What does dexamethasone give. How long does it take for dexamethasone to start working?

Dexamethasone is often used to treat a huge number of diseases, its benefits and harms are known to all specialists, but an overdose can lead to unforeseen consequences.

Intoxication of the body occurs abruptly without additional problems. The human body is designed in such a way that the reaction to all possible stimuli can appear suddenly. For some, malnutrition has become a real problem, as a result of which severe intoxication has arisen, and someone often encounters chemicals.

One of the most dangerous intoxications is drug poisoning. It seems that drugs should relieve unpleasant symptoms, but in fact, overdose, individual intolerance or other reasons can cause acute poisoning and the development of a huge number of pathologies.

Dexamethasone is often prescribed by specialists for the treatment of inflammation and infections of various kinds. At the same time, edema is significantly reduced, the risk of developing side diseases is significantly reduced, the victim returns to normal. Despite the fact that the beneficial effects of this drug are obvious, there are cases of extremely negative effects of the drug on the body.

Application

This drug provides good absorption in the body, due to which the treatment becomes as effective as possible. The maximum concentration of the drug is reached ninety minutes after taking the drug, and is excreted with the help of the kidneys and intestines.

It is important to consider that this remedy is absorbed into all parts of the human body, so nursing mothers should be treated with the utmost care. Instructions for use must be followed without fail, only in this way you will eliminate all possible risks and ensure effective treatment for yourself.

For adults, the use of this drug is recommended only with the approval of a doctor. In no case should you start treatment on your own. The benefits and harms of the drug can be strictly individual, and the medicine is used in the presence of the following diseases:

Serious diseases associated with the field of gynecology, caused by disruption of the endocrine system.
A state of shock arising from any of the possible causes.
Cerebral edema resulting from injury, disease, or hemorrhage.
Bronchial asthma, acute or chronic.
Severe allergic reactions.
Anaphylactic shock resulting from an allergy.
Diseases associated with insufficiency of the adrenal cortex.
Various diseases of the endocrine system.
Infectious diseases, dermatoses of various nature.
Blood diseases, including leukemia.

In fact, the list of diseases for the treatment of which this drug is used is much wider. Above are only the main and most popular ones, but experts often prescribe a remedy in the treatment of other diseases.

When using Dexamethasone, an overdose of which occurs at an amount above 20 mg per day, remember that exceeding the amount of the drug can result in serious dangerous consequences, and in some cases, death.

children

Treatment of various diseases in a child with the help of this drug should occur under the strict supervision of parents and strictly according to the doctor's prescription. The fact is that the children's body is prone to a lot of unpleasant diseases and is extremely susceptible to any unfamiliar substances, and therefore the symptoms of Dexamethasone overdose are quite common.

For the treatment of a small child, this drug is prescribed only in exceptional cases, when such therapy can greatly facilitate the life of a small patient or eliminate serious consequences. The permissible amount of the drug is prescribed only by a qualified specialist in full accordance with the weight, age of the child and the nature of his disease.

At the same time, the criteria for the growth of the baby are monitored throughout the entire course of treatment, and with the slightest change in the negative direction, the medication should be stopped immediately.

Contraindications

Dexamethasone is a fairly strong drug, therefore it is impossible to prescribe it on your own in any case. It is worth paying close attention to the individual characteristics of the patient, his condition and the course of the disease. This drug should be excluded or replaced by an analogue for people with a history of the following diseases:

allergic reactions to various irritants;
fungal and viral infections;
diseases of the cardiovascular system;
stomach problems;
diabetes.

With many other diseases, this drug is prescribed only after a detailed examination and passing the necessary tests, and only a doctor can approve the therapy.

During pregnancy, this medicine is prescribed only in exceptional cases, when the likelihood of an improvement in the mother's condition is much higher than the harm that will be done to the expectant mother and her child. At the same time, taking the drug without following the rules can lead to fetal death and subsequent miscarriage, therefore it is recommended to replace the drug with safe analogues.

Overdose

The symptoms of an overdose of this drug should be known to anyone who is being treated with this drug. This information is necessary at least in order to timely detect an excess of the permissible amount of the drug and avoid unpleasant consequences for the body.

Signs of an overdose directly depend on the amount of the substance taken and the nature of the disease for which it is used, and may be as follows:

Disorders of the central nervous system, including confusion, psychosis for no apparent reason, increased excitability, unreasonable anxiety and disorientation in space and time.
Problems in the work of the cardiovascular system, including a sharp increase in pressure, tachycardia, and even heart failure.
Increased intracranial pressure and convulsions accompanying this symptom in the limbs or throughout the body.
Allergic reactions, manifested by rashes on the skin.
Severe nausea, possible vomiting.

A single excess of the permissible amount of the drug will not bring any serious consequences for the body. In this case, it is important to detect the problem in time and adjust the treatment. To do this, you need not only to stop taking the drug for a certain period of time, but also to tell the doctor about your symptoms.

Video: Dexamethasone for joint pain.

First aid

If you or your loved ones have symptoms of an overdose of this drug, first aid is a chance for a quick recovery and the elimination of possible consequences. If the overdose manifests itself quite strongly, be sure to call a team of specialists - they will take all necessary actions to help the victim.

Mandatory actions to help the victim are considered:

Gastric lavage with plenty of warm water. A weak solution of potassium permanganate can be added to the liquid. Be sure to induce vomiting and remove the drug from the stomach.
After removing the drug, the victim must be taken. In this case, comes to the rescue, which is in every first aid kit.
The victim must be given complete rest, and only a doctor will prescribe additional therapy in case of an overdose.

Each person should take care of their health on their own, and only a responsible approach will allow not only to get rid of an unpleasant disease, but also to prevent consequences.

This drug allows you to quickly stop inflammation in the body, prevents the occurrence of edema of all mucous membranes, and inhibits eosinophilic infiltration of the submucosal layer. Despite the obvious benefits of this drug in the treatment of many diseases, an overdose of dexamethasone is possible if taken incorrectly.

General characteristics of dexamethasone

Dexamethasone tablets refers to a methylated derivative of fluoroprednisolone, it inhibits the production of substances such as interleukin and interferon gamma from lymphocytes and macrophages.

After entering the stomach, the drug is well absorbed from the digestive tract into the bloodstream, the maximum concentration of the substance in the blood is recorded one and a half hours after ingestion. It penetrates well into all tissues of the body, including the placenta and breast milk. Dexamethasone is excreted from the body by the kidneys and intestines.

Indications for use in adult patients

Adult patients take dexamethasone only as prescribed by a doctor and in the dosage prescribed by him. Indications for use are listed below:

Gynecological diseases that are caused by malfunctions in the endocrine system.
Shock state of various origins.
Swelling of the brain, provoked by a tumor, trauma or hemorrhage.
Acute or chronic form of bronchial asthma.
Severe allergic reactions.
Anaphylactic shock.
Acute insufficiency of the adrenal cortex.
Endocrine diseases.
Dermatoses.
infectious diseases.
Blood diseases - leukemia, leukemia, lymphoma.

This is only an approximate list of diseases for the treatment of which dexamethasone is used. The drug has a fairly broad spectrum of action and a tangible effect. The course of treatment should be prescribed only by a doctor.

The maximum dosage for an adult patient is up to 20 mg per day, but not more than 6 mg at a time.

Features of taking dexamethasone in children

For the treatment of children, the drug is prescribed only in exceptional cases, when it can greatly alleviate the condition of the sick child. The maximum allowable dosage is calculated by the doctor individually, based on the weight of the child and the severity of the disease. The entire treatment process should be supervised by a qualified specialist, with periodic measurements of the growth and development of the child. If there are any deviations from the norm, the drug is immediately canceled.

The maximum allowable dose for a child should not be more than 10 mg per day, otherwise there will be an overdose.

Contraindications

Dexamethasone is prescribed with caution to patients with a history of allergic reactions, fungal and viral infections. It is not recommended to take it for diseases of the cardiovascular system, stomach and diabetes. With diseases such as osteoporosis, psychosis, glaucoma, renal or hepatic insufficiency, the appointment of dexamethasone can only be after a thorough examination of the patient by a doctor.

During pregnancy, they try not to prescribe dexamethasone. Taking the drug can only be justified if the expected benefit to the female body is greater than the harm to the fetus.

Taking dexamethasone by a pregnant woman can lead to miscarriage and irreparable abnormalities in the development of the fetus.

Overdose symptoms

An overdose of dexamethasone is manifested by different symptoms, which depend on the amount of the drug taken and the general health of the person:

Malfunctions in the work of the central nervous system, which are characterized by confusion, psychosis, increased arousal, hallucinations, severe anxiety and disorientation;
Disorders in the work of the cardiovascular system - increased blood pressure, increased heart rate, heart failure;
intracranial pressure and convulsions;
Allergic rashes on the skin;
Severe nausea and vomiting.

There will be no consequences from a single dose excess, it is enough to stop taking the medication and adjust the dosage.

Emergency care for overdose

If an overdose of dexamethasone was noticed within a period of up to half an hour after administration, then the algorithm of actions is as follows:

the victim is given a lot of clean or slightly salted water, up to four glasses at a time, and induce vomiting;
give any adsorbents that are in the house - activated carbon, atoxil, polysorb. All these drugs are pre-diluted in a small volume of water;
put the victim to bed and wait for the ambulance to arrive.

Dexamethasone is a potent drug, so a doctor should be called immediately if an overdose is suspected.

It is strictly forbidden to self-medicate with dexamethasone poisoning, as bad health consequences are possible.

Dexamethasone overdose treatment

Intoxication after taking a large amount of dexamethasone is treated in a hospital setting, especially for children and people with chronic diseases. Hemodialysis in case of poisoning with this drug has no effect. Basically, supportive and symptomatic therapy is carried out, which is aimed at stabilizing the work of all organs and systems of the body. There is no specific antidote for dexamethasone. If Itsenko-Cushing's syndrome develops, the appointment of aminoglutethimide is indicated.

The patient after an overdose should be constantly under the supervision of the medical staff, as a deterioration in health is possible.

Reception features

The drug is taken orally. Dexamethasone should not be taken with other medicines. During treatment, you can not drive a car and work with mechanisms that require increased attention.

Treatment is canceled gradually and with great care. If the cancellation occurred abruptly after prolonged use, then a rise in temperature and general malaise are possible. Such a withdrawal reaction can occur even if there is no adrenal insufficiency. After dexamethasone therapy, corticotropin injections may be recommended to smooth out drug withdrawal.

Overdose warning

To prevent an overdose of dexamethasone, it is enough to follow a number of recommendations listed below:

Do not self-medicate, even if a friend or relative was prescribed this drug with similar diseases.
Do not increase your doctor's recommended dose.
Do not store medicines in places that are accessible to children.
When prescribing a drug, a doctor should pay attention to concomitant chronic diseases.
Do not use expired medicines for treatment.

Dexamethasone is good for a number of diseases when emergency care is needed. This drug is able to quickly remove a severe allergic reaction, helps to reduce temperature and inflammation, it is used as a first aid for Quincke's edema and in shock conditions. But, despite all the benefits of the drug, it can only be used as directed by a doctor, otherwise you can get health problems.

How much dexamethasone is excreted from the body?

How long does it take for dexamethasone to leave the body?

dexamethasone elimination period?

Dexamethasone after how much is excreted from the body?

Dexamethasone how long is excreted from the body?

How quickly is dexamethasone cleared from the body?

How long does it take for dexamethasone to be excreted from the body?

In practice, Dexamethasone is completely eliminated from the body no earlier than 72 hours after ingestion. Endocrinologists also told me about this, and I myself could feel it myself after I was forced to take this drug. Perhaps most of the "Dexamethasone" comes out right away (which is also hard for me to believe, since the same TIR is done for nine hours, but not three), but it has its effect on the body exactly three more days from the moment of admission. Therefore, if someone takes this medicine, then he should know that earlier than after 72 hours it is better for him not to meddle in any tests, since they will all be unreliable and usually bad.

Dexamethasone

Dexamethasone acts on almost all systems and organs of the human body. This drug is mainly intended for athletes. It relieves inflammation in the joints and heals damaged ligaments.

