Dexamethasone is a synthetic analogue of the hormone of the adrenal cortex, which has a pronounced effect on the metabolism of proteins and carbohydrates, and also has a powerful anti-allergic and anti-inflammatory properties.
Release form and composition
Dosage forms of the drug:
- Injection solution 4 mg / ml;
- Tablets 500 mcg.
The active component of Dexamethasone is the same substance.
The solution is available in ampoules of 1 or 2 ml, 25 ampoules in a carton of cardboard.
Tablets are sold in 10 pcs. in blister packs or dark glass bottles.
Indications for use
The use of Dexamethasone is indicated in the replacement therapy for adrenal insufficiency, including acute or relative, primary and secondary, and also developed after the withdrawal of glucocorticosteroids (GCS).
According to the instructions, Dexamethasone can also be included in the pathogenetic and symptomatic treatment regimen for:
- Allergic diseases;
- Systemic connective tissue diseases;
- Pulmonary diseases (including sarcoidosis, aspiration pneumonitis, etc.);
- Hematological diseases (including idiopathic thrombocytopenic purpura in adults and acute leukemia in children);
- Joint diseases (including osteoarthritis or rheumatoid arthritis);
- Dermatological diseases (including neutrophilic, contact, exfoliative dermatitis; erythema multiforme, toxic epidermal necrolysis, etc.);
- Diseases of the digestive tract (including with Crohn's disease, ulcerative colitis);
- Edematous syndrome;
- Ophthalmic diseases;
- Metabolic disorders (including hyperkalemia caused by a malignant tumor);
- Infantile spasms.
As part of the combination therapy, Dexamethasone is used for shock of various origins.
In combination with antimicrobial agents, the drug is often used in infectious diseases.
Systemic use of Dexamethasone is also indicated for sedation before surgery, and also as a supportive agent after surgery if there is a suspicion of insufficiency of the adrenal cortex.
If the drug is used for a short period of time and for health reasons, the only contraindication to the use of Dexamethasone is hypersensitivity to its components.
Dexamethasone should be used with caution:
- When viruses, fungi or bacteria are caused by infectious and parasitic diseases (currently occurring or recently transferred, including recent contact with a sick person);
- In the period before vaccination (8 weeks before vaccination), as well as in the post-vaccination period (14 days after immunization);
- When lymphadenitis, developed on the background of the introduction of BCG vaccine;
- Patients with immunodeficiency states, including AIDS and HIV infection;
- In diseases of the digestive tract;
- People with diseases of the heart and blood vessels, including recent myocardial infarction, decompensated chronic heart failure, hyperlipidemia, arterial hypertension;
- In endocrine diseases, including thyrotoxicosis, hypothyroidism, impaired glucose tolerance, diabetes, Itsenko-Cushing's disease;
- Patients nephroluritiasis;
- In severe forms of functional failure of the kidneys and / or liver;
- With hypoalbuminemia, as well as with conditions predisposing to its development.
Other conditions that require careful use of Dexamethasone include acute psychosis, systemic osteoporosis, grade 3 and 4 obesity, myasthenia gravis, poliomyelitis, glaucoma (both open-angle and closed-angle), lactation.
Special supervision is necessary for patients with heart failure, arterial hypertension, tuberculosis, osteoporosis, hepatic / renal failure, active peptic ulcers, diabetes mellitus, epilepsy.
In children and adolescents, Dexamethasone is used only for health reasons under the strict control of their growth and development.
Dosing and Administration
According to the instructions for Dexamethasone, the dose of the drug is selected individually, depending on the characteristics of the clinical situation. Children dosage is calculated based on their weight. The method of use of the drug depends on the patient's condition and indications.
In the acute period of the development of the disease, as well as in the initial stages of treatment, the use of elevated doses of Dexamethasone is indicated. After the therapeutic effect is achieved, the dose is gradually (usually 0.5 mg every 3 days) reduced to an effective maintenance dosage or until the drug is completely discontinued.
The duration of treatment is determined by the nature of the pathological process and the effectiveness of therapy. It can be several days or several months. The course of therapy is stopped gradually, at the end it is recommended to give the patient several injections of corticotropin.
Dexamethasone tablets are taken orally, the daily dose is divided into 2-4 doses. The solution is injected slowly intravenously (drip or jet method) or intramuscularly. Before IV infusion, Dexamethasone is diluted with 0.9% NaCl or 5% dextrose. The daily dose is divided into 3-4 injections.
In accordance with the instructions, Dexamethasone is generally well tolerated by patients. It exhibits low mineralocorticoid activity and has virtually no effect on water and electrolyte metabolism.
During the treatment with Dexamethasone, the state of the organ of vision, water and electrolyte balance, blood pressure indicators, blood glucose level and peripheral blood should be monitored.
Structural analogues - Dexazon, Dexamed, Megadexane.
Terms and conditions of storage
Dexamethasone is a prescription drug. Store it, according to the instructions, should be at a temperature up to 25 ° C in a place protected from sunlight. The shelf life of tablets with proper storage - 5 years, the solution - 3 years.