According to the instructions, Diprospan is a glucocorticosteroid intended for injective administration. The composition includes betamethasone in two forms: quick acting and prolonged. The medication is widely used in the treatment of diseases of muscle, bone, soft tissues, and is used in dermatology and against allergic reactions. It is a basic drug for systemic treatment with glucocorticosteroids. It has a pronounced anti-inflammatory effect with a small mineralocorticoid, it can slightly reduce the activity of the immune system, activate and normalize metabolic processes in the human body.
general information
In the instructions for Diprospan injections, the manufacturer draws attention to the presence of betamethasone in two forms. In the form of sodium phosphate, this compound is highly soluble. In a short time after injection, a hydrolysis reaction is initiated in the muscle . Suction - almost instant; the onset of action on the body - as soon as possible after administration. The removal of the active substance from the body requires no more than 24 hours.
The prolonged form of betamethasone as part of Diprospan is dipropionate. The period of elimination of this compound from the body reaches one and a half weeks. This ensures a lasting pronounced effect, which is referred to by the manufacturer in the instructions for the medicine "Diprospan".
Betamethasone can be administered in different areas:
- hearth;
- into the joint bag;
- near the joint;
- into the muscle.
This allows you to use "Diprospan" with the defeat of various areas of the body, with an allergic response, the inflammatory process. True, in the instructions for Diprospan injections, the manufacturer focuses on the impossibility of introducing the drug into a vein, under the skin.
Doses, the frequency of use of the drug, the method of administration is chosen by the doctor, focusing on the patient's condition. Much depends on the medical history, severity of the pathology, individual response to treatment. Usually, therapy is started with 1-2 ml, administration is repeated when the patient's condition requires it.
Application features
According to reviews, the instructions for the use of Diprospan give an accurate idea of how to use the product correctly, and yet many prefer to seek help from professionals - doctors, nurses. This allows you to be sure that the drug is administered correctly.
Intramuscularly, “Diprospan” is injected into the major muscle, making the injection as deep as possible, but carefully avoiding the introduction of components into adjacent muscle tissues, as this can provoke atrophic processes. If Diprospan is used as an element of emergency medical care, the dosage is 2 ml. With skin pathologies, half as much is enough. If diseases of the respiratory system, allergic, asthmatic, rhinitis are established, the effectiveness of the active compound can be felt in the first hours after the introduction of the composition. Dosage - from 1 ml to twice as much.
According to the instructions, reviews, Diprospan injections are effective for inflammation in the joint bag, and an equally pronounced result is observed in the acute process, the chronicle. Start treatment with 1-2 ml of the active substance. Repeated administration is possible if the condition of the patient requires it. In the absence of a pronounced effect in the time frame determined by the doctor, “Diprospan” is canceled and an alternative treatment method is chosen.
Diagnoses and rules
Local application of "Diprospan" is allowed, the use of analgesics is usually not required. If bursitis is established in acute form, 1 ml (or twice as much) of the drug is injected into the diseased cavity. This allows you to stop the pain syndrome, return mobility to the body for several hours. After eliminating the most unpleasant sensations, the dosage of the drug should be reduced.
Instruction "Diprospana" recommends to administer the composition once in acute inflammation in the tendons. Repeated administration is required when the disease is chronic. The need for repetition is determined by analyzing the patient's condition. Empirically identify which dosage gives a pronounced effect, alleviates the condition. After that, the selection of the maintenance amount is started.
In the instructions to Diprospan, the manufacturer draws attention to the need for gradual discontinuation of the drug if the patient has undergone a long therapeutic course. After discontinuing the drug, the patient needs medical monitoring for a while. The period is not less than a year, in some cases longer. Similar rules apply to long-term treatment with any glucocorticosteroid.
Pharmacology and Kinetics
In the instructions for Diprospan ampoules, the manufacturer indicates that the product has a pronounced glucocorticoid effect, accompanied by a weak mineralocorticoid. The drug stops inflammation, the allergic response of the body, inhibits the immune system, stimulates metabolism. The ability of an active compound to bind to plasma blood proteins is estimated at 62.5%. Transformation processes predominantly occur in the liver, leading to the formation of inactive compounds. A remedy with urine is excreted.
What's on sale?
