Dexamethasone is a hormonal synthetic drug from the group of glucocorticoids. Instructions for use of the drug dexamethasone - composition, indications for use, side effects and analogues

Dexamethasone tablets can be called a panacea in a certain sense. It is valued for its low allergenicity and excellent anti-inflammatory properties, and is used in the treatment of huge amount diseases of almost any specialization. The main task of this semi-synthetic hormone is to restore normal exchange substances in the body and maintain it.

Composition of the drug

Dexamethasone is a glucocorticosteroid identical to the hormone produced by the adrenal glands. The name of the drug comes from its main active ingredient – ​​dexamethasone. One of the forms in which the medicine is produced is white tablets, round, flat, with beveled edges.

One tablet contains 0.5 milligrams of dexamethasone.

In addition, there are auxiliary components:

• corn starch:
• lactose monohydrate;
• magnesium stearate;
• talc;
• povidone;
• anhydrous colloidal silicon dioxide.

Pharmacological properties and pharmacokinetics

Dexamethasone tablets are prescribed when there is a need to have a comprehensive effect on the body - to relieve shock and stop inflammation. Therefore, they are often indispensable during allergic manifestations of various forms and varying degrees of severity (excluding allergies to alcohol).

In the company of insulin, glucagon and catecholamines, dexamethasone regulates the body's accumulation and expenditure of energy. With its help, the liver begins to produce more glucose and glycogen.

The substance activates blood flow in the kidneys.

Slows down the impact of genes that form the culprits of inflammatory processes - enzymes, proteins and information molecules.

Dexamethasone also has several other pharmacological properties:

• anti-shock;
• immunosuppressive;
• antitoxic.

The medicine is quickly and almost completely absorbed. Different sources give a “bioavailability threshold”: from 80 to 100 percent. An hour or two after taking the tablets in a single dosage, the peak concentration of the hormone in the blood plasma occurs, and the therapeutic effect lasts for almost three days.

In plasma, most of the substance binds to albumin and enters the cells and the space between them. In the pituitary gland and hypothalamus, the pattern of action changes: there dexamethasone “works” through membrane receptors. In the so-called peripheral tissues - using cytoplasmic receptors.

The substance's molecules are destroyed directly in the body's cells and completely leave the patient's body after final breakdown in the liver. This is what is known for certain today. Most likely, the kidneys also participate in the process of releasing dexamethasone residues, transporting them into the urine, and with it out.

Gross formula

C 22 H 29 FO 5

Pharmacological group of the substance Dexamethasone

Nosological classification (ICD-10)

CAS Code

50-02-2

Characteristics of the substance Dexamethasone

Hormonal agent (glucocorticoid for systemic and local use). Fluorinated homolog of hydrocortisone.

Dexamethasone is a white or almost white, odorless, crystalline powder. Solubility in water (25 °C): 10 mg/100 ml; soluble in acetone, ethanol, chloroform. Molecular weight 392.47.

Dexamethasone sodium phosphate is a white or slightly yellow crystalline powder. Easily soluble in water and very hygroscopic. Molecular weight 516.41.

Pharmacology

pharmachologic effect- anti-inflammatory, antiallergic, immunosuppressive, antishock, glucocorticoid.

Interacts with specific cytoplasmic receptors and forms a complex that penetrates the cell nucleus; causes expression or depression of mRNA, changing the formation of proteins on ribosomes, incl. lipocortin, mediating cellular effects. Lipocortin inhibits phospholipase A2, suppresses the liberation of arachidonic acid and inhibits the biosynthesis of endoperoxides, PGs, leukotrienes, which contribute to inflammation, allergies, etc. Prevents the release of inflammatory mediators from eosinophils and mast cells. Inhibits the activity of hyaluronidase, collagenase and proteases, normalizes the functions of the intercellular matrix of cartilage and bone tissue. Reduces capillary permeability, stabilizes cell membranes, incl. lysosomal, inhibits the release of cytokines (interleukins 1 and 2, interferon gamma) from lymphocytes and macrophages. It affects all phases of inflammation, the antiproliferative effect is due to inhibition of the migration of monocytes into the inflammatory focus and the proliferation of fibroblasts. Causes involution lymphoid tissue and lymphopenia, which causes immunosuppression. In addition to reducing the number of T-lymphocytes, their influence on B-lymphocytes is reduced and the production of immunoglobulins is inhibited. The effect on the complement system is to reduce the formation and increase the breakdown of its components. The antiallergic effect is a consequence of inhibition of the synthesis and secretion of allergy mediators and a decrease in the number of basophils. Restores the sensitivity of adrenergic receptors to catecholamines. Accelerates protein catabolism and reduces their content in plasma, reduces glucose utilization by peripheral tissues and increases gluconeogenesis in the liver. Stimulates the formation of enzyme proteins in the liver, surfactant, fibrinogen, erythropoietin, lipomodulin. Causes a redistribution of fat (increases lipolysis of adipose tissue of the extremities and fat deposition in the upper half of the body and on the face). Promotes higher education fatty acids and triglycerides. Reduces absorption and increases excretion of calcium; retains sodium and water, ACTH secretion. Has an anti-shock effect.

After oral administration, it is quickly and completely absorbed from the gastrointestinal tract, T max - 1-2 hours. In the blood it binds (60-70%) to a specific carrier protein - transcortin. Easily passes through histohematic barriers, including the BBB and placental. Biotransforms in the liver (mainly by conjugation with glucuronic and sulfuric acids) to inactive metabolites. T1/2 from plasma - 3-4.5 hours, T1/2 from tissues - 36-54 hours. Excreted by the kidneys and through the intestines, penetrates into breast milk.

After instillation into the conjunctival sac, it penetrates well into the corneal epithelium and conjunctiva, while therapeutic concentrations of the drug are created in the aqueous humor of the eye. When the mucous membrane is inflamed or damaged, the rate of penetration increases.

