Inhibits the secretion of thyroid-stimulating hormone and follicle-stimulating hormone.

Increases the excitability of the central nervous system, reduces the number of lymphocytes and eosinophils, increases the number of red blood cells (stimulates the production of erythropoietins).

Interacts with specific cytoplasmic receptors and forms a complex that penetrates into the cell nucleus, stimulates the synthesis of matrix ribonucleic acid (mRNA); 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 synthesis of endoperoxides, prostaglandins, leukotrienes. contributing to the processes of inflammation, allergies and others.

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

Lipid metabolism: increases the synthesis of higher fatty acids and triglycerides, redistributes fat (fat accumulation 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, leading 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.

Water-electrolyte exchange; detains sodium ions and water in the body, stimulates the excretion of potassium ions (mineralocorticosteroid activity), reduces the absorption of calcium ions from the gastrointestinal tract, "flushes" calcium ions from the bones, increases the excretion of calcium ions by the kidneys.

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

The antiallergic effect develops as a result of suppression of the synthesis and secretion of allergy mediators, inhibition of the release of histamine and other biologically active substances from sensitized mast cells and basophils, and a decrease in the number of circulating basophils. suppression of the development of lymphoid and connective tissue, a decrease in the number of T- and B-lymphocytes, mast cells, a decrease in the sensitivity of effector cells to allergy mediators, inhibition of antibody production, changes in the body's immune response.

In chronic obstructive pulmonary disease, the action is mainly based on inhibition of inflammatory processes, inhibition of the development or prevention of edema of the mucous membranes, inhibition of eosinophilic infiltration of the submucous layer of the bronchial epithelium, deposition of circulating immune complexes in the mucous membrane of the bronchi, as well as inhibition of erosion and desquamation of the mucous membrane. Increases the sensitivity of small and medium-sized bronchial beta-adrenergic receptors to endogenous catecholamines and exogenous sympathomimetics, reduces the viscosity of mucus by inhibiting or reducing its production.

The anti-shock and antitoxic effect is associated with an increase in blood pressure (due to an increase in the concentration of circulating catecholamines and restoration of the sensitivity of adrenergic receptors to them, as well as vasoconstriction), a decrease in vascular wall permeability, membrane-protective properties, activation of liver enzymes involved in the metabolism of endo- and xenobiotics.

The immunosuppressive effect is due to inhibition of the release of cytokines (interleukin-1, interleukin-2; interferon gamma) from lymphocytes and macrophages.

Suppresses the synthesis and secretion of adrenocorticotropic hormone (ACTH). and secondarily, the synthesis of endogenous glucocorticosteroids.

A feature of the action is a significant inhibition of the function of the pituitary gland and an almost complete absence of mineralocorticosteroid activity. Doses of 1-1.5 mg / day inhibit the adrenal cortex; biological half-life - 32-72 hours (duration of inhibition of the hypothalamus-pituitary-adrenal cortex).

In terms of the strength of glucocorticoid activity, 0.5 mg of dexamethasone corresponds to approximately 3.5 mg of prednisolone, 15 mg of hydrocortisone or 17.5 mg of cortisone for oral dosage forms.

Pharmacokinetics
After oral administration, it is rapidly and completely absorbed, the maximum concentration of dexamethasone in the blood plasma is 1-2 hours. In the blood it binds (60-70%) with a specific carrier protein - transcortin. Easily passes through the histohematological barriers (including through the blood-brain and placental barriers). It is metabolized in the liver (mainly by conjugation with glucuronic and sulfuric acids) to inactive metabolites. It is excreted by the kidneys (a small part by the lactating glands). The half-life is 3-5 hours.

Acute and chronic inflammatory diseases of the joints: gouty and psoriatic arthritis, osteoarthritis (including post-traumatic), polyarthritis, periarthritis of the shoulder scapula, ankylosing spondylitis (ankylosing spondylitis), juvenile arthritis, Still's syndrome in adults, bursitis, nonspecific tendonitis and synovitis ...

Rheumatic fever, acute rheumatic heart disease.

Acute and chronic allergic diseases: allergic reactions to drugs and food, serum sickness, urticaria, allergic rhinitis, angioedema, drug exanthema, hay fever.

Skin diseases: pemphigus, psoriasis, eczema, atopic dermatitis, diffuse neurodermatitis. contact dermatitis (with lesions of a large surface of the skin), toxidermia, seborrheic dermatitis, exfoliative dermatitis, toxic epidermal necrolysis (Lyell's syndrome), bullous herpetiformis dermatitis, malignant exudative erythema (Stevens-Johnson syndrome).

Cerebral edema (including against the background of a brain tumor or associated with surgery, radiation therapy, or head injury) after prior parenteral administration.

Allergic eye diseases: allergic corneal ulcers, allergic forms of conjunctivitis.

Inflammatory eye diseases: sympathetic ophthalmia, severe indolent anterior and posterior uveitis, optic neuritis.

Primary or secondary adrenal insufficiency (including the condition after removal of the adrenal glands).

Congenital adrenal hyperplasia.

Kidney disease of autoimmune genesis (including acute glomerulonephritis): nephrotic syndrome.

Subacute thyroiditis.

