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

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

The composition of the medicinal product

"Dexamethasone" is a glucocorticosteroid, identical to the hormone that the adrenal glands produce. The name of the drug was given by its main active ingredient - dexamethasone. One of the forms in which a drug is produced is white color tablets, round, flat, with bevelled edges.

One tablet contains 0.5 milligrams of dexamethasone.

In addition, there are auxiliary components:

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

Pharmacological properties and pharmacokinetics

Dexamethasone tablets are prescribed when it becomes necessary to influence the body in a complex way - to relieve shock and stop inflammation. Therefore, they are often indispensable during allergic manifestations different forms and varying degrees of severity (excluding allergy to alcohol).

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

The substance activates blood flow in the kidneys.

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

Dexamethasone also has several other pharmacological properties:

• antishock;
• immunosuppressive;
• antitoxic.

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

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

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

Gross formula

C 22 H 29 FO 5

Pharmacological group of the substance Dexamethasone

Nosological classification (ICD-10)

CAS code

50-02-2

Characteristics of the substance Dexamethasone

Hormonal agent (glucocorticoid for systemic and topical use). Fluorinated hydrocortisone homologue.

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

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

Pharmacology

pharmachologic effect- anti-inflammatory, anti-allergic, immunosuppressive, anti-shock, glucocorticoid.

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

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

After instillation into the conjunctival sac, it penetrates well into the epithelium of the cornea and conjunctiva, while therapeutic concentrations of drugs are created in the aqueous humor of the eye. With inflammation or damage to the mucous membrane, the rate of penetration increases.

The use of the substance Dexamethasone

For systemic use(parenteral and orally)

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

For topical application

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

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

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

Contraindications

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

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

Eye forms. Viral, fungal and tubercular lesions of the eyes, incl. keratitis caused by herpes simplex, viral conjunctivitis, acute purulent eye infection(in the absence of antibiotic therapy), violation of the integrity of the corneal epithelium, trachoma, glaucoma.

Ear forms. Perforation of the tympanic membrane.

Application restrictions

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

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

Use during pregnancy and lactation

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

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

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

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

It should be borne in mind that with topical application of glucocorticoids, systemic absorption occurs.

Side effects of Dexamethasone

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 compliance. circadian rhythm appointment of drugs.

System effects

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

From the side of cardio-vascular system and blood (hematopoiesis, hemostasis): arterial hypertension, development of chronic heart failure (in predisposed patients), myocardial dystrophy, hypercoagulability, thrombosis, ECG changes characteristic of hypokalemia; when administered parenterally: flushes of blood to the face.

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

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

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

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

From the side of the skin: steroid acne, striae, thinning of the skin, petechiae and ecchymosis, delayed wound healing, increased sweating.

Allergic reactions: skin rash, hives, swelling of the face, stridor or shortness of breath, anaphylactic shock.

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

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

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

KNF (drug is included in the Kazakhstan National Formulary of Medicines)

ALO (Included in the Free Outpatient Drug Supply List)

Manufacturer: Krka, d.d., Novo Mesto

Anatomical-therapeutic-chemical classification: Dexamethasone

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

Date of registration: 24.08.2016 - 24.08.2021

Limit price: 24.03 KZT

Instruction

• Russian

Tradename

Dexamethasone

International non-proprietary name

Dexamethasone

Dosage form

Tablets 0.5 mg

Compound

One tablet contains

active substance- dexamethasone 0.5 mg,

inexcipients: lactose monohydrate, corn starch, povidone, magnesium stearate, talc, colloidal anhydrous silica

Description

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

Pharmacotherapeutic group

Corticosteroids for systemic use. Glucocorticosteroids. Dexamethasone.

