What is dexamethasone prescribed for, instructions for use, composition, release forms, analogues Pharmacological properties and pharmacokinetics

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The pharmacological group of glucocorticosteroids includes Dexamethasone injections. The hormonal drug is in demand in various fields of medicine. It is administered intravenously or intramuscularly if medically available. The transparent liquid contains no impurities. The doctor may prescribe the patient treatment with Dexamethasone in ampoules of 1 or 2 ml.

General characteristics of the drug

Dexamethasone is considered a hormonal drug and modern medicine refers to synthetic glucocorticosteroids that effectively affect all organs due to effective interaction with all systems, especially the brain and nervous.
Its popularity is due to:

• wide scope of application;
• a wide variety of release forms and methods of application;
• compatibility with other drugs;
• an effectiveness that is many times greater than the result from the use of similar agents (for example, Cortisone is approximately 30 times less effective).

Release form and packaging

There are 4 options for the production form of Dexamethasone:

• in tablets of 0.5 mg (the entire contents of the tablet is the active component), in a pack of 10 tablets;
• in ampoules Dexamethasone with a volume of 1 or 2 ml - solution for injection (active component - 4 mg), in a package - 5, 10 or 25 ampoules;
• in bottles (drops in the eyes or ears) 10 ml (1 mg of active ingredient per 1 ml of solution);
• in tubes (eye ointment) 2.5 g.

Compound

In all forms, the active ingredient is dexamethasone sodium phosphate.

Wherein:

• glycerin;
• disodium ededat;
• disodium phosphate dihydrate;
• water for injections

an auxiliary (but far from secondary) role is assigned. After all, they are responsible for shaping and stabilizing the active substance, delivering it to the site of the disease and facilitating absorption by the body.

pharmachologic effect

Dexamethasone, acting on specific cytoplasmic receptors, promotes the creation of a complex that penetrates the cell nucleus and stimulates the unification of matrix ribonucleic acid (mRNA). It intensively creates various proteins. At the same time, the drug does not allow the release of inflammatory mediators located in:

• masticides;
• labrocids;
• esinophils.

The drug reduces the active activity developed by proteases, collagenases and hyaluronidases. Normalizes the functions of the extracellular matrix (ECM) in cartilage and bone tissues, and returns lymphoid tissues to their original state.

Dexamethasone reduces the penetration of substances harmful to them through the walls of capillaries and helps stabilize cell membranes, especially lysosomal ones. Cytokines (gamma interferons and interleukins) slow down the release of macrophages and lymphocytes. The drug restores the susceptibility of the adrenergic receptor to catecholamine. Helps accelerate the metabolic breakdown of proteins, reduce the excretion of glucose from peripheral tissues, and increase gluconeogenesis in the liver. Reduces the degree of absorption and increases the rate of sodium excretion, inhibits the release of adrenocorticotropic hormones (ACHT).

Absorption and excretion from the body

If Dexamethasone is administered intravenously, a 70-80% relationship with transcortin, which acts as a specific carrier protein, is achieved. If a dose exceeding the norm is administered, then, first of all, transcortin is saturated, and, as a result, contact with proteins is reduced by at least 10%.

Do I need to dilute the injections before use? No, there is no need to dilute, the drug is ready for use. It begins to act with maximum efficiency within 1-2 hours after administration. After contact with sulfuric and glucuronic acids, biological transformations of one type into another occur in the liver. It takes 3-5 hours for partial removal of Dexamethasone from the blood, and 36-54 hours for complete removal. When taking the drug in tablet form, the metabolic process is accelerated and its duration of action is shortened. Most of the drug is excreted from the body in the urine. Absorption into the skin when applying the ointment depends on the presence of an airtight (occlusive) dressing and the integrity of the skin.

Is dexamethasone an antibiotic or not?

Dexamethasone is not an antibiotic. But for severe infectious diseases, the drug Dexamethasone is prescribed in ampoules in combination with antibiotics.

Drug interactions

A hormonal drug in combination with Idoxuridine provokes the development of destructive processes in the tissues of the organs of vision.

The intensity of the effects of barbiturates on the body increases significantly under the influence of Dexamethasone.

The concentration of Phenytoin decreases.

Under the influence of a combination of Warfarin and Dexamethasone, the risk of bleeding increases.

Heart failure develops in cases where the hormonal drug in question and diuretics are used simultaneously.

Dexamethasone does not improve the tolerability of cardiac glycosides, and the risk of complications in the form of diseases of the gastrointestinal tract increases.

Oral contraceptives have a negative effect on the clearance of dexamethasone (the value of this indicator increases), which leads to the development of side effects.

Oral contraceptives have a negative effect on the clearance of dexamethasone.

The combination of the drug in question with non-steroidal anti-inflammatory drugs or ethanol causes the development of gastric and intestinal ulcers.

Indications for use

There are situations when you have to inject the drug not into a muscle, but directly into a sore joint. In this case, the dose is 0.4-4 mg, and a second injection is prescribed only after 3 months.

Dexamethasone by injection is administered exclusively to those people whose condition is on the verge of life and death. And then, only after unsatisfactory results of treatment with other medications. Often, Dexamethasone injections are prescribed by emergency doctors when a patient experiences adrenal insufficiency, acute shock, or an intense increase in cerebral edema. Moreover, they are prescribed to people suffering from:

• acute thyroiditis;
• congenital hyperplasia of the adrenal cortex;
• traumatic, surgical, hypovolemic, burn shock;
• rheumatoid arthritis, lupus erythematosus and other systemic diseases associated with connective tissue;
• bronchospasm, asmatic status, when relief with traditional drugs does not help;
• severe angioedema, anaphylactic shock, urticaria, accompanied by severe itching;
• cerebral edema after hemorrhagic stroke, neurosurgical intervention, head injury, infection;
• aggravated neurodermatitis and severe dermatitis;
• from malignant tumors (both adults and children);
• idiopathic thrombocytopenic purpura (adults);
• visual impairment.

Contraindications

Dexamethasone has many contraindications. It reduces immunity. If there are viruses, fungi or bacteria in the body, this drug promotes their intensive reproduction. Therefore, such injections are not given to those suffering from tuberculosis. The drug leads to a slowdown in regenerative processes and destruction of bone and cartilage tissue. With an increase in the concentration of Dexamethasone in the blood, the intensity of leaching of calcium from the bones increases. This drug is strictly prohibited for use by people with:

• fractures;
• osteoporosis;
• severe osteoarthritis;
• diabetes mellitus;
• bleeding;
• heart attack;
• stomach ulcer;
• mental disorders;
• liver and/or kidney failure;
• individual intolerance to substances included in the drug.

Dexamethasone is prescribed very carefully for:

• systemic mycoses;
• convulsions;
• viral, bacterial and parasitic infections (such as various types of herpes, amebiasis, measles, chickenpox, strongyloidiasis).

It is not advisable to do intra-articular injections when:

• bleeding tendencies;
• bone fracture inside the joint;
• joint deformities;
• ankylosis;
• arthroplasty;
• bone destruction;
• joint necrosis.

Drops and ointment are prohibited for:

• damage to the cornea of ​​the eye due to injury or ulcer;
• acute suppuration of the ocular structure;
• glaucoma;
• viruses;
• fungus;
• tuberculosis bacillus.

Sore joints and synthetic hormone

In this case, treatment with “Dexamethasone” is prescribed only when other treatment methods have been tried, but they have not given a noticeable result. The injections are administered slowly; sometimes the doctor may prescribe the injection of the drug not only into the muscle, but also into the joint itself.

Most often, such therapy is prescribed for serious pathological diseases, such as rheumatoid arthritis, Still's disease or ankylosing spondylitis, synovitis, bursitis, lupus, polyarthritis, scleroderma (complicated by joint damage), etc.

What is the dose of the 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 severity of the disease. The approximate rate of the administered drug varies between 0.4 and 4 milligrams of the drug. For example, to treat a small joint, you will need 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 into the synovial bursa, the dose may be slightly increased (from two to three milligrams).

How often do procedures need to be performed? The drug should be administered once, with a break of three or four months. If you use the product more often or increase the dosage, this can lead to serious problems. For example, cartilage tissue may be damaged or a tendon may rupture.

Properties of the drug and its use

The substance Dexamethasone is a synthetic analogue of the secretion of the adrenal cortex, which is normally produced in humans, and has the following effects on the body:

1. It reacts with the receptor protein, which allows the substance to penetrate directly into the nuclei of membrane cells.
2. Activates a number of metabolic processes by inhibiting the enzyme phospholipase.
3. Blocks mediators of inflammatory processes in the immune system.
4. Inhibits the production of enzymes that affect protein breakdown, thereby improving the metabolism of bone and cartilage tissue.
5. Reduces the production of leukocytes.
6. Reduces vascular permeability, thereby preventing the spread of inflammatory processes.

