"Dexamethasone" is a drug from the group of glucocorticosteroid hormones. The drug has anti-inflammatory, as well as anti-allergic and decongestant effects on the body.
Dexamethasone is produced in several forms:
- injection;
- eye drops;
- tablets;
- eye ointment.
The solution for injection is a clear liquid without aroma and impurities. According to the instructions, the composition of "Dexamethasone" in ampoules:
- glycerol;
- sodium hydrogen phosphate dihydrate;
- disodium edetate dihydrate;
- dexamethasone sodium phosphate;
- water.
The tablets are intended for oral use. Available in blister packs or in dark glass bottles.
According to the instructions, the substance "Dexamethasone" contains the same substance.
Additional components are:
- lactose monohydrate;
- colloidal anhydrous silica;
- starch;
- talc;
- polyvinylpyrrolidone;
- a salt of magnesium and stearic acid.
Drops are available in five milliliter plastic dropper bottles. Eye drops "Dexamethasone" composition have the following:
- water;
- disodium edetate;
- dexamethasone sodium phosphate;
- borax;
- boric acid.
Dexamethasone nasal drops contain the same substance.
Pharmacological actions
The drug has anti-inflammatory, antihistamine and desensitizing effects. In addition, Dexamethasone has an immunosuppressive effect. In a small amount, it retains sodium and water in the body.
The drug inhibits the activity of cholecalciferol, which leads to a decrease in calcium absorption and an increase in its excretion. Dexamethasone inhibits the synthesis of endogenous glucocorticoids. A characteristic feature of the effect of the drug is a strong slowdown of the pituitary gland and the absence of mineralocorticoid activity.
When the drug is prescribed
"Dexamethasone" is recommended for use in the presence of the following conditions:
- Adrenal insufficiency.
- Thyroiditis (an inflammatory disease that occurs in the endocrine system).
- Congenital hyperplasia of the adrenal cortex (an increase in the volume of the adrenal glands due to a defect in steroidogenesis enzymes in the cortical zone, which leads to compensatory organ growth to eliminate hormonal deficiency).
- Different types of shock.
- Lupus erythematosus (a chronic disease of autoimmune origin, which is accompanied by a violation of connective tissue and capillaries).
- Rheumatoid arthritis (inflammation, which is characterized by symmetrical damage to the joints and internal organs).
- Asthmatic status (a complication of bronchial asthma, which develops, as a rule, subsequently a prolonged non-stopping attack).
- Bronchospasm (a pathology that develops with contraction of the smooth muscles of the bronchi and their lumen).
- Anaphylactic shock (allergic manifestations that occur after repeated penetration of the allergen into the body).
- Severe Quincke's edema (a disease of allergic origin, which manifests itself through the appearance of pronounced edema of the skin, as well as subcutaneous tissue and mucous epithelium).
- Cerebral edema.
- Thrombocytopenic purpura in adult patients (a pathological condition characterized by a quantitative lack of platelets in the blood, accompanied by a tendency to bleeding, as well as the occurrence of hemorrhagic syndrome).
- Severe diseases of the organs of the optic canal.
- Common infectious diseases.
- Conjunctivitis (damage to the mucous membrane of the organs of vision, which is provoked by allergic manifestations or infection).
- Keratitis (an inflammatory lesion of the cornea of the eye, which is characterized, as a rule, by its clouding, ulceration, pain and redness of the eye).
- Blepharitis (bilateral lesion of the ciliary edge of the eyelids).
- Iridocyclitis (damage to the iris and ciliary body of the eyeball).
- Keratoconjunctivitis (a disease of inflammatory origin that affects the cornea and conjunctiva of the eye).
What other indications does the drug have
The drug is prescribed in the following conditions:
- Scleritis (an inflammatory disease that affects the entire thickness of the connective tissue membrane of the eyeball).
- Iritis (a disease of the organs of vision in which the iris of the eye is affected).
- Uveitis (inflammatory lesion of the choroid of the visual organ).
- Injury to the cornea.