ATX code H02AB02

Pharmacological properties

Pharmacokinetics

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

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

Pharmacodynamics

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

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

Indications for use

replacement therapy for primary and secondary (pituitary) adrenal insufficiency

congenital hyperplasia adrenal glands

subacute thyroiditis and severe forms postradiation thyroiditis

rheumatic fever

acute rheumatic heart disease

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

toxidermia, toxic epidermal necrolysis (Lyell's syndrome)

malignant exudative erythema (Stevens-Johnson syndrome)

allergic reactions to drugs and foods

serum sickness, drug exanthema

urticaria, angioedema

allergic rhinitis, hay fever

diseases that threaten the loss of vision (acute central

chorioretinitis, inflammation of the optic nerve)

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

systemic immune diseases(sarcoidosis, temporal arteritis)

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

immunosuppressive therapy in corneal transplantation

ulcerative colitis, Crohn's disease, localized enteritis

sarcoidosis (symptomatic)

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

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

idiopathic thrombocytopenic purpura

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

leukemia, lymphocytic leukemia (acute, chronic)

kidney disease of autoimmune origin (including acute glomerulonephritis)

nephrotic syndrome

palliative care for leukemia and lymphoma in adults

acute leukemia in children

hypercalcemia with malignant neoplasms

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

Dosage and administration

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

Adults

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

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

Dosing in children over 6 years of age

Side effects

decreased glucose tolerance, "steroidal" diabetes mellitus, or manifestation of latent diabetes mellitus

Itsenko-Cushing's syndrome, weight gain

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

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

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

hypercoagulation, thrombosis

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

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

pseudotumor of the cerebellum

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

negative nitrogen balance (increased protein breakdown), hyperlipoproteinemia

increased sweating

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

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

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

"steroid" myopathy, muscle atrophy

delayed wound healing, a tendency to develop pyoderma and candidiasis

petechiae, ecchymosis, thinning of the skin, hyper- or hypopigmentation, steroid acne, striae

generalized and local allergic reactions

decreased immunity, development or exacerbation of infections

leukocyturia

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

withdrawal syndrome

Contraindications

hypersensitivity to active substance or auxiliary components of the drug

peptic ulcer of the stomach and duodenum

osteoporosis

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

Cushing's syndrome

severe arterial hypertension

severe renal failure

obesity III - IV degree

active tuberculosis

acute psychoses

pregnancy and lactation

cirrhosis of the liver or chronic hepatitis

childhood up to 6 years

Drug Interactions

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

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

special instructions

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

With the sudden withdrawal of the drug, especially in the case of high doses, there is a withdrawal syndrome of glucocorticosteroids: anorexia, nausea, lethargy, generalized musculoskeletal pain, general weakness. After discontinuation of the drug for several months, relative insufficiency of the adrenal cortex may persist. If during this period there are stressful situations, appoint temporarily glucocorticoids, and if necessary - mineralocorticoids.

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

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

If the patient has intercurrent infections, a septic condition, treatment with Dexamethasone should be combined with antibiotic therapy.

If treatment with Dexamethasone is carried out for 8 weeks before and 2 weeks after active immunization (vaccination), then in this case the effect of immunization will be reduced or completely neutralized. Patients with severe traumatic brain injury and impaired cerebral circulation according to the ischemic type, it is necessary to prescribe glucocorticoids with caution. Application in pediatrics

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

Children who are in contact with measles patients during treatment chicken pox prescribe specific immunoglobulins.

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

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

Overdose

Symptoms: possible aggravation of the side effects described in the corresponding section.

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

After the disappearance of symptoms of an overdose, the drug is resumed.

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

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

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

Application of the drug

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

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

Thus, indications for use may be problems associated with insufficiency of the adrenal cortex, swelling of the brain, the presence of tumors or head injuries in it. The drug is aimed at alleviating conditions caused by malignant formations and conditions: leukemia, childhood leukemia, and others.

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

Dexamethasone during pregnancy

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

Mode of application

Dexamethasone is used according to an individually drawn up plan. It is taken orally (tablets), by injection, conjunctival.

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

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

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

• Injections for children. Calculated based on body weight.

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

Contraindications

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

Side effects and overdose

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

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

Pharmacological group

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

Pharmacokinetics and pharmacodynamics

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

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

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

The drug controls almost all metabolic processes, changing them.