As a result of the listed properties, the substance Dexamethasone has a powerful antiallergic, anti-inflammatory, anti-shock, and immunosuppressive effect.

Dexamethasone in ampoules is used for the systemic treatment of pathologies, in cases where local therapy and internal medication have not produced any results, or their use is impossible.

Dexamethasone regulates protein metabolism, reducing synthesis and increasing protein catabolism in muscle tissue, reducing the amount of globulins in plasma, increasing albumin synthesis in the liver and kidneys

Dexamethasone injections can be purchased for 35-60 rubles, or replaced with analogues, including Oftan Dexamethasone, Maxidex, Metazon, Dexasone

Most often, Dexamethasone injections are used to relieve allergic reactions, as well as to treat joint diseases. The description of the drug indicates the following conditions and diseases for which Dexamethasone is used:

• Development of acute adrenal insufficiency;
• Rheumatic pathologies;
• Intestinal diseases of unknown nature;
• Shock conditions;
• Acute forms of thrombocytopenia, hemolytic anemia, severe types of infectious diseases;
• Skin pathologies: eczema, psoriasis, dermatitis;
• Bursitis, humeroscapular periarthritis, osteoarthritis, osteochondrosis;
• Acute laryngotracheitis in children;
• Multiple sclerosis;
• Swelling of the brain due to traumatic brain injuries, meningitis, tumors, hemorrhages, radiation injuries, neurosurgical interventions, encephalitis.

Dexamethasone injections are used in the development of acute and emergency conditions, when human life depends on the effectiveness and speed of action of the drug. The drug is usually used for a short course, taking into account vital indications.

How it affects the body

How is such an effect achieved from the use of a hormonal drug? The effect of Dexamethasone injections is due to its special composition and method of administration. For example, when administered intravenously, the drug has an almost instantaneous effect. If the drug is injected into the muscle, the effect will occur only after eight hours.

What happens when a synthetic hormone enters the human body? It immediately begins to react with cytoplasmic receptors found in almost all tissues, especially in an organ such as the liver. Penetrating into the nucleus of membrane cells, the active substance inhibits the phospholipase enzyme and activates basic metabolic processes. Dexamethasone improves protein metabolism by reducing globulins in the blood plasma and increasing the amount of albumin in the kidneys and liver. By increasing the synthesis of fatty acids and 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 gastrointestinal 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.

How is the anti-inflammatory effect of the drug achieved? The active substance suppresses the release of inflammatory mediators, reduces capillary permeability, increases the protective function of cell membranes under various damaging factors, and reduces the number of mast cells responsible for the production of hyaluronic acid.

The drug is used as an immunosuppressant due to its effect on lymphoid tissue, inhibition of T-lymphocyte proliferation, and reduction in the formation of antibodies.

Also, a hormonal agent can affect the synthesis and secretion of allergy mediators, reducing it. The active substance is also responsible for reducing the number of basophils and mast cells, inhibiting antibody formation, and changing the body’s defense response.

General instructions for use

According to the instructions, Dexamethasone injections can be prescribed to both adults and children over one year of age. If you use the hormone intravenously, it is best to pre-mix it with glucose or saline. Doctors may also prescribe the drug to be injected 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 dose does not exceed eighty milligrams of the drug. In some cases, when the patient's life is at stake, this dosage may be increased. However, only the attending physician should increase (or decrease) the rate of hormone intake.

How long should the injection solution be used? The optimal course of treatment, according to the recommendations of experts, should not exceed three to four days. If the drug helps and it is necessary to continue treatment, doctors may prescribe Dexamethasone tablets. As you improve, you should reduce the daily intake to the minimum. Only a doctor has the right to cancel the drug.

When injecting a solution into a muscle, the procedure must be carried out carefully and slowly, otherwise it can provoke the development of various complications. Patients and nurses often mention this in their reviews of the drug Dexamethasone.

Directions for use and dosage

Dexamethasone solution is administered by injection intravenously or intramuscularly. It is prescribed locally in the form of drops. This product can only be used with the permission of a doctor and under his close supervision.

Instructions for injections

The daily dosage of the solution is divided into 2 doses. Therapy should be carried out in the shortest possible course and discontinued gradually. The amount of active substance can vary from 0.5 to 24 mg per day.

In severe emergency conditions, a solution of up to 20 mg is administered once, the daily amount should not exceed 80 mg. After the desired effect is obtained, the dosage is reduced to 2-4 mg, and then discontinued.

The exact regimen and dosage depend on the diagnosis and severity of the condition:

1. In case of shock and other conditions that pose a direct threat to the patient’s life, the drug is administered at the rate of 2-5 mg per kg of body weight over an interval of 2 to 6 hours. You can also administer the medicine intravenously. The total duration of treatment is no more than 72 hours.
2. For cerebral edema, the medicine is administered intravenously in an amount of 10 mg, then 6 mg are added at intervals of 4 hours. If the body reacts positively to treatment, after a few days the dosage is reduced and treatment is gradually discontinued.
3. For oncological diseases, after the “impact course”, maintenance treatment is continued at 2 mg 3 times a day intravenously or intramuscularly.
4. In case of severe allergic reactions and exacerbations of chronic allergic diseases, intravenous injections are given in the first 24 hours, then they switch to oral tablets of 1 mg in the morning and evening, then the dose is reduced to 0.5 mg every 12 hours.

Local injections and inhalations

1. In case of shock and other conditions that pose a direct threat to the patient’s life, the drug is administered at the rate of 2-5 mg per kg of body weight over an interval of 2 to 6 hours. You can also administer the medicine intravenously. The total duration of treatment is no more than 72 hours.
2. For cerebral edema, the medicine is administered intravenously in an amount of 10 mg, then 6 mg are added at intervals of 4 hours. If the body reacts positively to treatment, after a few days the dosage is reduced and treatment is gradually discontinued.
3. For oncological diseases, after the “impact course”, maintenance treatment is continued at 2 mg 3 times a day intravenously or intramuscularly.
4. In case of severe allergic reactions and exacerbations of chronic allergic diseases, intravenous injections are given in the first 24 hours, then they switch to oral tablets of 1 mg in the morning and evening, then the dose is reduced to 0.5 mg every 12 hours.

Local injections and inhalations

For administration into the cavity of a large joint, 2-4 mg of the drug is prescribed. Such local injections are given once a day for 3 days to 3 weeks.

Instructions for use of Dexamethasone in ampoules also recommend the use of a solution for inhalation. Procedures are performed 3 times a day. To do this, ½ ml of solution is mixed with 3 ml of physiological solution. The course of therapy is continued for 4-7 days.

Pill use

The average therapeutic dose can vary from 0.75 to 9 mg of the drug in tablets, the highest dose is 15 mg per day. For children, the medicine is prescribed based on body weight, the daily dosage is divided into 3 doses.

Eye drops and ointment

For acute inflammatory lesions of the organs of vision, instill 2 drops every 2 hours into the conjunctival cavity. As the condition improves, the break between procedures is extended to 4-6 hours.

On the first day after an ophthalmological operation, as well as thermal or mechanical trauma, the eyes are instilled for prophylactic purposes, 1 drop 4 times a day. The amount is gradually reduced by using 1 drop 2-3 times a day, the total duration of treatment is up to 2 weeks.

Ointment for eye treatment is placed behind the lower eyelid in a small strip 2-3 times a day.

To treat ear diseases, instill 4 drops into the sore ear 2 times a day.

Action and composition

The active substance of the drug is dexamethasone phosphate disodium salt; water for injection, glycerol, Trilon B, sodium hydrogen phosphate dodecahydrate are used as auxiliary components. Dexamethasone solution is a clear, colorless liquid (sometimes with a light yellow tint).

The pharmacological effect of dexamethasone is due to the ability of glucocorticoids to interact with cytoplasmic cell receptors, resulting in the synthesis of messenger RNA. As a result, the formation of protein substances is induced, the synthesis of prostaglandins and other inflammatory mediators is suppressed. The drug affects protein, lipid and carbohydrate metabolism, has anti-inflammatory, antitoxic and anti-shock effects, and eliminates signs of allergic reactions.

In pharmacies you can purchase Dexamethasone in ampoules of 1 and 2 ml, which are packaged in cardboard boxes of 5, 10 or 25 pieces. 1 ml of solution contains 4 mg of active substance. The price of an ampoule of Russian-made Dexamethasone in a dosage of 4 mg is on average 5-7 rubles.

pharmachologic effect

The main properties of the drug: antiexudative, anti-inflammatory, antiallergic. It is intended for local treatment. Dexamethasone is used in the form of drops, only in ophthalmology. The main active ingredient is a synthetic hormone. This component belongs to the group of glucocorticosteroids and is a derivative of fluoroprednisolone.