Use of the substance Dexamethasone

For systemic use(parenterally and orally)

Shock (burn, anaphylactic, post-traumatic, postoperative, toxic, cardiogenic, blood transfusion, etc.); cerebral edema (including due to tumors, traumatic brain injury, neurosurgical intervention, cerebral hemorrhage, encephalitis, meningitis, radiation injury); bronchial asthma, status asthmaticus; systemic diseases connective tissue(including systemic lupus erythematosus, rheumatoid arthritis, scleroderma, periarteritis nodosa, dermatomyositis); thyrotoxic crisis; hepatic coma; poisoning with cauterizing liquids (in order to reduce inflammation and prevent cicatricial contractions); acute and chronic inflammatory diseases of the joints, incl. gouty and psoriatic arthritis, osteoarthritis (including post-traumatic), polyarthritis, glenohumeral periarthritis, ankylosing spondylitis (ankylosing spondylitis), juvenile arthritis, Still's syndrome in adults, bursitis, nonspecific tenosynovitis, synovitis, epicondylitis; rheumatic fever, acute rheumatic carditis; acute and chronic allergic diseases: allergic reactions to drugs and food products, serum sickness, urticaria, allergic rhinitis, hay fever, angioedema, drug exanthema; skin diseases: pemphigus, psoriasis, dermatitis ( contact dermatitis with damage to a large surface of the skin, atopic, exfoliative, bullous herpetiformis, seborrheic, etc.), eczema, toxicerma, toxic epidermal necrolysis (Lyell's syndrome), malignant exudative erythema (Stevens-Johnson syndrome); allergic eye diseases: allergic corneal ulcers, allergic forms of conjunctivitis; inflammatory eye diseases: sympathetic ophthalmia, severe sluggish anterior and posterior uveitis, neuritis optic nerve; primary or secondary adrenal insufficiency (including the condition after removal of the adrenal glands); congenital adrenal hyperplasia; kidney diseases of autoimmune origin (incl. acute glomerulonephritis), nephrotic syndrome; subacute thyroiditis; diseases of the hematopoietic organs: agranulocytosis, panmyelopathy, anemia (including autoimmune hemolytic, congenital hypoplastic, erythroblastopenia), idiopathic thrombocytopenic purpura, secondary thrombocytopenia in adults, lymphoma (Hodgkin, non-Hodgkin), leukemia, lymphocytic leukemia (acute, chronic); lung diseases: acute alveolitis, pulmonary fibrosis, stage II-III sarcoidosis; tuberculous meningitis, pulmonary tuberculosis, aspiration pneumonia(only in combination with specific therapy); berylliosis, Loeffler's syndrome (resistant to other therapy); lung cancer(in combination with cytostatics); multiple sclerosis; gastrointestinal diseases (to remove the patient from a critical condition): ulcerative colitis, Crohn's disease, local enteritis; hepatitis; prevention of transplant rejection; tumor hypercalcemia, nausea and vomiting during cytostatic therapy; multiple myeloma; carrying out a test for the differential diagnosis of hyperplasia (hyperfunction) and tumors of the adrenal cortex.

For topical use

Intra-articular, periarticular. Rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, Reiter's disease, osteoarthritis (if present) pronounced signs inflammation of the joint, synovitis).

Conjunctivally. Conjunctivitis (non-purulent and allergic), keratitis, keratoconjunctivitis (without damage to the epithelium), iritis, iridocyclitis, blepharitis, blepharoconjunctivitis, episcleritis, scleritis, uveitis of various origins, retinitis, optic neuritis, retrobulbar neuritis, superficial injuries of the cornea of ​​various etiologies (after complete epithelialization cornea), inflammatory processes after eye injuries and eye surgeries, sympathetic ophthalmia.

In outdoor ear canal . Allergic and inflammatory diseases of the ear, incl. otitis.

Contraindications

Hypersensitivity (for short-term systemic use for health reasons is the only contraindication).

For intra-articular administration. Unstable joints, previous arthroplasty, pathological bleeding (endogenous or caused by the use of anticoagulants), transarticular bone fracture, infected lesions of joints, periarticular soft tissues and intervertebral spaces, severe periarticular osteoporosis.

Eye shapes. Viral, fungal and tuberculous eye infections, incl. keratitis caused Herpes simplex, viral conjunctivitis, acute purulent eye infection(in the absence of antibacterial therapy), violation of the integrity of the corneal epithelium, trachoma, glaucoma.

Ear shapes. Perforation of the eardrum.

Restrictions on use

For systemic use (parenterally and orally): Itsenko-Cushing's disease, stage III-IV obesity, convulsive states, hypoalbuminemia and conditions predisposing to its occurrence; open angle glaucoma.

For intra-articular administration: general serious condition of the patient, ineffectiveness or short duration of action of the two previous administrations (taking into account the individual properties of the glucocorticoids used).

Use during pregnancy and breastfeeding

The use of corticosteroids during pregnancy is possible if the expected effect of therapy outweighs the potential risk to the fetus (adequate and strictly controlled safety studies have not been conducted). Women of childbearing age should be warned of the potential risk to the fetus (corticosteroids cross the placenta). It is necessary to carefully monitor newborns whose mothers received corticosteroids during pregnancy (adrenal insufficiency may develop in the fetus and newborn).

Dexamethasone has been shown to be teratogenic in mice and rabbits after local ophthalmic applications of multiple therapeutic doses.

In mice, corticosteroids cause fetal resorption and a specific disorder - the development of cleft palate in the offspring. In rabbits, corticosteroids cause fetal resorption and multiple disorders, incl. developmental anomalies of the head, ear, limbs, palate, etc.

Breastfeeding women are advised to stop either breastfeeding or the use of drugs, especially in high doses ah (corticosteroids pass into breast milk and may inhibit growth, the production of endogenous corticosteroids and cause unwanted effects in a newborn).

It should be borne in mind that when glucocorticoids are applied topically, systemic absorption occurs.

Side effects of the substance Dexamethasone

The incidence and severity of side effects depend on the duration of use, the size of the dose used and the ability to comply circadian rhythm prescription of drugs.

Systemic effects

From the nervous system and sensory organs: delirium (confusion, agitation, restlessness), disorientation, euphoria, hallucinations, manic/depressive episode, depression or paranoia, increased intracranial pressure with optic papilla congestion syndrome (pseudotumor cerebri - more common in children, usually after too rapid dose reduction, symptoms — headache, deterioration of visual acuity or double vision); sleep disturbance, dizziness, vertigo, headache; sudden loss vision (with parenteral administration in the head, neck, turbinates, scalp), formation of posterior subcapsular cataracts, increased intraocular pressure with possible damage to the optic nerve, glaucoma, steroid exophthalmos, development of secondary fungal or viral eye infections.

From the outside of cardio-vascular system and blood (hematopoiesis, hemostasis): arterial hypertension, development of chronic heart failure (in predisposed patients), myocardial dystrophy, hypercoagulation, thrombosis, ECG changes characteristic of hypokalemia; with parenteral administration: flushes of blood to the face.

From the gastrointestinal tract: nausea, vomiting, erosive and ulcerative lesions Gastrointestinal tract, pancreatitis, erosive esophagitis, hiccups, increased/decreased appetite.

