The article describes the main properties and differences hormonal medications based on betamethasone. Features are given original drug, generic drugs and drugs with similar effects. A description of Diprospan substitute drugs in ampoules for injections is given,
Instructions for use
Diprospan is a hormonal agent in the form of a sterile injection suspension, made on the basis of the synthetic corticosteroid betamethasone.
It is contained in the form of two compounds: sodium phosphate and dipropionate, 2.63 and 6.43 mg per milliliter (in terms of pure active substance, these are doses of 2 and 5 mg).
The medicine is available in 1 ml ampoules and filled syringes containing a white dispersion suspended in a colorless liquid. Manufactured in France, Belgium and the USA.
Effects of the product
Betamethasone has anti-inflammatory and antiallergic effects, exhibits immunosuppressive properties and affects metabolic processes.
Indications for use and contraindications
Diprospan is used for diseases that can be treated with adrenal hormones with a proven clinical effect of corticosteroids as main or auxiliary agents. The main reasons for prescribing Diprospan injections are bone and joint diseases, inflammation of peripheral nerves:
- osteoarthritis;
- rheumatoid arthritis;
- Bekhterev's disease;
- radiculitis;
- neuritis of the sciatic nerve;
- lumbodynia.
They also treat:
- allergic diseases;
- skin diseases: dermatitis, eczema;
- systemic lupus erythematosus and other collagenoses;
- leukemia and lymphoma;
- adrenal insufficiency;
- adrenogenital syndrome;
- glomerulonephritis;
- ulcerative colitis.
The use of Diprospan is contraindicated in cases of intolerance to betamethasone and other corticosteroid hormones, hypersensitivity to additional components and systemic lesions fungi.
Application
Before use, shake the medicine thoroughly before opening the ampoule. The drug is administered intramuscularly, into the joint cavities and into the affected tissues. Single dose – 0.25-2 ml, recommended frequency for systemic use – 1 ampoule per week. With a simultaneous administration of 2 ml of the drug, the next dose is administered after 2 weeks.
It cannot be entered into blood vessels, under the skin and into infected areas. The medicine is not used to treat children.
Adverse reactions
The severity of undesirable effects depends on the total dose and duration of use of the drug. Sometimes you may experience:
- swelling;
- increased blood pressure;
- weakness;
- decrease in muscle mass;
- erosions and ulcers of the digestive tract;
- irregular periods;
- carbohydrate metabolism disorders, decreased insulin production;
- decreased immunity;
- aseptic tissue necrosis at the injection site;
- joint damage with repeated injections.
Cost in pharmacies
An ampoule of Diprospan suspension in Russia costs 230 rubles.
What can replace a Diprospan injection?
The price of many medicines is unreasonably high; this always applies to original imported drugs, especially those actively promoted. Generic drugs reduce the cost of treatment. Two are registered in Russia injectable drug containing betamethasone: Flosteron (Slovenia) and Betaspan Depot (Ukraine).
Analogues of Diprospan Russian production- No!
Flosteron
A good analogue for injections, including for allergies, identical to Diprospan in terms of the main active ingredients and their dosage. It contains 7 mg betamethasone per 1 ml suspension.
That's why has the same indications, dosage regimen, route of administration, contraindications and application features, same as the original product.
The dose for intramuscular administration is 1-2 ml, 0.25-2 ml of suspension is administered intra-articularly. Use no more than 1 ml per week.
It should also not be used if you are hypersensitive to the components of the drug or other similar hormones.
With the simultaneous use of alcohol or non-steroidal anti-inflammatory drugs, the risk of ulcerative lesions of the stomach and intestines increases.
Betaspan Depot
A product containing 4 milligrams of betamethasone, calculated as pure substance in the form of sodium phosphate. Containing a corticosteroid in the form of one salt and in a smaller dose changes the properties of the medicine.
It has more indications and routes of administration. They also treat:
- cerebral edema;
- kidney allograft rejection;
- antenatal use to prevent neonatal respiratory distress;
- tuberculous meningitis.
In emergency situations, the drug should be administered intravenously in a solution of glucose or sodium chloride. More often it is used intramuscularly, intraarticularly and injected into areas of inflammation. Maximum daily dose for adults in normal situations - 16 mg, for kidney transplant rejection - up to 60 mg. For children, the dose is determined at the rate of 0.020-0.125 mg/kg.
At comparable doses, Betaspan causes the same adverse reactions, as other betamethasone drugs and has the same contraindications for use.
Price of Flosteron and Betaspan
Currently, both products are not available for sale in Russian pharmacies; their price in neighboring countries is 1.5-4 times less than the cost of Diprospan when the dose is recalculated. Thus, an ampoule of the original drug in Ukraine is sold for 240 hryvnia, while the price of Flosteron is 130 UAH, and Betaspan is 35 UAH (with a dose of betamethasone 4 mg).
Due to the periodic lack of generic betamethasone drugs in pharmacies, it is important to use other hormones with a similar effect.
In such cases, an alternative is triamcinolone, which is part of the drugs Kenalog (Italy) and Kenalog 40 (Slovenia).
These preparations contain the glucocorticosteroid triamcinolone, are available in ampoules in the form of a suspension, a dose of 1 ml is 40 mg.
Indications for use
- are common allergic diseases and anaphylactic reactions;
- rheumatic diseases;
- eye diseases: conjunctivitis, iridocyclitis;
- allergic skin diseases;
- adrenal insufficiency;
- aspiration pneumonitis;
- tuberculous meningitis;
- polymorphic sclerosis.
The drug is prescribed to children from 6 years of age.
Contraindications. In addition to intolerance to the drug, it cannot be used for systemic infections, chronic hemorrhagic diathesis and myopathy associated with the use of steroid hormones. Kenalog is not administered intravenously.