The drug exhibits antishock, desensitizing, antitoxic, and immunosuppressive properties.

The drug also exhibits other properties: antishock, desensitizing, antitoxic, immunosuppressive. The mechanism of action of Dexamethasone is based on the ability to interact with receptors. As a result, the main substance penetrates into the cell nucleus, where it activates a number of processes aimed at stimulating protein production. Due to this, other reactions are triggered. In particular, the production of arachidonic acid, prostaglandins, endoperoxides, etc. is suppressed.

Thanks to these processes, inflammation develops less intensely and is soon completely suppressed. A feature of dexamethasone is its effect on the metabolism of proteins and carbohydrates. Thus, the intensity of the protein transformation process increases. At the same time, the production of fatty acids and, at the same time, triglycerides are accelerated. Due to this, more intense accumulation of fat in the body occurs. It is predominantly deposited in the area of ​​the shoulder girdle and abdomen. As a result, hypercholesterolemia develops.

Dexamethasone helps accelerate the delivery of glucose into the blood. At the same time, more intense absorption of carbohydrates is noted, and gluconeogenesis begins. Another feature of the hormone is the retention of fluid and sodium in the body. At the same time, the excretion of potassium and calcium is accelerated.

The drug has an antiallergic effect by reducing the number of histamine basophils.

Anti-inflammatory activity is also manifested by suppressing the ability of eosinophils to release inflammatory mediators. Capillaries become less permeable. As a result, the anti-exudative property of the drug is manifested: biological fluids do not penetrate the walls of blood vessels as intensively, and the amount of exudate decreases.

A number of processes develop as a result of suppression of mast cell release. The drug has an antiallergic effect by reducing the number of histamine basophils. At the same time, the secretion of allergy mediators is inhibited.

Dexamethasone affects bronchial function. Along with this, there is a decrease in the viscosity of the secretion produced by them. The antitoxic and antishock effect is achieved through the development of a number of processes: an increase in blood pressure is observed, membrane protective properties appear, and liver enzymes are activated. The immunosuppressive effect is achieved by inhibiting the release of cytokines.

The main component penetrates into the structure of the eye tissue when the solution is instilled into the conjunctival sac. The drug is absorbed in the form of eye drops in minimal quantities. Metabolization occurs in the tissues surrounding the organ of vision. The active component does not penetrate the systemic circulation. The duration of action of the drug after use varies from 4 to 8 hours.

Pharmacological properties

Being a corticosteroid, the drug interacts with cytoplasmic receptors, which are found on the surface of cells of the immune system and are responsible for detecting pathogens. After exposure to Dexamethasone, new structures are formed that enter the cell nucleus and stimulate the synthesis of messenger (or messenger) RNA.

M-RNA begins to actively synthesize proteins that regulate important changes in enzymes in cells, as well as inhibit the main conductors of allergies, inflammation, pain and other unpleasant symptoms. The ability of the drug to bind to cell receptors is explained by the effect of Dexamethasone on the pituitary gland and hypothalamus.

Given the different forms of release of the drug, the method of administration and absorption time may vary. The therapeutic effect is achieved almost immediately after the drug enters the body, and the maximum effect will be felt after 1-2 hours. The drug retains its effect for 2-3 days.

When taking the drug orally, the active substance is absorbed almost completely (bioavailability - 80%). Dexamethasone is approximately 70% bound to plasma proteins. In addition, the active substance of the drug dissolves in fat, so it can get inside the cell.

The drug breaks down in the cells it affects. After this, a metabolization process occurs in the tissues of the liver and kidneys. Excretion occurs through the kidneys.

Analogues and substitutes

A replacement of the drug may be necessary if the patient is intolerant to the main or auxiliary active ingredients. An analogue is selected from the same group of drugs. The form of release is often changed: instead of injections, tablets or ointment are prescribed.

Drug name	Active substance	Manufacturer	Price, rub.)
Diprospan	betamethasone	Russia, USA, France, India, Slovenia, Ukraine	300-2000
Metipred	methylprednisolone	Belgium, India, Serbia, Italy, USA	250-1000
Hydrocortisone	hydrocortisone	Russia, Poland, Germany, Hungary, Canada, USA	80-350
Prednisolone	prednisolone	Russia, India, Republic of Belarus, Poland, Austria, Switzerland	70-150
Flosteron	betamethasone	Russia, France, India, USA, Ukraine	1000-1500

Dexamethosone analogues may also have side effects. They are observed immediately after administration or several days after the accumulation of the active substance in the body. In case of a severe allergic reaction, use should be stopped immediately.

Compound

The main component of any form of medication is dexamethasone in the form of sodium phosphate. This compound is contained in 1 ml of injection solution at a dose of 4 mg, and in one tablet - in an amount of 500 mcg (0.5 mg). The concentration of this substance in eye drops is 0.1%, which corresponds to 1 mg per 1 ml of solution.

In addition to the active compound, the injection solution contains sterile water, sodium hydrogen phosphate, disodium edetate and glycerol. The eye drops include additional ingredients such as benzalkonium chloride, disodium edetate, water, decahydrate and boric acid. Auxiliary additives in tablet form are lactose, corn starch, colloidal silicon dioxide, povidone, talc and magnesium stearate.

Dexamethasone tablets

The medicine has a complex mechanism of action and simultaneously affects many systems of the human body. Dexamethasone tablets are prescribed by a doctor with the dosage and course duration necessary to improve the condition. Indications for use include the following diseases:

• adrenal insufficiency;
• rheumatoid arthritis;
• bronchial asthma;
• scleroderma;
• cerebral edema;
• eczema;
• hives;
• psoriasis;
• leukemia;
• dermatitis;
• anemia.

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Dexamethasone pharmacological group

The instructions for use state that Dexamethasone is a hormonal drug (pharmacological group - glucocorticosteroids). The medicine is obtained synthetically. When introduced into the body, it has an effect similar to hormones of the adrenal cortex.

Dexamethasone injections in ampoules

The instructions for using dexamethasone compare it to hydrocortisone (cortisol), a hormone produced by the body. By its nature, dexamethasone is a homologue of hydrocortisone - it has a similar structure and structure, but the composition of its molecule is supplemented with fluorine atoms. Some instructions use the name fluoroprednisolone. Based on their chemical structure, hydrocortisone and dexamethasone have similar properties.

What is dexamethasone tablets used for?

However, the instructions for the drug indicate that the use of dexamethasone is recommended in smaller quantities compared to other medications in this group. Dexamethasone is significantly more effective when administered into the human body than its natural prototypes.

2 mg of dexamethasone in terms of prednisolone will already be 14 mg, and in terms of hydrocortisone it will already be 60 mg of the active substance.

Interaction with other pharmacological agents

It is very important to pay attention to the drugs that the patient takes along with Dexamethasone, since combining this drug with others may reduce the effectiveness of treatment or even lead to unpredictable consequences

For example, the combined use of the drug of interest to us with substances such as phenytoin, ephedrine, theophylline, phenobarbital reduces 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 consequences from using a synthetic hormone with other drugs:

• Diuretics enhance the process of potassium excretion, thereby contributing to the development of heart failure.
• Sodium-based products can cause swelling and increased blood pressure.
• Cardiac glycosides. Their combined use with Dexamethasone increases the risk of developing ventricular extrasystole.
• Ethanol, alcohol. The risk of developing ulcerative tumors in the gastrointestinal tract and bleeding increases.
• Insulin and other hypoglycemic agents. Due to combined use with Dexamethasone, the effectiveness decreases.
• Vitamin D. Its effect on the body is reduced.
• Vitamin C. “Dexamethasone” accelerates the process of excretion of acetylsalicylic acid.
• Paracetamol-based products. The result of taking two drugs together can be 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 medications whose active ingredients are ketoconazole and cyclosporine.
• Neuroleptics, as well as azathioprine, increase the risk of cataracts.

You can learn more about the interaction of this drug with other medications at an appointment with a specialist.

Side effects and contraindications

What is the medicine used for? Dexamethasone is used in various fields of medicine. Since the drug is most often used to treat joints and allergies, these indications should be analyzed separately.

Other indications include:

1. All types of shock.
2. Hydrocephalus, swelling of the brain in various pathological conditions - trauma, tumors, surgery, hemorrhage, infectious diseases of the organ.

Bronchospasm that cannot be relieved in bronchial asthma and other pathologies. Systemic autoimmune diseases with severe inflammatory syndrome. Thyrotoxic crisis is a high release of thyroid hormones, leading to a threat to life. Psoriasis, dermatitis, eczema and other inflammatory skin diseases. Glomerulonephritis and other inflammatory kidney diseases associated with autoimmune mechanisms. Alveolitis, pulmonary fibrosis and sarcoidosis. Multiple sclerosis – to suppress the demyelination process. Inflammatory bowel diseases of autoimmune origin.