From the side of metabolism: Na + and water retention (peripheral edema), hypokalemia, hypocalcemia, negative nitrogen balance due to protein catabolism, weight gain.

From the endocrine system: suppression of adrenal cortex function, decreased glucose tolerance, steroid diabetes or manifestation of latent diabetes mellitus, Itsenko-Cushing syndrome, hirsutism, irregular menstruation, growth retardation in children.

From the musculoskeletal system: muscle weakness, steroid myopathy, decrease muscle mass, osteoporosis (including spontaneous bone fractures, aseptic necrosis heads femur), tendon rupture; pain in muscles or joints, back; with intra-articular injection: increased pain in the joint.

From the skin: steroid acne, stretch marks, skin thinning, petechiae and ecchymosis, delayed wound healing, increased sweating.

Allergic reactions: skin rash, hives, facial swelling, stridor or difficulty breathing, anaphylactic shock.

Others: decreased immunity and activation infectious diseases, withdrawal syndrome (anorexia, nausea, lethargy, abdominal pain, general weakness and etc.).

Local reactions after parenteral administration: burning, numbness, pain, paresthesia and infection at the injection site, scarring at the injection site; hyper- or hypopigmentation; skin atrophy and subcutaneous tissue(with intramuscular administration).

Eye shapes: at long-term use(more than 3 weeks) possible increase in intraocular pressure and/or development of glaucoma with damage to the optic nerve, decreased visual acuity and loss of visual fields, formation of posterior subcapsular cataracts, thinning and perforation of the cornea; possible spread of herpes and bacterial infection; Patients with hypersensitivity to dexamethasone or benzalkonium chloride may develop conjunctivitis and blepharitis.

KNF (medicine included in the Kazakhstan National Formulary of Medicines)

ALO (Included in the List of free outpatient drug provision)

Manufacturer: KRKA, d.d., Novo Mesto

Anatomical-therapeutic-chemical classification: Dexamethasone

Registration number: No. RK-LS-5 No. 003395

Registration date: 24.08.2016 - 24.08.2021

Limit price: 24.03 KZT

Instructions

• Russian

Tradename

Dexamethasone

International nonproprietary name

Dexamethasone

Dosage form

Tablets 0.5 mg

Compound

One tablet contains

active substance- dexamethasone 0.5 mg,

Vexcipients: lactose monohydrate, corn starch, povidone, magnesium stearate, talc, colloidal anhydrous silicon dioxide

Description

Round tablets of white or almost white color with a flat surface, with a score on one side and a bevel.

Pharmacotherapeutic group

Corticosteroids for systemic use. Glucocorticosteroids. Dexamethasone.

ATX code H02AB02

Pharmacological properties

Pharmacokinetics

Dexamethasone is rapidly and almost completely absorbed when taken orally. The bioavailability of dexamethasone is 80%. After oral administration Cmax in blood plasma was observed after 1-2 hours; After a single dose, the effect lasts approximately 66 hours.

In blood plasma, about 77% of dexamethasone is bound to plasma proteins, and the majority is converted to albumin. Only minimal amount Dexamethasone binds to non-albumin proteins. Dexamethasone is a fat-soluble compound. The drug is initially metabolized in the liver. Small amounts of dexamethasone are metabolized in the kidneys and other organs. The predominant excretion occurs through urine. The half-life (T1\2) is about 190 minutes.

Pharmacodynamics

Dexamethasone is a synthetic adrenal hormone (corticosteroid) with glucocorticoid action. The drug has a pronounced anti-inflammatory, antiallergic and desensitizing effect, and has immunosuppressive activity.

To date, enough information has been accumulated about the mechanism of action of glucocorticoids to imagine how they act at the cellular level. There are two well-defined receptor systems found in the cytoplasm of cells. Through glucocorticoid receptors, corticosteroids exert anti-inflammatory and immunosuppressive effects and regulate glucose homeostasis; through mineralocorticoid receptors they regulate sodium and potassium metabolism, as well as water and electrolyte balance.

Indications for use

replacement therapy for primary and secondary (pituitary) adrenal insufficiency

congenital hyperplasia adrenal glands

subacute thyroiditis and severe forms post-radiation thyroiditis

rheumatic fever

acute rheumatic carditis

pemphigus, psoriasis, dermatitis (contact dermatitis affecting a large surface of the skin, atopic, exfoliative, bullous herpetiformis, seborrheic, etc.), eczema

toxicerma, toxic epidermal necrolysis (Lyell's syndrome)

malignant exudative erythema (Stevens-Johnson syndrome)

allergic reactions to medications and foods

serum sickness, drug exanthema

urticaria, angioedema

allergic rhinitis, hay fever

diseases that threaten vision loss (acute central

chorioretinitis, inflammation of the optic nerve)

allergic conditions (conjunctivitis, uveitis, scleritis, keratitis, iritis)

systemic immune diseases(sarcoidosis, temporal arteritis)

proliferative changes in the orbit ( endocrine ophthalmopathy, pseudotumors), sympathetic ophthalmia

immunosuppressive therapy for corneal transplantation

ulcerative colitis, Crohn's disease, local enteritis

sarcoidosis (symptomatic)

acute toxic bronchiolitis, chronic bronchitis, bronchial asthma (exacerbations)

agranulocytosis, panmyelopathy, anemia (including autoimmune hemolytic, congenital hypoplastic, erythroblastopenia)

idiopathic thrombocytopenic purpura

secondary thrombocytopenia in adults, lymphoma (Hodgkin, non-Hodgkin)

leukemia, lymphocytic leukemia (acute, chronic)

kidney diseases of autoimmune origin (including acute glomerulonephritis)

nephrotic syndrome

palliative therapy for leukemia and lymphoma in adults

acute leukemia in children

hypercalcemia with malignant neoplasms

cerebral edema due to primary tumors or brain metastases, due to craniotomy or head trauma

Directions for use and doses

For a long time orally high doses of dexamethasone, the drug is recommended to be taken with meals, and antacids should be taken between meals. During the day, it is recommended to use it taking into account daily fluctuations in endogenous secretion of glucocorticoids in the range from 6 to 8 am.

For adults

The recommended starting dose for adults is 0.5 mg to 9 mg per day. The maximum daily dose is 10-15 mg. The daily dose can be divided into 2 - 4 doses. The usual maintenance dose is from 0.5 mg to 3 mg per day.

