitant use of dexamethasone with anticholinesterase drugs can lead to severe weakness in patients with myasthenia gravis.
Cholestyramine may increase creatinine clearance. The simultaneous use of cyclosporin and corticosteroids leads to an increase in their activity, and convulsions may occur with their simultaneous use.
Types of interactions that have therapeutic benefits: Concomitant administration of dexamethasone and metoclopramide, diphenhydramine, prochlorperazine, or 5-HT3 receptor antagonists (serotonin or 5-hydroxy-tryptamine receptor type 3, such as ondansetron or granisetron) are effective in preventing nausea and vomiting, caused by chemotherapy with cisplatin, cyclophosphamide, methotrexate, fluorouracil.
Incompatibility.
The drug should not be mixed with other drugs except the following: 0.9% sodium chloride solution or 5% glucose solution.
When dexamethasone is mixed with chlorpromazine, diphenhydramine, doxapram, doxorubicin, daunorubicin, idarubicin, hydromorphone, ondansetron, pro-chlorperazine, galium nitrate and vancomycin, a precipitate will form.
Approximately 16% of dexamethasone is degraded in 2.5% glucose solution and 0.9% sodium chloride solution with amikacin.
Some drugs, such as lorazepam, must be mixed with dexamethasone in glass vials rather than in plastic bags (lorazepam concentration drops to below 90% after 3-4 hours of storage in polyvinyl chloride bags at room temperature).
Some drugs, such as metapaminol, have a so-called “slowly developing incompatibility” - it develops within 24 hours when mixed with dexamethasone.
Dexamethasone with glycopyrrolate: The pH value of the residual solution is 6.4, which is outside the stability range.
Contraindications:
Hypersensitivity to the components of the drug.
Gastrointestinal ulcers.
Osteoporosis.
Heavy (except for ).
Viral infections (eg. chicken pox, herpes simplex of the eye, herpes zoster (viremia phase), (with the exception of the bulbar-encephalitic form).
Lymphadenitis after BCG vaccination.
Systemic mycosis.
Closed-angle and open-angle glaucoma.
Overdose:
There are isolated reports of acute overdose or death due to acute overdose.
Overdose usually occurs only after several weeks of using excessive doses. Overdose can cause most of the unwanted effects listed in the Adverse Reactions section, most notably Cushing's syndrome.
There is no specific antidote. Treatment of overdose should be supportive and symptomatic. is not an effective method for accelerating the elimination of dexamethasone from the body.
Storage conditions:
Storage conditions. Store out of reach of children, protected from light at a temperature not exceeding 25°C.
Shelf life - 2 years.
Vacation conditions:
On prescription