The medicine is used for systemic treatment in the form of intramuscular injections at a dose of 40-80 mg, maximum dosage for initial administration – 120 mg. It is administered once a week, with a small single dose applied daily.
Locally, Kenalog is used for injection into affected tissues and joint cavities. For intra-articular use, the highest daily dose is 80 mg when administered into several joints.
The price for 1 ampoule of Kenalog is 125 rubles.
A comparison of Diprospan and generic betamethasone suspension drugs, as well as reviews of them, confirm the possibility of saving on replacing expensive drugs, but such a replacement will not always provide the desired effectiveness. A comparison of similar hormonal agents shows the possibility of achieving the desired effect at a lower cost.
However, replacement prescription drug for a medicine with another active substance should be carried out by a doctor. The patient can independently choose only medication options with the same active ingredient and dosage. Then the decision to purchase a cheap product instead of an expensive one will not lead to a decrease in the effectiveness of treatment and will not cause a worsening of the condition.
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This page provides a list of all Diprospan analogues by composition and indication for use. A list of cheap analogues, and you can also compare prices in pharmacies.
- The cheapest analogue of Diprospan:
- The most popular analogue of Diprospan:
- ATX classification: Betamethasone
- Active ingredients/composition: betamethasone
Cheap analogs of Diprospan
| # | Name | Price in Russia | Price in Ukraine |
|---|---|---|---|
| 1 | dexamethasone | 6 rub | 2 UAH |
| 2 | prednisolone Similar in indication and method of use | 13 rub. | 11 UAH |
| 3 | hydrocortisone Similar in indication and method of use | 23 rub. | 8 UAH |
| 4 | hydrocortisone Similar in indication and method of use | 84 RUR | 37 UAH |
| 5 | betamethasone Analogue in composition and indication | 108 rub. | 37 UAH |
When calculating the cost cheap analogs of Diprospan taken into account minimum price, which was found in price lists provided by pharmacies
Popular analogs of Diprospan
The list of drug analogues based on statistics of the most requested drugs
All analogues of Diprospan
The above list of drug analogues, which indicates Diprospan substitutes, is the most suitable because they have the same composition of active ingredients and coincide in indications for use
Analogues by indication and method of use
| Name | Price in Russia | Price in Ukraine |
|---|---|---|
| dexamethasone | 6 rub | 2 UAH |
| dexamethasone | -- | -- |
| dexamethasone | -- | 8 UAH |
| Dexamethasone | 7350 rub. | -- |
| methylprednisolone | 1600 rub. | 40 UAH |
| methylprednisolone | 160 rub. | 10 UAH |
| methylprednisolone | -- | 44 UAH |
| methylprednisolone | 146 RUR | 68 UAH |
| methylprednisolone | 333 RUR | 126 UAH |
| -- | 35 UAH | |
| -- | -- | |
| prednisolone | 13 rub. | 11 UAH |
| prednisolone | -- | 20 UAH |
| -- | 148 UAH | |
| Prednisone | 3990 rub. | -- |
| triamcinolone | -- | -- |
| triamcinolone | 270 rub. | 35 UAH |
| triamcinolone | 163 RUR | 90 UAH |
| hydrocortisone | 23 rub. | 8 UAH |
| 782 RUR | 590 UAH | |
| hydrocortisone | 139 RUR | 15 UAH |
| hydrocortisone | 84 RUR | 37 UAH |
| Deflazacort | 4740 rub. | -- |
To compile a list of cheap analogues of expensive drugs, we use prices that are provided to us by more than 10,000 pharmacies throughout Russia. The database of drugs and their analogues is updated daily, so the information provided on our website is always up to date as of the current day. If you have not found the analogue you are interested in, please use the search above and select the medicine you are interested in from the list. On the page of each of them you will find everything possible options analogues of the sought-after medicine, as well as prices and addresses of pharmacies where it is available.
How to find a cheap analogue of an expensive medicine?
To find an inexpensive analogue of a medicine, a generic or a synonym, first of all we recommend paying attention to the composition, namely the same active ingredients and indications for use. The same active ingredients of the drug will indicate that the drug is a synonym medicine, pharmaceutically equivalent or pharmaceutical alternative. However, we should not forget about the inactive components of similar drugs, which may affect safety and effectiveness. Do not forget about the instructions of doctors; self-medication can harm your health, so always consult a doctor before using any medication.Diprospan price
On the websites below you can find prices for Diprospan and find out about availability at a pharmacy near youDiprospan instructions
INSTRUCTIONS
on the use of the drug
DIPROSPAN
pharmachologic effect
This glucocorticoid drug has antiallergic, immunosuppressive, anti-inflammatory, antishock and desensitizing effects. It is also characterized by a mineralocorticoid effect, but it is rather weakly expressed and, when used in therapeutic doses, has no clinical significance. The disodium phosphate contained in the drug betamazone determines the speed of onset of the desired effect.
Indications for use
extra-articular rheumatism (myositis, synovitis, tenosynovitis, fibrositis, epicondylitis);
rheumatoid and psoriatic arthritis;
post-traumatic osteoarthritis;
osteochondrosis;
acute gouty arthritis;
allergic rhinitis;
bronchial asthma;
lumbago;
blood transfusion and anaphylactic shock;
shock (burn, surgical, traumatic, cardiogenic, toxic);
allergic and anaphylactoid reactions;
cerebral edema;
nonspecific ulcerative colitis;
contact and atopic dermatitis;
psoriasis;
keloid scars;
collagenoses;
acute adrenal insufficiency;
hepatic coma;
acute hepatitis;
malignant neoplasms.
Mode of application
The dose of diprospan and the method of administration depend on clinical picture and severity of the disease.