Indications for use

In medicine, Dexamethasone (read reviews about the drug at the end of the article) is used only in extreme cases, due to the very extensive side effects of the drug. For example, in diseases such as swelling or abscess of the brain, encephalitis, meningitis, leukemia and cancer therapy. In general, it is used only when the life of the patient is much more important than the side effects of this medicine. In addition, Dexamethasone inhibits the production of adrenocorticotropic hormone and, subsequently, the synthesis of endogenous glucocorticosteroids. This property of the drug justifies its use to increase muscle mass.

Side effects of dexamethasone

Dexamethasone is a drug whose side effects occur and depend on the duration of treatment and the dose used.

The most common side effects:

weight gain;
increased appetite;
mental disorders;
adrenal insufficiency;
glucose intolerance.

Less common are reactions such as:

With prolonged use of the drug:

obesity;
muscle atrophy;
skin vulnerability;
osteoporosis;
dysfunction of the adrenal glands.

In rare cases, you may experience:

glaucoma;
cataract;
aseptic necrosis of bones;
hypertension;
decreased immune defense;
increased susceptibility to infectious diseases.

The danger of osteoporosis

Regarding sports practice, osteoporosis can become a very unpleasant surprise. Side effects of dexamethasone have an antagonistic effect on vitamin D (calcium is "washed out" of the bones), as a result of which bone fragility will increase. With prolonged use of this drug, the ligaments will not only become elastic, but will soften, which should not be allowed.

Dexamethasone contraindications

The side effects of dexamethasone are not compatible with the actions of insulin-containing drugs, i.e. it cannot be used by people prone to diabetes, and even more so by those who already have it. After all, Dexamethasone increases insulin resistance. Also, the drug should not be used by those who suffer from a stomach or duodenal ulcer, kidney failure, infectious diseases.

Side effects on human systems and organs

Dexamethasone, the side effects of which are quite extensive, negatively affects the following human systems and organs:

Endocrine system: reduced glucose tolerance, steroid diabetes mellitus, worsening of adrenal function, Itsenko-Cushing's syndrome, in children, slowing down sexual development.
Digestive system: vomiting, nausea, pancreatitis, duodenal ulcer and stomach ulcer, erosive esophagitis, perforation and bleeding of the gastrointestinal tract, decreased or increased appetite, indigestion, hiccups, flatulence.
Cardiovascular system: arrhythmia and bradycardia; increased severity or development of heart failure, high blood pressure, hypercoagulation, thrombosis.
Nervous system: disorientation, delirium, euphoria, manic-depressive psychosis, hallucinations, depression, paranoia, nervousness or anxiety, increased intracranial pressure, insomnia, dizziness, convulsions, headache.
Sense organs: loss of vision, cataracts, increased intraocular pressure, a tendency to develop eye infections, exophthalmos, trophic changes in the cornea.
Musculoskeletal system: slowing down the process of ossification and growth in children, osteoporosis, steroid myopathy, rupture of muscle tendons, a decrease in muscle mass.
Local reactions: numbness, burning, tingling, pain, hyperemia or infection may occur at the injection site, in rare cases, necrosis or scar tissue may develop at the injection site; when administered intramuscularly, atrophy of the subcutaneous tissue and skin may occur.
Other reactions: exacerbation or development of new infections (for the appearance of such a reaction, the combined use of immunosuppressants contributes), leukocyturia.

With such an extensive list of side effects, Dexamethasone should be taken only in extreme cases, for a short time and in minimal doses. After all, the more you use this medicine, the more side effects you will begin to experience.

Dexamethasone

Exists.

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Dexamethasone. Pharmacology Dexamethasone is a glucocorticosteroid related to fluoroprednisolone.

It hinders activity.

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Dexamethasone. What is it. The active substance of the drug dexamethasone is a glucocorticosteroid hormone, which is produced by the cortex.

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Contraindications Dexamethasone If dexamethasone is prescribed in a short course, then it should not be used only in case of individual intolerance.

The benefits and harms of the popular drug Dexamethasone

Dexamethasone is often used to treat a huge number of diseases, its benefits and harms are known to all specialists, but an overdose can lead to unforeseen consequences.

Application

Serious diseases associated with the field of gynecology, caused by disruption of the endocrine system.
A state of shock arising from any of the possible causes.
Cerebral edema resulting from injury, disease, or hemorrhage.
Bronchial asthma, acute or chronic.
Severe allergic reactions.
Anaphylactic shock resulting from an allergy.
Diseases associated with insufficiency of the adrenal cortex.
Various diseases of the endocrine system.
Infectious diseases, dermatoses of various nature.
Blood diseases, including leukemia.

children

Contraindications

allergic reactions to various irritants;
fungal and viral infections;
diseases of the cardiovascular system;
stomach problems;
diabetes.

With many other diseases, this drug is prescribed only after a detailed examination and passing the necessary tests, and only a doctor can approve the therapy.

Overdose

Signs of an overdose directly depend on the amount of the substance taken and the nature of the disease for which it is used, and may be as follows:

Disorders of the central nervous system, including confusion, psychosis for no apparent reason, increased excitability, unreasonable anxiety and disorientation in space and time.
Problems in the work of the cardiovascular system, including a sharp increase in pressure, tachycardia, and even heart failure.
Increased intracranial pressure and convulsions accompanying this symptom in the limbs or throughout the body.
Allergic reactions, manifested by rashes on the skin.
Severe nausea, possible vomiting.

Video: Dexamethasone for joint pain.

First aid

Mandatory actions to help the victim are considered:

Gastric lavage with plenty of warm water. A weak solution of potassium permanganate can be added to the liquid. Be sure to induce vomiting and remove the drug from the stomach.
After removing the drug, the victim must take sorbents. In this case, activated charcoal comes to the rescue, which is in every first aid kit.
The victim must be given complete rest, and only a doctor will prescribe additional therapy in case of an overdose.

Each person should take care of their health on their own, and only a responsible approach will allow not only to get rid of an unpleasant disease, but also to prevent consequences.

Dexamethasone overdose

Dexamethasone is a hormonal agent containing a hormone that is produced by the adrenal cortex. The importance of the hormone is difficult to overestimate. With its participation, the processes of protein and carbohydrate metabolism take place. Due to a wide spectrum of action, the drug is prescribed as an anti-inflammatory, anti-allergic, anti-shock, immunosuppressive, desensitizing, anti-toxic agent.

It is characterized by a rapid suspension of the inflammatory process in the body, prevention of the development of mucosal edema, inhibition of the formation of eosinophilic infiltrate in the submucosal layer.

Information about the drug

Dexamethasone is a methylated derivative of fluoroprednisolone. This substance inhibits the production of interleukin (responsible for the course of immune reactions and the process of hematopoiesis) and interferon (viral antagonist proteins) from lymphocytes, as well as macrophages.

Upon penetration into the stomach, the substance is perfectly absorbed from the gastrointestinal tract into the bloodstream, reaching the highest concentration 30 minutes after taking the medicine. It also penetrates well into any tissue, placental and breast milk is no exception. It is excreted through the kidneys and through the intestines. According to the anti-inflammatory effect, this drug is 35 times more active than cortisone and 7 times more active than prednisolone.

Indications

Used in the treatment of bronchial asthma

Dexamethasone is a rather forgotten drug, but it has not completely disappeared from medical practice. It is used when the goal is to save lives with justifiable neglect of side effects. The range of application of the drug is quite wide:

diseases of a gynecological nature that have developed as a result of a failure of the endocrine function;
shock conditions of various etiologies;
swelling of the brain due to a tumor, injury or hemorrhage;
bronchial asthma in acute or chronic form;
allergic phenomena in severe form;
anaphylactic shock;
insufficiency of the adrenal cortex in acute form;
diseases of the endocrine organs;
dermatoses;
blood diseases;
infectious diseases.

And this is a rather incomplete list of cases when the drug is effective and justified in use. The course of therapy is determined solely by the attending physician.

Side effects

The frequency and degree of manifestation of side effects largely depends on the dosage and duration of therapy. With a short course, you can note such as:

increased appetite, as a result - weight gain;
mental disorders;
intolerance to glucose;
short-term adrenal insufficiency.

Less likely are allergic manifestations, hypertriglyceridemia, acute pancreatitis, peptic ulcers.

With a long course, manifestations such as:

With prolonged treatment, manifestations of osteoporosis are possible.

central obesity;
muscle atrophy;
osteoporosis;
vulnerability of the skin;
long-term impairment of renal function;
slow growth.

Quite rare, but still found:

aseptic necrosis of bone tissue;
cataract;
glaucoma;
high blood pressure (hypertension);
decrease in the protective properties of the immune system;
increased susceptibility to infections.

Moreover, a withdrawal syndrome is possible, which is manifested by fever, conjunctival hyperemia, runny nose, headaches and dizziness, excessive drowsiness, excessive irritability, muscle and joint pain, vomiting, weakness, convulsions and convulsions, weight loss.

Contraindications

An impressive list of negative effects determines the presence of contraindications. The drug is prescribed with caution to people with:

Use with caution in people with cardiovascular diseases

In the treatment of diseases in children, it is prescribed in exceptional situations. The maximum allowable rate is calculated by the attending physician, taking into account the weight and severity of the disease. The entire treatment course takes place under the obligatory supervision of a doctor, systematic measurement of growth and control of the development of the patient.

Pregnant women try not to prescribe the drug.

The expediency of taking the medicine is justified only when the expected benefit is many times greater than the negative impact on the fetus.

If an overdose has occurred

The active ingredient of the drug is the substance of the same name dexamethasone. An excessive amount of it can provoke serious poisoning or other negative manifestations. Therefore, it is necessary to adhere to the norms and rules recommended by experts.

Dosage

Norms should be calculated individually, according to specific diseases, duration of therapy, individual tolerability of corticosteroids, patient age.

For adults

The usual daily allowance for this group of patients is 2-3 mg. With a severe course of the disease, the dose is increased to 4-6 mg. However, upon the onset of a therapeutic effect, it is gradually reduced.

Maintenance is the dose corresponding to 0.5-1 mg per day.

Daily dose for adultsmg

The daily rate should be divided into 2-3 doses.

To avoid negative effects on the stomach, the medicine must be taken during or after a meal with a small amount of water.

For kids

The daily rate should be divided into three doses.

For other indications, the dosage corresponds to 0.08-0.3 mg per 1 kg of body weight or 2.5-10 mg per 1 sq. m. body surface area, respectively. This rate should be divided into 3-4 doses.

During pregnancy

This remedy normalizes the hormonal balance, contributes to the possibility of conception, the preservation of pregnancy, the process of the formation of the lungs in the fetus, the first breath in case of premature birth.

Dexamethasone is indicated to reduce androgen levels, which minimizes the possibility of miscarriage.

In the case of prolonged labor and the likelihood of a caesarean section, 100 mg of the drug is administered intravenously at intervals every 8 hours before birth.

Breast-feeding should not be temporarily performed until the treatment with this medicine is canceled.

Symptoms of an overdose

In case of overdose - malfunctions of the central nervous system

Dexamethasone intoxication usually occurs with prolonged (several weeks) administration of high doses. If dexamethasone was taken once, an overdose does not occur. And in such a situation, it is enough to stop taking the medicine or adjust the intake. If this is not done, then symptoms of dexamethasone toxemia will appear, characterized by:

disruptions in the activity of the central nervous system: hallucinations, psychosis, loss of consciousness;
disruptions in the activities of the CCC: heart failure, high blood pressure, rapid heart rate;
intracranial pressure, convulsions;
allergic reactions;
nausea and vomiting.

Treatment and initial results

It is good if signs of excessive medication were detected within half an hour. It is immediately necessary to call an ambulance team and take a number of measures to provide first aid.

Help at home

Take absorbent medications

The algorithm of actions is standard. Among them:

ensuring the intake of a large amount of clean and slightly salty water (4 glasses);
provoking a gag reflex;
taking absorbent drugs (atoxil, enterosgel).

Stationary measures

In the clinic, mainly symptomatic treatment is performed, the role of which is to stabilize and restore the functions of internal organs and all systems.

There is no antidote for the drug. Hemodialysis in such a case does not bring effect.

In the case of the development of Cushing's syndrome, aminoglutethimide is prescribed.