- Allergic rhinitis (an allergic disease of the nasal mucosa).
- Exacerbations of chronic ulcerative colitis (inflammation on the mucous membrane of the colon, which is accompanied by the appearance of non-healing ulcers, as well as areas of necrosis and bleeding).
- Crohn's disease (severe inflammation of the intestine).
- Severe forms of hepatitis as part of complex therapy (diffuse damage to the liver tissue as a result of a toxic, as well as an infectious or autoimmune process).
- The period after transplantation of internal organs.
- Hemolytic anemia (a disease whose common symptom is increased destruction of red blood cells, characterized by anemia and increased formation of red blood cell breakdown products).
- Aplastic anemia (a disease of the hematopoietic system, which is characterized by a suppression of the hematopoietic function of the bone marrow and develops a small formation of red blood cells, as well as white blood cells and platelets).
- Thrombocytopenia (a pathology that is characterized by a decrease in platelets circulating in the blood).
- Glomerulonephritis (an inflammatory lesion of the glomeruli of the kidneys of an autoimmune or infectious-allergic genesis, which is characterized by edema, increased blood pressure, decreased urine output).
- Interstitial nephritis (a disease that is characterized by acute or chronic inflammatory lesions in the interstitial tissue and tubules of the kidneys).
- Idiopathic nephrotic syndrome (a disease characterized by protein in the urine, as well as edema, hyperlipidemia).
- Rheumatoid arthritis (an inflammatory lesion that is characterized by symmetrical joint damage and inflammation of the internal organs).
- Vasculitis (a disorder that is associated with the destruction of blood vessels during inflammation).
- Systemic sclerosis (a disease with characteristic changes in the skin, as well as the musculoskeletal system, internal organs and common disorders, which are based on damage to the connective tissue).
- Scleroderma (damage to the connective tissue, the main manifestations of which are associated with impaired microcirculation, as well as compaction of organs and tissues).
- Dermatitis (inflammatory lesions of the skin, which develops subsequently damaging effects of environmental factors on it).
- Exacerbations of neurodermatitis (a skin disease of a neurogenic and allergic type, which occurs with remissions and exacerbations).
- Wet eczema (dermatosis, which is manifested by characteristic signs, such as the formation of rashes on the epidermis).
- Severe forms of psoriasis (a chronic disease that affects the skin).
Restrictions on the use of the drug
The drug can be used for therapy only as directed by a doctor. Before treatment, it is necessary to carefully study the annotation, since Dexamethasone has certain prohibitions. For instance:
- An ulcer of the stomach or duodenum (a defect in the skin or mucous membrane resulting from malnutrition of tissues).
- Intensive growth time in children.
- Nonspecific ulcerative colitis (a chronic inflammatory bowel disease characterized by superficial inflammation of the mucous membrane, rectal bleeding, diarrhea and abdominal pain).
- Herpes simplex (a viral disease with a characteristic rash of grouped vesicles on the skin and mucous membranes).
- Diseases of an infectious, viral, fungal, parasitic origin.
- Human immunodeficiency syndrome (a weakened state of the human immune system, which ultimately leads to more frequent infectious diseases).
- Recently suffered myocardial infarction (a focus of ischemic necrosis of the heart muscle that develops as a result of an acute violation of coronary circulation).
- Acute heart attack (one of the clinical forms of coronary heart disease occurring with the development of ischemic necrosis of the myocardial site, due to the absolute or relative insufficiency of its blood supply).
- Severe course of arterial hypertension (persistent increase in blood pressure and above).
- Chronic heart failure.
- Diabetes mellitus (metabolic disorder, characterized by an increase in blood sugar).
- Itsenko-Cushing's disease (a severe multisystem disease resulting from hypersecretion of hormones of the adrenal cortex, signs of which are obesity, stretch marks on the skin, muscle weakness).
- Obesity.
- Severe kidney and liver disease.
Additional Prohibitions
The drug is contraindicated in the presence of the following conditions:
- Pregnancy in the first trimester.