On the pharmacy shelves are cardboard boxes with the medicine "Diprospan", instructions for use. The ampoules contain a suspension - a transparent compound that does not have color. Perhaps staining in a light yellowish tint. Consistency - viscous. Particles are white or close to white. There should not be any impurities. Stirring allows you to get a stable white suspension. For 1 ml:
- sodium phosphate - 2.63 mg;
- dipropionate - 6.43 mg.
The manufacturer in the instructions to "Diprospan" lists all the additional compounds used in the manufacturing process of the product:
- sodium chloride;
- sodium hydrogen phosphate dihydrate;
- polysorbate;
- alcohol;
- carmellose;
- macrogol;
- water.
Since the crystals of the active compound are small enough, a 26 gauge syringe can be used to administer the drug. This is especially convenient when delivered inside the skin, to the focus of inflammation. When injecting the composition, sterility must be observed.
Features of use
According to the instructions, "Diprospan", used locally, does not require the use of additional analgesics. In rare cases, the need to use such formulations does occur. It is recommended to choose solutions of lidocaine, procaine in a concentration of 1-2%. Avoid drugs that include:
- phenol;
- propyl, methyl paraben.
Instructions for use "Diprospana" recommends mixing the drug and analgesic in a syringe. The sequence is as follows: first they collect the medicine, after that - the pain medication, slightly shake the medical instrument.
One injection is enough if an acute form of the disease is established:
- tendonitis;
- tenosynovitis;
- peritendinitis.
If the disease is established in a chronic form, a repeat of the administration is carried out if the condition of the patient requires it. Instructions for use "Diprospana" warns of the impossibility of introducing the composition into the tendon.
When using “Diprospan” for the treatment of large joints, the dosage is 1-2 ml, for medium-sized joints - half, and 0.25-0.5 ml is enough for small ones.
Dermatology, bursitis and features of the drug
Instructions for use "Diprospana" allows the use of medication for problems with the skin. The optimal form of administration is inside the skin, into the focus of the disease. Dosage - 0.2 ml per square centimeter of the affected surface. With a sufficiently large lesion, it is necessary to make several injections to evenly treat the entire territory. It is recommended to use a tuberculin syringe. The optimal needle diameter is 0.9 mm. It is unacceptable to use "Diprospan" in an amount of more than 1 ml per week for all affected areas. If it is necessary to introduce Diprospan into the focus of the disease, a size 26 tuberculin syringe should be used.
With bursitis, "Diprospan" is used once a week. Recommended single doses depend on the diagnosis:
- synovial cyst - 0.25-0.5 ml;
- spur - 0.5 ml;
- acute arthritis against the background of gout - 0.5-1 ml;
- tenosynovitis - 0.5 ml;
- callosity - 0.25-0.5 ml;
- limited ability to perform movements with a sick toe - 0.5 ml.
Callosities typically require a course of two injections. The manufacturer recommends the use of a tuberculin syringe for Diprospan (instructions for use mention this fact). The optimal size is 25-26. In some cases, an increase in dose relative to the minimum detected for the patient is required. This can provoke stressful situations (as well as the threat of their occurrence).
Overdose
The manufacturer draws attention to the instructions for use: “Diprospan”, when ingested in excessive quantities, does not pose a threat to life, but prolonged use of glucocorticosteroids in high dosage can cause unpleasant consequences, worsening of the patient's condition. The most difficult situations are associated with the use of "Diprospan" in a very high dose. In addition, the use of the drug is associated with certain risks in the following conditions:
- glaucoma;
- metabolic disorder (diabetes);
- ulcer, gastrointestinal erosion.
With the dangers associated with the simultaneous use of GCS and drugs that reduce blood coagulability by an indirect method, diuretics, leaching potassium from the body, digitalis.
If an overdose is established, it is required to monitor the patient's condition, drink sufficient volumes of fluid. In some cases, symptomatic therapy is needed. In the instructions for the use of "Diprospan", the manufacturer recommends regularly conducting a study of the patient's condition for the ratio of potassium, sodium ions in urine, as well as electrolytes in the circulatory system and urine.
Mutual influence
A decrease in the effectiveness of the drug and an increase in the rate of transformation of the active components of Diprospan is possible with the simultaneous use of this agent and drugs containing:
- rifampin;
- phenytoin;
- ephedrine;
- phenobarbital.