Initial result

More often, when an overdose of dexamethasone occurs, consequences are possible in the form of the development of Cushing's syndrome. Its early symptoms are characterized by such phenomena as:

local obesity;
changes in the quantitative indicators of glucose in the bloodstream;
the appearance of striae (striations on the skin);
acne;
slow wound healing;
local deposition of melanin;
hirsutism in women, impotence in men;
increased blood pressure;
osteoporosis;
weakness;
dizziness;
frequent headaches;
depressive state;
sleep phase disorder.

This medicine is quite strong. Therefore, in order to avoid the consequences of an overdose, one should strictly adhere to medical recommendations, do not resort to self-medication, and take into account the presence of chronic diseases.

Also do not forget to thank the doctors.

endocrinologist9 01:23

What treatment regimen was prescribed for you and for what diagnosis?

What aspect of the effect of dexamethasone on the body are you interested in?

endocrinologist9 04:47

To control the function of the adrenal glands, you need to pass:

blood test for ACTH;
a blood test for cortisol or a daily urine test for cortisol;
blood test for electrolytes - potassium and sodium.

endocrinologist9 14:56

endocrinologist9 22:49

endocrinologist0 01:23

endocrinologist0 02:39

endocrinologist2 13:54

First of all, issue your question separately, and not as the 35th comment to someone else's old one, and even in the middle of the page.

In a separate question, please indicate the specific dosages of dexamethasone you have taken and how long you have taken it. Also indicate what medications you are currently taking.

Sincerely, Nadezhda Sergeevna.

endocrinologist8 13:01

Regarding the treatment regimen for sinusitis, you need to consult with an appropriate specialist - an ENT doctor. The endocrinologist has nothing to do with the treatment of sinusitis at all.

Sincerely, Nadezhda Sergeevna.

endocrinologist6 12:17

If weight gain is really associated with taking Dexamethasone, then standard measures are used to normalize weight - diet No. 8 and daily physical activity, according to your physical capabilities. Additionally, during the first 4 weeks, you can take Stifimol 1 capsule 2 times a day.

Dexamethasone does not lead to the development of edema, consult a therapist about this.

endocrinologist6 17:07

The rest I have already written above, read the messages carefully - swelling is not associated with Dexamethasone, specific therapy is not required to normalize body weight. There is no need to specifically “remove” Dexamethasone from the body, it is perfectly excreted by itself.

endocrinologist8 20:35

In your case, Dexamethasone is used to treat pulmonological, and not endocrine, pathology. Accordingly, regarding its cancellation, you need to consult with a pulmonologist or therapist.

Dexamethasone is excreted from the body within 72 hours.

endocrinologist7 09:28

endocrinologist2 15:26

Your diseases do not belong to the field of endocrinology, so I will not help you, unfortunately. You need to choose the treatment of vasculitis together with a competent rheumatologist.

I have been without a thyroid gland for 6 years, constantly under the control of TSH. Now, after the flu, a cyst over the tooth has inflamed. I was given an injection of dexamethasone twice. And it was time for me to do or make the control TTG. How long after dexamethasone can I take TSH? Thanks in advance!

endocrinologist3 23:20

Dexamethasone injections will not affect the result of a blood test for TSH, donate it routinely.

Sincerely, Nadezhda Sergeevna.

endocrinologist8 21:41

It depends entirely on the reason for prescribing this drug and its dosage.

There is too little information in your question to answer.

Sincerely, Nadezhda Sergeevna.

endocrinologist8 21:48

Sincerely, Nadezhda Sergeevna.

endocrinologist8 22:07

In general, your question should be addressed to a general practitioner, an endocrinologist does not treat allergies and coughs.

Sincerely, Nadezhda Sergeevna.

endocrinologist1 17:57

Such a drug intake will not affect the weight.

Sincerely, Nadezhda Sergeevna.

It’s just that the drug is serious, I was a little scared, although I took it for a short period! There are a lot of side effects from the endocrine system!

endocrinologist1 21:04

Sincerely, Nadezhda Sergeevna.

She received dexamethasone in droppers as prescribed by a doctor, 5 droppers, 2 ampoules. Appointed by a neurologist to relieve inflammation and swelling that arose due to an intervertebral hernia. A few days later, everything was covered with purulent pimples (face, especially forehead, head, chest). A week has passed since the end of the droppers, but the problem with acne has not gone away. Did they disturb my hormonal background with this medicine? And now what i can do?

endocrinologist5 15:40

As I have repeatedly written above, such a use of dexamethasone does not lead to endocrine disorders. Consult with a dermatologist in person.

Sincerely, Nadezhda Sergeevna.

endocrinologist6 22:13

I am an adult endocrinologist and do not undertake to give recommendations to young children due to significant differences in approaches to diagnosis and treatment in adults and children. On this issue, it would be more correct to consult a pediatric endocrinologist.

Sincerely, Nadezhda Sergeevna.

endocrinologist9 14:30

I have repeatedly written above that such a use of dexamethasone does not lead to endocrine disorders and does not affect weight. Feel free to use the site search.

Sincerely, Nadezhda Sergeevna.

endocrinologist9 21:13

When taking dexamethasone, the level of cortisol in the blood decreases, this is a normal physiological reaction.

I want to draw your attention to the fact that a more informative analysis is a daily urine test for cortisol, and not a blood test.

Sincerely, Nadezhda Sergeevna.

endocrinologist2 15:54

As I have repeatedly written above, a single administration of Dexamethasone does not lead to the development of side effects. There is no allergy to Dexamethasone, on the contrary, this drug is used to treat allergies.

Sincerely, Nadezhda Sergeevna.

Dear Nadezhda Sergeevna! Please do not give to the elderly. YOU are an adult endocrinologist and do not undertake to give recommendations to young children, due to significant differences in approaches to diagnosis and treatment in adults and children. But our granddaughter, Boris, who is 2 years and 1 month old, has already been hospitalized three times this year and has been treated mainly with Deximethasone all the time. An average of two weeks. At the present time he is in the regional hospital due to poor analyses- BLOOD: ALP- 233.7; AST-52.9; CREA-43.2; UREA-1.8; Calcium-11.07; Sodium-140.

URINE: total. Nichiparenko delta=1.0* 10/ Protein was not detected, sugar was negative. Leukocytes are single VIZ, squamous epithelium is one VIZ. Could this be a consequence of treatment with Deximethasone?

Sincerely, The Gorobinsky Family, We kindly request, tell us what to do next.

endocrinologist9 22:57

I don't counsel children, not because I don't want to, but because I have a different qualification. Children have different test norms, different treatment regimens and a lot of other things. It is not for nothing that there are separate adult specialists - therapists and pediatric specialists - pediatricians who serve different age categories of patients. I simply do not have the knowledge necessary to treat your grandson.

You still need to consult a pediatric specialist.

Good luck to you and your grandson.

Sincerely, Nadezhda Sergeevna.

endocrinologist5 23:30

There is no need for additional measures to “normalize the hormonal background” with such a reception of dexamethasone. I have already written about this many times above.

Sincerely, Nadezhda Sergeevna.

endocrinologist7 20:00

Sincerely, Nadezhda Sergeevna.

I have brusitis-shoulder joint. I generally do not tolerate medicines well - gastritis. Esophagitis. There were medicinal ulcers.

the doctor convinced me to give three injections in the area of the joint - once a week - so that the inflammation goes away.

but already after the first injection, tachycardia, pain in the stomach and intestines began.

Should I finish the rest of the injections or is it dangerous?

there are few options. Diprospan and diclofenac are no better

Waiting for your reply!

endocrinologist3 15:30

In your case, Dexamethasone is absolutely not used for the purpose of treating endocrine pathology. The endocrinologist does not treat bursitis.

You should consult on this issue with a rheumatologist or traumatologist.

Sincerely, Nadezhda Sergeevna.

Klacid, sinupred, etc. were prescribed for the treatment of sinusitis. Medications + nasal lavage. Three days later, an acute attack of allergies. Iz-for what precisely cannot tell or say, have told or said toxic. The allergist prescribed a dropper with dexamethasone for 3 days: 12, 8 and 4 mg, respectively. I have a vacation in a week, the allergist said that I can’t be in the sun, because of dexamethasone (there may be spots).

I read above in the correspondence that the drug is active for 72 hours, and then for days. That is, in a week, dexamethasone will not be excreted from the body and it is really impossible to sunbathe in the sun?

endocrinologist6 13:19

I absolutely do not limit my patients in such a situation from exposure to the sun. It is better to further clarify this issue with your treating allergist.

I will be very grateful for the answer! We really need your professional opinion!

endocrinologist1 11:31

You have absolutely no cause for concern. You definitely need to continue the prescribed treatment.

Short-term use of Dexamethasone according to this scheme has a purely anti-allergic effect. Moreover, usually in case of allergic reactions, we prescribe Dexamethasone according to a longer regimen, this has absolutely no consequences.

endocrinologist9 00:05

Yes, it can.

endocrinologist1 18:55

I have already written dozens of times in this issue - in such dosages, Dexamethasone has no side effects. It is prescribed to you for the purpose of providing an anti-inflammatory and analgesic effect, nothing more. The injection can be done at any time of the day.

endocrinologist7 21:40

Dexamethasone was prescribed to your husband not to treat a tumor, but to eliminate cerebral edema. It is imperative to administer this drug, regardless of the final diagnosis.

I'm 36 years old. Main disease: C50.8 cancer of the right breast T2T1M0 since 2011. In July 2016, brain metastases were found. A palliative course of conformal external beam radiation therapy with mts irradiation of brain foci was carried out. Since July 17, 2016, dexamethasone 16 mg per day (8 mg 2 times a day IM) has been prescribed. Puffiness (moon-facedness) of the face appeared, a second chin grew and the stomach grows, hair began to grow on the face, ankles and knees swell very much, it’s hard to walk, I want to eat all the time, although I gained only 4 kg in weight (with a height of 160 see my weight is 63 kg). On August 18, 2016, on the recommendation of the oncologist, she gradually began to reduce the dosage by 2 mg every 3 days. After 5 days, I finish giving injections of dexamethasone. Tell me, please, how long will the body recover after such a dosage? And will I be able to get a normal appearance without any additional treatment? Thank you!

endocrinologist6 22:57

There is no need for additional drug treatment after the abolition of Dexamethasone:

to normalize weight, a non-strict adherence to diet No. 9 will be enough;
hair that has already appeared can be eliminated exclusively with the help of cosmetic procedures, but the appearance of new hair will stop after 2-3 weeks;
if the swelling does not go away 1-2 weeks after the drug is discontinued, then you will need to additionally consult with a therapist about this.

endocrinologist2 23:31

Dexamethasone does not cause pain in the joints and swelling of the face.

Dexamethasone (Dexamethason)

Release form, composition and packaging

Other Ingredients: lactose monohydrate, corn starch, povidone, magnesium stearate, talc, colloidal anhydrous silica.

No. UA/8538/02/01 from 07/25/2008 to 07/25/2013

Other Ingredients: Glycerin, disodium edetate, sodium hydrogen phosphate dihydrate, water for injection.

No. UA/8538/01/01 from 07/07/2008 to 07/07/2013

Pharmacodynamics. Dexamethasone is a synthetic hormone of the adrenal cortex (GCS), which has a glucocorticoid effect. It has anti-inflammatory and immunosuppressive effects, and also affects energy metabolism, glucose metabolism (through negative feedback), the secretion of the hypothalamus activation factor and the trophic hormone of the adenohypophysis.

The mechanism of action of GCS is still not fully understood. Currently, there is enough evidence about the mechanism of action of GCS at the cellular level. There are two distinct receptor systems in the cytoplasm of cells. By binding to glucocorticoid receptors, glucocorticoids have anti-inflammatory and immunosuppressive effects, regulate glucose metabolism, and by binding to mineralocorticoid receptors, they regulate the metabolism of sodium, potassium and water and electrolyte balance.

GCS dissolve in lipids and easily penetrate into target cells through the cell membrane.

Binding of the hormone to the receptor leads to a change in the conformation of the receptor, which increases its affinity for DNA. The hormone/receptor complex enters the nucleus of the cell and binds to the regulatory center of the DNA molecule, also called the glucocorticoid response element (GRE). An activated receptor associated with GRE or with specific genes regulates mRNA transcription, increasing or decreasing it.