- Glaucoma (the term combines a large group of eye diseases characterized by a constant or periodic increase in intraocular pressure, followed by the development of typical visual field defects, decreased vision, and atrophy of the optic nerve).
- Individual intolerance to the medicine.
- Keratitis (inflammation of the cornea of the eye, manifested mainly by its clouding, ulceration, pain and redness of the eye).
- Diseases of the conjunctiva or cornea that are provoked by viruses or fungi.
- Acute purulent inflammatory diseases of the organs of vision.
- Diseases of viral or fungal etiology.
- Parasitic diseases.
- Negative reactions after vaccination.
- Lymphadenitis (inflammation of the lymph nodes resulting from the ingress of various microorganisms and their toxins).
- Exacerbation of chronic diseases of the digestive system.
- Ulcerative colitis (a chronic inflammatory disease of the mucous membrane of the colon, resulting from the interaction between genetic factors and environmental factors).
- Coronary heart disease.
- Persistent increase in blood pressure.
- Itsenko-Cushing's disease (a severe multisystem disease resulting from hypersecretion of hormones of the adrenal cortex, signs of which are obesity, stretch marks on the skin, muscle weakness).
- Thyrotoxicosis (a pathological condition in which an excess of thyroid hormones is formed in the body).
- Hyperthyroidism (a complex of symptoms that are caused by increased secretion and an inadequately high degree of secretion of thyroid hormones in the blood).
How to apply the solution correctly
Use for anesthesia composition - "Dexamethasone 4 mg", "Lidocaine", vitamin B12. As a rule, a combined medication is used in rare situations.
The dosage regimen of Dexamethasone alone is individual for each patient and depends on the indications as well as the patient's condition. The medication is administered intravenously slowly in a stream or drip, as well as intramuscularly.
As you know, dexamethasone injections contain the component of the same name. For the manufacture of a solution for intravenous infusion, sodium chloride or dextrose must be used.
"Dexamethasone" is administered intravenously and intramuscularly in a dosage of 0.5-24 milligrams per day in 2 doses with a short course in a minimum concentration, the therapy is stopped gradually.
Long-term therapy should be carried out in a dose not exceeding 0.5 mg per day. Intramuscularly injections in the same place apply no more than 2 milliliters of solution.
In emergency conditions, use a solution in higher concentrations. The initial dosage varies from 4 to 20 milligrams, which is repeated until a positive effect is achieved, the total daily content rarely exceeds 80 milligrams.
After the pharmacological action is achieved, "Dexamethasone" is administered in 2-4 mg with a gradual withdrawal of the drug. To maintain a lasting effect, the medication is administered every 3-4 hours or in the form of a long drip infusion. After elimination of acute diseases, the patient is transferred to the tablet form.
In case of shock conditions, the drug is administered strictly intravenously in a dosage that varies from 2 to 6 milligrams per kilogram of weight. If necessary, repeated concentrations are administered every six hours either as a long intravenous infusion at a concentration of 3 mg per kg per day.
Therapy with the drug should be carried out as part of a comprehensive treatment of shock. The use of pharmacological dosages is permissible only in case of serious problems.
With cerebral edema, an initial concentration of 10 milligrams of the drug is administered intravenously, then 4 mg every six hours until the symptoms disappear. After two to four days, the dosage is reduced and the use of the medication is gradually canceled within five to seven days.
Patients with malignant diseases may require maintenance therapy - 2 milligrams intramuscularly or intravenously three times a day.
In acute cerebral edema, short-term treatment is performed for adult patients with a dose of 50 mg intravenously, then on the third day they use 8 milligrams every 2 hours.
In acute allergic manifestations, parenteral and oral use of "Dexamethasone" is combined:
- the first day - from 4 to 8 mg;
- twice a day - orally 1 milligram 2 times a day;
- on the fourth and fifth days - inside 0.5 mg twice a day.
Why are dexamethasone injections prescribed for children? According to reviews and instructions, the drug is used for acute cerebral edema in small patients weighing more than thirty-five kilograms, the loading concentration is 25 milligrams intravenously, then on the third day 4 mg is administered every two hours, on the fourth day - 4 milligrams every 4 hours, 5-8 day - 4 mg every six hours. In the future, the daily dosage is reduced by 2 milligrams per day until completely canceled.