The initial dose of dexamethasone should be used until therapeutic effect, then it is gradually reduced (usually by 0.5 mg every 3 days) to maintenance - 2 - 4.5 or more mg/day. If high-dose therapy continues for more than a few days, the dose of the drug is gradually reduced over the next few days or over a longer period. The minimum effective dose is 0.5-1 mg/day. Doses are set individually for each patient depending on the nature of the disease, the expected duration of treatment, tolerability of the drug and the patient's response to the therapy. The duration of use of Dexamethasone ranges from 5-7 days to several 2-3 months or more. Treatment is stopped gradually.

Dosing in children over 6 years of age

Side effects

decreased glucose tolerance, “steroid” diabetes mellitus or manifestation of latent diabetes mellitus

Itsenko-Cushing syndrome, weight gain

hiccups, nausea, vomiting, increased or decreased appetite, flatulence, increased activity of liver transaminases and alkaline phosphatase, pancreatitis

"steroid" ulcer of the stomach and duodenum, erosive esophagitis, bleeding and perforation gastrointestinal tract

arrhythmias, bradycardia (up to cardiac arrest), development (in predisposed patients) or increased severity of chronic heart failure, increased blood pressure

hypercoagulability, thrombosis

delirium, disorientation, euphoria, hallucinations, manic-depressive psychosis, depression, paranoia

increased intracranial pressure, nervousness, anxiety, insomnia, headache, dizziness, convulsions, vertigo

pseudotumor of the cerebellum

sudden loss of vision (with parenteral administration, deposition of drug crystals in the vessels of the eye is possible), posterior subcapsular cataract, increased intraocular pressure with possible damage to the optic nerve, trophic changes corneas, exophthalmos, development of secondary bacterial, fungal or viral eye infections

negative nitrogen balance (increased protein breakdown), hyperlipoproteinemia

increased sweating

fluid and sodium retention (peripheral edema), hypokalemic syndrome (hypokalemia, arrhythmia, myalgia or muscle spasms, unusual weakness and fatigue)

slower growth and ossification processes in children (premature closure of epiphyseal growth zones)

increased calcium excretion, osteoporosis, pathological fractures bones, aseptic necrosis of the head of the humerus and femur, tendon rupture

"steroid" myopathy, muscle atrophy

delayed wound healing, tendency to develop pyoderma and candidiasis

petechiae, ecchymoses, skin thinning, hyper- or hypopigmentation, steroid acne, stretch marks

generalized and local allergic reactions

decreased immunity, development or exacerbation of infections

leukocyturia

violation of the secretion of sex hormones (violation menstrual cycle, hirsutism, impotence, delayed sexual development in children

withdrawal syndrome

Contraindications

increased sensitivity to active substance or auxiliary components of the drug

peptic ulcer of the stomach and duodenum

osteoporosis

acute viral, bacterial and systemic fungal infections(when appropriate therapy is not used)

Cushing's syndrome

severe arterial hypertension

severe renal failure

obesity III - IV degree

active form of tuberculosis

acute psychoses

pregnancy and lactation

cirrhosis of the liver or chronic hepatitis

childhood up to 6 years

Drug interactions

Concomitant use of Dexamethasone and painkillers (non-steroidal anti-inflammatory drugs), antihypertensive drugs, antidiabetic drugs, antiepileptics, diuretics, anticoagulants, antiasthma aerosols or ritodrine may increase or decrease its effect and/or cause undesirable effects. Therefore, these drugs should not be used simultaneously.

During treatment with Dexamethasone, you should refrain from alcoholic beverages.

special instructions

For diabetes mellitus, tuberculosis, bacterial and amoebic dysentery, arterial hypertension, thromboembolism, cardiac and renal failure, nonspecific ulcerative colitis, diverticulitis, recently formed intestinal anastomosis, Dexamethasone should be used very carefully and subject to the possibility of adequate treatment of the underlying disease. If the patient has a history of psychosis, then treatment with glucocorticosteroids is carried out only for health reasons.

When the drug is suddenly discontinued, especially in the case of high doses, glucocorticosteroid withdrawal syndrome occurs: anorexia, nausea, lethargy, generalized musculoskeletal pain, general weakness. After discontinuation of the drug, relative insufficiency of the adrenal cortex may persist for several months. If during this period there are stressful situations, glucocorticoids are prescribed temporarily, and, if necessary, mineralocorticoids.

Before starting to use the drug, it is advisable to examine the patient for the presence of ulcerative pathology of the gastrointestinal tract. Patients with a predisposition to the development of this pathology should be prescribed antacids for prophylactic purposes.

During treatment with the drug, the patient must adhere to a diet rich in potassium, proteins, vitamins, with reduced fat, carbohydrates and sodium.

If the patient has intercurrent infections or a septic condition, treatment with Dexamethasone must be combined with antibacterial therapy.

If treatment with Dexamethasone is carried out for 8 weeks before and 2 weeks after active immunization (vaccination), then in this case the effect of immunization will be reduced or completely neutralized. Patients with severe traumatic brain injuries and impairment cerebral circulation for ischemic type, glucocorticoids must be prescribed with caution. Use in pediatrics

In children over 6 years of age, during long-term treatment it is necessary to carefully monitor the dynamics of growth and development. In children during the growth period, glucocorticosteroids should be used only for health reasons and under especially careful medical supervision. To prevent disruption of growth processes during long-term treatment of children aged 6 to 14 years with the drug, it is advisable to take a 4-day break in treatment every 3 days.

Children who are in contact with measles patients during treatment should chicken pox, specific immunoglobulins are prescribed.

Features of influencemedicine on the ability to manage vehicle or potentially dangerous mechanisms

Since Dexamethasone may cause dizziness and headache, it is recommended to refrain from driving a car or operating other potentially dangerous machinery.

Overdose

Symptoms: Possible worsening of the side effects described in the corresponding section.

Treatment: the drug should be discontinued and symptomatic therapy prescribed. There is no specific antidote.

After the symptoms of overdose disappear, the drug is resumed.

Dexamethasone – hormonal drug, which has an immunosuppressive effect, fights inflammation, and has a positive effect on the central nervous system. The substances in the composition have anti-allergic and anti-shock properties, and are also capable of removing toxins, so it is actively prescribed to patients with inflammatory processes in the eyeball or with cerebral edema.

Once in the cytoplasm, it interacts with its receptors, resulting in the formation of a complex that, penetrating into the cell nucleus, enhances the synthesis of messenger RNA. Available in the form of tablets and injection solutions. Belongs to the category of vital necessary funds, available by prescription.

Important! During the course of treatment with Dexamethasone, it is necessary to refrain from driving and other activities that require the fastest and most accurate response to dangerous factors.

