Instructions for use DEXAMETHASON solution

The hormonal agent shows antiallergic, anti-inflammatory and immunosuppressive activity. Injections are prescribed for antitoxic, desensitizing, antishock therapy. Due to the active components, the susceptibility of adrenergic receptors to endogenous catecholamines increases.

Composition and release form

Tablets - 1 tablet:

• Active ingredient: Dexamethasone – 0.0005 g
• Excipients: potato starch – 0.0340 g; sucrose (sugar) – 0.1140 g; stearic acid – 0.0015 g.

Tablets weighing 0.15 g.

Tablets 0.5 mg.

10, 14 tablets in a blister pack made of polyvinyl chloride film and aluminum foil.

5, 10 blister packs of 10 tablets each or 4 blister packs of 14 tablets each with instructions for use in a cardboard pack.

Active ingredient and composition

The main effect belongs to the hormonal substance dexamethasone, a synthetic analogue of the hormone produced by the adrenal cortex.

It is known that dexamethasone is a substance similar to the natural hormone of the adrenal glands, but its effect is 30 times stronger. This fluorinated glucocorticosteroid is obtained synthetically.

10 g of ointment contains 10 mg of dexamethasone.

Other components: Vaseline, methyl parahydroxybenzoate, liquid anhydrous lanolin, propyl parahydroxybenzoate.

Description of the dosage form

Tablets are white, flat-cylindrical with a chamfer.

Pharmacokinetics

Absorption

After oral administration, it is quickly and completely absorbed, the maximum concentration of dexamethasone in the blood plasma is 1-2 hours.

Distribution

In the blood it binds (60–70%) to a specific carrier protein – transcortin. Easily passes through histohematic barriers (including the blood-brain and placental barriers).

Metabolism

Metabolized in the liver (mainly by conjugation with glucuronic and sulfuric acids) to inactive metabolites.

Removal

Excreted by the kidneys (a small amount of dexamethasone passes into breast milk). Half-life is 3-5 hours.

Pharmacodynamics

Dexamethasone is a synthetic glucocorticosteroid (GCS), a methylated derivative of fluoroprednisolone. It has anti-inflammatory, antiallergic, desensitizing, immunosuppressive, antishock and antitoxic effects.

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 erythropoietin). Interacts with specific cytoplasmic receptors and forms a complex that penetrates the cell nucleus, stimulates the synthesis of matrix ribonucleic acid (mRNA); the latter induces the formation of proteins, including lipocortin, that mediate cellular effects. Lipocortin inhibits phospholipase A2, suppresses the release of arachidonic acid and suppresses the synthesis of endoperoxides, prostaglandins, leukotrienes, which contribute to inflammation, allergies and others.

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

Effect on 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.

Effect on carbohydrate metabolism: increases the absorption of carbohydrates from the gastrointestinal tract (GIT); 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, which leads to the activation of gluconeogenesis.

Effect on water-electrolyte metabolism: retains 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, “washes out” 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 reducing the number of mast cells that produce hyaluronic acid; with a decrease in capillary permeability; stabilization of cell membranes and organelle membranes (especially lysosomal ones).

The antiallergic effect 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, 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, reducing the sensitivity of effector cells to allergy mediators, suppressing antibody formation, changing the body's immune response.

In chronic obstructive pulmonary disease, the effect is based mainly on inhibition of inflammatory processes, inhibition of development or prevention of swelling of the mucous membranes, inhibition of eosinophilic infiltration of the submucosal layer of the bronchial epithelium, deposition of circulating immune complexes in the bronchial mucosa, as well as inhibition of erosion and desquamation of the mucous membrane. Increases the sensitivity of beta-adrenergic receptors of small and medium-caliber bronchi to endogenous catecholamines and exogenous sympathomimetics, reduces the viscosity of bronchial secretions due to inhibition or reduction of its production.

Antishock and antitoxic effects are 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 the permeability of the vascular wall, membrane protective properties, and 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 GCS.

The peculiarity of the action is significant inhibition of pituitary function and the almost complete absence of mineralocorticosteroid activity. Doses of 1-1.5 mg/day inhibit the adrenal cortex; biological half-life is 32-72 hours (duration of inhibition of the hypothalamic-pituitary-adrenal cortex system).

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.

Pharmacological properties

Antiallergic, anti-inflammatory, antiexudative, vasoconstrictor, decongestant.