For children weighing less than thirty-five kilograms, the loading concentration is 20 mg intravenously, then on the third day they use 4 milligrams every three hours, on the fourth day - 4 mg every 6 hours, on the eighth day - 2 milligrams every six hours, then daily the concentration is reduced by one milligram per day until the drug is completely discontinued.
Tablets
The dosage of the drug "Dexamethasone" in tablet form is determined by a medical specialist individually for each patient.
The initial concentration of the drug for adolescents from fourteen years old is from 500 micrograms per day, that is, one tablet. Gradually, if necessary, the dosage is increased to two to three tablets. "Dexamethasone" is used during meals, without chewing, washed down with water. The daily concentration of the drug is divided into several doses.
For small patients, the daily dosage of the medication is calculated by the doctor based on weight, general condition, as well as individual tolerance.
When the proper pharmacological effect is achieved, the daily concentration of the drug is gradually reduced, since with a sharp cessation of therapy, the patient has cancellation syndrome and suppression of adrenal cortex function.
If more prolonged treatment with tablets is necessary, patients are prescribed antacids in the intervals between drug use to prevent digestive mucosal irritation.
The composition of the ointment "Dexamethasone" includes the same active substance. It is used for the same indications as drops in people from six years old. Apply the drug three times a day. The maximum duration of therapy is no longer than twenty days.
Drops
"Dexamethasone" is prescribed to adults one or two drops in the conjunctiva according to indications. The duration of treatment and daily dosing is determined by the doctor, depending on the diagnosis. According to the instructions for the drug "Dexamethasone", the same substance is also included in the drops.
It must be understood that therapy with hormonal agents based on the studied substance is not recommended to continue for more than two weeks, since this can be addictive side reactions.
In the absence of a positive effect from the use of the drug for two to three days, the patient is recommended to contact a medical specialist again to clarify the diagnosis and adjust the therapy.
Composition of complex nasal drops with dexamethasone
The structure of the drug includes several groups of medicines, as well as hormonal and antimicrobial, vasoconstrictive and anti-allergic drugs. Dosage is adjusted by an otorhinolaryngologist.
The basic substances may be:
- "Dexamethasone".
- "Dioxidine".
- Fenistil.
- "Naphthyzine".
- Xylen.
- Ceftriaxone.
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The use of tablets in the second and third trimesters is possible only for strict medical reasons under the supervision of a doctor. During therapy with Dexamethasone, especially at elevated concentrations, sometimes suppression of the adrenal cortex in an infant and a slowdown in fetal growth were observed.
Eye drops are not prescribed for the treatment of visual injuries in women in an “interesting position” in the first three months, because although in small quantities, dexamethasone is still absorbed into the bloodstream. Since in the first twelve weeks of pregnancy all organs and systems of the fetus are formed, the use of any means is undesirable.
The use of eye drops in the second and third trimester of an "interesting position" is likely only after evaluating the benefits for the expectant mother and the likely risk to the fetus. Treatment is carried out for medical reasons and under the supervision of a doctor.
Adverse reactions
During therapy with "Dexamethasone" certain negative effects may be observed:
- The development of steroid diabetes mellitus (endocrine disease, which occurs subsequently with a high concentration of sugar in the blood of the hormones of the adrenal cortex and impaired carbohydrate metabolism).
- Impaired adrenal glands.
- Decreased glucose tolerance.
- The development of Itsenko-Cushing's syndrome (a disease in which there is a high content of glucocorticoid hormones in the blood of the adrenal cortex).
- Delayed puberty in adolescents.
- Increased blood pressure.
- The development of pancreatitis (inflammation in the pancreas in which there is a deficiency in the production of pancreatic enzymes of various etiologies).
- Nausea.
- Desires for vomiting.
- Pain in the abdomen.
- Dyspeptic symptoms (disturbance of the normal activity of the stomach, difficult and painful digestion).
