Dexamethasone: instructions for use, for what purpose, release forms, analogues

Dexamethasone is a hormonal drug, and is used in various branches of medicine. It belongs to the group of glucocorticosteroids and in its chemical formula is close to the adrenal hormone, which is produced by the endocrine glands. This drug has pronounced anti-inflammatory and anti-allergic properties, and is used in the treatment of diseases that are influenced by glucocorticoids.

Composition and release forms

The active substance is the compound Dexamethasone sodium phosphate. The medication is presented in such dosage forms:

• in tablets of 0.5 mg;
• in solutions for injection;
• in the form of eye drops;
• in the form of a suspension for the eyes.

The types of excipients depend on the form of release of the drug. In Dexamethasone tablets, such compounds are present:

• lactose monohydrate;
• silicon dioxide in colloidal anhydrous form;
• Mg stearate;
• croscarmellose Na.

In addition to the main component, Na hydroxide, purified water and various types of preservatives are present in injection solutions. In addition to the named substances, borax has been added to eye drops.

The suspension contains such additional substances:

• ethanol;
• sodium chloride, hydrogen phosphate and dihydrogen phosphate;
• polysorbate;
• benzalkonium chloride;
• purified water.

The drug is suitable for use within 24 months from the date of manufacture.It must be stored at a temperature of 5 to 25 ° C, without access to sunlight. Available in pharmacies only with a doctor’s prescription.

Pharmacological properties and pharmacokinetics

Dexamethasone has an anti-inflammatory, anti-allergic and immunosuppressive effect, while it has antitoxic and anti-shock activity. Since it belongs to synthetic corticosteroids, its active substances, reacting with receptors, allow you to regulate vital processes. Due to this, such changes occur:

• the invasiveness of blood vessels decreases;
• increased hepatic glucogenesis;
• protein catabolism is accelerated;
• cellular processes are stabilized;
• bone and cartilage tissue is restored;
• the balance of glucose, water and trace elements in the body is normalized.

Dexamethasone is absorbed almost completely shortly after use. Moreover, its molecules are able to penetrate not only into cells, but also into intercellular space. The decomposition of the substance occurs at the site of its exposure, and metabolism is carried out mainly by the liver, and in much smaller proportions by the kidneys and other tissues. The medicine is excreted in the urine.

Why is the drug prescribed?

Dexamethasone is used in the treatment of diseases associated with adrenal insufficiency, which has arisen as an independent or secondary disorder, as well as after the abolition of glucocorticosteroid drugs. The main indications for the appointment of this remedy are diseases affecting such organs and systems:

• disturbances in the digestive tract;
• damage and inflammation of the connective tissue;
• endocrine and neuroendocrine disorders, including Itsenko-Cushing's disease;
• rheumatic manifestations, osteoporosis and arthritis;
• severe manifestations of allergies of various etiologies;
• dermatological diseases;
• diseases of the organs of vision;
• disorders in the respiratory system;
• oncological diseases;
• shock conditions that are not amenable to classical methods of therapy;
• hematological problems;
• kidney dysfunction.

Dexamethasone in one dosage form or another is prescribed depending on the type and characteristics of the disorder.

Instructions for use Dexamethasone

The instructions for use of Dexamethasone describe standard methods for using this drug. But the doctor can make his adjustments to the treatment regimen, it depends not only on the nature of the disease, but also on a number of other factors. The following are general recommendations for the treatment of this medication.

Dexamethasone Tablets 0.5 mg

The daily dose of the drug in tablets is from 1 to 9 mg at the beginning of therapy. It must be divided into several parts, and drink the drug 2 to 4 times a day.

Then the volume is gradually reduced, and at the stage of maintenance treatment, the dosage will be from 0.5 to 3 mg. In these cases, the prescribed dose is drunk at one time, most often in the morning.

Injection vial for injection

If the patient was prescribed Dexamethasone injections, at the beginning of treatment, the medicine is used in high doses. As a rule, its daily volume for an adult patient is from 4 to 20 mg of a solution in ampoules, which must be administered 3 to 4 times a day.

For children, the dose of the drug is calculated based on body weight. The daily volume is 0.023 to 0.027 mg per 1 kg of weight.

Solutions are used both for intramuscular administration and for droppers. Therapy lasts several days, after which the patient is transferred to Dexamethasone tablets.

Dexamethasone eye drops

Dexamethasone eye drops are instilled into the conjunctival sac. In the first few days, this should be done every 2 hours, introducing one to two drops. Subsequently, the interval is increased, and it is from 4 to 6 hours.

When the medication is used to prevent inflammation due to injuries or surgical interventions, the recommended dose is 1-2 drops 4 times a day.Subsequently, the drug is administered in the same volume, but the number of applications is reduced to 2-3 times a day. The course of therapy is from 10 to 14 days.

Ophthalmic suspension 0.1%

As an alternative to drops, a suspension or dexamethasone ointment is prescribed. In case of ophthalmic diseases, it should be placed in the lower eyelid 2-3 times a day in small portions.

The duration of therapy is from 7 to 10 days, but if necessary, it can be longer.