At intramuscular injection use a dose of 1-2 ml. The drug is injected deep into the gluteal muscle. When administered intradermally into the lesion, one dose should contain no more than 0.2 ml/cm2, and general dosage per week should not exceed 1 ml. If periarticular and intraarticular administration is necessary, the dosage can vary from 0.25 to 2 ml. Here you need to take into account the size of the joint. If local infiltration is used, then diprospan is dosed as follows: for tenosynovitis and synovial cyst - 0.25-0.5 ml, for bursitis - from 0.25 to 1-2 ml, for fibrositis and myositis - from 0.5 to 1 ml, for tendonitis – 0.5 ml.
The injection of this drug is not painful, but in exceptional cases diprospan can be combined with an anesthetic. For pain relief, a local anesthetic is used - a one percent solution of lidocaine or procaine, which is mixed with the drug in one syringe.
Side effects
The occurrence and severity of side effects of this medicine depend on the dosage used, adherence to the prescribed circadian rhythm, and also on the duration of use.
If the drug was taken once or a short course of treatment was used, then the likelihood of side effects is minimized. In case of long-term use of the drug, the following deviations were noticed:
from the central nervous system: depression, agitation, sleep disturbances, anxiety syndrome and neuroses;
from the gastrointestinal tract: polyphagia, indigestion;
from the metabolic side: osteoporosis, weight gain, growth retardation in children, worsening infections, deterioration in people with diabetes, corticoadrenal suppression;
Various swelling is also possible.
Contraindications
With parenteral administration and a short course of treatment, hypersensitivity is the only contraindication.
When administered intra-articularly into the lesion, contraindications include infected areas of the lesion, unstable joints, periarticular infection, previous arthroplasty and impaired blood clotting.
For external use, contraindications include various skin diseases, dermatitis, dermatoses, bacterial, viral, fungal infections skin, acne.
With other methods of administration, diprospan cannot be used if the following diseases occur:
tuberculosis, peptic ulcer, HIV infection, chicken pox, thrombophlebitis, renal failure, diabetes, osteoporosis, glaucoma, psychosis, viral, bacterial, fungal infections, nephritis, uveitis, thrombophlebitis, diverticulitis, gastric ulcers and duodenum, impaired renal and liver function, vaccination period.
Also, taking the drug is contraindicated in case of hypersensitivity.
Pregnancy
This drug is not used during pregnancy. If it is necessary to take diprospan during lactation, then breastfeeding should be stopped immediately.
Drug interactions
At joint use with NSAIDs, the likelihood of bleeding and ulcerative lesions increases gastrointestinal tract. Diprospan weakens the effect of insulin, diuretics, anticoagulants, oral medications and vaccines. Therapeutic effect The drug is enhanced by hormonal contraceptives.
Overdose
Symptoms of an overdose of this medicine are as follows: agitation, sleep disturbance, euphoria, nausea, vomiting. With long-term use: swelling, osteoporosis, adrenal dysfunction. Symptomatic therapy is used for treatment.
Release form
A box with one or five transparent ampoules containing an injection solution. One ampoule contains 1 ml of solution.
Storage conditions
The drug should be stored in a place protected from light, and the temperature should be in the range from 2° to 25°C. Freezing the medicine is prohibited. The shelf life is 3 years.
Compound
1 ml of solution contains 6.43 mg of betamethasone dipropionate, 2.63 mg of betamethasone sodium phosphate. There are excipients: water, sodium chloride, polysorbate 80, sodium salt, Trilon-B, nipagin, polyethylene glycol 4000, nipazole, disubstituted anhydrous sodium phosphate and carboxymethylcellulose.
Pharmacological group
Hormones, their analogues and antihormonal drugs
Adrenal cortex hormones
Active ingredients: betamethasone dipropionate, betamethasone sodium phosphate.
Additionally
The medicine cannot be administered intravenously. During therapy, immunization and vaccination are contraindicated. Alcoholic drinks should be avoided.
This drug is dispensed from pharmacies with a doctor's prescription.
pharmachologic effect
GKS. It has high glucocorticoid and low mineralocorticoid activity. The drug has anti-inflammatory, antiallergic and immunosuppressive effects, and also has a pronounced and varied effect on various types of metabolism.
Pharmacokinetics
Suction and distribution
Betamethasone sodium phosphate is highly soluble and after intramuscular administration it quickly undergoes hydrolysis and is almost immediately absorbed from the injection site, which ensures a rapid onset of therapeutic action. Almost completely eliminated within one day after administration.
Betamethasone dipropionate is slowly absorbed from the depot, metabolized gradually, which causes long action drug, and is eliminated within more than 10 days.
The binding of betamatezone to plasma proteins is 62.5%.
Metabolism and excretion
Metabolized in the liver to form mainly inactive metabolites. It is excreted primarily by the kidneys.
Indications
Treatment of conditions and diseases in which GCS therapy allows one to achieve an adequate clinical effect (it must be taken into account that for some diseases GCS therapy is additional and does not replace standard therapy):
— diseases of the musculoskeletal system and soft tissues, incl. rheumatoid arthritis, osteoarthritis, bursitis, ankylosing spondylitis, epicondylitis, radiculitis, coccydynia, sciatica, lumbago, torticollis, ganglion cyst, exostosis, fasciitis, foot diseases;
— allergic diseases, incl. bronchial asthma, hay fever (hay fever), allergic bronchitis, seasonal or year-round rhinitis, drug allergies, serum sickness, reactions to insect bites;
— dermatological diseases, incl. atopic dermatitis, coin-shaped eczema, neurodermatitis, contact dermatitis, severe photodermatitis, urticaria, red lichen planus, insulin lipodystrophy, alopecia areata, discoid lupus erythematosus, psoriasis, keloid scars, pemphigus vulgaris, herpetic dermatitis, cystic acne;
— systemic diseases connective tissue, including systemic lupus erythematosus, scleroderma, dermatomyositis, periarteritis nodosa;
— hemoblastoses (palliative therapy of leukemia and lymphomas in adults, acute leukemia in children);
- primary or secondary insufficiency of the adrenal cortex (with mandatory simultaneous use of mineralocorticoids);
- other diseases and pathological conditions requiring treatment with systemic corticosteroids (adrenogenital syndrome, ulcerative colitis, regional ileitis, malabsorption syndrome, damage to the ocular mucosa if it is necessary to administer the drug into the conjunctival sac, pathological changes blood if necessary, use of corticosteroids, nephritis, nephrotic syndrome).