- Increased appetite.
- Changes in liver transaminases.
- Bradycardia (a decrease in heart rate of less than sixty beats per minute in adults at rest).
- Heart rhythm disturbances.
- Coagulation dysfunction.
- Changing the electrocardiogram.
- Overexcitation.
- Emotional lability.
- Impaired orientation in space.
- Depressive disorders or hallucinations.
- Insomnia.
- Dizziness.
- Cramps.
- Increased intraocular pressure.
- Cataract (a pathological condition associated with clouding of the lens of the eye and causing various degrees of visual impairment until its complete loss).
- Atrophy of the cornea of the eye and optic nerve.
- The development of eyebrows.
- Visual impairment.
- Foreign body sensation in the eye.
- Increased sweating.
- Weight gain.
- Allergic manifestations on the skin.
- Bad healing wounds.
- The development of bruising under the skin.
- Strengthening or reduction of pigmentation.
- Hypotrophy of subcutaneous fat (a clinical syndrome that occurs in children with severe diseases or due to nutritional deficiency).
- Thrombophlebitis (inflammation of the inner membrane of the walls of the veins, with the deposition of thrombotic masses on them, which can completely clog the vessel or located parietally).
- Burning.
- Numbness of the skin.
- The death of surrounding tissue at the injection site.
- Sensation of heat in the face.
- Withdrawal syndrome.
- Itching in the organs of vision.
- Blurred vision.
- Loss of sleep.
- Vertigo (a symptom known as dizziness, it is characteristic of ear pathology or, less commonly, brain damage).
- Anxiety.
- Osteoporosis (a progressive disease of the skeleton with a decrease in bone density and an increased risk of fractures).
- Muscle weakness.
Storage conditions
The drug in the form of a solution for injections is available on prescription. Keep "Dexamethasone" is recommended away from children, at a temperature of no more than twenty-five degrees. It is not allowed to freeze the solution. Shelf life is 36 months.
Dexamethasone tablets should be kept in a dark place, away from children. Shelf life is 60 months.
Eye drops can be stored for two years at a temperature of no more than ten degrees. The opened bottle must be tightly closed and kept in the refrigerator for no longer than one month, and then disposed of.
Analogs
Which drugs include dexamethasone:
- Dex-Allvoran.
- Dexabene
- Dexaven.
- Dex-Gentamicin.
- Dexacort.
- Dexapos.
- Dexafar.
- "Detason".
- Endometasone.
- Maxidex
- Maxitrol.
- Oftan.
- "Polydex".
- Sondex.
- Toradex.
- "Tobrazon".
- Fortecortin.
The cost of the drug "Dexamethasone" varies from 45 to 300 rubles (depending on the form of release). Next, the compositions of the most used drugs will be considered.
"Endometasone" contains - dexamethasone, hydrocortisone acetate, eugenol, paraformaldehyde, iodinated thymol and barium sulfate, anise and peppermint oils.
"Tobradex" - tobramycin and the studied substance, benzalkonium chloride, sodium chloride, sodium hydroxide, water.
"Polydex" - neomycin sulfate, sodium dexamethasone, phenylephrine hydrochloride, polymyxin B sulfate.
"Dex-Gentamicin" - gentamicin sulfate and the studied substance, lanolin, liquid paraffin and petroleum jelly.
The composition of Oftan Dexamethasone includes cytochrome C, adenosine and nicotinamide, sorbitol, water, sodium dihydrogen phosphate dihydrate, benzalkonium chloride. And also the substance of the same name is in the structure of the medication.
Conclusion
The feedback on Dexamethasone injections and tablets helps to conclude that the medication is effective and also has a wide range of indications. It can be used only as directed by a specialist.
Despite its effectiveness, the drug causes certain side effects, and this is considered its minus.
Reviews of doctors about eye drops indicate that the danger of hormonal medications in most cases is exaggerated.
The main thing that is important to consider when using them is the presence or absence of contraindications. In addition, dosage selection should be based on weight, as well as age, test results.