Attention! Corrections to the scheme of drug use in one form or another are made only by the attending physician. Unauthorized reduction or increase in dosage often leads to the development of side effects or worsening well-being in connection with the main violation.

Use during pregnancy and lactation

During pregnancy and lactation, a medicine in the form of tablets and drops is not recommended. The latter, they can be used in connection with certain conditions, but for the period of treatment, the child needs to be transferred to artificial nutrition.

Injections of the drug in these cases are prescribed only in situations where vital signs are present. For example, if a woman’s body recognizes the cells of the embryo as foreign, and directs her forces to reject them. Since Dexamethasone has immunosuppressive properties, its use is advisable under strict medical supervision.

Can I drink alcohol while taking the drug

If the patient is prescribed Dexamethasone in the form of drops or an ophthalmic suspension, alcohol intake during the treatment period is not dangerous, since the drug bypasses the stomach. In other cases, do not drink alcohol because they stimulate the bladder, which leads to a decrease in the effect of therapy, and can also cause side effects.

With the interaction of the active substances of the drug with ethanol, the probability of such violations is high:

• mucosal irritations;
• nausea and vomiting;
• upset stool;
• stomach pains;
• heavy rashes on the skin;
• internal bleeding;
• perforated ulcers.

In addition, alcoholic beverages in combination with Dexamethasone can lead not only to an exacerbation of the underlying disease, but also to the development of uncontrolled reactions in the body. Drinking alcohol in limited doses is possible only 2-3 days after taking the last portion of the medicine.

Drug Interactions with Other Drugs

In the treatment with Dexamethasone, other drugs should be discontinued due to incompatibility. When interacting with certain groups of drugs, this leads to the following consequences:

• when combined with phenobarbital, rifampicin and ephedrine, the effectiveness of the treatment is reduced;
• in the case of simultaneous administration of Dexamethasone and diuretics, potassium is washed out of the cells, which threatens the development of heart failure;
• parallel administration of the drug with medicines containing sodium, threatens swelling and jumps in blood pressure;
• in combination with cardiac glycosides, disorders of the functions of this organ are observed;
• when combined with anticoagulants, ulcerative lesions of the stomach and intestines may develop;
• in the case of simultaneous administration with non-steroidal mucous membranes of the digestive canals are damaged;
• when combined with paracetamol-containing compounds, the liver is affected;
• the combination of Dexamethasone with insulin weakens the therapeutic effect of the latter.

Tip. If the patient is prescribed Dexamethasone, it is worth notifying the attending physician about what other drugs the patient is taking at the moment.

Contraindications, side effects and overdose

When a short course of treatment with Dexamethasone is prescribed, intolerance to the components of the drug is considered the only contraindication. If long-term therapy is needed, a ban on taking pills and injections is imposed if the patient detects the following conditions:

• infectious or parasitic infections;
• mycoses;
• immunodeficiency disorders;
• systemic osteoporosis;
• chronic, including peptic ulcer of the gastrointestinal tract;
• serious disorders in the work of the heart and blood vessels;
• diabetes mellitus;
• acute hepatic or renal dysfunction;
• psychoses.

Also, Dexamethasone should not be prescribed before and after preventive vaccinations.

Contraindications to intraarticular administration are the following conditions:

• periarticular osteoporosis;
• pathological bleeding;
• intraarticular fractures;
• the presence of foci of infection in nearby tissues;
• recent surgery.

Drops for the eyes are not allowed in the presence of the following conditions:

• lesions of the visual organs of a fungal, viral or tuberculous nature;
• glaucoma and trachoma;
• corneal epithelial lesions.

In some cases, Dexamethasone is prescribed for instillation into the auditory canals. In such situations, contraindications to use are damage to the eardrum.

When treating with hormonal drugs, side effects are not uncommon. As a result of the use of Dexamethasone, the following manifestations can be observed:

• disorders in the functioning of the nervous system, characterized by depressive states, confusion, dizziness and headaches;
• violations of the functions of the visual organs, and in some cases a decrease or temporary loss of vision;
• cardiovascular disorders in the form of tachycardia and jumps in blood pressure;
• digestive problems, namely attacks of nausea, vomiting or hiccups, as well as erosive and ulcerative lesions of the stomach and intestines;
• metabolic disorders, expressed in edema and weight gain;
• endocrine system diseases;
• problems in the musculoskeletal system, occurring against a background of joint and muscle pain, rupture of tendons and osteoporosis;
• dermatological disorders;
• allergic manifestations.

With prolonged use of Dexamethasone or a violation of the recommended dosage, the severity of side effects increases. Treatment in such cases is symptomatic, and the drug is canceled.

Dexamethasone Analogs

In the case when the patient is contraindicated for one reason or another, Dexamethasone, treatment is carried out using analogues. It is permissible to replace it with such drugs:

• Oftan Dexamethasone;
• Maxidex;
• Dexaven
• Dexona
• Dexamethasone Long;
• Dexamed
• Fortecortinum;
• Dexaposome;
• Dexafar.

Dexamethasone and similar drugs can significantly alleviate the patient's condition in various disorders. However, it should be understood that these medicines are unsafe and can cause side effects. In addition, their use is associated with certain restrictions that must be adhered to so as not to harm your health.