Diseases of the hematopoietic organs - agranulocytosis, panmyelopathy, autoimmune hemolytic anemia, acute lymphocytic and myeloid leukemias, lymphogranulomatosis, thrombocytopenic purpura, secondary thrombocytopenia in adults, erythroblastopenia (erythrocytopenic anemia), congenital anemia

Lung disease: acute alveolitis. pulmonary fibrosis, stage II-III sarcoidosis. Bronchial asthma (in case of bronchial asthma, the drug is prescribed only in case of severe course, ineffectiveness or inability to take inhaled glucocorticosteroids).

Tuberculous meningitis, pulmonary tuberculosis, aspiration pneumonia (in combination with specific chemotherapy).

Beryllium disease, Leffler's syndrome (not amenable to other therapy).

Lung cancer (in combination with cytostatics).

Multiple sclerosis.

Diseases of the gastrointestinal tract: ulcerative colitis, Crohn's disease, local enteritis.

Prevention of graft rejection reaction as part of complex therapy.

Hypercalcemia associated with cancer, nausea and vomiting during cytostatic therapy.

Multiple myeloma.

Testing for the differential diagnosis of hyperplasia (hyperfunction) and adrenal cortex tumors.

Pre- and post-vaccination period (8 weeks before and 2 weeks after vaccination), lymphadenitis after BCG vaccination. Immunodeficiency states (including acquired immunodeficiency syndrome or human immunodeficiency virus (HIV infection).

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

Diseases of the cardiovascular system, incl. recent myocardial infarction (in patients with acute and subacute myocardial infarction, it is possible to spread the focus of necrosis, slow 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. obesity (stage 1II-1V).

Severe chronic renal and / or hepatic failure, nephrourolithiasis.

Hypoalbuminemia and conditions predisposing to its occurrence.

Systemic osteoporosis, myasthenia gravis, acute psychosis, poliomyelitis (except for the form of bulbar encephalitis), open and closed angle glaucoma, lactation period.

Application during pregnancy and during breastfeeding

Method of administration and dosage:

The average daily dose is 0.75-9 mg. In severe cases, large doses, divided into 3-4 doses, can be used. The maximum daily dose is usually 15 mg. After achieving a therapeutic effect, the dose is gradually reduced (usually by 0.5 mg every 3 days) to a maintenance dose of 2-4.5 mg / day. The minimum effective dose is 0.5-1 mg / day.

Children (depending on age) are prescribed 83.3-333.3 mcg / kg or 2.5-10 mg / sq. m / day in 3-4 doses.

The duration of the use of dexamethasone depends on the nature of the pathological process and the effectiveness of treatment and ranges from several days to several months or more. Treatment is stopped gradually (at the end, several injections of corticotropin are prescribed).

With bronchial asthma, rheumatoid arthritis, ulcerative colitis - 1.5-3 mg / day; with systemic lupus erythematosus - 2-4.5 mg / day; with oncohematological diseases - 7.5-10 mg.

For the treatment of acute allergic diseases, it is advisable to combine parenteral and oral administration: 1 day - 4-8 mg parenterally; Day 2 - inside. 4 mg 3 times a day; 3, 4 days - inside. 4 mg 2 times a day; 5.6 day - 4 mg / day. inside; Day 7 - drug withdrawal.

Dexamethasone test (Liddle test). Conducted as small and large tests. With a small test, dexamethasone is given to the patient at 0.5 mg every 6 hours during the day (i.e. at 8 am, at 2 pm and 2 am). Urine for the determination of 17-hydroxycorticosteroids or free cortisol is collected from 8 am to 8 am 2 days before the appointment of dexamethasone and also 2 days at the same time intervals after taking the indicated doses of dexamethasone. These doses of dexamethasone inhibit the formation of corticosteroids in almost all apparently healthy individuals. 6 hours after the last dose of dexamethasone, the plasma cortisol content is below 135-138 nmol / l (less than 4.5-5 μg / 100 ml). Decrease in the excretion of 17-oxycorticosteroids below 3 mg / day. and free cortisol below 54-55 nmol / day (below 19-20 μg / day) excludes hyperfunction of the adrenal cortex. In persons. suffering from Itsenko-Cushing's disease or syndrome, when a small test is performed, changes in the secretion of corticosteroids are not observed.

In a large test, dexamethasone is prescribed 2 mg every 6 hours for 2 days (i.e. 8 mg dexamethasone per day). Also, urine is collected to determine 17-oxycorticosteroids or free cortisol (if necessary, free cortisol in plasma is determined). In Itsenko-Cushing's disease, there is a decrease in the excretion of 17-oxycorticosteroids or free cortisol by 50% or more, while in adrenal tumors or adrenocorticotropic-ectopic (or corticoliberin-sctopic) syndrome, the excretion of corticosteroids does not change. In some patients with adrenocorticotropic-ectopic syndrome, a decrease in corticosteroid excretion is not detected even after taking dexamethasone at a dose of 32 mg / day.

Side effect

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

From the digestive system: nausea, vomiting, pancreatitis, "steroid" stomach and duodenal ulcer, erosive esophagitis, bleeding and perforation of the gastrointestinal tract, increased or decreased appetite, flatulence, hiccups. In rare cases - increased activity of "liver" transaminases and alkaline phosphatase ...

