Dexon injections: instructions for use for adults, children and pregnancy, analogues

Release form

Dexon is available in liquid and tablet form. One tablet contains 0.5 milligrams of dexamethasone. Packaging – blister of 10 pieces.

Injections

The solution is sealed in 2 milliliter ampoules, which corresponds to 8 milligrams of dexamethasone. The number of ampoules in the package is 6 pieces.

Drops

A dark glass bottle with a dropper included, 5 milliliters in volume, contains 5 milligrams of dexamethasone and 25 milligrams of neomycin. Percentage ratio in solution: dexamethasone – 0.1%; neomycin – 0.5%.

Pharmacological characteristics

Dexamethasone is a glucocorticosteroid, a synthetic hormone similar to adrenal enzymes. The anti-inflammatory effect is explained by blocking the conductors of inflammation and allergic reaction at the cellular level, reducing capillary permeability.

The ability to suppress the immune response reduces the reactivity of the body as a whole or locally when a pathological condition occurs.

Neomycin is an antimicrobial agent with bacteriostatic properties. It has an effect on gram-positive and gram-negative bacteria by suppressing the synthesis of protein cells. The combination of a hormone and an antibiotic enhances the anti-inflammatory effect.

Dexona solution

GCS is a methylated derivative of fluoroprednisolone, inhibits the release of interleukin1, interleukin2, interferon gamma from lymphocytes and macrophages. It has anti-inflammatory, antiallergic, desensitizing, antishock, antitoxic and immunosuppressive effects.

Suppresses the release of ACTH and beta-lipotropin by the pituitary gland, but does not reduce the level of circulating beta-endorphin. Inhibits the secretion of TSH and FSH.

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 the cell nucleus and stimulates mRNA synthesis; the latter induces the formation of proteins, incl. lipocortin, mediating cellular effects. Lipocortin inhibits phospholipase A2, suppresses the release of arachidonic acid and suppresses the synthesis of endoperoxides, Pg, leukotrienes, which contribute to inflammation, allergies, etc.

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

Lipid metabolism: increases the synthesis of higher fatty acids and TG, 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 metabolism: retains Na+ and water in the body, stimulates the excretion of K+ (MCS activity), reduces the absorption of Ca2+ from the gastrointestinal tract, “washes out” Ca2+ from the bones, increases the excretion of Ca2+ by the kidneys.

The anti-inflammatory effect is associated with inhibition of the release of inflammatory mediators by eosinophils; inducing the formation of lipocortin 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 allergic 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, inhibiting antibody formation, changing the body's immune response.

In COPD, the action 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 mucus by inhibiting or reducing 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 (interleukin1 and interleukin2, interferon gamma) from lymphocytes and macrophages.

Suppresses the synthesis and secretion of ACTH and, secondarily, the synthesis of endogenous corticosteroids. Inhibits connective tissue reactions during the inflammatory process and reduces the possibility of scar tissue formation.

The peculiarity of the action is significant inhibition of pituitary function and the almost complete absence of MCS activity. Doses of 1-1.5 mg/day inhibit the adrenal cortex; biological T1/2 - 32-72 hours (duration of inhibition of the hypothalamus-pituitary-adrenal cortex system).

In terms of the strength of GCS activity, 0.5 mg of the drug corresponds to approximately 3.5 mg of prednisone (or prednisolone), 15 mg of hydrocortisone or 17.5 mg of cortisone.

In what cases is it used

Dexon in tablet form is used:

with inflammation of the joints;
immunopathological reaction;
bronchospasm in asthma;
chronic inflammation of the large intestine;
complications after streptococcal infection, affecting joints, heart valves, nervous system;
skin lesions with itching, inflammation;
impaired filtration capacity of the kidneys;
malignant neoplasms.

Injections are prescribed to relieve severe conditions:

in a state of shock for any reason (due to intoxication, trauma, burns, allergies, blood group mismatch during transfusion);
cerebral edema due to hematoma, tumor, surgery, radiotherapy, head injury;
severe asthma;
functional adrenal insufficiency;
complications after removal of diffuse toxic goiter;
hepatic coma.