The combination with drugs of indirect action, correcting the level of blood coagulability, requires a change in the dosage of Diprospan. The simultaneous use with substances that remove potassium can cause a deficiency of this mineral in the tissues of the body. As tests have shown (this is mentioned in the instructions for use), "Diprospan" can cause a more active leaching of potassium when combined with amphotericin.
The combination of corticosteroids, estrogen can be the reason for the activation of one of the components of therapy. It is necessary to check with the doctor whether a dose adjustment is required, since the risk of an overdose increases. An increased likelihood of arrhythmias is observed against the background of a combination of corticosteroids and glycosides for the heart. This combination can cause digital intoxication if there is a lack of potassium in the body.
In the instructions for the use of Diprospan injections, the manufacturer draws attention to the possibility of combining with non-steroidal drugs for the relief of inflammatory processes and agents containing ethanol. With simultaneous use, careful monitoring by the doctor is necessary and, possibly, dose adjustment, since there is a risk of the appearance or exacerbation of ulcerative processes, erosion in the gastrointestinal tract.
The combination of salicylates and Diprospan can lead to a decrease in the concentration of the first group in blood plasma. The simultaneous use of growth hormone and "Diprospana" can provoke delayed absorption of the hormonal compound. If it is necessary to use growth hormone, it is recommended to adhere to a dosage in the range of 0.3-0.45 mg / m 2 per day. Under the influence of corticosteroids, it is possible to obtain false negative results of a tetrazole blue test for the presence of bacterial infection.
Side effects
According to reviews and instructions for use, Diprospana injections show a pronounced positive result even in severe conditions, but can cause a negative response from the body. In particular, it is possible to increase pressure, heart failure, if the patient's health is in such a state. Tests can show excess sodium, potassium deficiency, increased leaching of calcium. Against the background of Diprospan injections, the following are possible:
- alkalosis;
- delayed elimination of fluid from body tissues;
- negative nitrogen balance;
- lipomatosis;
- weight gain.
Studies and tests have shown that Diprospana injections (the instructions for use contain mention of these facts) can provoke muscle weakness, myopathy, increased myasthenia gravis, osteoporosis, non-critical processes, compression and pathological fractures, and impaired tendon integrity. When introduced into the joint, a decrease in the stability of this area is possible.
Diprospan may cause:
- sores;
- erosion;
- increased gas formation;
- hiccups;
- pancreatitis
- atrophy of the skin;
- increased sweating;
- dermatitis;
- acne
- candidiasis;
- convulsions
- personality disorders;
- sleep disturbances;
- menstrual irregularities;
- diabetes mellitus and its manifestation;
- impaired fetal development;
- growth retardation of the child;
- slowing adolescent puberty;
- Itsenko - Cushing's syndrome.
According to the instructions for use, Diprospan may cause an allergic reaction. Some patients complained that during the treatment they were sick and dizzy. Perhaps a change in the pigmentation of the treated skin areas.
The likelihood of the appearance of the listed adverse reactions depends on the dosage chosen, the duration of the course, and the combination with other medicines. The predominantly negative response of the body is reversible, it completely disappears after completion of the course or with a decrease in used volumes. As follows from the reviews, the instruction for Diprospan contains many references to possible negative reactions of the body, but most patients have encountered only the most harmless of them. In general, the composition is often well tolerated, and the slight discomfort from its administration is overlapped by the positive effect of use.
Indications for use
The manufacturer recommends using the drug in all conditions, diseases in which the use of GCS makes it possible to achieve a clinical effect. At the same time, attention is drawn to the fact that a number of diseases require GCS as an auxiliary element of a comprehensive therapeutic course; these injections cannot replace the main program.
List of indications from the instructions for the use of Diprospan injections:
- diseases of muscle, bone, soft tissues;
- allergies
- dermatological problems;
- systemic diseases that affect the connective tissue;
- hemoblastoses;
- adrenal cortex insufficiency.
