For the treatment of many inflammatory processes of an acute or chronic nature, intramuscular injections “Dexamethasone” are often prescribed. Instructions for use of this drug will be described in this article.
What is this medicine? Why are dexamethasone injections prescribed? How should they be applied in order to achieve the best result? Are dexamethasone injections prescribed for children? Instructions for use of this drug answer all these questions in detail. We also learn from the article whether it is possible to use the drug for the treatment of pregnant and lactating mothers. And, of course, we will get acquainted with numerous reviews about Dexamethasone injections, the instructions for use of which are of great interest to our compatriots.
What is the drug
Before you find out what “Dexamethasone” injections help from, you need to determine what is the active substance of the drug.
Dexamethasone is a synthetic hormone derived from fluoroprednisolone. The form of glucocorticosteroid release is an injection, which can be used as injections intravenously, intramuscularly, and even as drops in the eye for conjunctivitis. How to use the remedy for a particular disease, only the attending physician prescribes. Below we discuss the instructions for the use of Dexamethasone intramuscular injections for adults and children.
Briefly about the composition
Most often, "Dexamethasone" is produced by the manufacturer in glass ampoules, one or two milliliters. The solution itself is a clear liquid (less often with a yellowish tint) without a specific smell.
What is included in each ampoule volume of one milliliter? First of all - the active substance. There are four milligrams of it in solution. Then - auxiliary components. This is sodium chloride, and disodium edetate, and glycerin, and even purified water.
Due to its composition, the drug has a fairly wide spectrum of action. It is used as an anti-inflammatory, immunosuppressive, anti-allergic and even anti-shock agent. This is explained in the instructions for “Dexamethasone”. The price of injections will be discussed below.
How does it affect the body
Thanks to what is achieved such an effect from the use of a hormonal drug? The effect of Dexamethasone injections is due to its special composition and route of administration. For example, with intravenous injections, the agent has an almost instant effect. If you inject the drug into the muscle, then the effect will come only after eight hours.
What happens when synthetic hormone enters the human body? It immediately begins to react with cytoplasmic receptors located in almost all tissues, especially in such an organ as the liver. Penetrating into the nucleus of membrane cells, the active substance inhibits the enzyme phospholipase and activates the basic metabolic processes. Dexamethasone improves protein metabolism by reducing globulins in blood plasma and increasing the amount of albumin in the kidneys and liver. By increasing the synthesis of fatty acids and the redistribution of fats, lipid metabolism is normalized. Also, the active substance has a beneficial effect on carbohydrate metabolism, improving the absorption of carbohydrates from the digestive tract and accelerating the flow of glucose from the liver into the circulatory system. Moreover, the drug regulates water-electrolyte metabolism, retaining water and sodium in the body, as well as stimulating the excretion of potassium.
And how is the anti-inflammatory effect of the drug? The active substance inhibits the release of inflammatory mediators, reduces the permeability of capillaries, increases the protective function of cell membranes with various damaging factors, reduces the number of mast cells responsible for the production of hyaluronic acid.
The drug is used as an immunosuppressant because of its effect on lymphoid tissue, inhibition of T-lymphocyte proliferation, and a decrease in antibody formation.
Also, a hormonal agent can affect the synthesis and secretion of allergy mediators, lowering it. Also, the active substance is responsible for reducing the number of basophils and mast cells, suppressing antibody formation, changing the protective reaction of the body.
How is excreted from the body
Dexamethasone, due to its fusion with sulfuric and glucuronic acids, is metabolized in an organ such as the liver. Later it is excreted from the body by the kidneys, less often - by the lactating glands.
In what cases is the drug used?
Diseases and their conditions
What helps “Dexamethasone"? Injections can be prescribed for such serious and serious ailments as:
- Diseases of the endocrine system. These include pathological processes of the adrenal cortex, subacute stage of thyroiditis.
- Shock conditions of a patient of various etiologies (burns, operations, injuries, intoxications). However, the drug is prescribed only in case of ineffectiveness of specifically therapy, which includes vasoconstrictor, plasma-replacing and other drugs.
- Cerebral edema provoked by a brain tumor, hemorrhage, trauma, encephalitis, neurosurgical intervention, meningitis.
- Asthmatic manifestations. In this case, indications for the use of Dexamethasone injections are exacerbations of asthma, severe bronchospasm, chronic obstructive bronchitis.
- Allergic reactions of a severe form.
- Rheumatic diseases, joint diseases.