Use of the drug

Why is Dexamethasone prescribed? A doctor may prescribe it in cases where the patient has problems with the functioning of certain organ systems, as well as in the presence of a number of diseases:

• endocrine problems
• connective tissue pathologies
• skin diseases
• eye diseases
• problems in the functioning of the gastrointestinal tract
• blood diseases
• renal pathologies
• tumors
• other diseases

Thus, indications for use may include problems associated with adrenal insufficiency, swelling of the brain, the presence of tumors or traumatic brain injuries. The drug is aimed at relieving conditions caused by malignant tumors and conditions: leukemia, childhood leukemia and others.

Dexamethasone is effective in exacerbation of chronic diseases (bronchitis, asthma), as well as in severe allergic reactions and during infectious diseases (in combination with antibiotics). Designated for withdrawal from state of shock(at anaphylactic shock, burn, toxic, surgical). It is also often used in ophthalmology in the treatment of conjunctivitis, scleritis and to eliminate the consequences of eye injuries.

Taking Dexamethasone during pregnancy

Pregnancy can be a contraindication for taking many medications, and Dexamethasone is no exception. Its application on early stages shown only when possible risk for the life and growth of the embryo is greater than the possible side effect of the drug. Taking medication for last stages pregnancy can have a significant impact on the development of the adrenal glands: the child may experience atrophy of their cortex, so after childbirth there may be a need for replacement therapy. If you need to take the drug during lactation, you will have to stop breastfeeding.

Mode of application

Dexamethasone is used according to an individually drawn up plan. Taken orally (tablets), by injection, conjunctivally.

• Tablets for adults. Taken after or during meals, from 2-3 to 10-15 mg per day (depending on the doctor’s instructions).

• Tablets for children. 3-4 times a day, depending on the child’s body weight.

• Injections for adults. For emergency care – from 4 to 20 mg, up to 4 times a day. Used for shock loading dose– 20 mg, then 3 mg per 1 kg of weight during the day.

• Injections for children. Calculated depending on body weight.

• At ophthalmological diseases– up to 2 drops hourly, after that – every 5-6 hours (if the condition is acute). In other cases - up to 2 drops 3 times a day. The course is usually a couple of weeks.

Contraindications

If the body has diseases of the gastrointestinal tract (ulcers, gastritis, colitis, diverculitis), as well as the cardiovascular system (heart failure and especially myocardial infarction), taking Dexamethasone is fraught with rupture of the heart muscle. Disturbances in the functioning of the endocrine system (diabetes, hypothyroidism and others) and pathologies of the kidneys and liver are also contraindications. And, as mentioned above, pregnancy and lactation period.

Side effects and overdose

In case of an overdose, the threat to the body is not so large-scale, but it is there. Rising arterial pressure, swelling appears, consciousness may change. That is why the drug must be prescribed by a doctor and taken according to an individual plan.

Dexamethasone is one of the vital medications. It is included in the list of similar pharmaceuticals World Organization healthcare. Dexamethasone can penetrate the brain, nervous system, and have a central effect on the body. This property and its therapeutic effects (immunosuppressive, anti-inflammatory) make medicine in some situations – irreplaceable.

Pharmacological group

Medicinal group of the drug: glucocorticosteroid. Synthetic hormone, a derivative of 9-fluoro-prednisolone.

Pharmacokinetics and pharmacodynamics

Once in the blood, dexamethasone bypasses the protective blood-brain, placental and other barriers of organs and tissues (histohematic barriers). This ability to penetrate everywhere allows dexamethasone to act even on the brain: to relieve cerebral edema. Swelling occurs in extreme situations: with hemorrhages, injuries, tumors.

The high concentration of the drug in the blood is ensured by the connection of the active substance with the blood protein – transcortin. It is a transport protein for corticosteroids. Transcortin delivers the therapeutic agent everywhere, carrying it with the bloodstream.
The drug is metabolized in the liver and excreted by the kidneys. A small part is excreted by the intestines (10%). At breastfeeding a small amount comes with the milk.

It has a targeted effect on the adrenal cortex: it inhibits their function. The adrenal glands are under the influence of dexamethasone for a long time: its half-life lasts up to 72 hours. All this time, the function of the endocrine organ is suppressed. Need this for therapeutic effect: excessive production of secretion of hormones that cause pathological reactions is stopped.
Dexamethasone also affects the functions of the pituitary gland, inhibiting (slowing down) the production of hormones (the result of this action is reversible).

The medicine controls almost all metabolic processes, changing them.

Protein metabolism. Protein catabolism (breakdown into simple components) accelerates. This causes the accumulation of glucose in the “depot” - liver, lymph. The glucose level in the blood drops, sometimes critically – to the point of hypoglycemia.

When the liver releases glucose into the blood, the pancreas is stimulated. It intensively produces insulin and utilizes glucose. There are “jumps” in the content of the latter in the blood.

It is necessary to monitor blood glucose levels. It is especially important for those suffering from diabetes, their sugar curve often peaks up or down.

Lipid metabolism. It changes not for the better for the body. Synthesis fatty substance organized so that fat moves to the abdominal area. Obesity of the “apple” type occurs, a dangerous increase in the likelihood of vascular accidents (heart attacks, strokes). The amount of cholesterol in the blood is significantly higher than normal.

Mechanism of therapeutic action

The medicine has no best influence on metabolic processes. Why then is dexamethasone prescribed? Even with some negative effects, dexamethasone is a powerful anti-inflammatory drug. It initiates a series of complex chemical processes leading to increased protection cell membranes, works at the cellular level. Reduces capillary permeability. Blocks the inflammatory process at any stage.

By suppressing the immune response, the drug stops allergic reactions. Stops swelling of the mucous membranes, slows down the formation of connective tissues. As a result, impaired breathing is restored and the formation of scar changes in organs is prevented.

Blocking histamine also stops pathological allergic reactions.

Release form

The drug is available in four forms:

1. Tablets containing the active substance – dexamethasone – 0.5 mg;
2. Eye drops – 1 mg of the drug per milliliter;
3. Eye ointment – ​​2.5 g tubes;
4. Injection ampoules – 4 mg of dexamethasone per milliliter of ampoule contents.

All forms of the drug contain additives that stabilize and facilitate transportation to the site of pathology and absorption of the drug, and preservatives for preservation. Packaging from different manufacturers looks different (photo).

The price of dexamethasone in pharmacies across the country varies:

1. Tablets – 16 – 38 rub. for 10 pcs. dosage 0.5 mg;
2. Injection solutions – 141 – 209 rub. for 25 ampoules, dosage 4 ml;
3. Eye drops – 46 – 70 rub. per dropper bottle, 10 ml;
4. Eye ointment – ​​100–140 rubles. tube.