Dosage regimen
Diprospan ® is used for intramuscular, intra-articular, periarticular, intrabursal, intradermal, interstitial and intralesional administration.
The small size of betamethasone dipropionate crystals allows the use of small diameter needles (up to 26 gauge) for intradermal administration and injection directly into the lesion.
The drug is not intended for intravenous and subcutaneous administration.
Injections of the drug Diprospan ® should be carried out with strict adherence to the rules of asepsis.
When used systemically, the initial dose of Diprospan ® in most cases is 1-2 ml. The administration is repeated as necessary, depending on the patient's condition.
IM injection
Diprospan ® should be injected deep intramuscularly, selecting large muscles and avoiding contact with other tissues (to prevent tissue atrophy).
At severe conditions requiring emergency treatment, the initial dose is 2 ml.
At various dermatological diseases, as a rule, administration of 1 ml of Diprospan suspension is sufficient.
At diseases of the respiratory system The onset of action of the drug occurs within several hours after the intramuscular injection of the suspension. At bronchial asthma, hay fever, allergic bronchitis and allergic rhinitis a significant improvement in the condition is achieved after administration of 1-2 ml of Diprospan.
At acute and chronic bursitis The initial dose for intramuscular administration is 1-2 ml of suspension. If necessary, several repeated injections are performed.
If a satisfactory clinical response does not occur after a certain period of time, Diprospan ® should be discontinued and other therapy should be prescribed.
Local administration
When administered locally, simultaneous use of a local anesthetic drug is necessary only in rare cases. If it is required, then use 1% or 2% solutions of procaine hydrochloride or lidocaine that do not contain methylparaben, propylparaben, phenol and other similar substances. In this case, mixing is carried out in a syringe, first drawing the required dose of the Diprospan ® suspension into the syringe from the bottle. Then the required amount is drawn from the ampoule into the same syringe. local anesthetic and shake for a short time.
At acute bursitis(subdeltoid, subscapularis, ulnar and prepatellar) injection of 1-2 ml of suspension into bursa relieves pain and restores joint mobility within a few hours. After stopping the exacerbation of chronic bursitis, smaller doses of the drug are used.
At acute tenosynovitis, tendinitis and peritendinitis one injection of Diprospan ® improves the patient’s condition; at chronic - the injection is repeated depending on the patient's response. Injecting the drug directly into the tendon should be avoided.
Intra-articular administration of the drug Diprospan ® in a dose of 0.5-2 ml relieves pain and limited joint mobility for rheumatoid arthritis and osteoarthritis within 2-4 hours after administration. The duration of therapeutic action varies significantly and can be 4 or more weeks.
For some dermatological diseases intradermal administration of the drug Diprospan ® directly into the lesion is effective, the dose is 0.2 ml/cm 2 . The lesion is punctured evenly using a tuberculin syringe and a needle with a diameter of about 0.9 mm. The total amount of the drug administered at all sites should not exceed 1 ml for 1 week. For injection into the lesion, it is recommended to use a tuberculin syringe with a 26-gauge needle.
Featured single doses drug (with an interval between administrations of 1 week) with bursitis: at calluses 0.25-0.5 ml (usually 2 injections are effective), with spur- 0.5 ml, at limited mobility thumb feet– 0.5 ml, at synovial cyst– 0.25-0.5 ml, with tenosynovitis– 0.5 ml, at acute gouty arthritis- 0.5-1 ml. For most injections, a tuberculin syringe with a 25-gauge needle is suitable.
After reaching therapeutic effect The maintenance dose is selected by gradually reducing the dose of the drug Diprospan ®, which is carried out at intervals. The reduction is continued until the minimum effective dose is reached.
If a stressful situation (not related to the disease) occurs or threatens to occur, it may be necessary to increase the dose of Diprospan ®.
Side effect
From the side of metabolism: hypernatremia, increased potassium excretion, increased calcium excretion, hypokalemic alkalosis, tissue fluid retention, negative nitrogen balance (due to protein catabolism), lipomatosis (including mediastinal and epidural lipomatosis, which can cause neurological complications), weight gain bodies.
From the cardiovascular system: chronic heart failure (in predisposed patients), increased blood pressure.
From the musculoskeletal system: muscle weakness, steroid myopathy, loss of muscle mass, increased myasthenic symptoms in myasthenia gravis, osteoporosis, vertebral compression fracture, aseptic necrosis femoral head or humerus, pathological fractures tubular bones, tendon ruptures, joint instability (with repeated intra-articular injections).
From the digestive system: erosive and ulcerative lesions of the gastrointestinal tract with possible subsequent perforation and bleeding, pancreatitis, flatulence, hiccups.
Dermatological reactions: impaired wound healing, atrophy and thinning of the skin, petechiae, ecchymoses, excessive sweating, dermatitis, steroid acne, striae, tendency to develop pyoderma and candidiasis, decreased response to skin tests.
From the central nervous system and peripheral nervous system: seizures, increased intracranial pressure with disc edema optic nerve(more often after completion of therapy) dizziness, headache, euphoria, mood changes, depression (with severe psychotic reactions), personality disorders, increased irritability, insomnia.