- Malignant neoplasms, including leukemia and lymphoma in adults and leukemia in children, cancers, especially if oral therapy is impossible.
- Severe complicated infections (in combination with antibacterial agents).
- When else are dexamethasone injections prescribed? Indications may include ophthalmic diseases such as keratitis, iritis, allergic conjunctivitis, iridocyclitis, scleritis, blepharitis and other inflammations after injuries or surgery, as well as after surgical transplantation of the cornea.
- Multiple sclerosis.
- Severe dermatoses (psoriasis, eczema).
- Acute forms of anemia.
Most often, the drug is used shortly for health reasons, that is, when urgent medical intervention is necessary to save a human life. After injections of “Dexamethasone”, a long-term improvement of the condition occurs, the duration of which (in the chronic course of the disease) can reach from three days to three weeks.
When you can not take the remedy
Despite an impressive number of indications, there are many situations where it is better not to prescribe the drug, especially given its hormonal composition. With great caution, it is necessary to use the drug in the treatment of people with a history of such diseases:
- organs of the gastrointestinal tract (gastritis, stomach ulcers, diverticulitis, ulcerative colitis and so on);
- parasitic or infectious ailments (various kinds of herpes, measles, chickenpox, mycosis, amoebiasis, tuberculosis);
- immunodeficiency plan (HIV, AIDS);
- endocrine (diabetes mellitus, obesity of the third and fourth stages, hypothyroidism, thyrotoxicosis);
- hepatic or renal failure, hepatitis, cirrhosis;
- periarticular osteoporosis, joint instability, joint infections and so on;
- mental illness, especially in acute form;
- internal bleeding;
- pregnancy.
It is worth mentioning that the aforementioned ailments are not one hundred percent contraindications for Dexamethasone. If we are talking about saving lives, then injections must be prescribed, unless, of course, the patient does not have individual intolerance to the main component.
Why are there so many contraindications? The fact is that synthetic hormone has not only a positive, but also a negative effect on the human body. Which one? This can be read below.
Negative impact
According to reviews, Dexamethasone injections can inhibit the immune system, which increases the risk of developing serious infections and malignant neoplasms. The hormone also inhibits the formation of bone tissue, which negatively affects the absorption of calcium. Due to the fact that the active substance of the drug redistributes lipids, fat deposits begin to form in the abdomen and neck.
How is it necessary to use "Dexamethasone" to achieve the best result?
General directions for use
According to the instructions, Dexamethasone injections can be given to both adults and children who are one year old. If you use the hormone intravenously, it is best to pre-mix it with glucose or saline. Doctors may also prescribe injecting the drug intramuscularly. What should be the dosage of “Dexamethasone”?
Injections are prescribed three or four times a day, four to twenty milligrams at a time. The main thing is that the daily norm does not exceed eighty milligrams of the drug. In some cases, when it comes to the life of the patient, this dosage may be increased. However, only the attending physician should increase (or lower) the hormone intake rate.
How long should I use the injection? The optimal course of treatment, according to the recommendations of specialists, should not exceed three to four days. If the drug helps, and it is necessary to continue treatment, then doctors can prescribe “Dexamethasone” in tablets. As you improve, you should lower the accepted daily allowance to the minimum. Only a doctor has the right to cancel a drug.
With the introduction of the solution into the muscle, the procedure must be carried out carefully and slowly, otherwise the development of various complications can be provoked. Patients and nurses often mention this in their reviews of Dexamethasone.
How to prescribe to children
“Dexamethasone” can be administered to babies from one year old, however, only the attending physician prescribes the dosage and schedule. The instructions for use of the drug indicate general data on the basis of which the specialist makes a well-considered qualified decision.
The dosage that the manufacturer offers varies between 0.02776 and 0.16665 milligrams per kilogram of the weight of a small patient. A solution thus calculated must be administered intramuscularly every 12 or 24 hours. If we are talking about pathology of the adrenal glands, then the guys are prescribed a lower dosage. Its daily dose varies between 0.00776 and 0.01165 milligrams per kilogram of weight. There is another option for introducing the solution into the muscle. According to this recommendation, it is necessary to divide the daily dose of the drug three times (0.0233 milligrams per kilogram of weight) and administer the hormone every two days to the third.
It is clear that the exact dosage is calculated not only on the basis of the body weight of the small patient, but also his age, as well as the severity of the disease.
But how to take "Dexamethasone" to treat specific diseases? This information can be found in the annotation to the drug.