The medicine is valuable in its action, the cost of dexamethasone itself is low. Sale by prescription. In the Latin prescription, the drug dexamethasone is called: Dexamethasone.

The drug dexamethasone is listed in the RLS - the official register of medicines.

Indications for use

The nervous system is the regulator of the entire body, and dexamethasone acts through it

The systemic effect of the drug caused wide range use of this medicine. It is used for many diseases.

The list of painful conditions for which Dexamethasone is needed includes:

• Endocrine disorders - problems of the adrenal glands, thyroid gland, androgenital syndrome;
• Autoimmune dysfunctions;
• Respiratory dysfunction;
• Shock life-threatening conditions;
• Blood diseases;
• Nonspecific ulcerative colitis;
• Acute phase of eczema;
• Serum sickness;
• Connective tissue defects;
• Agranulocytosis;
• Addison-Beermer disease;
• Pemphigus;
• Hypoplasia of hematopoiesis;
• Ophthalmic diseases;
• Deforming joint diseases – bursitis, arthrosis, osteochondrosis;
• Myositis;
• Tuberculosis;
• Helminthiasis with organ damage;
• Exacerbation of bronchial asthma;
• Meningitis;
• Traumatic brain injury;
• Malignant tumors;
• Severe infections.

Methods of application

Internal use. Integral route of drug intake: orally – through the gastrointestinal tract. Tablet forms are taken orally. Usually prescribed after withdrawal acute conditions, in which dexamethasone is administered intramuscularly or intravenously - from 8 mg of the active substance in an injection solution. In the future, the doctor prescribes taking pills.

The average daily oral dose is usually 15 mg. The attending physician is responsible for adjusting doses.

Injections

Dexamethasone injections are administered intramuscularly or intravenously.

Intravenous injections of dexamethasone solution are divided into jet injections (slowly from a syringe into a vein) and drip injections - in droppers. In critical situations, when there is a high risk to the patient's life, it is preferable intravenous administration dexamethasone. The drug immediately appears in the blood, ensuring rapid action.

If the drug's tolerability is known and the person knows the symptoms of an impending dangerous condition, from which this particular drug removes him, the doctor prescribes dexamethasone in ampoules. The patient is learning how to set up intramuscular injections, has the drug with him. This way you can save your own life if the doctor is far away, and the time countdown is on minutes.
For this, at a minimum, you need to know how to inject dexamethasone into yourself or a person who needs an injection.

If the situation is difficult and ambulance necessary: ​​requires intravenous administration. But you still need to get an injection before the arrival of a specialized team - inaction is dangerous!

You will need:

• Syringe;
• Dexamethasone ampoule (or several);
• Sterile wipes (you can use cotton wool and an alcohol-containing solution to disinfect the injection site).

It is more convenient to inject yourself into the femoral muscle. Algorithm:

1. A person lies down, or better yet sits, if his condition allows.
2. Opens (breaks off) the upper part of the ampoule.
3. Opens the syringe package, assembles it or, if it is initially assembled, removes the cap from the needle.
4. Having inserted the needle into the ampoule, he draws its contents into the syringe, pulling the syringe rod towards himself.
5. By lifting it vertically, it removes air bubbles: it “drives” the air by pressing the rod up.
6. Grasping the thigh muscle with your left hand, inserts a needle into it. The depth depends on the size of the needle; if the needle is small, it is inserted right up to the cannula.
7. Slowly injects the medicine into the muscle.
8. Removes the needle with a quick movement (this way pain is felt less).
9. Wipe the injection site with a disinfectant wipe or cotton swab soaked in alcohol.
10. Knowing how to inject life-saving dexamethasone intramuscularly, a person gets an additional opportunity to survive and help himself immediately when needed.

Only healthcare workers administer the solution by drip. If necessary, in a hospital setting. Injection application medication is usually limited to three days. Then the patient is transferred to maintenance treatment with tablet forms with gradual decline dosage - until complete withdrawal.

Dexamethasone is also used for inhalation, be sure to follow the instructions for use. Respiratory diseases sometimes require just such an emergency approach. By inhalation, the drug is delivered locally – specifically to Airways, to the "destination".

For inhalation, take the same solution that is intended for injection.

The procedure is indicated for swelling of the bronchial mucosa, allergic inflammation and severe inflammatory processes of another nature.

Inhaled dexamethasone is used to treat:

• Pulmonary tuberculosis;
• Laryngitis;
• Allergic cough and accompanying other respiratory diseases;
• Pharyngitis;
• Residual manifestations of pneumonia;
• Bronchial asthma;
• Diseases of the respiratory system of fungal etiology;
• Bronchiectasis;
• Cystic fibrosis;
• Choking from swelling of the larynx (false croup).

There are contraindications. Inhalations are not carried out if:

Pregnant and breastfeeding women should avoid inhaling dexamethasone.

Carrying out inhalation:

1. The dosage is important: adults – one ampoule per procedure, children – half (1 and 0.5 ml, respectively). In severe cases, the doctor can increase the dose and perform inhalation personally, monitoring the patient’s condition. If the ampoules contain 2 ml of medicine, measure required quantity conveniently with a sterile syringe.
2. The hormone is a potent drug; a diluted substance is administered by inhalation. This is insurance against side effects and ease of use. Administering 0.5 ml of any substance by inhalation is almost impossible.
3. The medicine is diluted six times with saline solution.
4. The amount of liquid in diluted form is small, but modern nebulizers can spray even negligible amounts.
5. Inhalation should be carried out according to the instructions of the nebulizer. Breathe calmly and shallowly: deep breathing increases the likelihood of side effects.
6. Do not physically burden the body before and after inhalation with dexamethasone. Even eating food is considered a load.

The procedure itself will only take ten minutes or less.
It is important to follow the rules, then there is almost no risk of trouble. But it is not excluded.

Possible side effects from inhalations:

• Bronchospasm;
• Drying of the mucous membranes, their irritation, resulting in coughing;
• Overdose or hyperventilation (deep breathing) can cause swelling of the mucous membranes, dizziness, tachycardia, redness of the face, blurred vision, clouded consciousness.

All of these reactions are very rare. You just have to not panic. Usually the inhalation is successful.
The course of treatment is from three days to a week.

What is Dexamethasone used for?

The list of diseases in the indications shows how strong and varied the effect of the drug is.