On the part of the cardiovascular system: arrhythmias, bradycardia (up to cardiac arrest); development (in predisposed patients) or increased severity of chronic heart failure, electrocardiographic changes characteristic of hypokalemia, increased blood pressure, hypercoagulation, thrombosis. In patients with acute and subacute myocardial infarction - the spread of the focus of necrosis, slowing down the formation of scar tissue, which can lead to rupture of the heart muscle.

From the nervous system: delirium, disorientation, euphoria, hallucinations, manic-depressive psychosis, depression, paranoia, increased intracranial pressure, nervousness or anxiety, insomnia, dizziness, vertigo. cerebellar pseudotumor, headache, convulsions.

From the senses: posterior subcapsular cataract, increased intraocular pressure with possible damage to the optic nerve, a tendency to develop secondary bacterial, fungal or viral eye infections, trophic changes in the cornea, exophthalmos.

From the side of metabolism: increased excretion of calcium ions, hypocalcemia. increased body weight, negative nitrogen balance (increased protein breakdown), increased sweating.

Due to mineralocorticosteroid activity - fluid and sodium ion retention (peripheral edema), hypernatremia, hypokalemic syndrome (hypokalemia, arrhythmia, myalgia or muscle spasm, unusual weakness and fatigue).

From the side of the musculoskeletal system:growth retardation and ossification processes in children (premature closure of epiphyseal growth zones), osteoporosis (very rarely pathological bone fractures, aseptic necrosis of the humerus and femur head), rupture of muscle tendons, "steroid" myopathy, decreased muscle mass (atrophy).

From the skin and mucous membranes: delayed wound healing, petechiae, ecchymosis. thinning of the skin, atrophy of the skin and subcutaneous tissue, hyper- or hypopigmentation, "steroid" acne, striae. a tendency to develop pyoderma and candidiasis.

Allergic reactions: generalized (skin rash, itching of the skin, anaphylactic shock), local allergic reactions.

Others:the development or exacerbation of infections (the appearance of this side effect is facilitated by jointly used immunosuppressants and vaccinations), leukocyturia. withdrawal syndrome.

Overdose

Interaction with other medicinal products

special instructions

The ability to influence the rate of reactions when driving or operating other mechanisms.

Release form:

Storage conditions:

Shelf life:

Vacation conditions

Manufacturer / organization accepting claims

For the treatment of many acute or chronic inflammatory processes, intramuscular injections of "Dexamethasone" are often prescribed. Instructions for the use of this drug will be described in this article.

What is this medicine? Why are Dexamethasone injections prescribed? How should they be applied to achieve the best result? Are Dexamethasone injections prescribed for children? The instructions for use of this drug answer all these questions in detail. We also learn from the article whether it is possible to use the remedy for the treatment of pregnant and lactating mothers. And, of course, we will get acquainted with the numerous reviews about the injections of "Dexamethasone", the instructions for the use of which are of great interest to our compatriots.

What is the drug

Before you find out what the "Dexamethasone" injections help from, it is necessary to determine what is the active substance of the drug.

Dexamethasone is a synthetic hormonal substance derived from fluoroprednisolone. The release form of the glucocorticosteroid is an injection solution that can be used as injections intravenously, intramuscularly, and even as eye drops for conjunctivitis. How to use the remedy for a particular disease is prescribed only by the attending physician. Below we will discuss the instructions for the use of "Dexamethasone" injections intramuscularly for adults and children.

Briefly about the composition

Most often, "Dexamethasone" is produced by the manufacturer in glass ampoules of one or two milliliters. The solution itself is a clear liquid (less often - with a yellowish tinge) without a certain odor.

What is included in each one ml ampoule? First of all, the active substance. There are four milligrams of it in solution. Then - auxiliary components. These are sodium chloride, disodium edetate, glycerin, and even purified water.

Due to its composition, the drug has a fairly wide spectrum of action. It is used as an anti-inflammatory, immunosuppressive, anti-allergic and even anti-shock agent. This is explained in the instructions for "Dexamethasone". The cost of injections will be discussed below.

How does it affect the body

Thanks to this, such an effect is achieved from the application. The action of the injections "Dexamethasone" is due to its special composition and method of administration. For example, with intravenous injections, the drug has an almost instant effect. If the drug is injected into the muscle, then the effect will come only after eight hours.

What happens when a synthetic hormone enters the human body? It immediately begins to react with cytoplasmic receptors found in almost all tissues, especially in an organ such as the liver. Penetrating into the nucleus of membrane cells, the active substance inhibits the phospholipase enzyme and activates the main metabolic processes. Dexamethasone improves protein metabolism due to a decrease in plasma globulins and an increase in the amount of albumin in the kidneys and liver. By increasing the synthesis of fatty acids and the redistribution of fats, lipid metabolism is normalized. Also, the active substance has a beneficial effect on carbohydrate metabolism, improving the absorption of carbohydrates from the digestive tract and accelerating the flow of glucose from the liver into the circulatory system. Moreover, the drug regulates water-electrolyte metabolism, retaining water and sodium in the body, as well as stimulating the excretion of potassium.

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

As an immunosuppressant, the drug is used because of its effect on lymphoid tissue, inhibition of the proliferation of T-lymphocytes, and a decrease in the formation of antibodies.

Also, a hormonal agent can affect the synthesis and secretion of allergy mediators, lowering it. Also, the active substance is responsible for reducing the number of basophils and mast cells, suppressing antibody production, changing the body's defense reaction.