From the outside endocrine system: menstrual irregularities, secondary adrenal insufficiency (especially during periods of stress due to illness, injury, surgical intervention), Itsenko-Cushing syndrome, decreased carbohydrate tolerance, steroid diabetes mellitus or manifestation of latent diabetes mellitus, increased need for insulin or oral hypoglycemic drugs, impaired intrauterine development, delayed growth and sexual development in children.
From the side of the organ of vision: posterior subcapsular cataract, increased intraocular pressure, glaucoma, exophthalmos; in rare cases - blindness (when the drug is administered to the face and head).
Allergic reactions: anaphylactic reactions, shock, angioedema, arterial hypotension.
Local reactions: rarely - hyper- or hypopigmentation, subcutaneous and skin atrophy, aseptic abscesses.
Others: flushing of the face after injection (or intra-articular injection), neurogenic arthropathy.
The frequency of development and severity of side effects, as with the use of other corticosteroids, depend on the size of the dose used and the duration of use of the drug. These effects are usually reversible and can be eliminated or reduced by reducing the dose.
Contraindications for use
- systemic mycoses;
— intravenous or subcutaneous administration;
- for intra-articular administration: unstable joint, infectious arthritis;
- injection into infected surfaces and into the intervertebral space;
— childhood up to 3 years (presence of benzyl alcohol);
- hypersensitivity to the components of the drug;
- increased sensitivity to other corticosteroids.
WITH caution
Post-vaccination period (a period of 8 weeks before and 2 weeks after vaccination), lymphadenitis after BCG vaccinations. Immunodeficiency conditions (including AIDS or HIV infection).
Gastrointestinal diseases: peptic ulcer stomach and duodenum, esophagitis, gastritis, acute or latent peptic ulcer, recently created intestinal anastomosis, ulcerative colitis with threat of perforation or abscess formation, diverticulitis, abscess or other purulent infections.
Diseases of the cardiovascular system, incl. recent myocardial infarction (in patients with acute and subacute myocardial infarction, the necrosis focus may spread, the formation of scar tissue may slow down and, as a result, the heart muscle will rupture), decompensated chronic heart failure, arterial hypertension, hyperlipidemia).
Endocrine diseases - diabetes mellitus (including impaired carbohydrate tolerance), thyrotoxicosis, hypothyroidism, Itsenko-Cushing's disease.
Severe chronic renal and/or liver failure, nephrourolithiasis, liver cirrhosis.
Thrombocytopenic purpura (im injection).
Hypoalbuminemia and conditions predisposing to its occurrence.
Systemic osteoporosis, myasthenia gravis, acute psychosis, grade III-IV obesity, poliomyelitis (except for the form of bulbar encephalitis), open- and closed-angle glaucoma, eye diseases caused by Herpes simplex (due to the risk of corneal perforation), pregnancy, lactation.
For intra-articular administration: the general serious condition of the patient, the ineffectiveness (or short duration) of the action of 2 previous injections (taking into account the individual properties of the GCS used).
Use during pregnancy and breastfeeding
Due to the lack of controlled studies of the safety of using the drug Diprospan ® during pregnancy, if it is necessary to prescribe the drug to pregnant women or women of childbearing age a preliminary assessment of the expected benefit of therapy for the mother and the potential risk to the fetus is required.
Newborns whose mothers received therapeutic doses of GCS during pregnancy should be under medical supervision (for early detection of signs of adrenal insufficiency).
If it is necessary to prescribe the drug Diprospan ® during lactation, the issue of discontinuing breastfeeding, taking into account the importance of therapy for the mother (due to possible side effects in children).
Use in children
Overdose
Symptoms: Acute overdose of betamethasone does not lead to life-threatening situations. Administration of GCS in high doses for several days does not lead to undesirable consequences, except when using very high doses or when used for diabetes, glaucoma, exacerbation of erosive and ulcerative lesions of the gastrointestinal tract, or with the simultaneous use of digitalis preparations, indirect anticoagulants or potassium-removing diuretics.
Treatment: careful medical monitoring of the patient's condition is required. Optimal fluid intake should be maintained and plasma and urinary electrolytes should be monitored, especially the ratio of sodium and potassium ions. If necessary, appropriate therapy should be carried out.
Drug interactions
When the drug Diprospan ® is prescribed simultaneously with phenobarbital, rifampin, phenytoin or ephedrine, it is possible to accelerate the metabolism of betamethasone while reducing its therapeutic activity.
When using the drug Diprospan ® and indirect anticoagulants together, changes in blood clotting are possible, requiring dose adjustment.
When using the drug Diprospan ® and potassium-sparing diuretics together, the likelihood of developing hypokalemia increases.
Diprospan ® may enhance potassium excretion caused by amphotericin B.
When using corticosteroids and estrogens simultaneously, it may be necessary to adjust the dose of the drugs (due to the risk of overdose).
The simultaneous use of corticosteroids and cardiac glycosides increases the risk of arrhythmia or digitalis intoxication (due to hypokalemia).
With the combined use of GCS with NSAIDs, with ethanol or ethanol-containing drugs, it is possible to increase the frequency or intensity of erosive and ulcerative lesions of the gastrointestinal tract.
When used together, GCS can reduce the concentration of salicylates in the blood plasma.
Simultaneous administration of GCS and somatotropin may slow down the absorption of the latter (administration of betamethasone in doses exceeding 0.3-0.45 mg/m2 body surface/day should be avoided).
GCS may affect the nitrogen blue tetrazole test for bacterial infection and cause a false negative result.
Conditions for dispensing from pharmacies
The drug is available with a prescription.