Pharmacodynamics and pharmacokinetics

Dexamethasone does not exhibit mineralocorticoid activity. Reduces immunity, suppresses the production of antibodies and the recognition of antigens, thereby eliminating desensitization.

Blocks the release of mediators of allergy and inflammation, the migration of mast cells, and reduces the permeability of vascular tissues.

Penetrates the corneal tissue, creating therapeutic concentrations in it.

It interacts with proteins at the cellular level and affects their synthesis. Reduces the production, activity and release of histamine, lysosomal enzymes, kinin and other inflammatory mediators.

The duration of therapeutic action is on average 8 hours.

The half-life ranges from 24 hours to 3 days. Excretion is carried out in the urine. Metabolic processes occur in the liver.

Indications for use of Dexamethasone

Systemic connective tissue diseases (systemic lupus erythematosus, scleroderma, periarteritis nodosa, dermatomyositis, rheumatoid arthritis).

Acute and chronic inflammatory diseases of the joints: gouty and psoriatic arthritis, osteoarthritis (including post-traumatic), polyarthritis, glenohumeral periarthritis, ankylosing spondylitis (ankylosing spondylitis), juvenile arthritis, syndrome

Stilla in adults, bursitis, nonspecific tenosynovitis, synovitis and epicondylitis.

Rheumatic fever, acute rheumatic carditis.

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

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

Brain edema (only after confirmation of symptoms of increased intracranial pressure by magnetic resonance or computed tomography) caused by a brain tumor and/or associated with surgery or radiation injury.

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

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

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

Congenital adrenal hyperplasia.

Kidney diseases of autoimmune origin (including acute glomerulonephritis); nephrotic syndrome.

Subacute thyroiditis.

Diseases of the hematopoietic organs - agranulocytosis, panmyelopathy, autoimmune hemolytic anemia, acute lymphoid and myeloid leukemia, lymphogranulomatosis, thrombocytopenic purpura, secondary thrombocytopenia in adults, erythroblastopenia (erythrocytic anemia), congenital (erythroid) hypoplastic anemia.

Lung diseases: acute alveolitis, pulmonary fibrosis, stage II-III sarcoidosis. Bronchial asthma (for bronchial asthma, the drug is prescribed only in severe cases, ineffectiveness or inability to take inhaled corticosteroids).

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

Berylliosis, Loeffler's syndrome (not amenable to other therapy).

Lung cancer (in combination with cytostatics).

Multiple sclerosis.

Gastrointestinal diseases: ulcerative colitis, Crohn's disease, local enteritis.

Hepatitis.

Prevention of transplant rejection as part of complex therapy.

Hypercalcemia due to cancer, nausea and vomiting during cytostatic therapy.

Multiple myeloma.

Conducting a test for the differential diagnosis of hyperplasia (hyperfunction) and tumors of the adrenal cortex.

Indications

Dexamethasone eye ointment is prescribed for inflammation of the eye of various natures, not accompanied by suppuration:

• scleritis;
• keratitis inflammation of the cornea;
• keratoconjunctivitis;
• uveitis, inflammation of the choroid;
• episcleritis;
• optic nerve papillitis;
• retrobulbar neuritis;
• postoperative period.

Ear drops are prescribed to treat inflammation of the ears.

Dexamethasone ointment is prescribed for the treatment of skin inflammation:

• severe erythema multiforme;
• exudative erythema;
• exfoliative dermatitis;
• skin mycoses;
• dermatomyositis;
• severe forms of psoriasis;
• bullous dermatitis.

It is not recommended to use Dexamethasone for acne; there is a high probability of exacerbation of inflammation and side effects.

Contraindications to the use of Dexamethasone

• For short-term use for “life-saving” indications, the only contraindication is hypersensitivity; systemic mycosis;
• simultaneous use of live and attenuated vaccines with immunosuppressive doses of the drug;
• sucrose intolerance, isomaltase/sucrase deficiency, glucose-galactose malabsorption; breastfeeding period; children up to 3 years old.

Carefully:

Parasitic and infectious diseases of a viral, fungal or bacterial nature (currently or recently suffered, including recent contact with a patient) –

• herpes simplex, herpes zoster (viremic phase), chicken pox, measles;
• amebiasis, strongyloidiasis (established or suspected);
• active and latent tuberculosis.

Contraindications

Dexamethasone-based ointment is prohibited for use in the following cases:

• viral eye diseases, conjunctivitis, blepharitis;
• trachoma;
• damage to the eye epithelium;
• glaucoma;
• bacterial eye diseases;
• eye tuberculosis;
• fungal eye diseases;
• condition after removal of a foreign body.