The drop form is used for eye and ear pathologies caused by bacterial infection in acute and chronic form:

inflammation of the eyelids;
ocular mucous membrane;
corneas;
iris and eyeball;
external otitis.

special instructions

When the drug is abruptly discontinued, patients experience withdrawal syndrome, which is characterized by hyperthermia, headache, vertigo, drowsiness, nausea, myalgia and general weakness. In severe cases, drug withdrawal syndrome can be fatal.

The use of Dexon can neutralize the symptoms of fungal and bacterial infections, pulmonary tuberculosis and perforated intestinal ulcers. Therefore, the use of this drug is permissible only for miliary or fulminant tuberculosis. Patients who have had a tuberculosis infection and are receiving glucocorticosteroids should take chemoprophylaxis against relapse of the disease.

Dexon is contraindicated for patients in the acute and subacute periods of myocardial infarction, since it will disrupt myocardial regeneration and can provoke rupture of the heart muscle. The drug also slows down bone healing and wound healing.

During therapy with Dexon, it is necessary to monitor potassium levels and blood cell composition.

Dexon, like other glucocorticosteroids, reduces the immune response in allergy tests, so the result may be false negative.

When the drug is administered intra-articularly, its systemic effects appear. When introducing Dexon into the joint cavity, it is necessary to exclude bacterial inflammation.

Drug interactions

The following variants of drug interactions with Dexon are known:

During therapy with Dexon, live vaccines cannot be administered, as this is dangerous for infection;
potentiates the toxicity of digitalis preparations;
accelerates the elimination of salicylates from the body;
reduces the effectiveness of ftivazid and mexiletine by accelerating their breakdown in the liver;
increases the toxic effect of paracetamol on hepatocytes;
increases the content of vitamin B9 in the body;
reduces the effectiveness of somatotropin;
stimulates the effect of muscle relaxants;
potentiates the effect of coumarin anticoagulants;
during GCS therapy, the effectiveness of hypoglycemic drugs decreases;
simultaneous use with Cyclosporine and Ketoconazole increases the toxicity of Dexon;
non-hormonal anti-inflammatory drugs in combination with Dexon are dangerous for gastrointestinal bleeding;
sleeping pills, ephedrine, theophylline, fenithion and rifampicin reduce the effect of Dexon;
preparations with estrogens slow down the removal of dexamethasone from the body and increase the risk of adverse reactions.

Use during pregnancy and breastfeeding

Dexon penetrates the placenta into the bloodstream of the fetus, so it can cause developmental delays or even antenatal death, as well as underdevelopment of the adrenal glands. Therefore, during pregnancy, the drug can be used only in extreme cases, when its effect is higher than all the risks for the mother and child.

If a pregnant woman has been prescribed Dexon or another GCS, then after giving birth the child will be carefully examined for the presence of adrenal insufficiency.

Clinical studies have confirmed that Dexon passes into breast milk, so the lactation period is a contraindication to the use of this drug.

In childhood and old age

Dexon is widely used in pediatrics in acute emergency cases, but during therapy the physical and psychophysiological development of the child is monitored. For long-term systemic therapy, GCS is taken at intervals of four days.

If a child who receives Dexon has been in contact with a patient with measles or chickenpox, then he must be prescribed specific antibodies.

In old age, the number of adverse reactions increases, hypertension, osteoporosis, steroid diabetes, skin atrophy, and decreased resistance to infections are especially common.

Instructions for use

The daily frequency of Dexon tablets depends on the dosage: 2-4 times a day.

Before use, the contents of the ampoule are diluted in a glucose solution (5%) or physiological solution (0.9% sodium chloride). When preparing a solution for a dropper, sterility must be maintained due to the absence of preservatives in the composition. Use within 24 hours. Quality and suitability are determined by the color of the liquid and the presence of sediment.

Intravenously

The drug is administered as an injection or infusion slowly over 4-5 minutes.

Intramuscularly

Intramuscular injections are carried out slowly, for at least 5 minutes.

Local administration

Injection into the joint and soft tissues is performed depending on the degree of damage, but not more than 1 time within 3-5 days. With a shorter period of time between injections, cartilage tissue may be damaged.