Storage conditions and periods
The drug should be stored out of the reach of children, protected from light at a temperature not exceeding 25°C; do not freeze. Shelf life - 2 years.
Use for liver dysfunction
Use with caution in severe chronic liver failure, liver cirrhosis.
Use for renal impairment
Use with caution in severe chronic renal failure.
special instructions
The dosage regimen and route of administration are determined individually, depending on the indications, severity of the disease and patient response.
The drug should be used in a minimal amount effective dose, the period of application should be as short as possible.
The initial dose is adjusted until the desired therapeutic effect is achieved. If after a sufficient period of time the therapeutic effect is not observed, the drug is discontinued by gradually reducing the dose of the drug. Diprospan ® and select another appropriate treatment method.
After achieving a therapeutic effect, the maintenance dose is selected by gradually reducing the dose of betamethasone, which is administered at appropriate intervals. The reduction is continued until the minimum effective dose is reached.
If a stressful situation (not related to the disease) occurs or threatens to occur, it may be necessary to increase the dose of Diprospan.
Discontinuation of the drug after long-term therapy is carried out by gradually reducing the dose.
The patient's condition is monitored for at least a year after completion of long-term therapy or use in high doses.
Administration of the drug into soft fabrics, into the lesion and inside the joint can, with a pronounced local effect, simultaneously lead to a systemic effect.
Considering the likelihood of developing anaphylactoid reactions with parenteral administration of GCS, the necessary precautions should be taken before administering the drug, especially if there is a history of allergic reactions to drugs.
Diprospan ® contains two active substances - betamethasone compounds, one of which, betamethasone sodium phosphate, is a rapidly soluble fraction and therefore quickly penetrates the systemic circulation. Possible systemic action drug.
During the use of the drug Diprospan ®, mental disorders are possible, especially in patients with emotional instability or a tendency to psychosis.
When prescribing Diprospan to patients with diabetes mellitus, adjustment of hypoglycemic therapy may be required.
Patients receiving Diprospan ® in doses that suppress the immune system should be warned about the need to avoid contact with patients with chickenpox and measles (especially important when prescribing the drug to children).
When using the drug Diprospan ®, it should be taken into account that GCS can mask the signs infectious disease, and also reduce the body's resistance to infections.
Prescription of Diprospan for active tuberculosis is possible only in cases of fulminant or disseminated tuberculosis in combination with adequate anti-tuberculosis therapy. When prescribing Diprospan to patients with latent tuberculosis or with a positive reaction to tuberculin, the issue of preventive anti-tuberculosis therapy should be decided. At prophylactic use rifampin, an increase in the hepatic clearance of betamethasone should be taken into account (dose adjustment may be required).
If there is fluid in the joint cavity, a septic process should be excluded.
A noticeable increase in pain, swelling, increased temperature of the surrounding tissues and further limitation of joint mobility indicate infectious arthritis. Once the diagnosis is confirmed, antibacterial therapy must be prescribed.
Repeated injections into a joint for osteoarthritis may increase the risk of joint destruction. The introduction of GCS into the tendon tissue gradually leads to tendon rupture.
After successful therapy During intra-articular injections of the drug Diprospan ®, the patient should avoid overloading the joint.
Long-term use of corticosteroids can lead to posterior subcapsular cataracts (especially in children), glaucoma with possible damage to the optic nerve, and may contribute to the development of secondary eye infections (fungal or viral).
It is necessary to carry out periodically ophthalmological examination, especially in patients receiving Diprospan ® for more than 6 months.
With an increase in blood pressure, fluid and sodium chloride retention in tissues and an increase in potassium excretion from the body (less likely than with the use of other corticosteroids), patients are recommended to follow a diet with limited salt and are additionally prescribed potassium-containing drugs. All corticosteroids enhance calcium excretion.
With the simultaneous use of Diprospan and cardiac glycosides or drugs that affect the electrolyte composition of plasma, monitoring of the water-electrolyte balance is required.
Prescribe with caution acetylsalicylic acid in combination with the drug Diprospan ® for hypoprothrombinemia.
Development secondary failure adrenal cortex due to too rapid withdrawal of GCS, possibly within several months after the end of therapy. If a stressful situation occurs or is threatened during this period, therapy with Diprospan ® should be resumed and a mineralocorticoid drug should be prescribed at the same time (due to possible violation secretion of mineralocorticoids). Gradual withdrawal of GCS can reduce the risk of developing secondary adrenal insufficiency.
With the use of GCS, changes in sperm motility and number are possible.
During long-term therapy with GCS, it is advisable to consider the possibility of switching from parenteral to oral GCS, taking into account the assessment of the benefit/risk ratio.
Patients receiving GCS should not be vaccinated against smallpox or undergo other immunizations, especially during treatment with GCS in high doses, due to the possibility of developing neurological complications and low response immune reaction(lack of antibody formation). Immunization is possible when replacement therapy(for example, with primary adrenal insufficiency).
Use in pediatrics
Children treated with Diprospan ® (especially long-term) should be under close medical supervision for possible growth retardation and the development of secondary adrenal insufficiency.
Is there an analogue of Diprospan for allergies? Diprospan is a drug that is most often prescribed for allergic reactions and skin diseases, but this is the scope of this hormonal agent not limited. Diprospan injections turn out to be quite effective when a person has diseases of the musculoskeletal system, gastrointestinal tract, blood diseases, as well as autoimmune pathologies. If for some reason it is impossible to take Diprospan, you can select its analogues, which is done depending on the scope of application of this drug.
Although Diprospan is currently used as a treatment for a wide variety of conditions, its main use is to eliminate different types allergies:
- Fever.
- Asthma.
- Bronchitis caused by the development of allergies.
- Rhinitis that occurs with seasonal changes.
- Allergic reactions of the body to the bites of various insects (especially small soil insects).