The listed indications suggest the systemic action of dexamethasone.

The use of hormonal anti-inflammatory drugs in the treatment of joint diseases is a necessary measure. When non-steroidal drugs cannot relieve the inflammation process, dexamethasone and its analogues are used.

Indications for use of the drug for the musculoskeletal system:

1. Rheumatoid arthritis – to treat inflammation in joints and other affected organs.
2. Joint syndrome in psoriasis.
3. Ankylosing spondylitis.

Reiter's syndrome is an inflammation of the joints, eyes and genitals. Synovitis in deforming osteoarthritis (synovitis of the hip joint). Lupus and scleroderma with articular syndrome. Polyarthritis of joints of various origins. Damage to soft tissues – periarthritis of the knee joint, tendinitis, tendon sprains. Bursitis is an inflammation of the joint capsule.

Still's disease in children and adults.

These diseases require both systemic and local use of dexamethasone in the form of intra-articular injections.

In this case, dexamethasone, prednisolone and other hormonal anti-inflammatory drugs are used. By acting on mast cells, they stop the allergic reaction, and the symptoms quickly disappear.

To eliminate allergy symptoms, dexamethasone is used for the following conditions:

1. Angioedema of the tissues of the face and neck.
2. Allergic inflammation of the skin - eczema and dermatitis.
3. Inflammatory process in the nasal mucosa – rhinitis and hay fever.
4. Severe allergic reaction to medications, foods, plant and animal allergens.
5. Hives.
6. Quincke's edema.
7. Anaphylactic shock.

The listed indications do not always require steroid therapy. A specialist should choose a drug to treat allergies.

Indications

The form of the drug, dosage and schedule of administration are prescribed exclusively by the attending physician. The most common problems for which Dexamethasone is prescribed:

• Disruption of the normal functioning of the endocrine system, which leads to a decrease in the production of cortisol by the adrenal glands, as well as a decrease in their functioning, the development of subacute inflammation of the thyroid gland.
• Shock of various types - traumatic, burn, surgical, or manifested by the rapid loss of a large amount of fluid. However, Dexamethasone should be taken only if other medications have failed to provide the desired effect.
• Diseases accompanied by a systemic type of inflammation of the connective tissue, for example, skin tuberculosis, rheumatoid arthritis, inflammation of the mucous bursae, psoriatic and gouty arthritis, joint degeneration, infectious lesions of the synovial membrane, ankylosing spondylitis, epicondylitis, which accompanies osteoarthritis.
• Complications of bronchial asthma and bronchospasm, when attacks of the disease cannot be eliminated with conventional medications and methods.
• Angioedema or immediate allergic reaction.
• Brain swelling that occurs as a result of infection, skull trauma, neurosurgery, or cerebrovascular accident.
• Severe cases of inflammatory skin lesions and aggravated neurodermatitis.
• Undergoing a set of procedures aimed at treating malignant oncology. These include the treatment of acute leukemia in children, as well as lymphoma and leukemia in adults.
• A significant decrease in the number of platelets in the blood, which leads to increased bleeding.
• Serious eye diseases, which include optic neuritis, allergic corneal ulcers, anterior and posterior inflammation of the uvea, conjunctivitis caused by allergies.
• Infectious diseases with complications that require complex treatment, including antibiotics and Dexamethasone.
• Diseases of the digestive system, among which the most common are regional terminal ileitis and ulcerative colitis.
• Allergies, which include serum sickness, adverse reactions to certain foods and medications, seasonal nasal congestion, angioedema, and urticaria caused by a recent blood transfusion.
• Skin problems such as severe erythematosus multiforme, pemphigus, seborrheic dermatitis, mycosis fungoides or psoriasis.
• Complications of the respiratory tract such as eosinophilic pulmonary disease, tuberculosis, pneumonia degrees 2 and 3, inflammation when various substances enter the lungs in large quantities, berylliosis.
• Renal dysfunction associated with wolf lichen and primary nephrotic syndrome.
• In the case of a sharp suppression of the production of red blood cells, congenital hypoplastic, as well as autoimmune anemia, secondary thrombocytopenia.
• Sometimes with trichinosis with neurological symptoms or tuberculous meningitis.

It should be remembered that the final diagnosis and treatment method are determined solely by the doctor. Self-prescription of the drug is impossible and can greatly affect your well-being.

How to inject the drug intramuscularly instructions

Intramuscular and intravenous administration of the contents of the ampoule requires special care and patience, because the medication is administered slowly, and in the case of droppers, the drip method must be used. Otherwise, with rapid administration, cardiovascular collapse may occur.

An adult is administered only four to twenty milligrams three times a day. The maximum possible dose is eighty milligrams. But, if the situation threatens the patient’s life, then a larger amount of medicine is allowed to be administered. As a rule, the medication is used parenterally for three to four days, after which they switch to oral use of the drug. As soon as a positive effect is achieved, the dosage should be reduced to three to six milligrams per day.

In the case of cerebral edema at the initial stage, no more than sixteen milligrams are used for treatment. Afterwards, five milligrams are injected intramuscularly every six hours until a positive result is visible.

For babies, the drug is administered only intramuscularly, and the dosage is selected according to the baby’s weight. So you will need about 0.3 mg. per day for every kilogram.

The therapeutic effect of intramuscular administration of Dexamethasone occurs only after eight hours, while with intravenous administration the effect occurs literally in ten minutes.

★Treatment of ALLERGIES. First aid. Causes of occurrence. Nutrition for allergies.

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Dexamethasone during pregnancy

The use of the drug by a woman while expecting a child should be under the strict supervision of a gynecologist, who sets the dosage and treatment regimen. Its use in the first trimester is unacceptable so as not to harm the fetus. In many cases, it is necessary to use Dexamethasone during pregnancy, for which the medicine is prescribed in the form of injections or droppers.

When planning pregnancy, the drug is prescribed in case of problems with the adrenal glands. The effect of taking it can be very fast - a woman can conceive a child in a short time. The use of the medicine helps to open the lungs in newborns, in addition:

• prevents miscarriages;
• reduces immunity that interferes with pregnancy;
• normalizes hormonal levels;
• relieves allergic exacerbations.

What are dexamethasone injections prescribed for?

Dexamethasone is a hormonal drug. This medicine is a synthetic analogue of adrenal hormones. It is used for insufficient functioning of these glands and for other pathological conditions. If you refer to the instructions for the drug Dexamethasone, injections, the indications for use are as follows:

• diseases of the joints, muscles (arthritis, myositis);
• cerebral edema;
• kidney disease;
• dermatosis;
• psoriasis;
• liver diseases;
• pathology of the visual apparatus;
• oncological diseases;
• bronchial asthma;
• blood diseases.

Dexamethasone (injections) – why is it prescribed for adults?

The range of disorders for which the drug is used is wide. Dexamethasone injections intramuscularly help to quickly stop an allergic reaction and developed cerebral edema. Doctors talk about the positive effect of treating severe infectious diseases when Dexamethasone is used together with an antibiotic. This drug has a systemic effect on the body. When telling patients about Dexamethasone, injections, and why the drug is prescribed, doctors point to the following effect of the drug:

eliminating shock;

• relieving inflammation;
• regulation of metabolism;
• reduction of allegorical reaction;
• reducing the toxic effect on the body during the infectious process.

Dexamethasone (injections) – why is it prescribed to children?

Dexamethasone, injections, are rarely prescribed to children. Thus, the drug can be used for vaccination with live vaccines if the child is predisposed to developing allergies. As part of complex therapy, the medicine is used for Itsenko-Cushing syndrome, a disease accompanied by disruption of the adrenal glands. Injections are not prescribed for children if the blood coagulation system is disrupted. Among the main pathologies for which the use of Dexamethasone is indicated:

• severe skin lesions, dermatoses;
• Crohn's disease;
• hemolytic anemia;
• glomerulonephritis.

When talking about a dosage form such as Dexamethasone, injections, and why the drug is prescribed, it is necessary to note the possibility of local administration of the drug. Injections are often carried out into a neoplasm in soft tissues, a joint, and even into the eye. In rare cases, with severe and persistent hypothermia, Dexamethasone is used as part of a lytic mixture (administered together with Analgin and Diphenhydramine).

Dexamethasone (injections) – why is it prescribed to pregnant women?

When carrying a child, the drug is used with caution. It helps the expectant mother's body fight high levels of androgens in the blood - male hormones that can provoke miscarriage.

Under the influence of Dexamethasone, testosterone synthesis decreases. The drug can be used throughout the entire gestation period.

