Diprospan use and contraindications

What is it used for?

It is still often used in medical practice to treat diseases of the musculoskeletal system, including joints. This is a drug that can be used to quickly relieve inflammation or prevent the proliferation of connective tissue. It effectively suppresses immunological and allergic reactions and acts even when other drugs are powerless, but, being a glucocorticosteroid hormonal agent, it has serious side effects, so it should be used with extreme caution. In addition, its long-term use should be excluded - the number of side effects increases many times over.

Indications for use of the drug Diprospan

Rheumatoid arthritis, osteoarthritis, bursitis, tenosynovitis, tendonitis, peritendinitis, ankylosing spondylitis, epicondylitis, sciatica, coccydynia, sciatica, lumbago, torticollis, ganglion cyst, exostosis, fasciitis, foot disease, bursitis due to hard callus, spurs, stiffness of the big toe .
Asthma, status asthmaticus, hay fever, allergic bronchitis, allergic rhinitis, drug allergies, serum sickness, reactions to insect bites.
Atopic dermatitis (coin-shaped eczema), neurodermatitis, contact dermatitis, severe solar dermatitis, urticaria, lichen planus, insulin lipodystrophy, alopecia areata, discoid erythematous lupus, psoriasis, keloid scars, pemphigus vulgaris, herpetic dermatitis, cystic acne.
Systemic erythematous lupus, scleroderma, dermatomyositis, periarteritis nodosa.
Palliative therapy of leukemia and lymphomas in adults; acute leukemia in children.
Adrenogenital syndrome, ulcerative colitis, regional ileitis, sprue; pathological changes in the blood requiring corticosteroid therapy, nephritis, nephrotic syndrome.
Primary and secondary insufficiency of the adrenal cortex (with mandatory simultaneous administration of mineralocorticoids).

Contraindications

Diprospan should not be administered into an unstable joint if the ligamentous apparatus is damaged, the menisci or muscles are damaged, since this drug delays the maturation of the connective tissue that makes up the ligaments and tendons that hold the joint and causes dystrophy and degeneration of muscles and cartilage, and bone tissue loses calcium. This leads to muscle atrophy and increased bone fragility (osteoporosis and “steroid” myopathy), cartilage detachment and the development of arthrosis. After its use, aseptic necrosis of the humerus and femur, microcrystalline arthritis, and tendon ruptures may occur. If diprospan was used to treat children, then their growth and ossification processes may slow down (premature closure of the epiphyseal growth zones).

Administration of the drug into soft tissues, into the lesion and inside the joint can, with a pronounced local effect, simultaneously lead to a systemic effect:

with the use of diprospan, mental disorders are possible, especially in patients with emotional instability or a tendency to psychosis;
when prescribing diprospan to patients with diabetes mellitus, adjustment of hypoglycemic therapy may be required;
when using diprospan, it should be taken into account that glucocorticosteroids can mask the signs of an infectious disease, as well as reduce the body’s resistance to infections;
against the background of the use of glucocorticosteroids, changes in sperm motility and number are possible.

Pharmacological properties of the drug Diprospan

Pharmacodynamics. The drug Diprospan is a combination of soluble and poorly soluble betamethasone esters for intramuscular, intra-articular, periarticular, intrasynovial and intradermal administration, as well as for administration directly into the lesion. Diprospan has high GCS activity and insignificant mineralocorticoid activity. The small size of betamethasone dipropionate crystals allows the use of small diameter needles (up to 0.9 mm) for intradermal injections and injection directly into the lesion. Pharmacokinetics. Betamethasone sodium phosphate is a highly soluble component that is rapidly absorbed from the injection site, which ensures a rapid onset of therapeutic action. Betamethasone dipropionate is a poorly soluble component that is slowly absorbed from the depot created at the injection site and provides a long-lasting effect of the drug.

Conclusions:

Today, many modern high-tech methods have been developed for the treatment of injuries and diseases of the musculoskeletal system, bones, joints, tendons and muscles. These are various arthroscopic surgical techniques that, using the most modern equipment, make it possible, using the most modern equipment, to quickly, effectively and less traumaticly eliminate the cause of pain and dysfunction of the limb, return the person to the joy of movement, and not just alleviate the symptoms for a while, postponing the solution to the problem until later or not at all. deciding, as in the case of diprospan injections. Then it may already be too late.