Diprospan is now available in two forms - suspension or injection solutions. The dosage of this drug when introduced into the body depends on the place where the injection will be given. The lower it will be muscle mass, the lower the dose medicinal composition should be taken for injections. It is important to note that the drug can be injected into the body into the shoulder, ankle, hip, and knee joints.
In case of an allergic reaction from an insect bite, the injection is carried out directly in the place where the bite was made.
If you take Diprospan for allergies and other diseases for a long time, it can cause a variety of unpleasant consequences from the outside various systems And internal organs:- increased sodium levels in the blood;
- water retention in tissues, which leads to the appearance of edema (they are most noticeable on lower limbs);
- weight gain;
- metabolic disorder in muscle tissue;
- high blood pressure or its constant surges;
- weakness and disruption of the integrity of the tendons;
- fragility of bones or their severe thinning;
- gastrointestinal upset that may not go away for several days;
- hiccups
- severe and persistent temporal pain;
- dizziness, especially when making sudden movements or stress on the body;
- increased intracranial pressure;
- convulsions;
- depression;
- insomnia.
Despite the rather large list of side effects, you need to remember that they may not occur in all patients and therefore you should not refuse to take Diprospan for fear of their occurrence.
One of the popular questions that pharmacists hear is whether there is an analogue of Diprospan and which one is more effective. This is due to the fact that Diprospan is expensive medicine, and not every person is able to inject themselves, which makes it remedy inaccessible to many people. But you should not look for Diprospan substitutes in capsules or tablets, since they do not exist. And cope with unpleasant skin symptoms allergies will be well helped by analogues of this drug, presented in the form of gels or ointments.
- Soderm;
- Betamethasone;
- Celestoderm;
- Mesoderm;
All of the above analogues contain betamethasone (mainly active substance), which explains the related area of their use. The above drugs should be used as treatment after the testimony of a specialist.
Most popular in Lately uses Flosteron, which is the most “reliable” analogue of Diprospan, the composition of which is absolutely the same. Thanks to this, Flosteron exerts its therapeutic effect within 10-30 days, similar to Diprospan.
Since Flosteron is a domestic drug, its price will surprise many, since it is much cheaper than the original drug.
Flosteron is sold only with a doctor's prescription and is a suspension for injection. This drug is prescribed for many diseases of the respiratory system, musculoskeletal system, as well as in the treatment allergic manifestations.
The main contraindication to the use of Flosteron is intolerance to the substances included in its composition.
It is also contraindicated in following cases:- Itsenko-Cushing syndrome.
- Diabetes.
- Kidney failure.
- Hepatitis.
- Liver dysfunction.
- Pregnancy and breastfeeding.
Systemic use of Flosteron gives the following complications:
- eating disorder causing nausea, vomiting, diarrhea, dysbacteriosis, and so on;
- heart failure;
- ruptures or disruption of the integrity of tendons;
- lethargy and weakness in the body;
- frequent irritability;
- loss of body weight (especially muscles);
- dysfunction of the endocrine system;
- migraine;
- worsening metabolism;
- the appearance of acne on the surface of the skin;
- failure or complete absence menstruation;
- development of anaphylactic shock, the most dangerous to the patient’s health.
Each patient must remember that Diprospan substitutes can only be taken as prescribed by a doctor, who must take into account the severity of the disease and individual characteristics the patient's body.
It is prohibited to independently choose analogues of this medicinal composition for yourself, since only an experienced specialist will be able to assess the condition of your body, after which he will select the correct and effective drug.
The site provides reference information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!
Tradename
Diprospan(Diprospan).The active ingredient is betamethasone.
Pharmacological group
Belongs to group glucocorticoids(hormonal agents).Release form and composition
Available in the form of solution and suspension for injection. The solution is packaged in ampoules of 1 ml, 1 and 5 ampoules per box. The suspension is packaged in ampoules or syringes of 1 ml. In plastic cellular packaging - 1 or 5 ampoules, packed in a cardboard box.1 ml of suspension contains 6.43 mg of betamethasone dipropionate (equivalent to 5 mg of betamethasone) and 2.63 mg of betamethasone sodium phosphate (2 mg of betamethasone equivalent).
Excipients:
- water for injections;
- anhydrous disodium phosphate;
- trilon B;
- sodium chloride;
- benzyl alcohol;
- polysorbate 80;
- polyethylene glycol 4000;
- nipazole;
- carboxymethylcellulose sodium salt;
- nipagin.
Description of the drug Diprospan
When examined, the suspension looks like a colorless (may be yellowish), transparent, slightly viscous liquid containing a suspension of white particles. After shaking it becomes white and stable.pharmachologic effect
The drug belongs to the group of glucocorticosteroids. The main effect of Diprospan is associated with pronounced glucocorticoid activity; the mineralocorticoid effect is practically not expressed. The action of Diprospan is aimed at suppressing inflammation, allergic reactions, and immunosuppression. Inhibits the function of the pituitary gland. Diprospan is a medicine that consists of two active components with different rates of action.
One of them - betamethasone sodium phosphate- easily dissolves, hydrolyzes and is absorbed after administration, providing a quick therapeutic effect. Discharged within 24 hours.
Another - betamethasone dipropionate- after administration, it creates a depot, from where it is released gradually. As a result, a long-lasting effect of the drug is ensured. The time for complete elimination is 10 days or more.
Diprospan crystals are very small, which allows it to be inserted into small joints through a very thin needle.
Diprospan: indications for use
- Rheumatic diseases: rheumatoid arthritis, bursitis, eosinophilic fasciitis, ankylosing spondylitis, osteoarthritis, epicondylitis, lumbago, exostosis, tendinitis, bursitis against the background of hard callus, stiffness of the big toe, torticollis, heel spur.