Ear drops are contraindicated if the eardrum is damaged.

Dexamethasone cream for external use has its contraindications:

• adrenal dysfunction, Cushing's syndrome;
• inflammatory bacterial and fungal skin diseases without concomitant antibacterial and antifungal therapy;
• violation of the integrity of the skin;

The drug is not used if you are allergic to corticosteroids or other components.

Use of Dexamethasone during pregnancy and children

Dexamethasone crosses the placenta (can reach high concentrations in the fetus) and into breast milk. During pregnancy, especially in the first trimester, or in women planning pregnancy, the use of Dexamethasone is indicated only if the expected therapeutic effect outweighs the risk of negative effects on the mother or fetus. GCS should be prescribed during pregnancy only for absolute indications. With long-term therapy during pregnancy, the possibility of fetal damage cannot be excluded. If used in the third trimester of pregnancy, there is a risk of atrophy of the adrenal cortex in the fetus, which may require replacement therapy in the newborn. If it is necessary to carry out treatment with the drug during breastfeeding, breastfeeding should be stopped.

Description of Dexamethasone for inhalation

Dexamethasone for inhalation is a frequently prescribed drug for the treatment of diseases of the respiratory system. It is highly effective because it acts directly on the pathological focus. Can be used in therapy for children and adults, but only as prescribed by doctors and in strict accordance with the instructions.

Composition and release form

Dexamethasone is a hormonal drug (glucocorticosteroid) obtained through synthetic production. It completely imitates the qualities and properties of hormones that are produced by the adrenal cortex in the human body.

Sold in pharmacies in the form of tablets, drops for the treatment of ophthalmic diseases and an injection solution with a concentration of the main active ingredient of 0.4%. It is the latter type of pharmacological form that is used for inhalation.

The drug is contained in dark glass ampoules, which can be 1 or 2 ml in volume; the liquid is colorless and has no pronounced aroma.

We recommend reading about how to do inhalations with a nebulizer. From the article you will learn about how to breathe correctly during inhalation, the algorithm for performing inhalations through a nebulizer, the frequency of procedures for various diseases, and their duration. And here is more information about what inhalations can be done for bronchitis.

Therapeutic effect

Dexamethasone acts on the pathological focus in a complex manner and has powerful anti-inflammatory and antiallergic effects. That is why inhalations with the drug can quickly solve problems:

• swelling of the throat;
• severe, continuous coughing attacks;
• wheezing when breathing.

Additionally, the solution has an immunostrengthening and anti-shock effect. Even after one inhalation, the patient’s condition is significantly alleviated - swelling of the throat mucosa is eliminated almost immediately, the voice acquires a natural tone (hoarseness disappears), the number of attacks of “barking” cough decreases, breathing becomes deep and without wheezing.

Conditions for dispensing from a pharmacy

In pharmacies the drug is dispensed only with a doctor's prescription. This document remains with the buyer because it indicates the recommended dosage for complete and effective treatment of diseases of the respiratory system.

Cost of ampoules

The price of the drug ranges from 200 to 500 rubles and depends on the manufacturer, the outlet itself, and the volume of ampoules in the package.

Watch this video about the pharmacological properties and indications for use of the drug Dexamethasone:

Side effects of Dexamethasone

The incidence and severity of side effects depend on the duration of use, the size of the dose used and the ability to comply with the circadian rhythm of the prescription. Dexamethasone is usually well tolerated. It has low mineralocorticoid activity, that is, its effect on water and electrolyte metabolism is small. As a rule, low and medium doses of dexamethasone do not cause sodium and water retention in the body or increased potassium excretion.