Burying

For minor eye infections, instillation is carried out into the conjunctival sac 3-4 times during the day. For severe lesions - every hour. As inflammation subsides, the period between instillations is lengthened. For the treatment of otitis, the frequency of installations is from 2 to 4 times a day.

Dexona - tablets

GCS is a methylated derivative of fluoroprednisolone, inhibits the release of interleukin1 and interleukin2, interferon gamma from lymphocytes and macrophages. It has anti-inflammatory, antiallergic, desensitizing, antishock, antitoxic and immunosuppressive effects.

Suppresses the release of ACTH and beta-lipotropin by the pituitary gland, but does not reduce the level of circulating beta-endorphin. Inhibits the secretion of TSH and FSH.

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).

The immunosuppressive effect is due to inhibition of the release of cytokines (interleukin1, interleukin2; interferon gamma) from lymphocytes and macrophages.

In terms of the strength of GCS activity, 0.5 mg of dexamethasone corresponds to approximately 3.5 mg of prednisone (or prednisolone), 15 mg of hydrocortisone or 17.5 mg of cortisone.

Dosages

Daily dose:

tablets – 6-12 pieces;
drops in the eyes – 1-2;
drops in the ears – 3-4;
solution – 1-5 milliliters.

The maximum number of drops per eye/day is 30, for the ear – 12.

Treatment of children

Eye drops are prescribed for children from 12 years of age, for ear treatment - from 7 years of age. General dosage.

For adults

Dosage - in accordance with the instructions, taking into account contraindications.

To old people

The age of the patients is not indicated in the instructions.

During pregnancy and lactation

Intravenous, intramuscular, or local injections are not prescribed. The prescription of drops and tablets is at the discretion of a specialist.

Actions in case of overdose and contraindications

The steroid drug has numerous contraindications.

Dexon drops are not used:

for viral infection, including herpes;
fungal infection;
glaucoma;
clouding of the lens;
purulent ulcers of the cornea;
purulent conjunctivitis caused by an antibiotic-resistant pathogen;
violation of the integrity of the eardrum;
allergies to drug components;
during pregnancy;
lactation.

The solution is used with caution for chickenpox, measles, tuberculosis, and amoebiasis. For severe infections, it is used as part of complex therapy.

Dexon solution is not allowed for use:

in immunodeficiency conditions;
ulcerative conditions of the gastrointestinal tract;
high blood pressure;
hyperglycemia;
hyper-, hypothyroidism;
renal and liver failure in the final stages;
kidney stones;
progressive osteomyelitis of all skeletal bones;
both types of glaucoma;
after myocardial infarction.

If the dose is exceeded when instilled, it is necessary to rinse the eyes and ears with warm boiled water.

Indications and contraindications

Dexon is used both in acute emergency conditions and for systemic therapy. The drug is prescribed in the following cases.

Pathologies of the endocrine system:

adrenal insufficiency;
shock;
non-bacterial inflammatory processes in the thyroid gland.

Diseases of the musculoskeletal organs:

rheumatoid arthritis;
bursitis;
osteoarthritis;
synovitis;
psoriatic arthritis;
Bekhterev's disease;
epicondylitis.

Diseases of the skin and subcutaneous tissue:

pemphigus;
Stevens-Johnson syndrome;
mycoses;
psoriasis;
seborrhea;
bullous dermatitis;
exfoliative dermatitis.

Allergic diseases:

bronchial asthma;
atopic dermatitis;
contact dermatitis;
hay fever;
drug allergies;
urticarial rash after blood transfusion;
Quincke's edema.

Respiratory diseases:

berylliosis;
sarcoidosis;
milliary tuberculosis;
tuberculous pleurisy;
Loeffler's syndrome;
aspiration pneumonia.

Blood diseases:

hemolytic anemia;
Werlhof's disease;
thrombocytopenia;
erythrocyte anemia;
aplastic anemia;
leukemia

Eye pathologies:

iritis;
iridocyclitis;
chorioretinitis;
optic neuritis;
allergic conjunctivitis;
keratitis and others.

There are a number of acute emergency conditions in which it is impossible to do without the use of injectable Dexon. These include idiopathic nephrotic syndrome, cerebral edema, tuberculous meningitis and severe hypotension.