How is excreted from the body

"Dexamethasone", due to fusion with sulfuric and glucuronic acids, is metabolized in an organ such as the liver. Later it is excreted from the body by the kidneys, less often by the lactating glands.

In what cases is the drug used?

Diseases and their conditions

What does Dexamethasone help from? Injections can be prescribed for such severe and serious ailments as:

• Endocrine system diseases. These include pathological processes of the adrenal cortex, the subacute stage of thyroiditis.
• Shock conditions of the patient of various etiologies (burns, operations, trauma, intoxication). However, the drug is prescribed only in case of ineffectiveness of special therapy, which includes vasoconstrictor, plasma-substituting and other agents.
• Cerebral edema provoked by a brain tumor, hemorrhages, trauma, encephalitis, neurosurgical intervention, meningitis.
• Asthmatic manifestations. In this case, the indications for the use of injections "Dexamethasone" are exacerbations of asthma, severe bronchospasm, chronic obstructive bronchitis.

• Severe allergic reactions.
• Rheumatic diseases, joint diseases.
• Malignant neoplasms, including leukemia and lymphoma in adults and leukemia in children, cancers, especially if oral therapy is not possible.
• Severe complicated infections (in combination with antibacterial agents).
• When else is Dexamethasone injections prescribed? The indications can be ophthalmic diseases such as keratitis, iritis, allergic conjunctivitis, iridocyclitis, scleritis, blepharitis and other inflammations after trauma or surgery, as well as after surgical corneal transplantation.
• Multiple sclerosis.
• Severe dermatoses (psoriasis, eczema).
• Acute forms of anemia.

Most often, the drug is used for short-term reasons, that is, when urgent medical intervention is needed to save human life. After injections of "Dexamethasone" there is a long-term improvement in the condition, the duration of which (in the chronic course of the disease) can reach from three days to three weeks.

When you can't take the remedy

Despite the impressive number of indications, there are many situations when it is better not to prescribe a drug, especially given its hormonal composition. With great care, it is necessary to use the remedy when treating people with a history of the following diseases:

• organs of the gastrointestinal tract (gastritis, stomach ulcers, diverticulitis, ulcerative colitis, and so on);

It is worth mentioning that the ailments listed above are not absolute contraindications for Dexamethasone. If we are talking about saving lives, then injections are necessarily prescribed, unless, of course, the patient does not have an individual intolerance to the main component.

Why are there so many contraindications? The fact is that a synthetic hormone has not only a positive, but also a negative effect on the human body. Which one? You can read about this below.

Negative impact

According to reviews, injections "Dexamethasone" can suppress the immune system, which increases the risk of developing severe infections and malignant neoplasms. Also, the hormone inhibits the formation of bone tissue, which negatively affects the absorption of calcium. Due to the fact that the active substance of the drug redistributes lipids, fatty deposits begin to form in the abdomen and neck.

How should you use "Dexamethasone" to achieve the best result?

General instructions for use

According to the instructions, “Dexamethasone” injections can be prescribed for both adults and children who are one year old. If the hormone is used intravenously, it is best to pre-mix it with glucose or saline. Also, doctors may prescribe to inject the drug intramuscularly. What should be the dosage of "Dexamethasone"?

Injections are prescribed three or four times a day, four to twenty milligrams at a time. The main thing is that the daily rate does not exceed eighty milligrams of the drug. In some cases, when it comes to the patient's life, this dosage may be increased. However, only the attending physician should increase (or decrease) the hormone intake.

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

When the solution is injected into the muscle, the procedure must be carried out carefully and slowly, otherwise the development of various complications can be provoked. This is often mentioned by patients and nurses in their reviews of the drug "Dexamethasone".

How children are prescribed

"Dexamethasone" can be administered to babies from one year old, however, the dosage and schedule of admission is prescribed only by the attending physician. The instructions for use of the drug indicate general data, on the basis of which the specialist makes a deliberate qualified decision.

The dosage offered by the manufacturer varies between 0.02776 and 0.16665 milligrams per kilogram of the little patient's weight. A solution calculated in this way must be administered intramuscularly every 12 or 24 hours. If we are talking about the pathology of the adrenal glands, then the children are prescribed a lower dosage. Its daily dose ranges between 0.00776 and 0.01165 milligrams per kilogram of body weight. There is another option for injecting the solution into the muscle. According to this recommendation, it is necessary to divide the daily dose of the drug by three times (0.0233 milligrams per kilogram of body weight) and inject the hormone every two days for the third.

It is clear that the exact dosage is calculated not only on the basis of the body weight of the small patient, but also his age, as well as the severity of the disease.

But how do you take Dexamethasone to treat specific diseases? This information can be found in the annotation to the preparation.

How to treat ailments caused by cerebral edema

Drug therapy for this type of pathology includes the use of injections "Dexamethasone". The drug is prescribed from five to sixteen milligrams at a time, then the drug is injected into the muscle by five milligrams, observing a frequency of six hours. This treatment is continued until the patient's well-being improves.

If it is necessary to carry out an operation on the brain, the hormone is administered within a few days after the surgery.

Painful joints and synthetic hormone

In this case, treatment with "Dexamethasone" is prescribed only when other methods of treatment have been tried, but they did not give a tangible result. Injections are administered slowly, sometimes the doctor may prescribe the introduction of the drug not only into the muscle, but also into the joint itself.