Of the specific diagnoses, mention should be made of arthritis, bursitis, cysts, foot diseases, sciatica, osteoarthritis, lumbago, fasciitis, spondylitis, coccyalgodynia. As follows from the instructions for use, Diprospana injections help to alleviate the condition of asthmatics, patients with hay fever, bronchitis, rhinitis, as well as those suffering from allergies to insect bites, medications. "Diprospan" is indicated for serum sickness. The tool is used for:
- dermatitis;
- eczema
- urticaria;
- depriving;
- lipodystrophy;
- hair loss
- lupus erythematosus;
- scars;
- psoriasis
- pemphigus;
- acne
The manufacturer indicates the possibility of introducing Diprospan injections in case of periarthritis, scleroderma, dermatomyositis, various conditions, diseases, in which corticosteroids may show a pronounced therapeutic effect. This includes colitis, ileitis, violation of the integrity of the ocular mucosa, pathological changes in blood quality, kidney disease.
Contraindications
The instructions for Diprospana injections explicitly indicate a ban on the use of the drug during the period of gestation and breastfeeding. The product is not intended for infants. Do not use injections for administration under the skin and into a vein. In addition, contraindications in the instructions to "Diprospan" include:
- systemic fungal lesions;
- joint instability;
- arthritis provoked by an infectious agent.
You can not use the medication if hypersensitivity to any of its components or to other drugs from the GCS category has been established.
The contraindications mentioned in the instructions for use of Diprospan include infectious lesions of the area where the drug is planned to be administered: if an infection is detected, it will be necessary to refuse injections. It is unacceptable to use the drug in the intervertebral space. The manufacturer draws attention to the presence of benzyl alcohol in the composition of Diprospana injections. In the instructions for use, a contraindication based on this component is under the age of three years.
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Some recommendations
In case of insufficiency of the liver, kidneys in chronic form, cirrhosis "Diprospan" is allowed for use, but with caution.
The drug can be used in the treatment of children, but when taking a course, especially a long one, it is important to regularly conduct tests to establish a negative effect on the growth of the body. In addition, against the background of injections, insufficiency of the adrenal cortex is possible.
The manufacturer recommends using injections as short as possible, with the lowest possible dosage. The choice of the initial dose is the responsibility of the doctor. The doctor selects volumes until a pronounced therapeutic effect can be achieved. If after the time intervals established by the doctor there are no results, the drug is gradually canceled, reducing the dosage, after which an alternative treatment option is chosen.
If it was possible to achieve a positive effect, gradually reduce the dosage by administering the drug with a frequency selected by the doctor. Thus, they select which minimum amount is sufficient to maintain the effect. With an increased likelihood of stress, the occurrence of such a situation should increase the amount of composition used.
With the introduction of "Diprospan" in the focus, soft tissues, joint, not only local effects, but also a systemic effect are possible . Since the drug can cause an anaphylactoid response in the body, precautions should be taken before the administration procedure begins. This is especially important if the patient has already had allergic reactions to medications.
Note!
On sale, the drug is presented only as a suspension for injective administration, supplemented by instructions. Diprospan ointments and tablets under this name are not available. The suspension contains betamethasone in two varieties. Sodium phosphate is a compound that dissolves very quickly, which can easily penetrate the circulatory system and affect the entire body. This aspect must be considered before starting a course of treatment.
There are cases when, against the background of the use of the drug, mental deviations were observed. Those who are emotionally unstable, as well as those for whom the risk of psychosis is at greater risk, are more prone to these.
The use of Diprospan by patients with diabetes mellitus may require adjusting the dosage of drugs that change blood sugar levels. If the amount of "Diprospan" is selected that depresses the immune system, the patient will have to prevent any contact with people infected with measles, smallpox, during the course of the course. This is especially important if Diprospan is assigned to a child.
Is there an analogue?
The closest to the drug in question on the pharmacy shelves is “Flosteron”. Also available as an injectable substance.
In some cases, you can replace "Diprospan" ointment. The instructions for use before replacement will have to be carefully studied - it should include references to the effectiveness of the alternative. Replacement with ointments is possible if treatment for a skin disease is required. The options are quite widespread:
- Beladerm;
- "Mesoderm";
- "Celestoderm."
The listed medications, as well as some other means for external use, are based on corticosteroids, therefore they show a pronounced effect in dermatitis, allergies, and itching. Before choosing an alternative to the option recommended by the doctor, you should consult your doctor to make sure that the analogue really helps in this situation.
As analogues of the drug, funds for external use can be made:
One possible substitute is Celeston. On sale it is presented by means for injection, tablets for oral administration. The main component coincides with other similar means - it is betamethasone.