The newly formed mRNA is transported to the ribosomes, after which the formation of new proteins occurs. Depending on the target cells and the processes taking place in the cells, protein synthesis can be enhanced (for example, the formation of tyrosine transaminase in liver cells) or reduced (for example, the formation of IL-2 in lymphocytes). Since GCS receptors are present in all types of tissues, it can be assumed that GCS act on most body cells.

Pharmacokinetics. After oral administration, dexamethasone is almost completely absorbed in the gastrointestinal tract. The bioavailability of dexamethasone in the form of tablets approaches 80%. The maximum concentration in blood plasma and the maximum effect are observed after 1-2 hours; after taking a single dose, the effect lasts for approximately 2.75 days.

After intravenous administration, the maximum concentration of dexamethasone phosphate in plasma is reached in just 5 minutes, and after intramuscular administration - after 1 hour. When applied topically as an injection into the joint or soft tissues, absorption is slower. After intravenous administration, the effect of the drug begins quickly. When administered intramuscularly, the clinical effect is observed 8 hours after administration. The action of the drug is long-term: from 17 to 28 days after i / m administration and from 3 days to 3 weeks after topical application. Biological T? dexamethasone is 24–72 hours. In plasma and synovial fluid, dexamethasone phosphate is rapidly converted to dexamethasone.

Only a small amount of dexamethasone binds to other plasma proteins.

Dexamethasone is a fat-soluble substance, so it passes into the inter- and intracellular space. It acts (hypothalamus, pituitary gland) by binding to membrane receptors. In peripheral tissues, it binds and acts through cytoplasmic receptors. Dexamethasone breaks down at the site of its action, that is, in the cell. Dexamethasone is metabolized primarily in the liver. Small amounts of dexamethasone are metabolized in the kidneys and other tissues. The main route of excretion from the body is the kidneys.

The dose should be determined individually, taking into account the disease of a particular patient, the period of treatment, the tolerability of GCS and the individual reaction of the body.

The recommended starting dose for adults is 0.75–9 mg/day, depending on the diagnosis. The initial dose of dexamethasone should be used until a clinical response occurs, and then gradually reduced to the lowest clinically effective dose. If oral treatment at high doses lasts more than a few days, the dose should be reduced gradually over several days or longer (usually by 0.5 mg over 3 days). The maintenance dose is usually 2–4.5 mg/day. The daily dose can be used in 2-4 doses.

The maximum daily dose is usually 15 mg, the minimum effective dose is 0.5–1 mg/day.

In the treatment of exacerbations of multiple sclerosis, the daily dose may be 30 mg of dexamethasone during the 1st week of treatment, followed by doses of 4 to 12 mg every other day for 1 month.

During long-term treatment at high doses, it is recommended to take dexamethasone orally with food, and take antacids between meals.

Doses for children. For children, the initial dose of dexamethasone is determined according to the characteristics of the particular disease.

For all other indications, the starting dose range is 0.02–0.3 mg/kg/day in 3–4 doses (0.6–9 mg/m2 body surface area/day).

Diagnostic study of hyperfunction of the adrenal glands

The dexamethasone test (Liddle's test) is done as a small test and a large test.

During the small test, dexamethasone is administered at 0.5 mg every 6 hours for 48 hours (namely: at 8.00; 14.00; 20.00 and 2.00 am). Before and after the appointment of dexamethasone, the content of 17-hydroxycorticosteroid or free cortisol in daily urine is determined.

The given doses of dexamethasone suppress the formation of corticosteroids in almost all practically healthy individuals. 6 hours after the last dose of dexamethasone, plasma cortisol levels are below 135–138 nmol/l (4.5–5 µg/100 ml). Reduced excretion of 17-hydroxycorticosteroid? 3 mg / day, and free cortisol? 54-55 nmol / day (19-20 μg / day) excludes adrenal hyperfunction. In persons with Itsenko-Cushing's disease or syndrome, the excretion of GCS does not change during a small test.

During a large test, dexamethasone is prescribed 2 mg every 6 hours for 48 hours (namely: 8 mg dexamethasone per day). Urine is also collected to determine 17-hydroxycorticosteroid or free cortisol (if necessary, determine free cortisol in blood plasma). In Itsenko-Cushing's disease, there is a decrease in the excretion of 17-hydroxycorticosteroid or free cortisol by? 50%, while with a tumor of the adrenal gland or ACTH-ectopic (or corticoliberin-ectopic) syndrome, the excretion of corticosteroids does not change. In some patients with ACTH-ectopic syndrome, a decrease in the excretion of corticosteroids is not detected even after taking dexamethasone at a dose of 32 mg / day.

For purposes of comparison, equivalent doses (mg) for different corticosteroids are listed below.

A dose of 0.75 mg of dexamethasone is equivalent to a dose of 2 mg of paramethasone, or 4 mg of methylprednisolone and triamcinolone, or 5 mg of prednisone and prednisolone, or 20 mg of hydrocortisone, or 25 mg of cortisone, or 0.75 mg of betamethasone.

This ratio of dosages applies only to oral or / in the use of these drugs. If these drugs or their derivatives are administered intramuscularly or intra-articularly, the ratio of their doses can vary significantly.

Assign to adults and children, starting from the neonatal period. It is administered intravenously (as an injection or infusion), intramuscularly or topically by intra-articular injection or injection into the site of a lesion on the skin or into the area of soft tissue infiltration.

As a solvent for intravenous infusion, 0.9% sodium chloride solution or 5% glucose solution is used.

Solutions intended for intravenous administration or further dissolution of the drug should not contain preservatives if used for infants, especially premature ones.

When mixing the drug with a solvent for infusion, it is necessary to observe aseptic and antiseptic measures. As infusion solutions generally do not contain preservatives, mixtures should be used within 24 hours.

Preparations for parenteral administration require visual inspection for the presence of foreign particles and discoloration before each administration in order to determine the suitability of the solution and container.

The dose must be determined individually, according to the disease in a given patient, the period of treatment, the tolerance of corticoids and the reaction of the body.

The recommended starting dose varies from 0.5 to 9 mg/day, depending on the diagnosis. In less severe cases, a dosage of ≤0.5 mg may be sufficient, while in severe cases, a dosage of 9 mg/day may be necessary.

Initial doses of Dexamethasone should be used until a clinical response occurs, and then gradually reduced to the lowest clinically effective dose. If high doses are given for more than a few days, the dose should be gradually reduced over the next few days or longer.

In the absence of a positive clinical effect on the part of the patient for a certain period of time, dexamethasone phosphate injections are stopped and another treatment is prescribed.

It is necessary to carefully monitor the symptoms that may require dosage adjustment, namely, changes in the clinical state as a result of remission or exacerbation of the disease, individual response to the drug and the impact of stress (for example, surgery, infection, trauma). During times of stress, a temporary increase in dosage may be required.

When discontinuing the drug after more than a few days of treatment, as a rule, its cancellation should be carried out gradually.

With intravenous administration, dosing is usually the same as with oral administration. However, in some urgent, acute, life-threatening situations, it may be justified to use doses higher than usual, and in combination with oral dosing. It should be taken into account that with the / m administration of the drug, the rate of absorption is slower.

Currently, in medical practice, there is a trend towards the use of corticosteroids in high (pharmacological) doses to relieve shock, in which traditional therapy is ineffective. Various authors suggest the following dosing for dexamethasone phosphate injection.

3 mg/kg body weight over 24 hours by continuous IV infusion after the initial 20 mg IV injection;
2–6 mg/kg body weight as a single intravenous injection;
40 mg initially, then repeated IV injections every 4 to 6 hours until symptoms of shock are observed;
40 mg initially, then repeated IV injections every 2 to 6 hours until symptoms of shock are observed;
1 mg/kg body weight as a single intravenous injection.

The use of high-dose corticosteroid therapy should be carried out only until the patient's condition stabilizes and usually no more than 48-72 hours.

Dexamethasone, injection, is usually prescribed at an initial dose of 10 mg IV, then 4 mg every 6 hours IM until symptoms disappear.

The response to treatment is usually observed within 12-24 hours, the dosage can be reduced after 2-4 days of treatment, the drug is gradually canceled over 5-7 days. For palliative use in patients with recurrent or inoperable brain tumors, maintenance therapy with a dosage of 2 mg 2-3 times a day may be effective.

Severe allergic diseases

In acute allergic diseases or severe exacerbations of chronic allergic diseases, the following dosing regimen is prescribed, combining parenteral and oral therapy:

Descametasone, injection, 4 mg/ml: Day 1 1–2 ml (4 or 8 mg) IM.

Dexamethasone, tablets, 0.5 mg: 2-3 days - 6 tablets in 2 divided doses daily; 4th day - 3 tablets in 2 doses; 5-6th days - 1 1/2 tablets every day; 7th day - no treatment; 8th day - a second visit to the doctor.

This regimen is intended to provide adequate treatment during exacerbation episodes and to reduce the risk of overdose in chronic cases.

Intra-articular injection, injection into the lesion site or into soft tissues is usually used in cases where the lesion is limited to one or two joints (areas). Dosage and frequency of injections depends on the conditions and site of administration. The usual dose is 0.2–6 mg. The frequency of application ranges from 1 injection every 3-5 days to 1 injection every 2-3 weeks. Frequent intra-articular injection can damage articular cartilage.

Intra-articular injection of corticosteroids can additionally lead to local, systemic effects.

Intra-articular injection of corticosteroids into infected joints should be avoided.

Corticosteroids should not be injected into unstable joints.

Some common single doses for intra-articular administration are given below:

Injection site Dose of dexamethasone phosphate (mg)

Large joints (eg knee) 2–4

Small joints (eg.

interphalangeal, temporomandibular) 0.8–1

Intermuscular bags 2-3

Tendon sheaths 0.4–1

Soft tissue infiltration 2–6

Dexamethasone injection is especially recommended for use in combination with one of the less soluble long acting steroids for intra-articular and soft tissue injection.

For all other indications, the starting dose range is 0.02–0.3 mg/kg/day in 3–4 injections (0.6–9 mg/m2 body surface area/day).

the frequency of manifestations of side effects depends on the dose and duration of treatment. The most common side effects of short-term therapy are temporary adrenal insufficiency, glucose intolerance, increased appetite and weight gain, mental disorders; more rare side effects are allergic reactions, hypertriglyceridemia, peptic ulcer of the stomach and duodenum, and acute pancreatitis.

Long-term treatment most often leads to prolonged adrenal dysfunction, growth retardation in children and adolescents, central obesity, skin fragility, muscle atrophy, osteoporosis, less often - a decrease in immune defense and increased susceptibility to infectious diseases, cataracts, glaucoma, hypertension, aseptic bone necrosis.

Adverse reactions by organ systems

From the hematopoietic and lymphatic systems: cases of thromboembolism, a decrease in the number of monocytes and / or lymphocytes, leukocytosis, eosinophilia (as with other GCS), rarely - thrombocytopenia and non-thrombocytopenic purpura.

From the immune system: rarely - skin rash, urticaria, angioedema, bronchospasm and anaphylactic reactions.

From the side of the cardiovascular system: polytopic ventricular extrasystole, paroxysmal bradycardia, heart failure, hypertension and hypertensive encephalopathy; very rarely - rupture of the heart wall in patients who have recently had a myocardial infarction.

From the side of the central nervous system: after treatment, edema of the optic nerve head and increased intracranial pressure (pseudotumor) may occur. There may also be neurological side effects such as dizziness, convulsions, headache, neuritis, neuropathy, paresthesia.

Psychiatric disorders: Personality and behavioral changes, most commonly defined as euphoria; The following side effects have also been reported: insomnia, irritability, hyperkinesia, depression, emotional lability, mood swings, and (rarely) psychosis.

On the part of the respiratory system, chest and mediastinum: pulmonary edema.

On the part of the endocrine system and metabolism: inhibition of function and atrophy of the adrenal glands (decrease in response to stress), Cushing's syndrome, growth retardation in children and adolescents, menstrual irregularities, hirsutism, transition of latent diabetes to a clinically active form, decreased carbohydrate tolerance, increased need for insulin or oral medicinal antidiabetic drugs in patients with diabetes mellitus, negative nitrogen balance due to protein catabolism, hypokalemic alkalosis, sodium and water retention in the body, increased excretion of potassium.