Protein metabolism. Catabolism (breakdown into simple components) of the protein is accelerated. This causes the accumulation of glucose in the "depot" - the liver, lymph. In the blood, the glucose content drops, sometimes critically - to hypoglycemia.

When glucose is released from the liver into the bloodstream, the pancreas is stimulated. It intensively produces insulin, utilizes glucose. There are "jumps" in the content of the latter in the blood.

It is necessary to control the level of glucose in the blood. It is especially important for those suffering from diabetes, their sugar curve often peaks up or down.

lipid metabolism. It does not change for the better for the body. Synthesis fatty matter organized so that the fat moves to the abdominal region. There is obesity according to the "apple", a dangerous increase in the likelihood of vascular accidents (heart attacks, strokes), type. The amount of cholesterol in the blood is significantly higher than normal.

Mechanism of therapeutic action

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

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

Blocking histamine also stops pathological allergic reactions.

Release form

The drug is available in four forms:

1. Tablets, the content of the active substance - dexamethasone - they contain 0.5 mg;
2. Eye drops - in a milliliter 1 mg of the drug;
3. Eye ointment - tubes 2.5 g;
4. Ampoules for injection - 4 mg of dexamethasone per milliliter of the contents of the ampoule.

All forms of the drug contain additives that stabilize and facilitate transportation to the focus of pathology and assimilation of the drug, preservatives for preservation. Packages from different manufacturers look different (photo).

The price of dexamethasone in pharmacies of the country fluctuates:

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

The drug is valuable in action, the cost of dexamethasone itself is small. Sales by prescription. In a Latin prescription, dexamethasone is called Dexamethasone.

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

Indications for use

The nervous system is the regulator of the whole organism, and dexamethasone acts through it

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

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

• Endocrine disorders - problems of the adrenal glands, thyroid gland, androgenital syndrome;
• Autoimmune dysfunctions;
• Respiratory dysfunction;
• Shock life-threatening conditions;
• blood diseases;
• Nonspecific ulcerative colitis;
• Acute phase of eczema;
• serum sickness;
• connective tissue defects;
• Agranulocytosis;
• Addison-Birmer disease;
• Pemphigus;
• Hypoplasia of hematopoiesis;
• Ophthalmic diseases;
• Deforming joint diseases - bursitis, arthrosis, osteochondrosis;
• Myositis;
• Tuberculosis;
• Helminthiasis with damage to organs;
• Exacerbation of bronchial asthma;
• Meningitis;
• Traumatic brain injury;
• malignant tumors;
• severe infections.

Application methods

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

The average daily oral dose is usually 15 mg. The attending physician is engaged in adjustment of doses.

Injections

Dexamethasone injections are administered intramuscularly or intravenously.

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

If the tolerability of the drug is known and the person knows the symptoms of an impending dangerous state, from which this particular drug removes it, the doctor prescribes dexamethasone in ampoules. The patient learns to staging intramuscular injections, has the drug with him. So you can save your own life if the doctor is far away, and the time countdown goes on - for minutes.
For this, at least you need to know how to inject dexamethasone for yourself or for a person in need of an injection.

If the situation is difficult and Ambulance required: intravenous administration is required. But you still need to give an injection before the arrival of a specialized team - inaction is dangerous!

You will need:

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

It is more convenient to inject into the femoral muscle on your own. Algorithm:

1. A person lies, better - sits, if the condition allows.
2. Opens (breaks off) the upper part of the ampoule.
3. Opens the syringe package, collects it or, if it is originally assembled, removes the cap from the needle.
4. Inserting the needle into the ampoule, draws, pulling the syringe rod towards itself, its contents into the syringe.
5. Raising it vertically, removes air bubbles: "drives" the air by pressing the stem up.
6. Grabbing the thigh muscle with his left hand, he inserts a needle into it. The depth depends on the size of the needle, if the needle is small, it is inserted through the cannula itself.
7. Slowly injects the drug into the muscle.
8. Removes the needle with a quick movement (so pain is less felt).
9. Wipe the injection site with a disinfectant wipe or cotton swab dipped in alcohol.
10. Knowing how to inject saving dexamethasone intramuscularly, a person gets an additional opportunity to survive, to help himself immediately when needed.