In each case, specialists determine individually the need to use the drug. When Dexamethasone is prescribed, injections, indications for use of the drug during pregnancy are always associated with the threat of termination of gestation

The drug is used with caution: its components penetrate the placental barrier and therefore may affect the fetus

Dexamethasone (injections) – why is it prescribed to cancer patients?

Dexamethasone, an injection solution, is often included in the list of prescriptions for patients with oncology. It is used for tumor-like processes in the brain as a drug for complex therapy. It allows you to improve the general condition of the patient: relieve swelling, reduce inflammation. Systematic use of the medicine helps to normalize intracranial pressure and relieve the patient of severe, prolonged headaches. The dosage, frequency and duration of therapy are determined individually, taking into account the stage of the pathological process.

Contraindications

The injection solution has many contraindications related to the patient's health condition. An absolute contraindication is intolerance to the drug.

Other contraindications include:

• osteoporosis;
• pregnancy (1st trimester);
• stomach ulcer;
• obesity;
• Cushing's syndrome;
• duodenal ulcer;
• increased individual sensitivity to the components of the injection solution;
• vaccination with live vaccine;
• glaucoma;
• epilepsy;
• severe liver damage;
• heart failure;
• psychoses;
• active tuberculosis;
• renal failure, etc.

Side effects of Dexamethasone

Like any steroid drug, Dexamethasone also has side effects. The instructions for use state that they are directly dependent on the dose of the medication, duration of use, and the possibility of use taking into account the time of day. Let's consider the main ones:

Symptoms of the nervous system and sensory organs:

• euphoric state;
• disturbance of consciousness;
• manic and depressive symptoms;
• disturbance in space;
• hallucinatory symptoms;
• increased intracranial pressure with the occurrence of congestive symptoms of the optic nerve head. Develops due to an accelerated reduction in the dose of the drug. In most cases, it manifests itself in childhood. The main symptoms of this disease include blurred vision, dizziness and headaches;
• vertigo;
• problems falling asleep, sleep disturbances;
• decreased vision. It may occur when the solution gets into the areas of the head, turbinates, and cervical region;
• clouding of the lens of the eye with the main location in the posterior region;
• increased intraocular pressure;
• hypertensive state with a high risk of optic nerve pathology;
• spread of infectious pathology of the eye of fungal and viral etiology;
• exophthalmos of steroid origin.

Symptoms of blood vessels and heart:

• increased vascular pressure;
• dystrophic processes of the heart muscle;
• hypokalemic conditions manifested on the ECG tape;
• hypercoagulable states;
• thrombotic vascular damage;
• in the presence of predisposing conditions - chronic heart failure;
• increased blood flow to the head.

Clinical manifestations in the digestive system:

• inflammation of the pancreatic islets;
• hiccups;
• nausea and vomiting;
• damage to the digestive system with the development of erosions and ulcerative defects;
• loss of appetite;
• esophagitis of erosive origin.

Symptoms of metabolic disorders:

• decreased calcium and potassium levels in the bloodstream;
• weight gain;
• swelling resulting from impaired fluid and sodium metabolism.

Clinic of endocrine pathologies:

• diseases that are accompanied by an increase and decrease in the amount of adrenal hormones in the bloodstream;
• manifestation of symptoms of latent diabetes mellitus;
• diabetes of steroid origin;
• growth disturbance in childhood;
• increased hair growth of the skin;
• change in the menstrual cycle.

Clinical manifestations of the musculoskeletal system:

• pain in the back;
• pain in joints and muscles;
• myopathy of steroid genesis;
• violation of the integrity of the tendon apparatus;
• muscle weakness;
• thinning of the bone tissue structure, with loss of elastic and durable properties;
• decreased muscle strength;
• when the drug is administered into the joint area, increased pain in the joint is possible.

Symptoms of damage to the skin and mucous membranes:

• acne of hormonal origin;
• ecchymotic and petechial skin lesions;
• striae;
• thinning of the skin structure;
• increased sweat production;
• disruption of recovery processes in the body.

Allergic symptoms:

• pinpoint rash on the skin;
• violation of respiratory movements;
• swelling of the neck and face;
• stridor breathing;
• shock of anaphylactic origin.

The following pathological manifestations occur:

• manifest of infectious diseases;
• disruption of the immune response system;
• clinical symptoms of withdrawal - difficulties in perception, weakness, nausea and vomiting, indigestion, pain in the intestines.

Local manifestations when administering Dexamethasone in solution:

• impaired skin sensitivity at the injection site;
• pain;
• burning;
• the occurrence of scar defects in the injection area;
• increase and decrease in skin pigmentation.

When performing an intramuscular injection, the following side effect may occur - the occurrence of a mechanism of atrophy of the skin and subcutaneous layer.

Undesirable manifestations when using Dexamethasone eye drops:

• with long-term use of the solution (more than 3 weeks), the pressure inside the eye may increase;
• formation of glaucoma with damage to the optic nerve structures;
• clouding of the eye lens localized in the posterior subcapsular region;
• impairment of the visual system;
• thinning and rupture of the cornea;
• development of infectious pathologies of bacterial and herpetic origin.

If high susceptibility to the components of the drug occurs, conjunctivitis and blepharitis may develop.

Local manifestations:

• skin irritation, burning and itching symptoms;
• dermatitis.

Analogs

Dexamethasone has a lot of contraindications and side effects, so this ophthalmic drug is not suitable for all patients. In this case, it is necessary to select medications with a similar effect.

The most effective analogues of Dexamethasone include:

1. Oftan . Ophthalmic drops made in Finland. It is a combination drug that has an antioxidant effect. Prescribed for cataracts, as well as in the treatment of inflammatory processes. Among the contraindications, only hypersensitivity to the components of the composition and age under 18 years are noted. It extremely rarely causes adverse reactions. They are expressed mainly in the form of shortness of breath, dizziness and pulsation in the temples.

You can buy 10 ml drops for about 330 rubles.

If we compare Oftan/Dexamethasone, it can be noted that the analogue is several times more expensive. The advantages of Oftan include a minimum of contraindications and side effects (unlike Dexamethasone). But the original has a wider scope.

1. Maxidex . The drug is made in America and has an anti-allergic and anti-inflammatory effect. It is used as a prophylactic agent, as well as in the treatment of various diseases of the organs of vision. Prohibited for use in case of severe lesions of the cornea and individual intolerance to the components of the composition. Long-term use of an ophthalmic agent can lead to itching in the eyes, watery eyes, and discomfort.

The average cost for a medicine is 340 rubles.

Compared to Dexamethasone, Maxidex is much more expensive and has minimal contraindications and side effects. The therapeutic effect of Dexamethasone is not inferior to its expensive analogue.

Dexamethasone is a powerful ophthalmic agent that is dispensed from pharmacies strictly according to a doctor’s prescription. Causes a large number of adverse reactions, especially if the drug is used incorrectly.

To avoid undesirable consequences, it is forbidden to exceed the dose prescribed by the doctor. You also need to pay attention that the dosage of the drug is selected strictly individually.

Instructions for use

The medicine can be prescribed to adults and children regardless of age. The dosage and regimen of the drug depends on the severity of the lesion and the patient’s response to treatment.

Dexamethasone can be administered in several ways:

• intra-articular;
• periarticular;
• intravenous drip or stream;
• intramuscularly.

Treatment regimens

Age	Introduction	Dose, mg	Number of times per day	Features of treatment
Adults	Intravenously or intramuscularly	4 – 20	3 — 4	No more than 80 mg per day, parenterally - up to 4 days, later - oral therapy. The dose varies depending on the condition.
Children	Intramuscularly	The dosage is calculated depending on the child’s body weight. Typically this is 0.2 - 0.4 mg per 1 kg of weight per day.

When treating joints, the drug is administered directly into the joint and depends on the size of the joint and location. The treatment regimen involves an injection every few days.

Side effect

Glucocorticosteroids have a significant list of possible side effects. The most commonly noted are the following:

• anaphylactic reactions;
• arterial hypertension;
• headache;
• increase in intracranial pressure;
• sleep problems;
• Cushing's syndrome;
• disorders of the adrenal glands;
• bradycardia;
• impotence;
• skin atrophy;
• blood clotting disorder;
• numbness;
• scars in the places where injections were performed;
• suppression of the adrenal glands, etc.

Features of use in children

For children, the drug can be prescribed from birth only if such treatment is absolutely necessary. During this period, the child must be under constant medical supervision.

During therapy, indicators of the child’s development and growth should be monitored.

In order to prevent growth disturbance, if long-term treatment is necessary for children under 14 years of age, it is important to take at least a four-day break after a three-day course of treatment

The medicine is hormonal and can only be prescribed by a doctor. For children, the dosage is calculated based on the child's body weight.