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

What is the dose of the drug administered? It is clear that in each situation the doctor prescribes the dosage individually, based on such data as the age and weight of the patient, as well as the neglect of the disease. The approximate rate of the drug administered varies between 0.4 and 4 milligrams of the drug. For example, to treat a small joint, only 0.8 or 1 milligram will need to be used. Whereas for a large joint, the dose increases from two to four milligrams.

If there is a need for an injection into the tendon, then use one or two milligrams of "Dexamethasone". If the drug is injected into the synovial bag, then the dose may increase slightly (from two to three milligrams).

How often should the procedure be performed? The drug should be administered once, with an interval of three or four months. If you use the product more often or increase the dosage, then this is fraught with serious violations. For example, cartilage tissue can be damaged or a tendon ruptured.

Allergic reactions and drug treatment

Of course, common allergies are treated with antihistamines. However, if the inflammatory processes do not decrease and ordinary drugs do not help, “Dexamethasone” may be prescribed. Most often, it is attributed by the attending physician for such serious pathologies as eczema, Quincke's edema, urticaria, angioedema on the face or neck, anaphylactic shock, severe inflammatory processes in the nasopharyngeal mucosa.

Expectant and nursing mothers

How to use Dexamethasone injections during pregnancy? As mentioned above, the waiting period for a child is a contraindication for using the drug. This is due to the fact that the active substance is able to penetrate any barriers in the human body (including through the placenta), that is, it can have a negative effect on the fetus. On the other hand, the attending physician may consider prescribing Dexamethasone injections to pregnant women as justified when the benefits to the life and health of the mother outweigh the possible risk to the embryo. Be that as it may, the decision is made by a specialist individually in each specific case.

How can a hormone affect an unborn baby? For example, long-term use of the drug entails disturbances in the growth of the embryo. If you use the remedy during the third trimester, then it can provoke adrenal pathology in the fetus, as a result of which it will be necessary to conduct serious replacement therapy in the baby in the future.

Can the drug be used by nursing mothers? The answer is unequivocal - no! If there is a need to treat a woman who is breastfeeding a baby, then she needs to transfer the baby to artificial feeding. Many women, according to reviews, did just that. Some stopped breastfeeding while taking the drug, and then, a week after the drug was canceled, resumed lactation.

One way or another, when deciding whether to take "Dexamethasone" for pregnant and lactating mothers or not, it should be borne in mind that the drug can cause serious deviations in the baby (growth and development inhibition, congenital and acquired defects, abnormal formation of the baby's limbs and head).

A few words about side effects

Naturally, such a serious drug has a large number of side effects that should be remembered during the period of treatment with the drug. So what are the signs that should alert you? The following are the most common negative reactions of the body:

• Skin rashes (dermatitis, urticaria).
• High blood pressure, encephalopathy.
• Palpitations, heart failure (up to cardiac arrest).
• Visual impairment. Cataracts and glaucoma can also be triggered, as well as the development of eye infections.
• Neuroses, manifested in insomnia, depression, mood swings.
• Mental disorders. The most common are schizophrenia, paranoia, and hallucinations.
• Dizziness, convulsions.
• Abdominal pain, accompanied by nausea, vomiting, hiccups. Undesirable consequences are possible in the form of stomach ulcers, bleeding in the organs of the gastrointestinal tract, pathologies of the gallbladder, pancreatitis.
• Joint and bone pain. As a result, muscle weakness, osteoporosis, bone necrosis, cartilage damage in the joints, tendon rupture.
• Weakening of libido, impotence.
• Violation of the menstrual cycle.
• Increased appetite, as a result - an increase in body weight.
• Increased perspiration.
• Slow healing of common wounds and abrasions.
• The injection site can hurt for a long time or, conversely, become insensitive. Formation of rough scars at the site of the injection hole.
• Profuse bleeding from the nose.

According to the reviews of patients and doctors, most often such negative symptoms occur against the background of improper use of "Dexamethasone". Be that as it may, the patient needs to carefully listen to his health and at the first signs of side effects, immediately report them to the attending physician. If the dose is not adjusted or the use of the drug is not stopped, then the situation may worsen, up to death.

According to the annotation to the drug, the course of treatment should be completed gradually so as not to cause withdrawal syndrome. In rare cases, refusal from "Dexamethasone" may be accompanied by an increase in body temperature, headaches and muscle pain, irritability.

Long-term use of the drug should be carried out under the close supervision of the attending physician, monitoring the level of hormones and blood sugar.

Interaction with other pharmacological agents

It is very important to pay attention to the drugs that the patient takes together with "Dexamethasone", since the combination of this drug with others can reduce the effectiveness of treatment or even lead to unpredictable consequences.

For example, the joint use of the drug of interest to us with substances such as phenytoin, ephedrine, theophylline, phenobarbital lowers the concentration of "Dexamethasone", which means that it reduces its effectiveness. On the other hand, the use of adrenocorticotropic hormone enhances the effect of the drug of interest in the human body.