Drip solution is administered only by health workers. If necessary, in a hospital setting. injection application medication is limited to usually three days. Then the patient is transferred to maintenance treatment with tablet forms with gradual decline dosage - until complete cancellation.

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

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

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

Dexamethasone inhalations treat:

• Pulmonary tuberculosis;
• Laryngitis;
• Cough allergic and concomitant with other diseases of the respiratory organs;
• Pharyngitis;
• Residual manifestations of pneumonia;
• Bronchial asthma;
• Diseases of the respiratory system of fungal etiology;
• bronchiectasis;
• cystic fibrosis;
• Suffocation from swelling of the larynx (false croup).

There are contraindications. Inhalations are not carried out with:

It is better for pregnant and lactating women to refrain from inhalation of dexamethasone.

Carrying out inhalation:

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

The procedure itself takes only ten minutes or less.
It is important to follow the rules, then the risk of trouble is almost absent. But not excluded.

Possible side effects from inhalation:

• Bronchospasm;
• Drying of the mucous membranes, irritation of them, as a result - cough;
• An overdose or hyperventilation (deep breathing) can cause swelling of the mucous membranes, dizziness, tachycardia, redness of the face, blurred vision, clouded consciousness.

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

What is Dexamethasone used for?

According to the list of diseases in the indications, it is clear how strong and diverse the effect of the drug is.

Joint diseases

Inflammatory diseases of the joints that occur with acute pain treated with a short course of dexamethasone by injection directly into the joint. The properties of the drug allow you to quickly stop the pain and relieve inflammation.

If the inflammatory process has entered a stage when conventional NSAIDs cannot stop it, pain unbearably painful, hormones are connected to the treatment of prostatitis.

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

For a longer period with prostatitis, it is not advisable to prescribe a drug of such a strong effect. He suppresses immune reactions, and for the treatment of prostatitis, immunomodulators are needed, stimulation of the immune system. There is a conflict of opposition. It cannot be extended. Increases with prolonged use of dexamethasone and the risk of side effects. The failure of metabolic processes is especially dangerous.

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

asthmatic status

The positive effect of the hormone dexamethasone on the bronchial mucosa, the prevention or elimination of edema is guaranteed to improve the patient's condition, helps to cope with asthma, relieves exacerbation in short time. The danger of suffocation disappears, attacks are reduced and weakened. The mucus that clogs the bronchi ceases to accumulate.

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

One drop continues to act after instillation - 8 hours. All this time, the solution heals the inflamed eye, normalizes metabolic processes in the focus of pathology.

Traumatic brain injury

In such a situation, cerebral edema is not ruled out, and stopping and eliminating it is vital. Glucocorticosteroid can do it.

infectious diseases

If antibiotics are not able to cope, the body loses strength. Medicine connects "heavy artillery" - hormones. Not for long, but the effect will have time to appear. With this support, the body will cope with the infection.

Anaphylactic shock

Same allergic reaction, but life-threatening, proceeding violently, quickly, requiring immediate help. The anti-allergic effect of the drug is salutary in this situation.

The adrenal cortex normally produces a glucocorticosteroid that regulates many processes in the body. When the production of a hormone is disturbed, a person gets sick.

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

Its introduction in case of disturbed work of the latter stabilizes the patient's well-being.

Thyroid disease

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

Dexamethasone or Prednisolone

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

Dexamethasone is stronger in effect, the course of treatment is only short-lived. Then therapeutic effect dexamethasone has time to manifest itself, and the risk of side effects is minimal.

Prednisolone can be used longer, but it is weaker in effect.