Use in pregnant women

Dexamethasone is contraindicated for use during pregnancy in the first trimester. If objectively necessary, the medicine can be used in the 2nd and 3rd trimester, taking into account the potential risk for fetal development.

Long-term use of Dexamethasone can negatively affect the intrauterine development of the fetus, lead to disorders such as growth retardation, and even cause atrophy of the child’s adrenal cortex and abnormalities in the formation of limbs. If it is necessary to use dexamethasone to treat a woman during breastfeeding, then the child is transferred to artificial infant formula.

Original instructions for use - Download

Special instructions for long-term use

Before starting treatment and after, it is necessary to do a general blood test. During treatment with Dexamethasone, the patient should be under the supervision of an ophthalmologist and monitor blood pressure, calcium and glucose levels in the blood. If side effects occur, the patient should increase the intake of calcium into the body.

To do this, you need to add high-protein foods to the menu and monitor how many carbohydrates the patient consumes per day.

A patient with withdrawal syndrome experiences nausea, pain in the limbs, and loss of appetite. He becomes sluggish, absent-minded, and suffers from general weakness. Sometimes taking Dexamethasone provokes an immune response in the body if the immune system recognizes it as a toxic substance. In this case, you need to increase the rate of water consumption to 2-2.5 liters per day in order to quickly remove Dexamethaon from the body.

Long-term use of Dexamethasone is contraindicated for children; it is associated with slower development and growth. Bone fragility increases and the risk of fracture increases. If a child comes into contact with patients with chickenpox during treatment, he needs prophylactic administration of immunoglobulins.

Advantages and disadvantages

Reviews from doctors about the use of Dexamethasone indicate that the danger of hormonal drugs is somewhat exaggerated, and their use is very effective in the treatment of allergic conditions, cerebral edema, and joint lesions.

The main advantages of Dexamethasone injections are:

• Wide spectrum of action;
• Low price;
• Pronounced positive and rapid effect;
• Possibility of using the drug in complex therapy.

The disadvantages of Dexamethasone injections include:

• Limited use during pregnancy;
• The need for monitoring during the period of use of the medicine;
• Large list of side effects;
• The need to select the lowest possible dosage.

To avoid the negative effects of the drug Dexamethasone, it is enough to take into account the presence or absence of contraindications, and select the dosage taking into account the patient’s age, weight, and test results.

On video: Dexamethasone injections - reviews, chondrosis.

Dexamethasone in ampoules

A solution of the drug Dexamethasone, 4 mg ampoule, is used in acute conditions of patients to provide emergency care:

• inject into the joint to relieve inflammation;
• do inhalations to eliminate breathing problems;
• give intramuscular injections in case of shock;
• use slow intravenous infusions or drips in cases of cerebral edema.

Good reviews from doctors regarding the treatment of severe infections with Dexamethasone - prescribed simultaneously with antibiotics. The drug has a rapid effect if:

• endocrine diseases;
• meningitis;
• hemorrhages;
• tumors;
• exacerbation of bronchitis, asthma;
• severe dermatosis;
• hypercalcemia;
• leukemia;
• allergies;
• blood diseases.

Dexamethasone for children

When the question arises about the baby’s life and urgent intervention is required, Dexamethasone is prescribed for children. The drug is used in cases of:

• laryngeal edema – false croup;
• severe chronic diseases - asthma, bronchitis, atypical dermatitis;
• oncology;
• rheumatoid arthritis;
• acute allergies;
• connective tissue diseases;
• respiratory failure in newborns.

Dexamethasone is used under the strict supervision of a pediatrician, who prescribes the dose and regimen. This is due to the effect of the medicine on the child’s growth process. It is used in the form of injections, tablets, eye drops, and ointment is prescribed starting from the age of 6 years. The solution in ampoules, which is used for inhalation, receives good reviews. The drug relieves:

• allergic cough;
• bronchospasms;
• coughing attacks;

Dexamethasone eye drops

This low-priced drug has found widespread use in ophthalmology in the form of ointments and drops. The effect is based on the anti-inflammatory, antiallergic properties of the drug. Dexamethasone drops are prescribed in the period after eye surgery, in case of injury, burns of the organs of vision. The drug is used for diseases:

• century;
• iris;
• sclera;
• choroid;
• bodies of the eyeball;
• cornea;
• optic nerve.

Although the drug is available and has good treatment results, its independent use without a doctor’s prescription is unacceptable. This is dangerous because there are serious contraindications, including:

• eye tuberculosis;
• fungal, viral infections;
• purulent infections;
• glaucoma;
• increased intraocular pressure;
• damage to the epithelium of the cornea;
• trachoma;
• thinning of the cornea.

Side effect

The use of Dexamethasone in the form of an injection solution can cause various negative consequences. Because of them, patients recover more slowly and incur additional financial costs.

To avoid side effects from Dexamethasone, you must use it according to the instructions. If this is not done, the following consequences are possible:

1. Endocrine system. In some patients, blood pressure increases, steroid-induced diabetes mellitus develops, and the normal functioning of the adrenal glands is disrupted. In more severe cases, Itsenko-Cushing syndrome is observed.
2. Gastrointestinal tract and digestive organs. In addition to pain, patients may experience nausea and decreased appetite. In addition, the likelihood of developing pancreatitis increases.
3. Heart and blood vessels. Improper use of the medicine leads to heart rhythm disturbances and worsening blood clotting.
4. Nervous system. Side effects of Dexamethasone manifest themselves in the form of insomnia, depression, dizziness, and loss of orientation in space. In some cases, seizures and hallucinations may occur.
5. Organs of vision. Failure to follow the doctor's recommendations can lead to increased intraocular pressure and deterioration of visual acuity. Other side effects include: cataracts, optic nerve and corneal atrophy.
6. Other consequences. If the drug is used incorrectly, weight increases and wound healing is slow. In addition, symptoms of an allergic reaction appear. In rare cases, inflammation may occur in the area where the medication was administered. If this happens, it is recommended to use a compress. It will reduce swelling and reduce pain.

Overdose

Too large doses of the medicine or taking it for a long time can lead to an overdose. In this case, various side effects will increase and several additional symptoms will appear.

Consequences of a drug overdose:

• rash in the area where Dexamethasone was administered;
• nausea and vomiting;
• severe hiccups;
• muscle weakness;
• excessive sweating;
• pain at the injection site;
• nose bleed;
• joint pain.

In the case of children, an overdose can lead to more dangerous consequences, including death. Therefore, when the first signs appear, you must stop taking the medication and undergo examination at a medical facility.

How long does it take to be eliminated from the body?

During the administration of Dexamethasone, the active substance immediately enters the blood and interacts with transcortin. The maximum concentration of the drug is observed 2 hours after its use.

After about 5 hours, the drug is eliminated from the blood. After this, the components of the drug enter the urinary system. Dexamethasone is completely eliminated from the body within 72 hours.

Drug interactions

While using Dexamethasone, other medications should be used with caution. Some interactions may worsen the patient's condition and complicate the treatment process

Various drug combinations:

1. Ephedrine, Phenobarbital and Rifampicin. In this case, simultaneous use of drugs leads to a decrease in the therapeutic effect of hormones.
2. Various diuretics. This combination enhances the excretion of potassium from the body. If this process is not controlled, acute heart failure may develop.
3. Sodium-containing medications. Simultaneous use leads to an increase in blood pressure and the risk of developing edema.
4. Glucocorticosteroids. In combination with Dexamethasone, they increase the likelihood of developing ventricular extrasystole.
5. Anticoagulants of indirect action. Combination with Dexamethasone reduces their effectiveness.
6. Non-steroidal anti-inflammatory drugs. In this case, ulcers may occur on the gastrointestinal tract.
7. Paracetamol. This medication's interaction with Dexamethasone increases the risk of liver toxicity.
8. Insulin. Its therapeutic effect is weakened due to combination with Dexamethasone.

Dexamethasone release forms

The substance Dixamethasone is a poorly soluble powder with a crystalline structure, white or yellowish in color, without a distinct odor. According to the instructions for use, the most common form of release is a solution for parenteral administration. Methods of administration: into a vein, into a muscle, into a joint, into periarticular tissue. Subcutaneous dexamethasone is used in veterinary medicine.

Dexamethasone indications for use

In the pharmacy chain you can buy dexamethosone in the following pharmaceutical forms::

• Dexamethasone tablets in a dosage of 0.5 mg of active ingredient.
• Solution for injections, in ampoules of 4 mg and 8 mg.
• Eye drops in solution or suspension, concentration 0.1%.
• Dexocort spray with dexamethasone (and neomycin) for the treatment of dermatological pathologies.

Accumulating information from the instructions for the use of dexamethasone for various dosage forms, the drug is produced by several domestic manufacturers, the German Bayer AG and Weimer Pharma, Polish pharmacists, Slovenia Krka and a pharmaceutical company in Thailand. The price depends on the manufacturer and release form. The estimated cost is from 60 to 100 rubles per package of ampoules.