Joint diseases

Inflammatory joint diseases occurring with acute pain Treat with a short course of dexamethasone, injecting it directly into the joint. The properties of the drug allow you to quickly relieve pain and relieve inflammation.

If the inflammatory process has entered a stage where conventional NSAIDs cannot stop it, painful sensations are unbearably painful, hormones are used to treat prostatitis.

Powerful and effective dexamethasone in three days will have an effect sufficient to mitigate the disease.

For prostatitis, it is not advisable to prescribe a drug of such a strong effect for a longer period. He suppresses immune reactions, and to heal from prostatitis, immunomodulators and stimulation of the immune system are needed. A conflict of opposition arises. It cannot be prolonged. The risk of side effects increases with long-term use of dexamethasone. Failure of metabolic processes is especially dangerous.

But a short, three-day, hormonal medication will help relieve inflammation and pain. This is important both psychologically and for the successful treatment of prostatitis.

Asthmatic status

The positive effect of the hormone dexamethasone on the bronchial mucosa, preventing or eliminating edema is guaranteed to improve the patient’s condition, helps cope with asthma, and relieves exacerbations in short time. The danger of suffocation disappears, attacks are reduced and weakened. The mucus that clogs the bronchi stops accumulating.

The immunosuppressive and anti-inflammatory properties of the drug have found application in the treatment of eye ailments of allergic etiology. Eye drops are used to treat keratoconjunctivitis, keratitis, inflammatory processes of the conjunctiva, and iritis caused by allergies. At the same time, inflammation is relieved and its cause is eliminated.

One drop continues to act after instillation - 8 hours. All this time, the solution treats the inflamed eye and normalizes metabolic processes at the site of pathology.

Traumatic brain injury

In such a situation, cerebral edema is possible; stopping and eliminating it is vitally important. A glucocorticosteroid can do this.

Infectious diseases

If antibiotics are unable to cope, the body loses strength. Medicine uses the “heavy artillery” – hormones. Not for long, but the effect will have time to appear. With such support, the body will cope with the infection.

Anaphylactic shock

Is the same allergic reaction, but life-threatening, occurring rapidly, rapidly, requiring immediate help. The antiallergic effect of the drug is life-saving in this situation.

The adrenal cortex normally produces glucocorticosteroids, which regulate many processes in the body. When hormone production is disrupted, a person gets sick.

Dexamethasone is a synthetic hormone identical to what the adrenal glands are supposed to produce.

Its introduction in case of impaired functioning of the latter stabilizes the patient’s well-being.

Thyroid diseases

The drug acts on the pituitary gland, and through it - indirectly - on thyroid gland. It reduces the increased secretion of thyroid-stimulating hormone.

Dexamethasone or Prednisolone

When choosing Dexamethasone or, it is worth considering the difference in dosage. In terms of glucocorticoid activity, prednisolone lags behind, and by much: seven times. Single dose the first in injections - 4 mg, and prednisolone - up to 80 mg. Decide which medication is better: prednisolone or dexamethasone, in each specific situation should the doctor. Patients are different, and tolerance and concomitant diseases may be different.

Dexamethasone has a stronger effect; the course of treatment with it is only possible for a short period. Then therapeutic effect dexamethasone will have time to manifest itself, and the risk of side effects is minimal.

Prednisolone can be used longer, but it has a weaker effect.

Test with Dexamethasone

What does the dexamethasone test do? In the use of the drug there is such a concept: test. The study is carried out if there is a suspicion of pathological abnormalities in the work of the adrenal cortex. It is an important endocrine organ that produces hormones. When failures occur, human health suffers greatly.

In the human body of any gender endocrine system produces the secretion of male (androgens) and female (estrogens) hormones. Normal homeostasis requires a certain ratio of both. For men, the predominance of androgens is important for health, for women - estrogen.

Balance is ensured by endocrine organs reproductive system each gender separately. But these same hormones are controlled by the adrenal cortex. To check the functioning and health of this important endocrine organ, a test with dexamethasone is performed.

Normally, this hormone is secreted by the adrenal cortex. Homeostasis is the controller of a strictly defined amount of secretion.
The purpose of the test is to determine the amount of cortisol produced by the adrenal glands.

Initially, the patient detects problems in health, painful symptoms and abnormalities. The following are likely:

• Formation in women external signs, characteristic of men (hair growth male type, deepening of the voice, sharp facial features, even the character becomes tougher);
• Delayed or atypical signs of puberty, reproductive problems;
• Symptoms of neoplasms of the reproductive system.

Having contacted a specialist, a person receives an appointment to take tests. The need for a test with dexamethasone is determined by urine analysis. If the analysis showed that the content of 17-ketosteroids in daily urine is increased, pathology of the adrenal glands and more is likely.

An additional study of 24-hour urine hormones may include checking the content of oxycorticosteroids or 17-OX analysis. It will show the amount of all metabolites steroid hormones, not just cortisol. The goal is the same - to check the function of the adrenal glands.

If these tests reveal abnormalities, it is advisable to test with dexamethasone. This manipulation is informative regarding:

• Etiology of hyperandrogenism (increased secretion of androgens);
• Diagnosis of tumors of the adrenal cortex that affect the secretion of hormones;
• Detection of hyperplasia (growth like neoplasms) of the adrenal glands;
• Diagnosis of hypercortisolism - a long-term pathological effect of an excess of adrenal hormones on the body (Itsenko-Cushing disease).

The test also reveals: tumor processes pituitary gland, ovaries, cysts of the reproductive organs.

Other violations are also diagnosed: the readings are interpreted by a trained doctor

How is the test carried out?

The procedure is performed permanently. It is simple and not very stressful for the body. But the accuracy of compliance and medical control. Repeated blood sampling is also carried out, which the patient cannot do on his own at home.

The hospitalization is short, there is no need to worry. Calmness is also important for correct diagnosis: stressful conditions change hormonal levels.

On the eve of the examination, stop taking painkillers: they can affect these tests. The attending physician needs to know all the medications the patient is taking. To take into account their influence on the data obtained, if these drugs are capable of distorting the result.

Doctors will monitor both the dose of the drug and the time between subsequent doses of the drug. Violations must not be allowed in order for the result to be reliable.

There are small and large diagnostic tests with dexamethasone.

1. In the morning on an empty stomach, venous blood is collected. It will determine the initial level of cortisol. Blood is drawn at 8 o'clock.
2. Then dexamethasone is started. Every six hours - a tablet. And so - for two days.
3. Third morning – another blood draw. The time, as on the previous, first day, is 8 am.
4. The cortisol levels in both samples are compared.