• Endocrine system disorders: decreased glucose tolerance, “steroidal” diabetes mellitus or manifestation of latent diabetes mellitus, suppressed adrenal function, Itsenko-Cushing syndrome (moon face, pituitary type obesity, hirsutism, increased blood pressure, dysmenorrhea, amenorrhea, myasthenia gravis, striae), delayed sexual development in children.
• Blood and lymphatic system disorders: moderate leukocytosis, leukocyturia, lymphopenia, eosinopenia, polycythemia.
• Gastrointestinal tract disorders: nausea, vomiting, abdominal pain, discomfort in the epigastric region, pancreatitis, “steroid” gastric and duodenal ulcers, erosive esophagitis, bleeding and perforation of the stomach and intestinal wall, increased or decreased appetite , flatulence, hiccups. In rare cases, increased activity of liver transaminases and alkaline phosphatase.
• Disorders of the heart and blood vessels: arrhythmias, bradycardia (up to cardiac arrest); development (in predisposed patients) or progression of CHF, electrocardiographic changes characteristic of hypokalemia, increased blood pressure, hypercoagulation, thrombosis and thromboembolism, vasculitis, increased capillary fragility. In patients with acute and subacute myocardial infarction, the necrosis focus spreads, the formation of scar tissue slows down, which can lead to rupture of the heart muscle.
• Nervous system disorders: increased intracranial pressure, cerebellar pseudotumor, headache, convulsions.
• Mental disorders: nervousness or anxiety, insomnia, emotional lability, delirium, disorientation, euphoria, hallucinations, manic-depressive psychosis, depression, paranoia, suicidal tendencies.
• Visual disorders: 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, corneal perforation, central serous chorioretinopathy.
• Hearing and labyrinthine disorders: dizziness, vertigo.
• Metabolic and nutritional disorders: hypercholesterolemia, increased excretion of calcium ions, hypocalcemia, weight gain, negative nitrogen balance (increased protein breakdown), increased sweating, epidural lipomatosis. Caused by mineralocorticosteroid activity - fluid and sodium ion retention (peripheral edema), hypernatremia, hypokalemic syndrome (hypokalemia, arrhythmia, myalgia or muscle spasm, unusual weakness and fatigue).
• Disorders of the musculoskeletal and connective tissue: slowing of growth and ossification processes in children (premature closure of the epiphyseal growth plates), osteoporosis (very rarely - pathological bone fractures, aseptic necrosis of the head of the humerus and femur), rupture of muscle tendons, "steroid" myopathy, decreased muscle mass (atrophy).
• Disorders of the skin and subcutaneous tissues: delayed healing of wounds, petechiae, ecchymoses, thinning of the skin, atrophy of the skin and subcutaneous tissue, hyper- or hypopigmentation, “steroid” acne, stretch marks, a tendency to develop pyoderma and candidiasis, impaired skin pigmentation (hypo- or hyperpigmentation), telangiectasia.
• Immune system disorders: generalized (skin rash, skin itching, anaphylactic shock), local allergic reactions.
• Infectious and parasitic diseases: development or exacerbation of infections (the appearance of this side effect is facilitated by jointly used immunosuppressants and vaccination), masking of infections.
• General disorders and disorders at the injection site: withdrawal syndrome.

What does Dexamethasone help with, indications and contraindications

The drug is a synthetic corticosteroid, an analogue of the hormone of the adrenal cortex. The component composition of the medication helps:

• normalize the functioning of extracellular structures of cartilage and bone tissues;
• reduce the level of capillary permeability;
• stabilize membranes;
• slow down the processes of cytokine release from lymphocytes and macrophages;
• accelerate protein catabolism;
• slow down glucose utilization and calcium absorption;
• retain water and sodium ions in tissues.

The processing of components occurs in the liver, partially in the kidneys and other organs. Metabolic products are excreted through the genitourinary system.

The drug is used against pathologies amenable to systemic therapy, as an addition to the main course of treatment. Intravenous and intramuscular injections are given when tablets or local medications are ineffective.

Dexamethasone is prescribed to patients:

• with allergies and rheumatic diseases;
• swelling of brain tissue;
• shock states of various origins;
• individual kidney lesions;
• autoimmune disorders;
• diseases of the respiratory tract, blood;
• acute severe dermatoses.

The drug is prescribed for hormone replacement therapy and the fight against inflammatory bowel pathologies. Dexamethasone is contraindicated:

• with hypersensitivity to the component composition;
• infectious, parasitic diseases of bacterial and viral origin;
• systemic mycoses, osteoporosis, immunodeficiency;
• myasthenia gravis, ulcers, colitis and other gastrointestinal diseases;
• lesions of the cardiovascular department;
• diabetes mellitus, psychosis, acute renal or liver failure.

The medicine is not injected into the joints if they are unstable, spontaneous bleeding of the apparatus, fractures or infectious lesions. The ban includes periarticular osteoporosis, the postoperative period - after arthroplasty.

Drug interactions

Dexamethasone increases the toxicity of cardiac glycosides (due to the resulting hypokalemia, the risk of developing arrhythmias increases).

Accelerates the elimination of acetylsalicylic acid, reduces its concentration in the blood (when dexamethasone is discontinued, the concentration of salicylates in the blood increases and the risk of side effects increases).