- Allergic diseases: bronchial asthma and status asthmaticus, allergic rhinitis, serum sickness, atopic dermatitis, drug allergies, urticaria, allergic reaction for insect and snake bites.
- Systemic diseases: scleroderma, periarteritis nodosa, systemic lupus erythematosus, dermatomyositis.
- Skin diseases: contact dermatitis, insulin lipodystrophy, arthropathic psoriasis, lichen planus, keloid scars, alopecia areata, pemphigus vulgaris, diffuse forms of neurodermatitis and eczema.
- Blood diseases: leukemia and lymphoma, transfusion reactions.
- Adrenal diseases: primary and secondary adrenal insufficiency and adrenogenital syndrome.
- Digestive tract diseases: nonspecific ulcerative colitis, celiac enteropathy, Crohn's disease.
- Kidney diseases: glomerulonephritis, nephrotic syndrome.
Diprospan: contraindications
TO absolute contraindications Only individual intolerance to the drug Diprospan applies.If long-term treatment is necessary, it is necessary to take into account the presence concomitant diseases in which it is better to refrain from using Diprospan (relative contraindications):
- severe arterial hypertension;
- viral and purulent infections;
- vaccination period;
- systemic fungal infection skin and mucous membranes;
- stomach ulcer;
- Cushing's syndrome;
- mental illness;
- thromboembolic syndrome;
- intramuscular injection for thrombocytopenic purpura.
- infectious arthritis;
- periarticular cellulitis with ulcerations;
- infective endocarditis;
- aseptic necrosis in the adjacent epiphyses;
- treatment with anticoagulants;
- foci of psoriasis at the injection site;
- joint instability;
- diabetes;
- hemarthrosis.
Diprospan: instructions for use
For systemic use, it is administered intramuscularly.For arthritis best effect is achieved by introducing Diprospan into the joint or periarticularly. For eye diseases, the drug can be administered through the skin in the lower eyelid area.
Administration of Diprospan intravenously and subcutaneously is contraindicated!
The dose of the drug in each individual case is selected individually and depends on the disease and its severity. Diprospan is administered to create a drug depot in the body against the background of hormonal therapy with short-acting drugs.
Systemic therapy
The initial dose is 1-2 ml, injected deep into the muscles of the buttocks. Systemically used for the following diseases:
- allergic rhinitis;
Local administration (Blockade with Diprospan)
In most cases, Diprospan injection does not require the simultaneous use of anesthetics. If necessary, lidocaine can be administered. In this case, you first need to draw Diprospan into the syringe, then lidocaine, and shake thoroughly.Blockade with Diprospan is carried out in the treatment of the following pathologies:
- phantom pain;
- headaches and facial pain.
Periarticular blockades (Diprospan is injected into the tissues surrounding the joint) are indicated for bursitis and tendinitis. During these manipulations, the drug is injected into the periarticular bursa, or directly near the tendon, with care not to damage it.
When isoniazid is used together with Diprospan, a decrease in concentration is observed. Mental disorders may occur.
Antiepileptic drugs reduce the concentration of Diprospan - therefore, its therapeutic effect decreases, which requires an increase in the dose of the drug.
The likelihood of ulcers in the digestive tract increases when Diprospan is used simultaneously with ibuprofen, aspirin, indomethacin, butadione.
Glucocorticoids cross the placenta and are excreted in milk in small quantities.
When prescribing Diprospan, you should evaluate possible risk for mother and child with the expected beneficial effect.
The use of Diprospan together with beta-2 agonists in the third trimester of pregnancy promotes possible occurrence the mother has pulmonary edema.
Application of Diprospan in pediatric practice
Long-term use of Diprospan in children can lead to growth retardation and sexual development. While taking the drug, it is necessary to limit the child’s contact with patients with measles and chickenpox. It should be taken into account that intramuscular administration of the drug leads not only to the development of a local therapeutic effect, but also to a systemic effect.
To prevent the development of atrophy of subcutaneous fat and skin, Diprospan must be injected deep into the muscle.
Intra-articular and periarticular injections can only be performed by a medical professional of a certain qualification.
When treating with Diprospan, vaccination is impossible, since antibodies are not formed under the influence of glucocorticoids, and the vaccination will be ineffective.
There is a need for regular examination by an ophthalmologist of patients taking Diprospan due to the risk of developing cataracts and glaucoma.
In men, there may be a decrease in spermatogenesis and a decrease in sperm motility with long-term use of the drug.
Diprospan: analogues of the drug
The pharmacy may offer you a substitute for Diprospan - Flosteron. It is an absolute analogue of Diprospan.Storage conditions and periods
The drug is stored in a cool, dark place, at a temperature of no more than +25 o C (preferably in the refrigerator, but do not allow freezing).Shelf life – 3 years.
Conditions for dispensing the drug in pharmacies
You can buy Diprospan in pharmacies only with a doctor's prescription.Diprospan: price
You can buy Diprospan in Moscow at average price, amounting to 211.15 rubles per 1 ampoule of injection solution and 213.04 rubles per 1 ampoule of injection suspension.Price in Ukraine: Diprospan can be purchased at an average price of 68 - 494 hryvnia for 5 ampoules.
It is possible to buy Diprospan in Minsk at a price of 300,000 – 333,400 Belarusian rubles.
Manufacturer of suspension Diprospan
Schering-Plough, Belgium.Diprospan: reviews
Most doctors and patients are satisfied with the durability and speed of manifestation of the therapeutic effect from the use of the drug Diprospan. But it is worth noting that the effect depends not only on the drug itself, but also on the type of disease and its severity, the presence of concomitant diseases and the drugs used to treat them. In each specific case, the effect of Diprospan on the body will be different. This must be taken into account when carrying out treatment, especially long-term treatment.