Here is a list of other consequences of using synthetic hormone with other drugs:

• Diuretics enhance the process of excreting potassium, thereby contributing to the development of heart failure.
• Sodium-based products can trigger the development of edema and increased blood pressure.
• Cardiac glycosides. Their joint reception with "Dexamethasone" increases the risk of developing ventricular extrasystole.
• Ethanol, alcohol. The risk of developing ulcerative neoplasms in the digestive tract and the occurrence of bleeding increases.
• Insulin and other hypoglycemic agents. Due to the joint reception with "Dexamethasone", the effectiveness decreases.
• Vitamin D. Its effect on the body decreases.
• Vitamin C. "Dexamethasone" accelerates the elimination of acetylsalicylic acid.
• Paracetamol-based products. Intoxication of the body can be the result of joint administration of two drugs.
• Anticoagulants and thrombolytics. The risk of ulcers and bleeding may increase.
• Indomethacin-based drugs increase the number and severity of side effects from the use of "Dexamethasone". This may also apply to drugs with ketoconazole and cyclosporine as active ingredients.
• Antipsychotics, as well as azathioprine, increase the risk of cataracts.

More information about the interaction of this drug with other medications can be found at an appointment with a specialist.

What about the cost?

Many people are interested in the price of "Dexamethasone". Depending on the manufacturer and the pharmacy chain, injections cost from two hundred to three hundred rubles per pack. As many patients note, it is inexpensive, since one package of the drug contains 25 ampoules (four milligrams each).

Substitute drugs

If “Dexamethasone” causes serious side effects, the drug can be replaced with another one. Most often, such drug analogues are prescribed as "Dexaven", "Deksona", "Dexafar", "Dexamed" and others.

Opinions of real patients

What do people who use this drug say in their treatment? Many argue that they have faced such negative consequences after therapy as weight gain, skin rash, shortness of breath and some others. However, some managed to win in the fight against excess weight very simply - he left a few weeks after the end of treatment.

However, not everyone felt the negative effects of Dexamethasone. Most often, people who exactly follow the doctor's recommendations tolerated the therapy well and were satisfied with the effectiveness of the medicine. True, many admit that the remedy leaves behind painful sensations in the area of \u200b\u200bsolution administration.

Also, many people like that the drug is able to have a quick effect on the disease. However, his aggressiveness is alarming for many patients. Therefore, before starting treatment with Dexamethasone, it is necessary to consult, if possible, several specialists.

Finally

As you can see, "Dexamethasone" is a widely used potent drug based on a synthetic hormonal substance. Only the attending physician has the right to prescribe and cancel this medication. He also calculates the optimal dose and schedule for taking injections.

As you can see, the range of action of injections is quite wide, and the effect is quick and long-term. And yet, "Dexamethasone" has a number of side effects and contraindications, which must be taken into account when using it.

Dexamethasone is a hormonal drug that is used to treat a variety of medical conditions. Applied only as directed by a doctor in strictly established dosages. The drug is available in the form of eye drops, tablets and injection solution.

In contact with

Composition and mechanism of action

Dexamethasone has the following component composition:

• dexamethasone phosphate in the amount of 4 mg;
• propylene glycol;
• edetate disodium;
• buffer solution.

Pharmacological effects medication is to provide antihistamine, anti-inflammatory, antitoxic, immunosuppressive, anti-shock action.

The hormonal drug is of synthetic origin.

Favorably affects the following processes in the body:

• decreased capillary permeability;
• elimination of glucose utilization;
• decrease in calcium absorption and its excretion;
• fluid and sodium retention;
• acceleration of the catabolism of protein structures.

If such a drug is injected intramuscularly, then a rapid absorption of the active substance into the body, the therapeutic effect occurs within 3 days. The decomposition process takes place in the liver, and the final products are excreted through the intestines and kidneys in a natural way.

Prescribing injections

Why are Dexamethasone injections prescribed, indications for the use of the drug:

• severe exacerbation of rheumatic diseases;
• extensive manifestations of allergic reactions in the body;
• shock state of various origins;
• edema of the brain;
• disorders of an autoimmune nature;
• diseases of the blood and respiratory organs;
• dermatoses during periods of exacerbation;
• carrying out special therapy for a lack of hormones.

Important! Injections can be used and pricked only under the supervision of the attending physician, since the use of drugs of hormonal origin is fraught with the development of a large number of side effects and contraindications.

Dexamethasone is prescribed for children for allergies, colds, inflammatory processes and many other diseases.

How to use

Dexamethasone instructions for use advise intramuscular administration of the drug in case of severe disease or in the case when the internal intake of tablets is impossible due to for a number of specific reasons.

The amount of medication depends on the disease. Dexamethasone injections are used:

• in case of shock, 2 to 6 mg is administered every 6 hours. Therapy lasts no more than 72 hours and is carried out as needed when a person's health is in danger;
• with cerebral edema, a primary dosage of 10 mg is required and for further relief of pain 4 mg after 6 hours.
• as a maintenance therapy for oncology, the amount of the drug is 2 mg three times throughout the day;
• with an exacerbation of the disease, the dosage for adults is 50 mg, and for children weighing up to 35 kg - 20 mg. After obtaining the desired effect, the volume of drug intake is reduced in accordance with the prescribed course of treatment;
• allergic reactions are stopped by injections of Dexamethasone only at the beginning of treatment, and later transferred to the internal use of the drug. The primary dosage is 4–8 mg, and within 8 days of treatment is reduced to 0.5 mg, depending on the effect of therapy.

Important!The maximum daily dosage of Dexamethasone for intramuscular administration is no more than 80 mg. In the same place, it is possible to inject no more than 2 mg of the drug.