How to treat ailments caused by cerebral edema
Drug therapy for this type of pathology includes the use of Dexamethasone injections. The drug is prescribed from five to sixteen milligrams one-time, then the drug is injected into the muscle for five milligrams, observing a frequency of six hours. This treatment is continued until the patient feels better.
If it will be necessary to carry out an operation on the brain, then the hormone is administered within a few days after surgery.
Sore joints and synthetic hormone
In this case, treatment with “Dexamethasone” is prescribed only when other methods of treatment have been tried, but they did not give a tangible result. Injections are administered slowly, sometimes the doctor may prescribe the administration of the drug not only to the muscle, but also to the joint itself.
Most often, such therapy is prescribed for serious pathological diseases, such as rheumatoid arthritis, Still or Ankylosing spondylitis, synovitis, bursitis, lupus, polyarthritis, scleroderma (complicated by joint damage), etc.
What is the dose of drug administered? It is clear that in each situation, the doctor prescribes the dosage individually, based on data such as the age and weight of the patient, as well as the neglect of the disease. The estimated norm of the drug administered varies between 0.4 and 4 milligrams of the drug. For example, for the treatment of a small joint, it will be necessary to use only 0.8 or 1 milligram. Whereas for a large joint, the dose increases from two to four milligrams.
If there is a need for an injection into the tendon, then use one or two milligrams of “Dexamethasone”. If the drug is administered in a synovial bag, the dose may slightly increase (from two to three milligrams).
How often is the procedure necessary? The drug should be administered once, with an interval of three or four months. If you use the product more often or increase the dosage, then this is fraught with serious violations. For example, cartilage may be damaged or a tendon may rupture.
Allergic reactions and drug treatment
Of course, common allergies are treated with antihistamines. However, if the inflammatory processes do not decrease and ordinary drugs do not help, “Dexamethasone” may be prescribed. Most often, it is attributed by the attending physician for such serious pathologies as eczema, Quincke's edema, urticaria, angioedema on the face or neck, anaphylactic shock, severe inflammatory processes in the nasopharynx.
With such ailments, the recommended dose for adults should not exceed eighty milligrams. The schedule of administration and the specific dosage is prescribed individually by the attending physician.
Future and lactating mothers
How to use Dexamethasone injections during pregnancy? As mentioned above, the period of expectation of the child is a contraindication for the use of the drug. This is due to the fact that the active substance is able to penetrate any barriers in the human body (including through the placenta), that is, it can have a negative effect on the fetus. On the other hand, the attending physician may consider the administration of Dexamethasone injections to pregnant women justified when the benefits to the life and health of the mother outweigh the possible risk to the embryo. Be that as it may, the decision is made by a specialist individually in each case.
How can a hormone affect an unborn baby? For example, prolonged use of the drug leads to impaired embryo growth. If you use the drug during the third trimester, then it can provoke a pathology of the adrenal glands in the fetus, as a result of which it will be necessary to conduct serious replacement therapy in the baby in the future.
Can I use the drug for nursing mothers? The answer is unequivocal - no! If there is a need for the treatment of a woman who is breast-feeding a baby, then she needs to transfer the baby to artificial feeding. Many women, according to reviews, did just that. Some at the time of taking the drug stopped breastfeeding, and then, a week after the withdrawal of the drug, they resumed lactation.
One way or another, when deciding whether to take Dexamethasone for pregnant and lactating mothers or not, it should be borne in mind that the drug can cause serious deviations in the baby (inhibition of growth and development, congenital and acquired defects, abnormal formations of the limbs and baby's head).
A few words about side effects
Naturally, such a serious drug has a large number of side effects, which should be remembered during the treatment period. So, what signs should alert you? The following are the most common negative body reactions:
- Skin rashes (dermatitis, urticaria).
- High blood pressure, encephalopathy.
- Palpitations, heart failure (up to cardiac arrest).
- Visual impairment. Cataracts and glaucoma, as well as the development of infectious eye diseases, can also be triggered.
- Neurosis, manifested in insomnia, depression, mood swings.
- Mental disorders. Most often, schizophrenia, paranoia, hallucinations are found.
- Dizziness, cramps.
- Abdominal pain, accompanied by nausea, vomiting, hiccups. There are undesirable consequences in the form of stomach ulcers, bleeding in the organs of the gastrointestinal tract, pathologies of the gallbladder, pancreatitis.