Features of the drug use

Treatment with Dexamethasone is an emergency measure that is prescribed based on vital signs when there is a real risk to the life of the mother and her unborn child. In other cases, treatment with this drug is resorted to only if alternative, more gentle means are not able to help. Then, usually, the doctor prescribes tablets with a higher dosage at the beginning of treatment and then reducing it. Tests are also regularly carried out to monitor the patient’s hormonal levels.

It is important that it is strictly forbidden to suddenly stop taking the drug; this can provoke a “withdrawal syndrome”, which can be accompanied by vaginal bleeding, and will only cause even greater harm to the health of the fetus.

According to the experience of mothers who underwent treatment with Dexamethasone during pregnancy, to alleviate side effects, you should pay attention to your diet, for example, by balancing your diet: enriching your food with vitamins and proteins, while at the same time reducing the content of carbohydrates, fats and salt. Your doctor may also prescribe a diet enriched with foods high in potassium.

Usually, taking Dexamethasone causes a deficiency of this element in the body, and therefore pregnant women feel weak in their muscles and complain of fatigue during the day.

Opinions

The overwhelming number of reviews for dexamethasone note a persistent positive effect from the use of the drug, with virtually no side effects reported.

Oleg, 32 years old, Nizhny Novgorod: “I was prescribed drops with dexamethasone by an ophthalmologist when my chronic runny nose “gave” me complications in the form of conjunctivitis. I couldn’t cure it with simple drops, so I had to go to the doctor. After dexamethasone, I felt relief already on the third day, and after a week everything went away. I didn’t use it for a long time, the doctor explained that complications could arise. Everything went well for me.”

Irina, 27 years old, Omsk: “At one time my eyes began to fester greatly. I washed it with tea and used drops, the effect was short, and then everything came back. I went to the doctor, it turns out the cause was an infection, which had already become chronic. The ophthalmologist prescribed me drops with dexamethasone, to use for a month, twice a day. A week later there was no more pus, the course of treatment was completed.”

Path in the body

There are several ways to administer the drug dexamethasone into the body. You can use the medicine:

• Inside – in the form of tablets.
• Parenterally - using intravenous and intramuscular injections.
• Locally - on the skin, conjunctiva of the eye, in the joint cavity.

In this case, the drug will go through the same pathway of metabolism and excretion.

After entering the digestive system, the tablets are absorbed in the intestines. This occurs completely after 1–2 hours. Dexamethasone then attaches to a transporter protein in the blood.

Intramuscular administration leads to rapid entry into the bloodstream. This process occurs even faster with intravenous injection.

From the blood, the drug is transferred to the site of inflammation - the joint cavity or the site of an allergic reaction. Dexamethasone can reach the site of action by penetrating any barrier, including the placenta or blood-brain barrier.

Local application of the drug or intra-articular injections require minimal absorption into the blood. The medicine immediately appears at the site of action.

The further route of dexamethasone:

1. After providing a therapeutic effect, the drug returns to the blood.
2. The drug is delivered to the liver through the bloodstream and becomes inactive through a series of transformations.
3. Dexamethasone metabolites are formed in the liver 3–4 hours after the onset of action; the drug disappears from all tissues after 1–2 days.
4. Next, inactive substances enter the kidneys and intestines. Medicine is released through these organs.

The metabolic pathway involves the penetration of the drug into the breast milk of a lactating woman.

Reviews

Irina, 56 years old I am always prescribed Dextamethasone when attacks of bronchial asthma begin to torment me. I want to say that this is a very good medicine. Relieves choking when even theophedrine does not help. They are the only ones who save me now.

Igor, 32 years old It became impossible to step on the heel. I went to the hospital and the picture showed a heel spur. The surgeon prescribed physical therapy with hydrocortisone ointment. They explained to me that the ointment was hormonal, with detomexasone. To my surprise, my heel stopped hurting after several uses.

Nadezhda, 62 years old Treatment with dexamethasone was carried out in the hospital. I gained a lot of weight on hormones. The medicine is strong and affects the body from different sides. Afterwards the swelling did not go away for a long time. We did several injections a day. I wouldn't want to use hormones anymore.

Lydia, 26 years old At the end of pregnancy, 4 injections were given. Painful, but no worse than magnesia. They told me to let the baby’s lungs open normally if I was going to give birth early. The feeling is strange, like anesthesia for a toothache. Everything went well and the baby is healthy.

Adverse symptoms

If Dexamethasone is used incorrectly, the following adverse reactions may occur:

1. Urticaria, allergic dermatitis, rash and angioedema.
2. Arterial hypertension and encephalopathy.
3. Heart failure, cardiac arrest or rupture.
4. A decrease in the number of lymphocytes and monocytes, as well as thrombocytopenia.
5. Swelling of the optic nerve head. The development of neurological side effects, as well as seizures, dizziness and sleep disturbances, cannot be ruled out.
6. Mental disorders, insomnia, depressive psychosis, hallucinations, paranoia, schizophrenia.
7. Adrenal atrophy, growth problems in children, menstrual irregularities, increased appetite and weight, hypocalcemia.
8. Nausea, vomiting, hiccups, stomach ulcers, internal bleeding in the gastrointestinal tract, pancreatitis and perforation of the gallbladder.
9. Muscle weakness, osteoporosis, damage to articular cartilage and bone necrosis, tendon rupture.
10. Delayed wound healing, itching, bruising, erythema, excessive sweating.
11. Excessive intraocular pressure, glaucoma, cataracts, exacerbation of bacterial and viral eye infections.
12. Development of impotence.
13. Pain at the injection site. Atrophy of the skin, scar formation at the injection site.

The development of nosebleeds, as well as increased pain in the joints, cannot be ruled out. The development of side effects in patients who abruptly terminated treatment after completing a course of therapy cannot be ruled out. These side effects include the following ailments: adrenal insufficiency, arterial hypotension, and death.

Drug interactions

The drug is incompatible with other drugs, since it can form insoluble compounds with them.

The injection solution can only be mixed with 5% glucose solution and 0.9% NaCl solution.

Dexamethasone should not be combined with many other drugs, including non-steroidal anti-inflammatory drugs, macrolides, ketoconazole, frothinolones, phenytoin, thiazide diuretics, antihypertensives, heparin and other drugs. A complete list of them is included in the instructions for the medication.

Use for pregnant and lactating women

At the moment, there is not enough clinical data regarding the effect of the drug on a woman’s health and the development of the baby. Therefore, the use of Dexamethasone is permissible only as prescribed by a doctor.

During lactation, the use of drops is carried out with the utmost caution. The active components of Dexamethasone can be transmitted to the baby through mother's breast milk.

It is for this reason that during therapy it is necessary to abstain from breastfeeding.

Analogs, price

There are analogues of solution and tablets - Dexamed, Dexazone, Dexamethasone-Vial, etc. Analogues of drops - Maxidex, Dexamethasone-LENS, Ozurdex, etc. The ointment can be replaced with hydrocortisone ointment.

Prices vary significantly depending on the form of the drug, its volume, manufacturer, markups of pharmacy chains, etc. On average, the cost of tablets (10 pieces per package) is 20-40 rubles, ampoules of 1 ml (4 mg) - 100-200 rubles, eye drops - 30-70 rubles.

Drops and solution are stored in places with temperatures up to 15 degrees; freezing is prohibited. Tablets - up to 25 degrees. The product is suitable for use for 2 years. The drops retain their properties for 28 days after the bottle is opened.

What is it prescribed for?

Dexamethasone is actively used in various fields of medicine. This is due to the fact that the medicine has anti-inflammatory, anti-edema and anti-allergic effects. Depending on the indications, Dexamethasone injections are prescribed in the following cases:

• problems with the functioning of the adrenal glands;
• Quincke's edema;
• anaphylactic shock;
• lupus erythematosus;
• rheumatoid arthritis;
• osteoarthritis;
• swelling of the brain caused by injury, infectious disease or surgery;
• ulcerative colitis;
• Crohn's disease;
• atopic dermatitis;
• bronchial asthma;
• hives;
• tuberculosis;
• anemia;
• severe infections (in complex treatment, antibiotics are also used according to indications);
• traumatic, surgical and burn shock.

To treat these diseases, injections are prescribed to children and adults. In this case, the dosage of the drug and the frequency of injections will differ.

A drip with Dexamethasone helps against the same diseases as injections. However, it is prescribed in the most severe cases, when you need to get the fastest possible effect. In addition, this method of administering the drug reduces the risk of developing some adverse reactions. When prescribed as a drip, Dexamethasone can be mixed with other medications that will enhance its effect.