Use of the drug Diprospan

IM if systemic GCS therapy is necessary; directly into the affected soft tissue or in the form of intra-articular and periarticular injections for arthritis; in the form of intradermal injections for various dermatological diseases; in the form of local injections into the lesion for some foot diseases. The dosage regimen and route of administration are set individually, depending on the indications, severity of the disease and the patient’s response to treatment. If a satisfactory clinical effect does not occur after a certain period of time, treatment with Diprospan should be discontinued and other appropriate therapy initiated. For systemic therapy, the initial dose of Diprospan in most cases is 1–2 ml. The administration is repeated as necessary, depending on the patient’s condition. The drug is injected deep intramuscularly into the gluteal muscle:

in severe conditions requiring the use of emergency measures, the initial dose of the drug can be 2 ml;
for various dermatological diseases, as a rule, 1 ml of Diprospan is sufficient;
for asthma, hay fever, allergic bronchitis and allergic rhinitis, a significant improvement in the condition is achieved within a few hours after intramuscular administration of 1–2 ml of the drug;
for acute and chronic bursitis, the initial dose for intramuscular administration is 1–2 ml of Diprospan, with several repeated injections if necessary.

When administered locally, simultaneous use of a local anesthetic is necessary only in isolated cases. If simultaneous administration of a local anesthetic is desirable, use 1–2% solution of procaine hydrochloride or lidocaine, using solutions of drugs that do not contain methylparaben, propylparaben, phenol and other similar substances. When using an anesthetic in combination with Diprospan, the solution is prepared in this way: first, the required dose of the drug is drawn into a syringe from the bottle, then the required amount of local anesthetic is drawn from the ampoule into the same syringe and shaken for a short time. In case of acute bursitis (subdeltoid, subscapular, ulnar and prepatellar), the introduction of 1-2 ml of Diprospan into the synovial bursa can relieve pain and restore mobility within several hours. Treatment of chronic bursitis is carried out with lower doses of the drug after stopping an acute attack of the disease. In case of acute tenosynovitis, tendonitis and peritendinitis, 1 injection of Diprospan alleviates the patient’s condition; in case of a chronic disease, the injection of the drug should be repeated depending on the reaction. It is necessary to avoid injecting the drug directly into the tendon. Intra-articular administration of Diprospan in a dose of 0.5-2 ml eliminates pain and stiffness of joints in rheumatoid arthritis and osteoarthritis for 2-4 hours after administration. The duration of the therapeutic effect of the drug varies significantly and can be 4 weeks or more. Recommended doses of Diprospan when administered into large joints are 1–2 ml; medium - 0.5–1 ml; in small ones - 0.25–0.5 ml. For some dermatological diseases, intradermal administration of Diprospan directly into the lesion , the dose is 0.2 ml/cm2. The lesion is evenly pricked using a tuberculin syringe and a needle with a diameter of approximately 0.9 mm. The total number of Diprospan injections into all areas should not exceed 1 ml over 1 week. Recommended single doses of Diprospan (with intervals between injections of 1 week) for diseases of the feet: for hard calluses - 0.25–0.5 ml (as a rule, 2 injections are effective); for “spur” - 0.5 ml; for stiffness of the big toe - 0.5 ml; for synovial cyst - from 0.25 to 0.5 ml; for tenosynovitis - 0.5 ml; for acute gouty arthritis - from 0.5 to 1 ml. For administration, it is recommended to use a tuberculin syringe with a needle with a diameter of approximately 1 mm. After achieving a therapeutic effect, the maintenance dose is selected by gradually reducing the initial dose by reducing the concentration of betamethasone in the solution, which is administered at appropriate time intervals. The dose reduction is continued until the minimum effective dose is reached. If a stressful situation (not related to the disease) occurs or threatens to occur, it may be necessary to increase the dose of Diprospan. Discontinuation of the drug after long-term therapy should be carried out by gradually reducing the dose. The patient's condition is monitored for at least a year after the end of long-term therapy or after using Diprospan in high doses.

Note!

The description of the drug Diprospan on this page is a simplified author’s version of the apteka911 website, created on the basis of the instructions for use.
Before purchasing or using the drug, you should consult your doctor and read the manufacturer's original instructions (attached to each package of the drug). Information about the drug is provided for informational purposes only and should not be used as a guide to self-medication. Only a doctor can decide to prescribe the drug, as well as determine the dose and methods of its use.