From the gastrointestinal tract: esophagitis, nausea, hiccups, rarely - peptic ulcer of the stomach and duodenum, ulcerative perforation and bleeding from the gastrointestinal tract (bloody vomiting, melena), pancreatitis, perforation of the gallbladder and intestines (especially in patients with chronic colitis) are also possible.

From the musculoskeletal system and connective tissue: muscle weakness, steroid myopathy (muscle weakness is the cause of muscle catabolism), osteoporosis (increased excretion of calcium) and compression fractures of the spine, aseptic osteonecrosis (more often - aseptic necrosis of the femoral head and shoulder), tendon ruptures (especially with the simultaneous use of certain quinolones), articular cartilage damage and bone necrosis (due to intra-articular infection).

On the part of the skin and subcutaneous tissues: delayed wound healing, thinned and sensitive skin, petechiae and hematomas, erythema, increased sweating, acne, inhibition of the reaction to skin tests. Allergic dermatitis, urticaria and angioedema are also possible.

On the part of the organ of vision: increased intraocular pressure, glaucoma, cataracts or bulging eyes.

From the reproductive system: rarely: impotence.

Disorders during pregnancy, postpartum and perinatal period: cortical paralysis in premature infants, retrolental fibroplasia.

General disorders: edema, hyper- or hypopigmentation of the skin, atrophy of the skin or subcutaneous tissue, sterile abscess and hyperemia of the skin.

Signs of GCS withdrawal syndrome

In patients on prolonged therapy with dexamethasone, withdrawal syndrome and cases of adrenal insufficiency, arterial hypotension or death may occur during a rapid dose reduction.

In some cases, withdrawal symptoms may be similar to those of worsening or recurrence of the disease for which the patient was being treated.

In the event of severe adverse reactions, drug treatment should be discontinued.

Severe erythema multiforme (Stevens-Johnson syndrome).

Hypercalcemia caused by a cancerous lesion;

Nonpurulent inflammation of the thyroid gland.

Acquired (autoimmune) hemolytic anemia;

Congenital (erythroid) hypoplastic anemia;

Idiopathic thrombocytopenic purpura in adults;

True erythrocyte aplasia;

Some cases of secondary thrombocytopenia.

Palliative care for leukemia and lymphoma.

Exacerbation of multiple sclerosis;

Cerebral edema due to primary or metastatic brain tumor, craniotomy, or head trauma.

Inflammatory diseases of the eye that are not treatable with corticosteroids for topical use.

Stimulation of diuresis or reduction of proteinuria in idiopathic nephrotic syndrome and impaired renal function in systemic lupus erythematosus.

Focal or disseminated pulmonary tuberculosis, used in combination with appropriate anti-tuberculosis chemotherapy;

Idiopathic eosinophilic pneumonia;

Acute rheumatic carditis;

Rheumatoid arthritis, including juvenile rheumatoid arthritis (in some cases, low-dose maintenance therapy may be necessary);

Treatment of dermatomyositis, polymyositis and systemic lupus erythematosus.

Diagnostic testing for hyperfunction of the adrenal glands;

Trichinosis with neurological symptoms or myocardial trichinosis;

Tuberculous meningitis with subarachnoid block or threat of block (in combination with appropriate anti-tuberculosis therapy).

Dexamethasone is administered intravenously or intramuscularly in urgent cases, as well as when oral administration of the drug is impossible in such conditions:

Replacement therapy for primary or secondary (pituitary) adrenal insufficiency (hydrocortisone or cortisone are the drugs of choice; if necessary, synthetic analogues can be used in combination with mineralocorticoids; in pediatric practice, combined use with mineralocorticoids is extremely important);

Acute adrenal insufficiency (hydrocortisone or cortisone are the drugs of choice; simultaneous use with mineralocorticoids may be necessary, especially in the case of synthetic analogues);

Before surgery and in cases of serious injury or disease in patients with established adrenal insufficiency or with an indeterminate adrenocortical reserve;

Shock resistant to conventional therapy, with existing or suspected adrenal insufficiency;

Congenital adrenal hyperplasia;

Nonpurulent inflammation of the thyroid gland;

Hypercalcemia due to cancer.

Rheumatic diseases: as an adjuvant therapy for short-term use (to remove the patient from an acute condition or during an exacerbation of the disease) for:

Synovitis with osteoarthritis;

Rheumatoid arthritis, including juvenile rheumatoid arthritis (in some cases, low-dose maintenance therapy may be necessary);

Acute gouty arthritis;

Collagenoses: during an exacerbation or in some cases as maintenance therapy for:

Systemic lupus erythematosus;

Acute rheumatic carditis.

Severe erythema multiforme (Stevens-Johnson syndrome);

bullous dermatitis herpetiformis;

severe seborrheic dermatitis;

Allergic diseases: control of severe or disabling allergic conditions that are not amenable to conventional therapy:

Chronic or seasonal allergic rhinitis;

Urticaria after blood transfusion;

Acute non-infectious laryngeal edema (epinephrine is the drug of choice).

Eye diseases: severe acute and chronic allergic and inflammatory processes with eye damage:

Eye damage caused by Herpes zoster;

Diffuse posterior uveitis and choroiditis;

Optic neuritis;

Inflammation of the anterior segment;

Allergic marginal ulcer of the cornea.

Diseases of the gastrointestinal tract: to remove the patient from the critical period with:

Ulcerative colitis (systemic therapy);

Crohn's disease (systemic therapy).

Respiratory diseases:

Focal or disseminated pulmonary tuberculosis (combined with appropriate anti-tuberculosis chemotherapy);

Lefler's syndrome, not amenable to therapy by other methods;

Acquired (autoimmune) hemolytic anemia;

Idiopathic thrombocytopenic purpura in adults (only in / in the introduction! In / m administration is contraindicated!);

Secondary thrombocytopenia in adults;

Erythroblastopenia (erythrocytic anemia);

Congenital (erythroid) hypoplastic anemia.

Palliative care for leukemia and lymphoma in adults;

Acute leukemia in children.

Conditions accompanied by edema:

Stimulation of diuresis or reduction of proteinuria in idiopathic nephrotic syndrome (without uremia) and impaired renal function in systemic lupus erythematosus.

Diagnostic study for hyperfunction of the adrenal glands: cerebral edema:

Cerebral edema due to primary or metastatic brain tumor, craniotomy, or head trauma.

Use in cerebral edema does not replace immediate neurosurgical examination and, if necessary, neurosurgical intervention and other specific therapy.

Tuberculous meningitis with subarachnoid blockade or threat of blockade (combined with appropriate anti-tuberculosis therapy);

Trichinosis with neurological symptoms or myocardial trichinosis.

Indications for intra-articular or soft tissue administration: as an adjuvant therapy for short-term use (to remove the patient from an acute condition or during an exacerbation of the disease) for:

Rheumatoid arthritis (severe inflammation of a single joint);

Synovitis with osteoarthritis;

Acute and subacute bursitis;

Acute gouty arthritis;

Acute nonspecific tendosynovitis;

Local administration (introduction to the lesion site):

Localized hypertrophic, inflammatory and infiltrative lesions in herpes zoster, psoriasis, granuloma annulare, discoid lupus erythematosus;

Lipoid atrophic dermatitis of Oppenheim;

It can also be used for cystic tumors of the aponeurosis or tendon (ganglion).

hypersensitivity to dexamethasone or any other ingredient of the drug.

Acute viral, bacterial or systemic fungal infections (unless appropriate therapy is given concomitantly), Cushing's syndrome, vaccination with a live vaccine, and lactation (except in emergencies). It can be used during pregnancy only for health reasons.

in patients who have received dexamethasone for a long time, a withdrawal syndrome (without visible signs of adrenal insufficiency) may occur upon discontinuation of treatment (fever, runny nose, conjunctival hyperemia, headache, dizziness, drowsiness or irritability, muscle and joint pain, vomiting, decreased body weight, weakness, often convulsions). Therefore, the dose of dexamethasone should be reduced gradually. Sudden discontinuation of treatment can be fatal.

During parenteral treatment with corticosteroids, hypersensitivity reactions may occur in rare cases, so appropriate measures must be taken before starting dexamethasone therapy, given the likelihood of allergic reactions (especially in patients with a burdened allergic history).

If the patient is under severe stress (due to trauma, surgery or serious illness) during therapy, the dose of dexamethasone should be increased, and if stress occurs during the period of stopping treatment, hydrocortisone or cortisone should be used.

Patients who have been administered dexamethasone for a long time and who experience severe stress shortly after stopping therapy should resume the use of dexamethasone, since the adrenal insufficiency caused by it can last for several months after stopping GCS therapy.

Treatment with dexamethasone or natural corticosteroids may mask symptoms of an existing or new infection, as well as symptoms of intestinal perforation. Dexamethasone can exacerbate systemic fungal infection, latent amoebiasis, and pulmonary tuberculosis.

Patients with active pulmonary tuberculosis should receive dexamethasone (along with anti-tuberculosis therapy) only for acute or disseminated pulmonary tuberculosis. Patients with inactive pulmonary tuberculosis who are treated with dexamethasone, or those who test positive for tuberculin, should receive chemoprophylactic anti-tuberculosis drugs.

Caution in use and medical supervision are recommended in patients with osteoporosis, hypertension, heart failure, tuberculosis, glaucoma, hepatic or renal failure, diabetes, active peptic ulcer, recent intestinal anastomosis surgery, ulcerative colitis, and epilepsy. Special care is needed for patients during the first weeks after myocardial infarction, patients with thromboembolism, myasthenia gravis, hypothyroidism, psychosis or psychoneurosis, as well as the elderly.

During treatment, an exacerbation of diabetes mellitus or a transition from a latent phase to clinical manifestations of diabetes is possible.

With prolonged therapy, it is necessary to control the level of potassium in the blood serum.

Vaccination with a live vaccine is contraindicated during treatment with dexamethasone. Vaccination with a killed viral or bacterial vaccine does not lead to the expected antibody synthesis and does not provide the expected protective effect. Dexamethasone is usually not prescribed 8 weeks before vaccination and is not started earlier than 2 weeks after vaccination.

Patients who have been receiving high-dose dexamethasone for a long time and who have not had measles should avoid contact with measles-infected persons; in case of accidental contact, prophylactic use of immunoglobulin is recommended.

Caution must be exercised when used in patients recovering from surgery or bone fracture, as dexamethasone may delay wound healing and bone formation.

The action of GCS is enhanced in patients with cirrhosis of the liver or hypothyroidism.

Intra-articular use of dexamethasone can lead to systemic effects. Frequent use may cause cartilage damage or bone necrosis.

Before intra-articular injection, it is necessary to remove the synovial fluid from the joint and examine it (check for infection). The introduction of corticosteroids into infected joints should be avoided. If a joint infection develops after an injection, appropriate antibiotic therapy should be given.

The patient should be warned to avoid physical activity on the affected joints until the inflammation has been cured.

Avoid injecting the drug into unstable joints.

GCS can distort the results of skin allergy tests.

Catad_pgroup Systemic corticosteroids

Catad_pgroup Preparations for ophthalmology

Dexamethasone for injection - instructions for use

INSTRUCTIONS for the medical use of the drug

Name of the medicinal product:

Trade name of the drug:

Dexamethasone

International non-proprietary name:

dexamethasone

Dosage form:

injection

Compound

Active substance:
Dexamethasone sodium phosphate (dexamethasone phosphate disodium salt) in terms of 100% substance - 4.0 mg

Excipients:
glycerol (distilled glycerin) - 22.5 mg
disodium edetate (trilon B) - 0.1 mg
sodium hydrogen phosphate dodecahydrate (sodium phosphate disubstituted 12-water) - 0.8 mg
water for injection - up to 1 ml

Pharmacotherapeutic group:

glucocorticosteroid

ATC code:

H02AB02

Description:

clear colorless or light yellow liquid.

pharmachologic effect

Synthetic glucocorticosteroid is a methylated derivative of fluoroprednisolone. It has anti-inflammatory, anti-allergic, desensitizing, anti-shock, anti-toxic and immunosuppressive effects.