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

Increases the metabolism of isoniazid, mexiletine (especially in “fast acetylators”), which leads to a decrease in their plasma concentrations.

Increases the risk of developing the hepatotoxic effect of paracetamol (induction of “liver” enzymes and the formation of a toxic metabolite of paracetamol).

Increases (with long-term therapy) the content of folic acid.

Hypokalemia caused by GCS can increase the severity and duration of muscle blockade due to muscle relaxants.

In high doses, it reduces the effect of somatropin.

Antacids reduce the absorption of corticosteroids.

Dexamethasone reduces the effect of hypoglycemic drugs; enhances the anticoagulant effect of coumarin derivatives.

Weakens the effect of vitamin D on the absorption of calcium ions in the intestinal lumen.

Ergocalciferol and parathyroid hormone prevent the development of osteopathy caused by GCS.

Reduces the concentration of praziquantel in the blood.

Cyclosporine (inhibits metabolism) and ketoconazole (reduces clearance) increase toxicity.

Thiazide diuretics, carbonic anhydrase inhibitors, other corticosteroids and amphotericin B increase the risk of hypokalemia, sodium-containing drugs - edema and increased blood pressure.

Non-steroidal anti-inflammatory drugs and ethanol increase the risk of developing ulceration of the gastrointestinal mucosa and bleeding; in combination with non-steroidal anti-inflammatory drugs for the treatment of arthritis, it is possible to reduce the dose of GCS due to the summation of the therapeutic effect.

Indomethacin, displacing dexamethasone from its association with albumin, increases the risk of developing its side effects.

Amphotericin B and carbonic anhydrase inhibitors increase the risk of osteoporosis.

The therapeutic effect of GCS is reduced under the influence of phenytoin, barbiturates, ephedrine, theophylline, rifampicin and other inducers of “liver” microsomal enzymes (increased metabolic rate).

Mitotane and other inhibitors of adrenal function may necessitate an increase in the dose of GCS.

The clearance of GCS increases against the background of thyroid hormones.

Immunosuppressants increase the risk of developing infections and lymphoma or other lymphoproliferative disorders associated with Epstein-Barr virus.

Estrogens (including oral estrogen-containing contraceptives) reduce the clearance of corticosteroids, prolong the half-life and their therapeutic and toxic effects.

The appearance of hirsutism and acne is facilitated by the simultaneous use of other steroid hormonal drugs - androgens, estrogens, anabolic steroids, oral contraceptives.

Tricyclic antidepressants may increase the severity of depression caused by taking dexamethasone (not indicated for the treatment of these side effects).

The risk of developing cataracts increases when used in conjunction with other corticosteroids, antipsychotic drugs (neuroleptics), carbutamide and azathioprine.

Simultaneous administration with m-anticholinergics (including antihistamines, tricyclic antidepressants), nitrates contributes to the development of increased intraocular pressure.

When used simultaneously with fluoroquinolones, the risk of tendonopathy (mainly Achilles tendon) increases in elderly patients and in patients with tendon diseases.

Antimalarials (chloroquine, hydroxychloroquine, mefloquine) in combination with dexamethasone may increase the risk of developing myopathy and cardiomyopathy.

Angiotensin-converting enzyme inhibitors, when administered concomitantly with dexamethasone, can change the composition of peripheral blood.

When is it not recommended to use the drug?

A contraindication for taking Dexamethasone is pathological intolerance to the components of the drug. It is also recommended to refuse treatment with this drug if the cat has a history of:

• diabetes;
• renal/liver failure;
• diseases of the cardiovascular system;
• myasthenia gravis, ulcers, colitis and other diseases of the gastrointestinal tract.

ZooMedic specialists advise not to use a hormonal drug to treat kittens (during the formation of the bone skeleton), pregnant or lactating animals. The reason is simple - calcium is washed out when taking it. For the same reason, this type of glucocorticosteroids is contraindicated in patients with bone fractures or osteoporosis.

When assessing the benefits of Dexamethasone for a cat, a veterinarian in Moscow takes into account not only her chronic diseases, but also what medications she is currently taking. So, in particular, the option of combining a steroid hormone with Cyclosporine, Digoxin, Amphotericin, Rimadyl, etc. is allowed. and so on. However, it cannot be used with other glucocorticosteroids. It is strictly forbidden to use a hormonal drug while taking barbiturates, immunobiological, antihistamine and antidiabetic drugs.