- Pain in joints and bones. As a result - muscle weakness, osteoporosis, bone necrosis, damage to cartilage in the joints, tendon rupture.
- Weakening of libido, impotence.
- Menstrual irregularities.
- Increased appetite, as a result - an increase in body weight.
- Enhanced perspiration.
- Slow healing of common wounds and abrasions.
- The injection site may hurt for a long time or, conversely, become insensitive. The formation of rough scars at the site of the injection hole.
- Heavy bleeding from the nose.
According to the reviews of patients and doctors, most often such negative symptoms occur against the background of improper use of “Dexamethasone”. Be that as it may, the patient must carefully listen to their health and at the first signs of side effects, immediately inform the attending physician about them. If the dose is not adjusted or the use of the drug is not stopped, then the situation may worsen, even fatal.
Other recommendations for use
According to the annotation to the drug, the course of treatment should be completed gradually so as not to cause withdrawal syndrome. In rare cases, rejection of “Dexamethasone” may be accompanied by fever, headaches and muscle pain, irritability.
Long-term use of the drug should be carried out under the close supervision of the attending physician, controlling the level of hormones and sugar in the blood.
Interaction with other pharmacological agents
It is very important to pay attention to the drugs that the patient takes with Dexamethasone, since combining this drug with others can reduce the effectiveness of the treatment or even lead to unpredictable consequences.
For example, the joint use of a drug of interest to us with substances such as phenytoin, ephedrine, theophylline, phenobarbital lowers the concentration of “Dexamethasone”, and therefore reduces its effectiveness. On the other hand, the use of adrenocorticotropic hormone enhances the effect of the drug of interest to us in the human body.
Here is a list of other effects of using synthetic hormone with other drugs:
- Diuretics enhance the potassium excretion process, thereby contributing to the development of heart failure.
- Sodium-based products can trigger the development of edema and increased pressure.
- Cardiac glycosides. Their combined use with “Dexamethasone” increases the risk of ventricular extrasystole.
- Ethanol, alcohol. The risk of developing ulcerative neoplasms in the digestive tract and bleeding increases.
- Insulin and other hypoglycemic agents. Due to the joint administration with “Dexamethasone”, the effectiveness decreases.
- Vitamin D. Its effect on the body is reduced.
- Vitamin C. “Dexamethasone” accelerates the elimination of acetylsalicylic acid.
- Paracetamol-based products. The result of a joint intake of two drugs can be an intoxication of the body.
- Anticoagulants and thrombolytics. The risk of ulcers and bleeding may increase.
- Indomethacin-based drugs increase the number and severity of side effects from the use of “Dexamethasone”. This may also apply to drugs whose active ingredients are ketoconazole and cyclosporine.
- Antipsychotics, as well as azathioprine, increase the risk of cataracts.
More information about the interaction of this drug with other medications can be found at a specialist appointment.
What about the cost?
Many are interested in the price of “Dexamethasone”. Depending on the manufacturer and the pharmacy chain, injections cost from two hundred to three hundred rubles per package. As many patients note, this is inexpensive, since in one package of the drug there are 25 ampoules (four milligrams each).
Substitutes
In the event that “Dexamethasone” causes serious side effects, the drug can be replaced by another. Most often prescribed such analogues of the drug as “Dexaven”, “Dexon”, “Dexafar”, “Dexamed” and others.
Opinions of real patients
What do people using this drug in their treatment say? Many claim that they have encountered negative consequences after therapy, such as weight gain, skin rash, shortness of breath, and some others. However, some managed to win the fight against excess weight very simply - he left a few weeks after the end of treatment.
However, not everyone felt the negative effects of Dexamethasone. Most often, people who strictly follow the doctor’s recommendations tolerated the therapy well and were satisfied with the effectiveness of the medicine. True, many recognize that the product leaves behind painful sensations in the area of the solution.
Also, many people like that the drug is able to have a quick effect on the ailment. However, its aggressiveness alarms many patients. Therefore, before proceeding with the treatment with “Dexamethasone”, it is necessary to consult, if possible, with several specialists.
Finally
As you can see, “Dexamethasone” is a widely used potent drug based on synthetic hormonal substances. Only the attending physician is entitled to prescribe and cancel this medicine. He also calculates the optimal dose and schedule for taking injections.
As you can see, the spectrum of injections is wide enough, and the effect is fast and long-term. Nevertheless, “Dexamethasone” has a number of side effects and contraindications, which must be taken into account when using it.