Interactions of the drug Diprospan

The simultaneous administration of phenobarbital, rifampicin, phenytoin or ephedrine may increase the metabolism of the drug, thereby reducing its therapeutic effectiveness. With the combined use of GCS and estrogens, dose adjustment of the drug may be required (due to the possibility of overdose). The simultaneous use of Diprospan with diuretics, which promotes the excretion of potassium, increases the likelihood of developing hypokalemia. The combined use of GCS and cardiac glycosides increases the risk of arrhythmia or digitalis intoxication (due to hypokalemia). Diprospan may enhance potassium excretion caused by amphotericin-B. Concomitant use of Diprospan and indirect anticoagulants may lead to changes in blood clotting, which may require dose adjustment. With the combined use of GCS with NSAIDs or ethanol, it is possible to increase the incidence or severity of erosive and ulcerative lesions of the gastrointestinal tract. With simultaneous use, GCS can reduce the concentration of salicylates in the blood plasma. The combined administration of GCS and somatropin may slow down the absorption of the latter.

Belgian glucocorticoid Diprospan

The drug Diprospan is a simple corticosteroid for systemic use.
It is used in various fields of medicine as part of monotherapy and complex hormone replacement therapy, and has a pronounced therapeutic effect. It is most widely used to treat joints. Inflammation, trauma, degenerative processes, age-related changes in cartilage and muscle tissue, accompanied by limited mobility, respond well to GCS therapy. The drug is used to treat moderate and severe forms of allergies.

Side effects of the drug Diprospan

As with the use of other corticosteroids, side effects are determined by the dose and duration of use of the drug. These reactions are usually reversible and can be reduced by reducing the dose (which is preferable to stopping the drug). From the side of water and electrolyte balance: hypernatremia, increased potassium excretion, hypokalemic alkalosis, increased calcium excretion, fluid retention in the body. From the cardiovascular system: congestive heart failure in predisposed patients, hypertension (arterial hypertension). From the musculoskeletal system: muscle weakness, myopathy, decrease in muscle mass, worsening of symptoms in myasthenia gravis, osteoporosis, aseptic necrosis of the femoral or humeral head, long bone fractures, tendon ruptures, joint instability (after repeated injections). From the digestive system: erosive and ulcerative lesions of the gastrointestinal tract with possible subsequent perforation and bleeding, pancreatitis, flatulence, esophageal ulcers. Dermatological: impaired wound healing, skin atrophy, thinning of the skin, petechiae and ecchymoses, erythema of the facial skin, increased sweating, dermatitis, skin rash, angioedema. From the nervous system: convulsions, increased intracranial pressure with papilledema (usually upon completion of treatment), dizziness, headache. From the endocrine system: menstrual irregularities, development of the Cushingoid constitution, intrauterine growth retardation of the fetus or child growth, impaired glucose tolerance, manifestations of latent diabetes mellitus, increased need for insulin or oral hypoglycemic agents. Ophthalmologic: posterior subcapsular cataract, increased intraocular pressure, glaucoma, exophthalmos. Metabolism: negative nitrogen balance (due to protein catabolism). Psychoneurological disorders: euphoria, mood changes, depression (with severe psychotic reactions), increased irritability, insomnia. Other manifestations: hypersensitivity reactions, including anaphylactic shock. Other adverse reactions associated with parenteral administration of the drug: isolated cases of visual impairment with intralesional administration in the face and head, hyper- or hypopigmentation of the skin, atrophy of the skin and subcutaneous fat, sterile abscesses, flushing of the face after injection (intra-articular administration) and neurogenic arthropathy.

Overdose of the drug Diprospan, symptoms and treatment

Symptoms An acute overdose of betamethasone is not life-threatening. Administration of GCS for several days in high doses does not lead to undesirable consequences (except for cases of use in very high doses or in case of use for diabetes mellitus, glaucoma, exacerbation of erosive and ulcerative lesions of the gastrointestinal tract, or in patients who are simultaneously receiving therapy with digitalis preparations, indirect anticoagulants or potassium-sparing diuretics). Treatment. Careful monitoring of the patient's condition is necessary. Optimal fluid intake and control of electrolyte levels in blood plasma and urine, primarily the balance of sodium and potassium, are shown. If an imbalance of these ions is detected, appropriate therapy must be carried out.

Instructions for use DIPROSPAN® (DIPROSPAN)