Interacts with specific cytoplasmic receptors and forms a complex that penetrates the cell nucleus and stimulates mRNA synthesis; the latter induces the formation of proteins, incl. lipocortin mediating cellular effects. Lipocortin inhibits phospholipase A2, inhibits the release of arachidonic acid and inhibits the biosynthesis of endoperoxides, prostaglandins, leukotrienes, which promote inflammation, allergies, and others.

Protein metabolism: reduces the amount of protein in plasma (due to globulins) with an increase in the albumin / globulin ratio, increases the synthesis of albumins in the liver and kidneys; enhances protein catabolism in muscle tissue.

Lipid metabolism: increases the synthesis of higher fatty acids and triglycerides, redistributes fat (accumulation of fat mainly in the shoulder girdle, face, abdomen), leads to the development of hypercholesterolemia.

Carbohydrate metabolism: increases the absorption of carbohydrates from the gastrointestinal tract; increases the activity of glucose-6-phosphatase, which leads to an increase in the flow of glucose from the liver into the blood; increases the activity of phosphoenolpyruvate carboxylase and the synthesis of aminotransferases, leading to the activation of gluconeogenesis.

Antagonistic action in relation to vitamin D: "washing out" of calcium from the bones and increasing its renal excretion.

The anti-inflammatory effect is associated with inhibition of the release of inflammatory mediators by eosinophils; inducing the formation of lipocortins and reducing the number of mast cells that produce hyaluronic acid; with a decrease in capillary permeability; stabilization of cell membranes and organelle membranes (especially lysosomal ones).

The antiallergic effect is due to a decrease in the number of circulating eosinophils, which leads to a decrease in the release of immediate allergy mediators; reduces the effect of allergy mediators on effector cells.

The immunosuppressive effect is due to inhibition of the release of cytokines (interleukin1 and interleukin2, interferon gamma) from lymphocytes and macrophages.

Suppresses the synthesis and secretion of adrenocorticotropic hormone and secondarily - the synthesis of endogenous glucocorticosteroids. The peculiarity of the action is a significant inhibition of the function of the pituitary gland and the almost complete absence of mineralocorticosteroid activity.

Doses of 1-1.5 mg / day inhibit the function of the adrenal cortex; the biological half-life is 32-72 hours (the duration of the inhibition of the hypothalamus-pituitary-adrenal cortex system).

According to the strength of glucocorticosteroid activity, 0.5 mg of dexamethasone corresponds to approximately 3.5 mg of prednisone (or prednisolone), 15 mg of hydrocortisone, or 17.5 mg of cortisone.

Pharmacokinetics
In the blood, it binds (60-70%) to a specific protein - the carrier - transcortin. Easily passes through histohematic barriers (including through the blood-brain barrier and placental). A small amount is excreted in breast milk. Metabolized in the liver (mainly by conjugation with glucuronic and sulfuric acids) to inactive metabolites. Excreted by the kidneys.

Indications for use:

The drug is used for diseases requiring the introduction of a fast-acting glucocorticosteroid, as well as in cases where oral administration of the drug is not possible:

Endocrine diseases (acute insufficiency of the adrenal cortex, primary or secondary insufficiency of the adrenal cortex, congenital hyperplasia of the adrenal cortex, subacute thyroiditis);
- shock resistant to standard therapy; anaphylactic shock;
- cerebral edema (with a brain tumor, traumatic brain injury, neurosurgical intervention, cerebral hemorrhage, encephalitis, meningitis, radiation injury);
- status asthmaticus; severe bronchospasm (exacerbation of bronchial asthma, chronic obstructive bronchitis);
- severe allergic reactions;
- rheumatic diseases;
- systemic connective tissue diseases;
- acute severe dermatoses;
- malignant diseases (palliative treatment of leukemia and lymphoma in adult patients; acute leukemia in children; hypercalcemia in patients suffering from malignant tumors when oral treatment is not possible);
- diagnostic study of hyperfunction of the adrenal glands;
- blood diseases (acute hemolytic anemia, agranulocytosis, idiopathic thrombocytopenic purpura in adults);
- severe infectious diseases (in combination with antibiotics);
- intra-articular and intra-synovial administration: arthritis of various etiologies, osteoarthritis, acute and subacute bursitis, acute tendovaginitis, epicondylitis, synovitis;
- local application (in the area of pathological formation): keloids, discoid lupus erythematosus, granuloma annulare.

Contraindications for use:

For short-term use according to "vital" indications, the only contraindication is hypersensitivity.

For intra-articular administration: previous arthroplasty, pathological bleeding (endogenous or caused by the use of anticoagulants), intra-articular bone fracture, infectious (septic) inflammatory process in the joint and periarticular infections (including history), as well as a general infectious disease, severe periarticular osteoporosis, lack of signs of inflammation in the joint (the so-called "dry" joint, for example, in osteoarthritis without synovitis), severe bone destruction and joint deformity (sharp narrowing of the joint space, ankylosis), joint instability as an outcome of arthritis, aseptic necrosis of the epiphyses of the bones forming the joint.

Post-vaccination period (period lasting 8 weeks before and 2 weeks after vaccination), lymphadenitis after BCG vaccination. Immunodeficiency states (including AIDS or HIV infection).

Diseases of the gastrointestinal tract (gastric ulcer and 12 duodenal ulcer, esophagitis, gastritis, acute or latent peptic ulcer, recently created intestinal anastomosis, ulcerative colitis with the threat of perforation or abscess formation, diverticulitis).

Diseases of the cardiovascular system, incl. recent myocardial infarction (in patients with acute and subacute myocardial infarction, the focus of necrosis may spread, slowing down the formation of scar tissue and, as a result, rupture of the heart muscle), decompensated chronic heart failure, arterial hypertension, hyperlipidemia.

Endocrine diseases - diabetes mellitus (including impaired carbohydrate tolerance), thyrotoxicosis, hypothyroidism, Itsenko-Cushing's disease.

Severe chronic renal and / or liver failure, nephrourolithiasis. Hypoalbuminemia and conditions predisposing to its occurrence.

Systemic osteoporosis, myasthenia gravis, acute psychosis, obesity (III-IV stage), poliomyelitis (except for the form of bulbar encephalitis), open and angle-closure glaucoma, pregnancy, lactation.

For intra-articular administration: the general serious condition of the patient, the inefficiency (or short duration) of the action of 2 previous injections (taking into account the individual properties of the glucocorticosteroids used).

Dosage and administration:

Intra-articular, in the lesion - 0.2-6 mg, repeated 1 time in 3 days or 3 weeks.

Intramuscularly or intravenously - 0.5-9 mg / day.

For the treatment of cerebral edema - 10 mg in the first injection, then 4 mg intramuscularly every 6 hours until the symptoms disappear. The dose can be reduced after 2-4 days with a gradual withdrawal in the period of 5-7 days after the elimination of cerebral edema. Maintenance dose - 2 mg 3 times / day.

For the treatment of shock, 20 mg intravenously at the first injection, then 3 mg/kg for 24 hours as an intravenous infusion or intravenous bolus - from 2 to 6 mg/kg as a single injection or 40 mg as a single injection given every 2- 6 h; possible intravenous administration of 1 mg / kg once. Shock therapy should be canceled as soon as the patient's condition stabilizes, the usual duration is no more than 2-3 days.

Allergic diseases - intramuscularly in the first injection of 4-8 mg. Further treatment is carried out with oral dosage forms.

With nausea and vomiting, during chemotherapy - intravenously 8-20 mg 5-15 minutes before a chemotherapy session. Further chemotherapy should be carried out using oral dosage forms.

For the treatment of respiratory distress syndrome in newborns - intramuscularly 4 injections of 5 mg every 12 hours for two days.

The maximum daily dose is 80 mg.

For children: for the treatment of adrenal insufficiency - intramuscularly at 23 mcg / kg (0.67 mg / sq. M) every 3 days, or 7.8-12 mcg / kg (0.23-0.34 mg / sq. m.). m / day), or 28-170 mcg / kg (0.83-5 mg / sq. m) every 12-24 hours.

Precautions for use

Children who are in contact with patients with measles or chicken pox during the treatment period are prescribed special immunoglobulins prophylactically.
In children during the period of growth, glucocorticosteroids should be used only according to absolute indications and under the most careful supervision of a physician.
It should be borne in mind that in patients with hypothyroidism, the clearance of glucocorticosteroids decreases, and in patients with thyrotoxicosis it increases.

Overdose

Symptoms: increased blood pressure, edema, peptic ulcer, hyperglycemia, impaired consciousness.
Treatment: symptomatic, there is no specific antidote.

Side effect

The frequency of development and severity of side effects depend on the duration of use, the size of the dose used and the possibility of observing the circadian rhythm of the appointment.

From the side of metabolism: sodium and water retention in the body; hypokalemia; hypokalemia alkalosis; negative nitrogen balance caused by increased protein catabolism, increased appetite, increased body weight.

From the side of the cardiovascular system: higher risk of thrombosis (especially in immobilized patients), arrhythmias, increased blood pressure, development or aggravation of chronic heart failure, myocardial dystrophy, steroid vasculitis.

From the musculoskeletal system: muscle weakness, steroid myopathy, decreased muscle mass, osteoporosis, vertebral compression fractures, aseptic necrosis of the femoral head and humerus, pathological fractures of long bones.

From the digestive system: nausea, vomiting, erosive and ulcerative lesions of the gastrointestinal tract (which can cause perforations and bleeding), hepatomegaly, pancreatitis, ulcerative esophagitis.

Dermatological reactions: thinning and vulnerability of the skin, petechiae and subcutaneous hemorrhages, ecchymosis, striae, steroid acne, delayed wound healing, increased sweating.

From the side of the central nervous system: fatigue, dizziness, headache, mental disorders, convulsions and false symptoms of a brain tumor (increased intracranial pressure with congestive optic disc).

From the endocrine system: reduced glucose tolerance, "steroidal" diabetes mellitus or manifestation of latent diabetes mellitus, adrenal suppression, Itsenko-Cushing's syndrome (moon face, pituitary-type obesity, hirsutism, increased blood pressure, dysmenorrhea, amenorrhea, myasthenia gravis, striae), delayed sexual development in children.

From the side of the organs of vision: posterior subcapsular cataract, increased intraocular pressure, exophthalmos.

Side effects associated with immunosuppressive action: more frequent occurrence of infections and aggravation of the severity of their course.

Others: allergic reactions.

Local reactions (at the injection site): hyperpigmentation and leukoderma, atrophy of subcutaneous tissue and skin, aseptic abscess, hyperemia at the injection site, arthropathy.

Interaction with other drugs

Simultaneous use with phenobarbital, rifampicin, phenytoin or ephedrine can accelerate the biotransformation of dexamethasone, thereby weakening its effect. Hormonal contraceptives enhance the effect of dexamethasone.

Simultaneous use with diuretics (especially "loop") can lead to increased excretion of potassium from the body.

With simultaneous appointment with cardiac glycosides, the possibility of cardiac arrhythmias increases.

Dexamethasone weakens (rarely enhances) the effect of coumarin derivatives, which requires dose adjustment.

Dexamethasone enhances the side effects of non-steroidal anti-inflammatory drugs, especially their effect on the gastrointestinal tract (increased risk of erosive and ulcerative lesions and bleeding from the gastrointestinal tract). In addition, it reduces the concentration of non-steroidal anti-inflammatory drugs in the blood serum and thereby their effectiveness.

Carbonic anhydrase inhibitors: increase the risk of hypernatremia, edema, hypokalemia, osteoporosis.

Reduces the effectiveness of insulin and oral hypoglycemic drugs, antihypertensive drugs.

Antacids weaken the effect of dexamethasone.

In combination with paracetamol leads to an increased risk of hepatotoxicity, due to the induction of liver enzymes and the formation of a toxic metabolite of paracetamol.

The simultaneous use of androgens, steroid anabolics contributes to the appearance of edema, hirsutism and acne; estrogen, oral contraceptives - leads to a decrease in clearance, an increase in the toxic effects of dexamethasone.

The risk of developing cataracts increases with the use of antipsychotics (neuroleptics) and azathioprine in combination with dexamethasone.

Simultaneous administration with M-anticholinergics (including antihistamines, tricyclic antidepressants) and nitrates contributes to the development of glaucoma.