Test with Dexamethasone

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

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

Balance is provided by the endocrine organs reproductive system each gender separately. But these same hormones are controlled by the adrenal cortex. To check the work, the health status of this important endocrine organ, a test with dexamethasone is carried out.

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

Initially, the patient discovers problems in well-being, painful symptoms and deviations. Likely are:

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

Turning to a specialist, a person receives an appointment to take tests. The need for a test with dexamethasone is determined by the analysis of urine. If the analysis showed that the content of 17-ketosteroids is increased in the daily urine, the pathology of the adrenal glands is likely and not only.

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

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

• Etiology of hyperandrogenism (increased secretion of androgens);
• Diagnosis of tumors of the adrenal cortex, affecting the secretion of hormones;
• Identification of hyperplasia (growth of the type of neoplasms) of the adrenal glands;
• Diagnosis of hypercortisolism - a long-term pathological effect of an excess of hormones of the adrenal cortex on the body (Itsenko-Cushing's disease).

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

Other violations are also diagnosed: the decoding of the testimony is carried out by a doctor who has undergone specialization

How the test is carried out

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

Hospitalization is short, you should not worry. Calmness is also important for correct diagnosis: stressful conditions change the hormonal background.

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

Doctors will control both the dose of the drug and the time between regular doses of the drug. Violations must not be allowed so that the result is reliable.

There are small and large diagnostic tests with dexamethasone.

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

Big sample:

1. The beginning is similar - blood sampling in the morning.
2. Tablets are taken only two, but once, at 23 o'clock on the same day.
3. Blood donation at 8 in the morning.

The first method is reliable up to 100%, the second - up to 95%. If cortisol has become half as much, the result of the test is positive. The absence of changes is interpreted as a negative test. How to proceed further, it is up to the doctor.

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

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

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

There are contraindications for injections into the joints:

• excessive bleeding;
• Fracture of bone tissue in the joint;
• Infections in the joint;
• operated joints.

Side effects

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

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



drug interaction

Some medicines increase or decrease the effect of dexamethasone.

Weaken:

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

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

Diuretics taken at the same time remove potassium into more possible potassium deficiency. It weakens the heart.

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

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

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

NSAIDs in such a tandem do not spare the gastrointestinal tract, damaging its sections before bleeding. Their therapeutic effect at the same time - is reduced.

During the treatment of anabolics, it is desirable to exclude: the combination will cause swelling, may cause excessive hair growth (hirsutism).

Antipsychotics contribute to the formation of cataracts.

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

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

Sodium preparations - edema, increased blood pressure.

special instructions

The drug can cause developmental disorders of the developing fetus in pregnant women. It is undesirable to use it, the risk is great. Sometimes pregnant women are prescribed dexamethasone - for health reasons. The newborn will subsequently require intensive care.

Do not use while breastfeeding. If it is necessary for the mother, the child should be transferred to nutrition with adapted mixtures.

Taking the drug often affects concentration. Work related to the need for increased concentration should not be carried out during the treatment period.

If the recipient of dexamethasone has been in contact with a patient with a herpetic disease (chickenpox, herpes zoster), he needs immunoglobulins. Immunity suppressed by the drug must be supported.

Do not use dexamethasone before or after vaccinations: it neutralizes their effect. It can even provoke viral infections against the background of depressed immunity.

A person undergoing serious hormonal treatment understands that a health disorder is not a joke. Sometimes understanding this is so depressing that he wants to take a certain amount of alcohol as an "antidepressant". The question naturally arises: is it possible?

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

Willingly or unwittingly, some patients experienced these unpredictability.

None made me happy. Cross-reactions give up to four dozen negative side effects. Among them:

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

Organisms are individual, it is impossible to predict all the troubles. positive influence was not noticed.

If a person is dependent on alcohol, he should not take dexamethasone, it is necessary to adjust the prescription of drugs. You can’t do this on your own, you need to admit it, tell the doctor about the problem.

Analogues

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

Absolute analogues of Dexamethasone:

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

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

Preparations with the same active ingredient:

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