Dexamethasone dosage

Orally, in individually selected doses, the amount of which is determined by the type of disease, the degree of its activity and the nature of the patient’s response.

The average daily dose is 0.75-9 mg. In severe cases, large doses can be used, divided into 3-4 doses. 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 dexamethasone use 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).

For bronchial asthma, rheumatoid arthritis, ulcerative colitis – 1.5-3 mg/day; for systemic lupus erythematosus – 2-4.5 mg/day; for 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 – orally, 4 mg 3 times a day; 3, 4 days – orally, 4 mg 2 times a day; 5, 6 days – 4 mg/day, orally; Day 7 – drug withdrawal.

Dexamethasone test (Liddle test). It is carried out in the form of small and large tests. For a small test, dexamethasone is given to the patient 0.5 mg every 6 hours during the day (that is, at 8 a.m., 2 p.m., 8 p.m., and 2 a.m.). Urine for the determination of 17-hydroxycorticosteroids or free cortisol is collected from 8 a.m. to 8 a.m. 2 days before the administration 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, plasma cortisol levels are below 135-138 nmol/l (less than 4.5-5 mcg/100 ml). Reducing the excretion of 17-hydroxycorticosteroids below 3 mg/day, and free cortisol below 54-55 nmol/day (below 19-20 mcg/day) excludes hyperfunction of the adrenal cortex. In persons suffering from Cushing's disease or syndrome, no changes in the secretion of corticosteroids are observed during a small test.

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

How to take Dexamethasone and Novocaine

Only a doctor should prescribe the use of therapeutic blockades (determine their composition, calculate the regimen and duration of use).

They can be used to relieve pain in the first 3-7 days from the onset of the inflammatory process.

You can relieve unpleasant symptoms with the help of a compress. To do this take:

• 2-3 parts of Dimexide solution;
• 1 part Dexamethasone (1 ampoule);
• 1 part Novocaine (1 ampoule);
• 1 part distilled water.

A bandage soaked in this solution is applied to the sore spot for 30 minutes. The course of such treatment is 5 days.

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Breakthrough from the past

Effective: 35 regions will receive the first batches of Avifavir

Deliveries will be made in two weeks

Immunosuppressants, which include the anti-inflammatory drug dexamethasone, can help fight severe coronavirus infection. As Oleg Batishchev, deputy director for scientific work at the Institute of Physics and Chemistry of the Russian Academy of Sciences, told Izvestia, this remedy helps with complications caused by overactivity of the immune system (the so-called cytokine storm).

— As far as I know, quite a lot of drugs were tested that were supposed to help combat the development of this path of the disease. “All of them have existed for a long time, and they were used in the treatment of a number of other, mainly autoimmune, pathologies,” the scientist said. “The fact that dexamethasone showed its effectiveness is certainly an important finding. I hope this will help treat severe forms of COVID-19.

Researchers at the University of Oxford previously announced breakthrough results. A report on their website suggests that inexpensive and long-established dexamethasone reduces mortality in hospitalized patients with severe respiratory complications of COVID-19. British infectious disease specialists conducted a randomized trial in which 2,104 patients received 6 mg of this drug once a day (in tablet form or intravenously) for ten days.

Photo: tass/dpa/Marcel Kusch

The results were so impressive that WHO immediately reported them. This is despite the fact that the study itself has not yet been published. The WHO Director General called the data on the effectiveness of dexamethasone a “scientific breakthrough.” According to him, the anti-inflammatory drug reduces the risk of death of patients with COVID-19 connected to ventilators by 35%. And among patients receiving oxygen - by 20%.

Izvestia Help

Dexamethasone has been widely used since the 1980s. This is a medicine from the group of glucocorticosteroids, which has a pronounced anti-inflammatory, antiallergic, decongestant and immunosuppressive (suppressing immunity) effect on the body. The product is of synthetic origin; in fact, it is an analogue of a person’s own hormones secreted by the adrenal glands. It suppresses the functions of tissue macrophages and also limits the migration of leukocytes to the area of ​​inflammation. As experts emphasize, the use of this drug is dangerous, since all steroids have a large number of serious side effects.

Side effects

Most patients tolerate the drug well. Side effects appear with long-term use of the drug:

• blurred vision;
• increased intraocular pressure;
• glaucoma;
• damage to the optic nerve;
• cataract;
• thinning of the stratum corneum;
• allergic conjunctivitis;
• allergic blepharitis;
• the addition of a viral or bacterial infection.

The skin of the periorbital area may react with irritation, itching, burning, and the development of dermatitis.