When used simultaneously with live antiviral vaccines and against the background of other types of immunizations, it increases the risk of virus activation and the development of infections.

Amphotericin B increases the risk of developing heart failure.

In combination with anticoagulants and thrombolytics, the risk of developing gastrointestinal ulcers and bleeding increases.

Reduces the plasma concentration of salicylates (increases the excretion of salicylates).

Increases the metabolism of mexiletine, reducing its plasma concentration.

Possibilities and features of the use of the drug during pregnancy

(especially in the first trimester), the drug can be used only when the expected therapeutic effect outweighs the potential risk to the fetus. With prolonged therapy during pregnancy, the possibility of impaired fetal growth is not ruled out. In the case of use at the end of pregnancy, there is a risk of atrophy of the adrenal cortex in the fetus, which may require replacement therapy in the newborn.

If it is necessary to carry out treatment with the drug during breastfeeding, then breastfeeding should be discontinued.

The effect of the drug on the ability to drive vehicles, mechanisms

During treatment, driving is not recommended, as well as engaging in activities that require quick psychomotor reactions and precise movements.

Release form:

Solution for injections 4 mg/ml.

1 ml in neutral glass ampoules.

10 ampoules, together with instructions for use and a knife for opening ampoules or an ampoule scarifier, are placed in a cardboard box.

5 ampoules in a blister pack made of polyvinyl chloride film.

1 or 2 blister packs, together with instructions for use and a knife for opening ampoules or an ampoule scarifier, are placed in a pack of cardboard.

When using ampoules with notches, rings and break points, an ampoule scarifier or a knife for opening ampoules may not be inserted.

Best before date:

2 years. Do not use after the expiry date stated on the packaging.

Storage conditions:

In a place protected from light at a temperature of 5 to 25 ° C.
Keep out of the reach of children.

Conditions for dispensing from pharmacies:

Released by prescription.

Name, address of the manufacturer and address of the place of manufacture of the medicinal product / organization accepting claims

JSC DALHIMFARM, 680001, Russian Federation, Khabarovsk Territory, Khabarovsk, st. Tashkentskaya, 22.

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Dexamethasone is a hormonal drug that is a synthetic substitute for the glucocorticoid hormones of the adrenal cortex (cortisone and hydrocortisone).

These hormones play a huge role in all vital processes of the body, and dexamethasone is widely used in medicine in various dosage forms. This is a fast-acting and very effective substance, which, along with benefits, can harm the body in case of overdose or prolonged use.

The effect of dexamethasone on the body

Dexamethasone is an analogue of prednisolone, but the difference is that it exceeds its activity by more than 30 times. It quickly penetrates into all organs and tissues, passing through the placental and blood-brain barrier (to the brain), into women's milk and the secrets of other glands. With internal use, after half an hour it is absorbed into the blood and stays in it for up to 5 hours, is destroyed in the liver, its remains are excreted in the urine.

The role of dexamethasone in medicine can hardly be overestimated, it is called the "disaster hormone" because it is used to quickly eliminate life-threatening conditions.

The hormone has an anti-shock effect, quickly increases blood pressure, eliminates the allergic process, has a powerful anti-inflammatory effect, inhibits autoimmune reactions, eliminates disorders of carbohydrate, protein, fat and water-electrolyte metabolism.

Dexamethasone is also used to treat various chronic diseases. when other means are ineffective: with bronchial asthma, diseases of the nervous system, blood, endocrine organs, digestion, bones and joints, skin, organ of vision and hearing.

Side effects of dexamethasone in overdose:

The benefits and harms of dexamethasone depend on the correct definition of indications and selection of dosage, its excess and leads to negative consequences.

The use of the drug and the normal dose

Indications for the appointment of dexamethasone are:

Shock of various origins;
Cerebral edema (with trauma, stroke, tumors);
Bronchial asthma;
Severe allergy;

Endocrine disorders (adrenal, thyroid, ovarian);
Blood diseases;
Gynecological diseases;
Chronic skin diseases;
Eye diseases.

Dexamethasone is used in injections, tablets, in the form of external ointments and eye drops, injected into the joint cavity, abdominal and pleural cavities, spinal canal.

The daily dose for adults with emergency use is 8-20 mg, maintenance - up to 0.5-1.5 mg, it is divided into 3 doses. Children are prescribed at the rate of 0.02 mg / kg of body weight per day, also in 3-4 doses. From 2 to 6 mg are injected into various cavities for adults, 0.05-1 mg for children, depending on age.

The body quickly gets used to hormonal help, so when the effect is achieved, the dose is gradually reduced to avoid overdose and dependence. If necessary, a maintenance dose is prescribed for a long period, while taking breaks.

Symptoms of an overdose of dexamethasone

Excessive intake of dexamethasone in the body leads to disruption of the work of all organs and systems, which results in the following symptoms:

From the side of the nervous system- headache, dizziness, poor sleep, depression, mental disorders, convulsions;
From the side of the circulatory system- hypertension, cardiac arrhythmias, angina attacks;

First aid and recovery of the body after an overdose

If a patient taking hormone therapy has at least the initial signs of the symptoms listed above, you should immediately call an ambulance and proceed with measures to cleanse the body:

Rinse the stomach with lightly salted water;
Give plenty of drink - warm mineral water without gas or slightly salted boiled water - at least 4 glasses, for a child - 1-2 glasses;

Give any enterosorbent(activated carbon, atoxil, enterosgel, karbogel and analogues);
Provide peace.

In the hospital, the patient is given complex treatment to restore all body functions.: intravenous infusions to relieve intoxication, heart drugs, vitamins, normalization of water-salt metabolism, blood clotting, immunity.

Treatment and subsequent recovery after an overdose can be very lengthy, because dexamethasone is quite difficult to remove from the body until it is itself decomposed in the liver.

There is no antidote, and even extracorporeal blood purification (hemodialysis) has no effect, the hormone penetrates deeply into the cellular structures of tissues and organs.

The recovery period consists in observing the diet and exercise, regular visits to the doctor and taking medications, which are prescribed individually, depending on the nature and degree of violations. This may be the treatment of the nervous system or exacerbated peptic ulcer, hypertension, dysfunction of the thyroid or sex glands, obesity.

Complications and consequences

Among the severe complications with a significant overdose of the drug, the most dangerous are heart attack and acute heart failure, cerebral edema, hypertensive crisis with intracerebral hemorrhage, acute liver and kidney failure.

An overdose of dexamethasone can lead to later effects:

Frequent headaches, general lethargy, poor sleep, low mood;
Violation of carbohydrate metabolism;
Increased appetite, obesity;

Hypertension;
Pain in the joints, the development of metabolic polyarthritis, osteoporosis;
Excessive hair growth in women, decreased potency in men;
Age spots on the skin, seborrhea, acne and pustular rash, suppuration of wounds and abrasions.

Most often, those who have taken long-term hormonal therapy gradually develop Itsenko-Cushing's syndromeassociated with the effect of the hormone on all organs and tissues. It includes a violation of carbohydrate metabolism (increased glucose), electrolyte (accumulation of sodium, development of edema), fat metabolism (fat deposits increase, the location of subcutaneous fat is redistributed, the body changes shape), the functions of the genital organs (fertility decreases, hirsutism develops in women, men testicular hypotrophy, sexual weakness).

The treatment of such a syndrome is long, the drug mamomit is used, which depresses the function of the adrenal glands, sometimes a surgical method is used - the removal of one adrenal gland.

How much dexamethasone is excreted from the body?

Once in the body, dexamethasone circulates in the blood for 3-5 hours, gradually settling in the cells of organs and tissues. Passing through the portal vein of the liver, which carries blood from all organs, it is gradually decomposed by the liver cells to inactive components, they enter the bloodstream and are excreted by the kidneys with urine.

In total, the time during which the hormone completely leaves the body lasts from 1.5 to 3 days. At this time, it is not recommended to undergo a laboratory examination, because the test results will differ from the norm.

The rate of excretion of the drug depends on the state of the function of the liver, kidneys. If they are violated, then it will be slowed down, but as a result, the accumulation of the hormone in the tissues and organs is not observed, it is completely eliminated.

Dexamethasone and alcohol

Some people mistakenly believe that a little alcohol during hormone therapy will help reduce the negative effects of taking dexamethasone. In fact, the opposite is true: it only enhances the side effects of the drug. It should be learned that you need to stop drinking alcohol at least 3 days before before starting the drug, and resume - not earlier than 3-4 days after cancellation.

The combination of dexamethasone with alcohol leads to the development of such complications:

heart failure;
Nausea, vomiting, diarrhea;
stomach bleeding;
Decreased vision;
Allergic skin reactions in the form of swollen red spots on the face, chest.

Although dexamethasone is used in narcological practice for withdrawal from withdrawal symptoms (delirium tremens) to prevent cerebral edema, this is done when absolutely necessary in a hospital under the supervision of a doctor.

lethal dose of hormone

Deaths from overdose of dexamethasone are very rare, because it is mainly used in large doses only in a hospital setting. Maintenance doses of the drug in tablets taken at home are not life-threatening. The exception is rare cases of deliberate use of a large number of tablets, or accidental use of them by children.

A single dose for adults exceeding 50-60 mg, and a daily dose of more than 80 mg may be life-threatening due to the development of complications. For a child, a dose of 20-25 mg may be of great danger.

Habituation and Dexamethasone Withdrawal Syndrome

Prolonged use of dexamethasone leads to addiction to it, but this addiction does not have the character of psychological dependence. The drug, replacing natural glucocorticoids, gradually inhibits the function of the adrenal cortex. Rather, the body thus tries to regulate the hormonal level so that it does not rise sharply, this is an automatic defense mechanism.

All organs and systems also “get used” to the hormone. because it regulates many biochemical processes in the body. When the drug is stopped, the so-called withdrawal syndrome develops: the hormone does not come from the outside, and the function of the adrenal glands is still reduced, it takes time to restore it. Hypocorticism develops, which can be recognized by the following symptoms:

Sharp general weakness, dizziness;
drop in blood pressure;
Depressive state.

In addition, symptoms of the disease for which the hormone was prescribed appear, for example, exacerbation of polyarthritis, allergies, resumption of asthmatic attacks, relapse of an inflammatory disease. It is possible to prevent such consequences by reducing the dose gradually, this issue should be decided by the doctor.

Dexamethasone is a drug that can save lives, and can seriously harm health. It must be used strictly according to the doctor's prescription, observing the dosage, be attentive to your well-being, and if complaints appear, immediately consult a doctor.

The normal functioning of the human body largely depends on the state of the hormonal system. Even minor malfunctions in its work lead to diseases of varying severity. Currently, pharmacists have developed a huge number of synthetic hormonal preparations that allow you to correct the lack of a particular hormone, and also make it possible to influence the body systemically. One such analogue of hormones is the substance dexamethasone.

What is dexamethasone?

Dexamethasone is a fluorinated derivative of the glucocorticosteroid hormone, which is normally produced by the adrenal cortex.

Systemic drugs based on this hormone have anti-inflammatory, anti-allergic effects, and can reduce immune responses. Doctors, using dexamethasone in their medical practice, leave reviews about its effectiveness in eliminating acute allergy attacks.

Mechanisms for reducing inflammatory and allergic reactions are of a chain nature. Dexamethasone reacts with receptor formations in the cytoplasm, creating a complex compound that penetrates the nuclear envelope and increases the formation of messenger RNA. As a result of translation on mRNA, lipocortin protein is synthesized. This protein mediates the action of dexamethasone. So, under the influence of lipocortins, the action of phospholipases A2 slows down, the production of eicosatetraenoic acid, prostaglandin endoperoxides, leukotriene decreases, the main effects of which are inflammatory, allergic reactions. The production of prostanoids also decreases due to a decrease in the synthesis of cyclooxygenase.

With the participation of dexamethasone, the production of adrenocorticotropic, β-lipotropic and follicle-stimulating hormones by the pituitary gland is slowed down, the secretory function of the thyroid gland decreases during the production of thyroid-stimulating hormone, but the content of polypeptide endorphins in the blood does not decrease.