How long can dexamethasone injections be used and is it hormonal.

The drug is a synthetic corticosteroid in origin, so the duration of its use should be controlled by the attending physician.

Uncontrolled use of the drug leads to serious consequences.

In case of an overdose of Dexamethasone risk increases the appearance of side effects. To eliminate the negative reaction of the body, symptomatic therapy is prescribed in the form of cleansing the body by drip.

The drug is available at the pharmacy only with a prescription. The shelf life is 2 years from the date of production. After the expiration of the period indicated on the package, the use of the medicine is strictly prohibited. It must be stored at a temperature not exceeding 15 degrees in a dry, dark place, out of the reach of children.

Dexamethasone injections, as a sedative, are widely used in veterinary medicine to eliminate shock in cats and dogs during an exacerbation of various diseases.

Use during pregnancy

Qualified doctors do not recommend Dexamethasone during pregnancy if it is proceeding normally. The need for admission arises only if the woman's body rejects the engrafted embryo and there is a threat of miscarriage.

The drug suppresses the immune activity of the body, therefore, contributes to the preservation of pregnancy. In parallel, the drug has a considerable number of side effects in the form of changes in body weight, the appearance of depression and hormonal disruption in the body.

Side effects of Dexamethasone depend on many factors, but they are quite impressive list:

• the development of euphoria, depression, disorders of a manic nature on the part of the nervous system;
• inflammation of the optic nerve, blurred vision and headaches;
• hallucinations, insomnia, migraines;
• the possible appearance of cataracts and glaucoma;
• arterial hypertension, thrombosis, increased blood flow to the brain;
• ulcerative manifestations in the stomach, intestines, pancreatitis of the pancreas;
• change in body weight, water retention in the body;
• the appearance of latent diabetes mellitus, the absence of menstruation, impaired growth of children due to poor functioning of the endocrine system;
• weakness of muscle mass, development of osteoporosis, increased pain with intra-articular drug administration;
• various skin rashes, weak healing of wounds;
• urticaria in the form of pruritus, anaphylactic shock.

When using injectionsDexamethasone, it is necessary to take into account all contraindications to the use of the drug:

• infectious diseases of bacterial and viral origin;
• mycoses of a systemic nature;
• state of immunodeficiency;
• period before or after vaccination;
• diabetes mellitus in a progressive form;
• stomach ulcer, intestines;
• serious violations of the kidneys, liver;
• the presence of myasthenia gravis and systemic osteoporosis;
• nervous disorders (psychosis, prolonged depression).

Important!In the presence of the above-described contraindications, injections are prohibited, as this can lead to an exacerbation of existing chronic diseases and cause severe complications.

Analogs

If Dexamethasone causes a side effect, the doctor can change it to similar drugs with a similar composition and pharmacological effect.

Common substitutes:

Dexazon. An analogue of Dexamethasone of hormonal origin in the form of tablets and solution for injection. The field of application of the drug is the treatment and removal of acute syndrome with the development of various diseases. Contraindications: systemic mycoses, osteoporosis, intolerance to components, viral infections, poliomyelitis, lymphadenitis, vaccination. The price is 150-200 rubles.

Metazone. A close substitute containing an identical new generation active ingredient.

The drug is presented in the form of ampoules containing a solution for internal administration. The medicine is prescribed for acute diseases of various origins.

Contraindications: allergic manifestations, mycoses, viral infections, pregnancy, breastfeeding, childhood. The price is 150-180 rubles.

Maxidex... An effective analogue of Dexamethasone with a high degree of impact. Indications for use: allergic and acute eye diseases. Contraindications: intolerance to the active substance, chickenpox, purulent infections, development of keratitis. The price is 180-200 rubles.

Dexamed. Hormonal preparation of synthetic origin in the form of tablets and solution for injection. The medicine is prescribed to treat a wide range of diseases that develop in the vital systems of the body. Contraindications: allergic manifestations, mycoses, viral infections, pregnancy, lactation, liver and kidney dysfunction. The price is 1000-1200 rubles.

Megadexane. A structural analogue with the content of Dexamethasone, used to treat diseases of various etiologies of origin. Contraindications: the first trimester of pregnancy, breastfeeding, systemic mycosis, impaired liver and kidney function, stomach ulcer, intestinal ulcer, viruses, lactose intolerance. The price is 550-600 rubles.

Important! It is up to the attending physician, who has carefully studied the clinical picture of the current disease, to decide whether to take Dexamethasone to the patient or not.

Video: dexamethasone in ampoules

Conclusion

Dexamethasone belongs to a number of hormonal drugs with a high degree of effectiveness. The medicine has a considerable number of contraindications and side effects, so it requires careful use under the supervision of a physician. Obtaining the expected effect depends on compliance with the prescribed dosage and taking into account the advisability of taking the solution.

In contact with

For 1 ml:

active substance: dexamethasone sodium phosphate 4.37 mg(which corresponds to 4.00 mg dexamethasonephosphate):

excipients : glycerol 22.50 mg, disodium edetate dihydrate 0.10 mg, sodium hydrogen phosphate dihydrate 0.80 mg, water for injection q.s. up to 1.00 ml.

Transparent, colorless or slightly yellowish liquid.