Large sample:

1. The beginning is similar - blood sampling in the morning.
2. Only two tablets are taken, but once, at 23:00 on the same day.
3. In the morning at 8 – blood donation.

The first method is reliable up to 100%, the second – up to 95%. If cortisol decreases by half, the test result is positive. The absence of changes is interpreted as a negative test. It is up to the doctor to decide what to do next.

The test is based on the ability of dexamethasone to inhibit the secretion of corticotropin. The adrenal cortex reduces the production of hormones: the function is dependent on corticotropin. But if the tumor secretes hormones, it continues to secrete them: the pituitary gland does not control the activity of the tumor.

If an injected drug is urgently administered to save a life, all likely side effects are ignored. Only one thing is taken into account absolute contraindication: drug intolerance. When the situation is not so dramatic, and the drug is prescribed in a course, other contraindications should be taken into account:

• Open form of tuberculosis;
• Obesity;
• Diabetes mellitus, including hidden (latent) course;
• Decompensated heart failure;
• Hypercholesterolemia;
• Shingles;
• AIDS;
• Ulcerations of any part of the gastrointestinal tract;
• Itsenko-Cushing's disease;
• Thyroid diseases;
• Severe failure of any organ.

There are contraindications for injections into joints:

• Excessive bleeding;
• Fracture of bone tissue in a joint;
• Infections in the joint;
• Operated joints.

Side effects

Hormones should always be used with caution. Even synthetic, they are deeply embedded in the systems that control the body. They take control of it themselves. It is necessary to master the technique of hormonal treatment in order to minimize the likelihood and severity of side effects. Dexamethasone, and if the instructions for use are followed, has many side effects after injections, tablets, even after inhalation:

1. Metabolic disorders - hypokalemia, protein breakdown, bulimia, excess weight gain.
2. Cardiovascular system - arrhythmia, thrombosis, hypertension, myocardial dystrophy, heart failure, bradycardia, asystole ( sudden stop hearts).
3. Digestive system – gastritis, pancreatitis, ulcerative colitis, intestinal bleeding, vomiting, nausea.
4. Musculoskeletal system – myasthenia gravis, myopathy, muscle dystrophy, osteoporosis, weakness spinal column, susceptibility to fractures.
5. Endocrine system – diabetes mellitus, including latent form, abdominal obesity, adrenal insufficiency, hypertension, menstrual irregularities.
6. Visual organs – increased eye pressure, cataracts.
7. Nervous system – headache, psychosis, dizziness, convulsions, high intracranial pressure, fast fatiguability.
8. Immune suppression is a common infectious disease.



Drug interactions

Some medications increase or decrease the effect of dexamethasone.

Weaken:

• Ephedrine;
• Phenobarbital;
• Phenytoin;
• Rifampicin;
• Antacids.

Hormones act in different ways. Contraceptives (hormonal) have an additive effect: the effect of dexamethasone is enhanced.
Cardiac glycosides in the presence of the drug can provoke arrhythmia.

Diuretics taken simultaneously remove potassium from more Potassium deficiency is possible. It weakens the heart.

Coumarins behave unpredictably: they can act stronger, they can weaken.

Diacarb and other carbonic anhydrase inhibitors (affecting the kidneys, diuretics) can lead to increased excretion of potassium from the body, retaining sodium. Result: edema, potassium deficiency.

Paracetamol by itself is a blow to the liver, and when paired with dexamethasone it is a double blow.

NSAIDs in this tandem do not spare the gastrointestinal tract, damaging its parts to the point of bleeding. Their therapeutic effect is simultaneously reduced.

During treatment, it is advisable to exclude anabolic steroids: the combination will cause swelling and may cause excess hair growth (hirsutism).

Neuroleptics promote the formation of cataracts.

Amphotericin B – its combination with dexamethasone is fraught with heart failure.

Live vaccines - the suppressed immune system will not cope, the incidence of infections will increase.

Sodium preparations – edema, increased blood pressure.

special instructions

The drug may cause developmental disorders of the developing fetus in pregnant women. It is not advisable to use it; the risk is great. Sometimes pregnant women are prescribed dexamethasone for health reasons. The newborn will subsequently require intensive treatment.

Do not use during breastfeeding. If this is necessary for the mother, the child should be switched to feeding with adapted formulas.

Taking the drug often affects concentration. Work that requires increased concentration should not be carried out during the treatment period.

If a person taking dexamethasone has been in contact with a patient with a herpetic disease (chickenpox, shingles), he needs immunoglobulins. Immunity suppressed by the drug must be supported.

Dexamethasone should not be used before or after vaccinations: it neutralizes their effect. It can even provoke viral infections against the background of suppressed immunity.

A person undergoing serious hormonal treatment understands that health problems are not a joke. Sometimes this understanding is so depressing that he wants to take some alcohol as an “antidepressant”. The question naturally arises: is it possible?

Each of these substances, taken separately, distorts the normal processes and internal reactions of the body. Combining them will give unpredictable, unplanned results.

Willingly or unwittingly, some patients experienced these unpredictabilities.

Not a single one pleased me. Cross-reactions give up to four dozen negative side effects. Among them:

• Uncontrollable diarrhea;
• Sudden loss or severe decrease in vision;
• “Acute abdomen” – pain in the abdomen, stomach, gag reflex, nausea;
• The injection site becomes intensely painful: two incompatible substances collide there - medicine and alcohol;
• The skin of the body, especially the chest area, reacts to the “explosive mixture” with a rash of large red spots;
• The digestive tract is affected by ulcers;
• The skin of the face becomes acne-greasy.

Organisms are individual, and all troubles cannot be predicted. Positive influence was not noticed.

If a person is dependent on alcohol, he cannot take dexamethasone; the prescription of the drugs must be adjusted. You can’t do this on your own; you need to admit it and tell your doctor about the problem.

Analogs

Dexamethasone has analogues - medications with the same active ingredient. There are also drugs that act similarly, but have a different composition. These concepts need to be distinguished simply because the second group will have other indications, contraindications, other side effects and other nuances of use are possible.

Absolute analogues of Dexamethasone:

• Dexamethasone sodium phosphate;
• Vero-Dexamethasone;
• Dexafar;
• Dexamethasone-Ferey;
• Decdan;

In addition to these, there are a dozen more analogues, differing in names and prices, but the active ingredient in all of them is dexamethasone. And the properties, accordingly, are indistinguishable from the original drug.

Preparations with similar active ingredients:

• Berlicourt;
• Budesoni;
• Hydrocortiso;
• Decortin Triamcinolo;
• Budesoni;
• Hydrocortiso;
• Prednisolone.