Operating principle

Dexamethasone, which is a glucocorticoid hormone, has a very strong anti-inflammatory effect on the body. This substance blocks the release and reduces the activity of compounds called inflammatory mediators. Under its influence, cellular immune reactions are inhibited; due to a decrease in the permeability of cell membranes and capillary walls, Dexamethasone has an anti-exudative effect. In addition, it participates in metabolic processes and affects the functioning of the pituitary gland.

A strong anti-inflammatory effect also occurs when used topically. The use of the drug for inhalation with a nebulizer directly affects the respiratory tract, which leads to a reduction in swelling of the throat and elimination of bronchospasm.

Sometimes these drops are prescribed for a runny nose and sinusitis, if such diseases have a protracted course or are allergic in nature. In this case, Dexamethasone is used to relieve nasal congestion (for emergency help), as well as for adenoids, sinusitis or otitis media.

In addition, in some cases, ENT doctors include such a drug in complex drops. In their recipes, the hormone is combined with antiseptics, antibacterial agents, vasoconstrictor drugs and other drugs - for example, they combine Dexamethasone, Xylene and Dioxidin.

note

The product should be used only for its intended purpose, for ophthalmic therapy. Before each use, the bottle with the drug must be shaken.

If relief does not occur after four days of using dexamethasone drops, you should consult a doctor to intensify therapy.

Soft contact lenses should be used with caution; before using drops, they must be removed from the eye and reinserted no earlier than 15 minutes later.

You should follow the dosage regimen and the scheme for using drops if it is necessary to use several drugs at once. The next instillation is possible only after 15 minutes.

Infectious eye pathologies must be treated with combined types of drugs, since drops with dexamethasone will only smooth out the picture, but will not get rid of the cause of infection. Doping tests may be false positive while using any form of dexamethasone.

The instructions for the use of eye drops with dexamethasone do not provide for restrictions in the control of mechanisms during therapy with this drug. However, you should wait at least half an hour before driving.

Interaction of the drug with other drugs

Since the drug Dexamethasone is quite serious, it is very important to consider its compatibility with other drugs. Phenoborbital, phenytoin, ephedrine, etc. taken simultaneously with it can reduce its effect. But hormonal contraceptives are quite capable of enhancing the effect of the drug.

When using the drug simultaneously with diuretics, the risk of potassium being removed from the body increases. If you use the product together with various heart medications, there is a possibility of developing heart rhythm disturbances.

What else is worth knowing

Once in the body, Dexamethasone is not completely absorbed. Only 60-70% of the active substance binds to transocrtin, a carrier protein. The drug easily penetrates tissue, including the placental barrier. Metabolism occurs in the liver, the remaining substances are excreted from the body by the kidneys. The disintegration and half-life takes 3-5 hours.

Dexamethasone is a drug that has proven itself as a rapid action against allergies and inflammatory diseases of joint tissue. It is not addictive, injections do not cause any particular pain. Following the instructions reduces the risk of side effects and speeds up the effect of the drug.

Dexamethasone analogues and price

Similar drugs that can replace dexamethasone are usually not indicated in the instructions for use. The use of generic drugs is possible according to the instructions for dexamethasone, since there is only one active ingredient in these medications. Exact information on dosage and use is indicated in the annotation for the drug.

List of drugs with different trade names, but with one active ingredient - dexamethasone:

• Decadron
• Dexa-Allvoran
• Supertendin
• Fortecort
• Dexacort
• Sondex
• Dexabene
• Detazon
• Maxidex

Table of drugs that are analogues of dexamethasone. Their use is regulated by separate instructions, since having a similar effect, the drugs contain other active hormonal substances.

Drug (trade name)	Release form	Price in rubles (approximate)
Methylprednisolone (Metypred)	tablets solution for injection, bottle	190 360
Naphthyzin dioxidine	complex nasal drops	60
Methylprednisolone aceponate (Advantan)	ointment cream emulsion	1219 548 563
Fluocinolone acetonide (Sinaflan)	ointment	96
Triamcinolone (Fluorocort, Kenalog)	ointment pills amp	260 330 515
Betamethasone (Diprospan, Akriderm)	amp, solution cream, ointment	580 160
Desonide (Desoven)	cream, gel lotion	from 350
Alclomethasone (Afloderm)	cream	370
Beclomethasone	metered aerosol for inhalation	292
Clobetasol (Dermovate)	ointment	435
Fluticasone	aerosol nasal spray cream	800 400 300
Hydrocortisone (cortisol)	solution suspension for intra-articular injections ointment, gel ointment, ophthalmic suspension	155 196 33 from 46
Dexamethasone Ferein	solution, ampoules	—
Prednisolone	tablet solution	48 108
Dexa Gentamicin	eye ointment	140

The instructions indicate that all drugs containing doximethasone cannot be used without a doctor’s prescription. When purchasing, the pharmacist will need to present a prescription in Latin.

Storage conditions for ampoules: at room temperature, in original packaging. Store no more than 5 years from the date of release.

Useful tips

During therapy with Dexamethasone, you should regularly visit an ophthalmologist to monitor blood pressure and water-electrolyte balance. In addition, blood tests should be available in the observation area. This is especially important for long-term therapy.

To reduce the risk of side effects, additional vitamin K should be used - this can be achieved with a special diet and taking potassium supplements. Food must be complete and contain:

• Proteins;
• Vitamins and other microelements.

Fats, carbohydrates and salt should be excluded.

The drug should be used with caution in those with hypothyroidism and liver problems (eg, cirrhosis). After all, it can intensify a person’s existing emotional problems and psychotic disorders.

It should be used very carefully in case of myocardial infarction. In such a situation, the risk of spreading and enlarging the focus of necrosis increases, worsening and slowing down the rate of tissue scarring, and the drug can cause heart rupture.

If a person gets into a stressful situation during maintenance treatment, for example, he is undergoing surgery, or an infectious disease has manifested itself, the dose should be adjusted, because at this point, the need for glucocorticosteroids increases.

If the drug is withdrawn, this is especially true in the case when high doses of the drug were taken before, withdrawal syndrome may become very pronounced.

In this case, a person may experience anorexia, a feeling of nausea, lethargy, muscle and skeletal pain, and general weakness.

When conducting therapy in children, it is imperative to constantly monitor their development and growth. If during the treatment period children come into contact with others who have measles or chickenpox, they additionally need to be given immunoglobulins.

People suffering from diabetes should be constantly monitored by a doctor and regularly donate blood so that therapy can be adjusted if necessary. Ideally, x-rays should be taken to monitor the condition of the bones and joints.

Dosage

About how dexamethasone should be dosed, the instructions clearly indicate only that the dosage is selected individually. Treatment with corticosteroids begins with a small dose, the middle of therapy is an intensive course, the final stage is a gradual reduction in dosage

Note! The introduction of a synthetic hormone into the body will inevitably provoke a slowdown in the production of its own corticosteroid analogues. Unjustified use of potent hormonal medications can undermine your health.

In the official instructions for the use of dexamethasone, the classic dosage regimen for the drug in injections looks like this:

• initiation of therapy – from 2 to 4 mg of the drug per day;
• in the zone of therapeutic effect (2-3 days of treatment) - maximum dosage;
• The final stage of treatment is a gradual reduction in the daily dose to 0.5 mg.

The instructions warn that the initial intake of doximethasone orally at the maximum dose can provoke hormonal shock in the patient. The same effect occurs when the drug is abruptly discontinued.

According to the instructions, not only the dosage varies, but also the form of use of dexamethasone. At the intensive stage of therapy, Dexomethosone is injected into a vein by stream, drip or intramuscular injection. For maintenance therapy, taking tablets is sufficient.

What can replace Dexamethasone?

When treating joints, dexamethasone is administered locally, directly into the affected joint.

Instructions for treatment are as follows:

• from 0.2 to 8 mg of dexamethasone is injected into the joint once, every 3 days;
• full course – 3 weeks.

Children are dosed with doximethasone according to their age. The minimum allowed use per day is 0.25 mg, the maximum is 2.5 mg of the active substance per day.

Note! The dosage varies not only depending on age or individual reactions, but also on its diagnosis and medical history. For children, the daily dose is divided into 3-4 doses.

Instructions for the ophthalmic use of drugs containing dexamethasone:

• initial stage of treatment - 1-2 drops every 1-2 hours;
• after the development of a stable therapeutic effect, the time period is increased to 4-6 hours.

The duration of use of medications with dexamethasone varies depending on the severity of the condition. According to the instructions, no more than 3 weeks.

In dermatology, the use of drugs containing dexamethasone, according to the instructions for the corresponding medications.

Note! Uncontrolled use of hormonal drugs for skin allergic reactions leads to exacerbation of the disease. One of the consequences of non-compliance with instructions is tissue necrosis.