This synthetic substance takes part in the metabolism of proteins, fats and in the synthesis of glucose without carbohydrate components. Under the action of dexamethasone, gluconeogenesis enzymes are activated, then glucose is synthesized from lactic and pyruvic acid in the cells of the liver and kidneys. The liver begins to store more glycogen, which in turn activates glycogen synthetase and the production of glucose from amino acid residues. There is an increase in plasma glucose concentration, which leads to the synthesis of insulin by the pancreas.

Treatment with dexamethasone:

It leads to an increased process of splitting fats in cells due to a decrease in the intake of glucose into them. But this process is reversible, since dexamethasone stimulates the production of insulin, which activates the synthesis of fats from glucose and their accumulation.
It enhances the process of dissimilation of complex substances into simpler ones in such tissues as connective, bone, muscle, fat and lymphoid.
Violates the activity of all leukocyte cells, including monocytes, in tissues.
It reduces the entry of these cells into the area with foreign agents and their phagocytic activity, the production of interleukin mediators. Due to the strengthening of the membrane membrane of lysosomes of cells, the number of enzymes that cleave peptide bonds in proteins, causing inflammatory foci, decreases.
Reduces the number of T-lymphocytes and B-lymphocytes, monocytic cells, basophilic and eosinophilic leukocytes in the vascular bed due to their transition into the lymphatic fluid, reduces the production of immunoglobulins, collagen fibers, and the permeability of capillary walls.

Variety of dosage forms of dexamethasone

The substance dexamethasone is part of glucocorticoid drugs, which are produced in various dosage forms. It may be in tablet form. There is also the drug "Dexamethasone" in ampoules in the form of solutions for injection, in the form of eye drops and ointments. Each dosage form has its own purpose for certain diseases, instructions for use and dosage, a list of adverse reactions. Depending on the nature of the course of the disease and the duration of treatment, doctors prescribe a certain form of the drug.

There is an opinion among doctors that injectable forms have a number of advantages over tablets. So, the solutions of the drug after their administration are able to almost instantly have a therapeutic effect due to the rapid entry of the active substance into the bloodstream, and from it to the receptors. In liquid form, the drug is completely absorbed, and when using tablets, part of the active ingredient is destroyed by the contents of the digestive tract.

The drug "Dexamethasone", patient reviews

The drug "Dexamethasone" has many indications for use. Its main directions are anti-inflammatory, anti-allergic, immunosuppressive actions.

After a course of therapy with the drug "Dexamethasone", the reviews of some patients indicate its effectiveness in the treatment of acute allergic reactions, inflammatory processes in the joints or attacks of bronchial asthma, while others remain dissatisfied with the large number of side effects of this drug.

Therapy with hormonal agents has always been accompanied by a share of the risk of undesirable consequences. Therefore, the attending physician must compare the benefits in the treatment of the disease and the risk of adverse reactions before prescribing Dexamethasone. Reviews of patients taking this medicine indicate that they have adverse reactions that affect certain body systems.

These may be reactions associated with endocrine disorders, such as the development of various types of diabetes mellitus, a decrease in the body's resistance to glucose molecules, and an increase in the production of ACTH hormones by the adrenal glands. As a result, Cushing's disease develops with symptoms such as obesity, excessive body hair, rounding of facial features with a pronounced double chin, hypertension, menstrual cycle disorders in women, and excessive fatigue of striated muscles.

Changes also occur in the work of the heart and blood vessels, they are characterized by a violation of the heart rhythm in the direction of its decrease, as well as a deterioration in the pumping function of the heart to supply the body with blood, hypertension, increased blood clotting, and the formation of blood clots. The digestive system can also be negatively affected by the drug "Dexamethasone", which is manifested by impaired digestion of food, gag reflexes, nausea, gastritis and pancreatitis, ulcers or bleeding of the stomach and intestines, bloating, hiccup reflexes.

Side effects can also occur in the nervous system. These can be hallucinations, a state of euphoria, delirium, nervousness, paranoid disorders, accompanied by headache, convulsions, sleep disturbance.

Sometimes patients complain of fluid retention in the body due to the accumulation of sodium ions and excretion of potassium, overweight, increased sweating, fragility of bone tissue and tendons, long-term non-healing skin lesions, the appearance of red spots on the skin due to hemorrhages, impaired pigment content in the skin, acne rash.

Ampoule form of dexamethasone

The drug "Dexamethasone" in ampoules (injection forms) is used for emergency therapy, as well as when the agent can only be administered as intravenous or intramuscular injections. This is a colorless or yellowish solution of the substance dexamethasone sodium phosphate at a concentration of 4 mg dexamethasone phosphate per 1 ml of water for injection.

The ampouled drug "Dexamethasone" is widely used, the indications for the use of which are based on its anti-inflammatory, anti-allergic, immunosuppressive effects.

Diseases requiring injection of dexamethasone include acute and chronic adrenal insufficiency, hereditary overgrowth of the adrenal cortex; destruction of thyrocytes of the thyroid gland; a state of shock of various origins, when other drugs do not work. Excessive accumulation of fluid in the brain due to tumors, injuries, surgical procedures, meningoencephalitis is treated with the drug; asthma attack, bronchospasm in acute bronchitis, acute allergy attacks. Indications include rheumatoid arthritis; pathologies of bone, cartilaginous tissues, skin rashes and various dermatitis; malignant leukemias, leukemias, tumors; destruction of red blood cells, lack of granulocytes, diathesis with a hemorrhagic decrease in the number of platelet cells; various infections.

This drug is used both separately and in combination with other drugs.

Instructions for use for dexamethasone in ampoules

In several ways, it recommends injecting the drug "Dexamethasone" instructions for use. Injections are made intravenously by jet or drip method. With drip administration, a solution is prepared from sodium chloride isotonic or dextrose solution of five percent. You can give injections intramuscularly or inject the drug locally at the site of the disease, for example, inside the joint.

The doctor prescribes the dosage and number of doses to the patient in accordance with the nature and severity of the disease, as well as the person's ability to tolerate this drug. In acute conditions, treatment begins with high doses of the drug "Dexamethasone" in ampoules. Instructions for the introduction of this drug for the first day prescribes a dosage of about 4-20 mg of the drug, which is distributed into 3 or 4 doses, with the first dose always greater than the subsequent ones. So, the first dosage for relieving cerebral edema is 10 mg, 20 mg is used to eliminate the state of shock, and about 8 mg for an allergic reaction. After the condition improves, the dosage is reduced. The duration of injection treatment is about 3-5 days.

When the drug is injected into a diseased joint, the dose is from 0.2 to 6 mg, injections are given every three days.

When treating children as a result of insufficient production of adrenal hormones, the dosage of the drug is set at 0.023 mg per kilogram of body weight, which is administered by three injections intramuscularly after three days. For the treatment of other diseases, a maximum dose of 0.1667 mg per kilogram of body weight is prescribed.

With the simultaneous use of dexamethasone injections with other drugs, there may be an incompatibility of their actions, for example, when it is combined with a heparin solution, precipitation occurs, which is unacceptable. Therefore, pharmacists recommend using intravenous dexamethasone alone, without other drugs.

Dexamethasone tablets

There are several dosages of the tablet form of the drug "Dexamethasone". Tablets of this drug are white, contain 0.5 mg and 1.5 mg of the active ingredient - dexamethasone.

A wide range of Dexamethasone is presented on the pharmaceutical market. What are these tablets for? Usually doctors prescribe this form after injection therapy, when an acute attack of the disease has been eliminated, as a maintenance treatment.

The drug is indicated for replacement therapy of insufficient work of the adrenal cortex, thyroiditis of various forms.

When using a remedy such as the drug "Dexamethasone", indications for use - treatment of rheumatoid diseases of the joints, edema of the brain or spinal cord, connective tissue lesions in vasculitis, lupus erythematosus, sclerosis, amyloidosis, various dermatitis and erythema, psoriasis and lichen, allergic diseases , systemic immune diseases.

The drug is also prescribed for endocrine diseases of the organs of vision, various changes in the structure of the eye, to reduce immune reactions during lens or cornea transplantation.

Effective treatment based on the drug "Dexamethasone", indications for its use include diseases of the digestive system, such as colitis, granulomatous enteritis, liver disease; diseases of the respiratory system: tuberculous lesions of the lung tissue, fibrosis and sarcoidosis of the lungs; diseases of the circulatory system: various anemias, aplasia of erythroblasts, lack of platelets, leukemias and lymphomas.

Rules for taking dexamethasone tablets

The drug "Dexamethasone", tablets of 0.5 mg or 1.5 mg, is prescribed to each patient individually. The dosage depends on the type of disease, severity, duration of treatment, the body's ability to tolerate this drug. Usually, the medicine is taken with food, and antacids are taken after a meal.

At the beginning of treatment, the dosage per day is from 0.70 to 9 mg. The maximum dose that can be used per day should not exceed 15 mg, and the minimum - 1 mg. When the patient's condition is stable, the amount of dexamethasone is reduced to 3 mg per day. The drug "Dexamethasone" for children is used at a dosage per day from 83.3 to 333.3 mcg per kilogram of weight.

The duration of treatment can be several days, or it can take months, it all depends on the therapeutic effect. After the end of taking the drug, corticotropin is administered for several days.

Dexamethasone eye drops

Another type of dexamethasone are eye drops "Oftan Dexamethasone" for local action. They are a colorless transparent solution of the substance dexamethasone sodium phosphate in the amount of 1.32 mg per 1 ml of water for injection; the most active component of dexamethasone in solution is 1 mg per 1 ml. This drug is used in ophthalmic practice as an anti-inflammatory, anti-allergic and anti-exudative agent.

The active substance dexamethasone affects the synthesis of proteins, reduces the production of substances responsible for inflammatory processes, such as histamine, kinin, lysosome enzymes, reduces the flow of macrophages to the site of inflammation, and reduces the permeability of the vascular walls. Due to the action of the hormone, the production of immunoglobulins, interleukins, mediators of inflammatory reactions is disrupted, which prevents the inflammatory process from developing in various disorders. The duration of this effect after the introduction of one drop is about eight hours.

Application of dexamethasone drops

For the treatment of eye diseases, the drug "Dexamethasone" is used - drops. The instruction describes the treatment of diseases of an acute or chronic nature with this remedy. It can be a non-purulent inflammatory process in the membrane of the eye, its cornea, chronic inflammation of the edge of the eyelid, acute inflammatory process of the protein membrane of the eye, episcleral tissue, inflammation between the sclera and conjunctiva, in the iris, as well as in it and in the ciliary body of the eyeball. The cornea is treated with drops of dexamethasone for various injuries, inflammation in the posterior ocular segment, postoperative or post-traumatic edema and inflammation, sympathetic ophthalmia, allergic conjunctivitis or keratoconjunctivitis, and ear diseases, such as otitis media.

The method of application of 0.1% drops is to instill the eyes into the area of the conjunctival sac, one or two drops every two hours. After reducing the inflammatory process, the number of instillations is reduced to five per day. The duration of treatment is determined by the doctor, after examining the patient and measuring the pressure inside the eye. The period of use of the drug should be no more than three weeks.

In the treatment of ear diseases, 3 or 4 drops are dripped into the affected ear 2-3 times a day.

It should be borne in mind that during treatment with dexamethasone, concomitant fungal or infectious diseases may not be noticed, and if any are detected, hormonal drops are combined with antimicrobial drugs.

Oftan dexamethasone eye drops contain the preservative benzalkonium chloride, which is bad for the eyes and can be absorbed by the surface of contact lenses.

The cost of drugs

All dosage forms of dexamethasone differ in price. The highest cost is for injection solutions of the drug "Dexamethasone", which each manufacturer has its own. You can buy ampouled solutions at a pharmacy, ampoules of 25 pieces per pack, the content of dexamethasone in 1 ml is 4 mg. Ampoules may contain 2 ml and 1 ml of solution. Must be contained in the box of the drug "Dexamethasone" instructions for use. The price for such a drug starts from 200 rubles for 25 ampoules of 1 ml and from 226 rubles for 25 ampoules of 2 ml.

Dexamethasone tablets with a dosage of 0.5 mg, 50 pieces per pack can be bought for 28 rubles.

Dexamethasone 0.1% eye drops cost a little more, their price varies from 40 rubles per pack. They are sold in dropper bottles of 5 ml and 10 ml, in a pack with instructions for use.