At the same time, along with a wide range of indications for the use of Dexon, there is a fairly impressive list of contraindications. The drug should not be used in the following situations:

individual intolerance to the drug and its components;
infectious diseases of bacterial, viral and fungal nature;
decreased bone density;
bacterial arthritis, in particular gonorrheal or tuberculosis;
acute phase of peptic ulcer of the stomach and duodenum;
myopathy;
shingles;
polio;
complications after BCG vaccination;
increased intraocular pressure and glaucoma;
gestation period;
Itsenko-Cushing syndrome;
two weeks before and a month after vaccination with live immunotherapy drugs;
gastrointestinal bleeding.

Side effects from the medication

The frequency and degree of side effects depends on the dosage, duration of therapy, and time intervals between taking the medication.

Side effects and overdose

When treated with Dexon, side effects may occur, the risk of which depends on the dose and duration of therapy.

List of possible adverse reactions when using this drug:

on the part of the skin - atrophy and thinning of the skin, increased pigmentation, acne, the appearance of stretch marks on the skin, slower wound regeneration, petechiae, skin rash, dermatitis, itching, redness, urticaria;
from the digestive system - nausea, vomiting, epigastric pain, loss of appetite, bloating, the appearance of ulcers or erosion in the stomach and duodenum;
from the heart and blood vessels - slow heartbeat, other heart rhythm disturbances, worsening chronic heart failure, increased blood pressure, blood thickening, tendency to thrombosis;
from the central nervous system - hallucinations, delirium, euphoria, psychosis, paranoia, increased intracranial pressure, increased excitability, cephalgia, dizziness, convulsions, sleep disturbances;
from the endocrine system - impaired glucose tolerance, development of hormonal diabetes mellitus, disruption of the adrenal glands, Itsenko-Cushing syndrome, abdominal obesity, menstrual disorders, sexual development, increased hairiness in the face, chest and arms;
from the metabolic side - decreased calcium levels in the blood, increased body weight, hyperhidrosis;
from the organ of vision - decreased visual acuity, cataracts, glaucoma;
from the musculoskeletal system - slowdown in physical development in children, decreased bone density, melting of the heads of the humerus and femur, muscle atrophy.

In addition to the listed systemic effects, local reactions in the form of skin burning, numbness, and, in severe cases, necrosis may be observed at the site of drug administration.

When treated with high doses of the drug, patients may experience symptoms of overdose:

abdominal type of obesity;
“bull hump” – accumulation of fatty tissue on the back below the neck;
moon-shaped face;
hirsutism.

Long-term use of the drug leads to inhibition of the endocrine function of the adrenal glands, so discontinuation of the drug should be gradual. There is no specific treatment for an overdose of Dexon.

What to pay attention to

The use of Dexon eye drops requires:

control of intraocular pressure after 10 days of therapy;
neomycin content in the blood, with simultaneous use of similar antibiotics;
do not use contact lenses to avoid bacterial infection;
keep the pipette sterile, avoiding touching the eyelashes and eyelids.

To avoid side effects, the duration of treatment with a steroid should be short. Prescription for viral or fungal infection is not allowed.

Interaction with other drugs

The simultaneous use of dexamethasone with other types of drugs causes side effects, which is explained by its pharmacological incompatibility.

What disorders does the hormonal drug cause?

With cardiac glycosides - the occurrence of arrhythmia due to a decrease in the level of potassium in the blood.
When vaccinated with live viruses, infection develops.
Increased toxicity of paracetamol to the liver.
Blockade of the action of antiglycemic drugs.
Blood clotting disorders when taking coumarin derivatives.
Neutralization of the effect of vitamin D on the absorption of calcium ions in the intestines.

Medicines that increase the toxicity or neutralize dexamethasone:

Cyclosporine: interferes with excretion from the body.
Diuretics: increase potassium deficiency.
Immunosuppressants: promote the development of secondary infection against the background of a sharp decrease in immunity.
Antidepressants: increase the depressive state after taking a glucocorticosteroid.
Other steroids: the appearance of acne, facial hair.
Psychotropic drugs: threat of cataracts.
Antiallergenic agents with nitrates: promote the development of glaucoma.

The dosage of GCS requires adjustment when taking drugs that suppress the action of the adrenal glands.