Dexamethasone is a synthetic adrenal cortex hormone with glucocorticosteroid action (GCS). It has anti-inflammatory and immunosuppressive effects, and also affects energy metabolism, glucose homeostasis and(through negative feedback) on the secretion of hypothalamic activating factor and pituitary adrenocorticotropic hormone.

GCS are fat-soluble substances and therefore easily penetrate into target cells through cell membranes. The binding of the hormone to the receptor causes conformational changes in the receptor and increases its affinity for DNA. The hormone-receptor complex enters the cell nucleus and binds to the regulatory region of the DNA molecule, also known as the glucocorticoid response element (GRE).

The activated receptor binds to GRE or specific genes and regulates messenger RNA (mRNA) transcription. The newly formed mRNA is transported to the ribosomes, which are then involved in the formation of new proteins. Depending on the type of target cells and cellular processes, the formation of new proteins can both be enhanced (for example, the synthesis of tyrosine transaminase in liver cells), andsuppressed (for example, the synthesis of IL-2 in lymphocytes). Since receptors for GCS are found in all tissues, their action is realized in most cells of the body.

Effects on energy metabolism and glucose homeostasis: , along with insulin, glucagon and catecholamines, regulates the accumulation and expenditure of energy. In the liver, it stimulates the formation of glucose from pyruvate and amino acids and the formation of glycogen. INperipheral tissues, in particular in muscles, reduces glucose uptake and mobilizes amino acids (from proteins), which are a substrate for gluconeogenesis in the liver. Direct effects on fat metabolism are manifested by central redistribution of adipose tissue and increased lipolysis in response to exposure to catecholamines.

Through receptors in the proximal renal tubules, it stimulates renal blood flow and glomerular filtration, inhibits the formation and secretion of vasopressin, and improves the ability of the kidneys to excrete acids.

Increases the sensitivity of blood vessels to pressor agents.

In patients who received long-term therapy with dexamethasone and were exposed to stress after its withdrawal, it is necessary to resume the use of dexamethasone due to the fact that induced adrenal insufficiency can persist forseveral months after discontinuation of the drug.

Dexamethasone therapy can mask signs of infectious processes and signs of bowel perforation.

Dexamethasone can aggravate the course of fungal infections, latent amebiasis, or pulmonary tuberculosis. Patients with acute pulmonary tuberculosis can be prescribed (together with anti-tuberculosis drugs) only in the case of a fulminant or severe disseminated process. Patients with inactive pulmonary tuberculosis receiving therapy with Dexamethasone, or patients with positive tuberculin tests should simultaneously receive anti-tuberculosis drugs therapy.

Patients with osteoporosis, arterial hypertension, heart failure, tuberculosis, glaucoma, hepatic or renal failure, diabetes mellitus, active peptic ulcers, fresh intestinal anastomoses, ulcerative colitis and epilepsy need special attention and careful medical supervision. Use with caution in the first weeksafter acute myocardial infarction, as well as in patients with thromboembolism, myasthenia gravis, glaucoma, hypothyroidism, psychosis or psychoneuroses, as well as in elderly patients.

During dexamethasone therapy, diabetes mellitus decompensation or the transition from latent diabetes to clinically manifest diabetes is possible.

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

Vaccination with live vaccines is contraindicated during dexamethasone therapy.

Immunization with killed viral or bacterial vaccines does not give the expected increase in the titer of specific antibodies and therefore does not have the necessary protective effect. usually not applied 8 weeks before vaccination and within 2 weeks after vaccination.

Dexamethasone may increase susceptibility or mask symptoms of infectious diseases. Chickenpox, measles, and other infections can be more difficult and even fatal in non-immunized individuals. Immunosuppression often develops with prolonged use of GCS, but it can also occur with short-term treatment.

Patients taking high doses of dexamethasone for a long time should avoid contact with infectious patients; in case of accidental contact, prophylactic treatment with immunoglobulin is recommended.

Care must be taken when treating patients who have recently undergone surgery or bone fractures, as it can slow the healing of wounds and fractures.

The effect of glucocorticosteroids is enhanced in patients with liver cirrhosis or hypothyroidism.

Intra-articular use of glucocorticosteroids may be accompanied by local and systemic effects.

Frequent use leads to destruction of articular cartilageand bone necrosis.

Before intra-articular injection, the synovial fluid must be pumped out of the joint and examined (for the presence of an infectious process). Injection of glucocorticosteroids into the infected joint should be avoided. If septic inflammation develops in the joint after injection, appropriate antibiotic therapy is necessary. Patients should avoid stress on the injection joint until the inflammatory process is completely relieved.

Glucocorticosteroids can alter the results of allergy skin tests.

Dexamethasone is used in children and adolescents only under strict indications. During treatment, strict control of the growth and development of the child or adolescent is required.

Special information about some components of the drug

The drug contains less than 1 mmol (23 mg) sodium per dose.

Dexamethasone does not affect the ability to drive vehicles and work with other technical devices that require increased concentration of attention and speed of psychomotor reactions.

Solution for injection, 4 mg / ml.

1 ml in dark glass ampoules (typeI). A colored dot is applied to the ampoule, indicating the ampoule break line and a color coding ring.

5 ampoules in a blister of PVC-aluminum foil.

5 blisters, together with instructions for use, are placed in a cardboard box.

At a temperature not higher than 25 ° C.

Keep out of the reach of children.