Dexamethasone tablets - official instructions for use. What does Dexamethasone help with? Analogues with similar effects, but different composition

Compound Dexamethasone in ampoules: Dexamethasone sodium phosphate (4 mg/ml), glycerin, propylene glycol, disodium edetate, phosphate buffer solution (7.5 pH), methyl and propyl parahydroxybenzoate, water d/i.

Dexamethasone tablets contains 0.5 mg of active substance, as well as lactose in the form of monohydrate, MCC, colloidal anhydrous silicon dioxide, magnesium stearate, croscarmellose sodium.

Dexamethasone eye drops: Dexamethasone sodium phosphate (1 mg/ml), boric acid, benzalkonium chloride (preservative), Trilon B, water d/i.

Release form

• Dexamethasone eye drops 0.1% (ATC code S01BA01; 5 and 10 ml bottles).
• Tablets 0.5 mg (package No. 50).
• Injection solution 0.4% (ampoules 1 and 2 ml).

pharmachologic effect

Dexamethasone is a hormonal drug with antiallergic , anti-inflammatory , immunosuppressive , desensitizing , antitoxic , antishock activity . Increases the susceptibility of β-adrenergic receptors to endogenous catecholamines.

Dexamethasone eye drops have antiallergic, antiexudative and anti-inflammatory effects.

Pharmacodynamics and pharmacokinetics

Dexamethasone is a synthetic corticosteroid (hormone of the adrenal cortex). Wikipedia and the Vidal reference book indicate that the substance, when interacting with cytoplasmic receptors, forms complexes that penetrate the cell nucleus and stimulate the synthesis of m-RNA.

m-RNA, in turn, induces the biosynthesis of proteins (including enzymes that regulate vital processes in cells), which inhibit phospholipase A2, the release of arachidonic acid, the biosynthesis of endoperoxides, LT and PG, which are mediators of allergies, inflammation, pain, etc. .

Inhibits the activity of proteases, collagenase, hyaluronidase, as well as the release of inflammatory mediators from eosinophils, promotes:

• normalization of the function of the intercellular matrix of bone and cartilage tissue;
• decreased capillary permeability;
• stabilization of membranes (including lysosomal) cells;
• inhibition of the release of cytokines from macrophages and lymphocytes (gamma interferon and IL);
• involution of lymphoid tissue;
• acceleration of protein catabolism;
• decreased glucose utilization;
• increased gluconeogenesis in the liver;
• decreased absorption and increased excretion of Ca;
• Na and water retention;
• delayed ACTH secretion.

After oral administration, the substance is almost completely absorbed. The bioavailability of the drug in tablet form is up to 80%. Cmax and the maximum effect of use are observed after one to two hours. The effect after taking a single dose lasts for 2.75 days.

Binding to plasma proteins (mainly albumin ) - approximately 77%.

The substance is fat-soluble, therefore it is able to penetrate both inside the cell and into the intracellular space. The action manifests itself in the central nervous system (pituitary gland, hypothalamus), which is due to the ability of dexamethasone to bind to cell membrane receptors.

In peripheral tissues it binds and acts through cytoplasmic receptors. Dexamethasone breaks down in the cell (at the site of its action). Metabolization occurs primarily in the liver and, partly, in the kidneys and other tissues. The main route of elimination is through the kidneys.

Indications for use

Why is Dexamethasone prescribed in injections and tablets?

Indications for the use of Dexamethasone are diseases amenable to systemic treatment with GCS (if necessary, the drug can be used as an addition to the main therapy). The solution is administered intravenously and intramuscularly in cases where oral administration or local treatment is ineffective or impossible.

The medicine Dexamethasone (injections and tablets) is indicated for rheumatic and allergic diseases, cerebral edema , shock of various origins, certain kidney diseases, autoimmune disorders, respiratory tract diseases, blood diseases, acute severe dermatoses, IBD, during HRT (for example, with insufficiency of the adenohypophysis/adrenal glands).

Why is Dexamethasone eye drops prescribed?

In ophthalmological practice, the use of GCS is advisable for allergic and non-purulent conjunctivitis, , irite , , keratoconjunctivitis without damaging the integrity of the corneal epithelium, blepharoconjunctivitis , sclerite , blepharitis , episcleritis , sympathetic ophthalmia , as well as to relieve inflammation after surgery or eye injury.

What is instillation of the drug into the ear indicated for?

The drug is instilled into the canal of the external ear for inflammatory and allergic diseases of the ear.

Contraindications

The only contraindication for systemic use in a short course for health reasons is hypersensitivity to the components of the drug.

Intra-articular administration is prohibited when:

• joint instability;
• pathological bleeding;
• previous arthroplasty;
• transarticular fractures;
• the presence of infected lesions of joints, intervertebral spaces,
• periarticular soft tissues;
• expressed periarticular osteoporosis .

Contraindications to the use of eye drops:

• tuberculous, fungal, viral eye lesions ;
• trachoma ;
• epithelial damage to the cornea .

Instillations into the ear canal are contraindicated if the integrity of the eardrum is compromised.

Side effects of Dexamethasone

The incidence and severity of side effects of Dexamethasone depend on the dosage of the drug, duration of use of the drug, and the possibility of use taking into account the circadian rhythm.

Systemic side effects of Dexamethasone:

• from the senses and the nervous system - delirium, euphoria, depressive/manic episode, disorientation, hallucinations, increased ICP with congestive disc syndrome (non-inflammatory swelling) optic nerve (benign intracranial hypertension, the development of which is a consequence of a rapid reduction in the dosage of the drug (more often in children) and is accompanied by blurred vision and headaches), vertigo , sleep disturbances, headache, dizziness, loss of vision (when the solution is administered in the area of ​​the turbinates, head, neck, scalp), cataract with localization of opacity in the posterior part of the lens, glaucoma , ocular hypertension with the possibility of damage to the optic nerve, development of a secondary viral/fungal infection of the eye, steroid exophthalmos ;
• from the SSS side - arterial hypertension , ECG changes characteristic of hypokalemia, hypercoagulation, , with a predisposition - the development of CHF, with parenteral use - a rush of blood to the head;
• from the digestive system - nausea, hiccups, vomiting, , erosive and ulcerative lesions of the digestive canal, increased/decreased appetite, erosive esophagitis;
• metabolic disorders - peripheral edema due to water and Na+ retention, nitrogen deficiency, hypocalcemia , hypokalemia , weight gain;
• endocrine disorders - hyper- or hypocortisolism syndrome, manifestation latent (hidden) diabetes mellitus , steroid diabetes, growth retardation in children, irregular menstrual bleeding, ;
• from the locomotor system - joint or muscle pain, back pain, steroid myopathy, tendon rupture, , muscle weakness, decreased muscle mass; with intra-articular administration of the solution, the intensity of pain in the joint may increase;
• from the side of the skin - striae , ecchymosis and petechiae, steroid acne, thinning of the skin, increased sweating, poor wound healing;
• hypersensitivity reactions - , skin rashes, difficulty breathing, stridor, swelling of the face, .

Also possible: decreased immune system function, activation of infectious diseases, withdrawal syndrome (general weakness, lethargy, nausea, anorexia, abdominal pain).

Local reactions when injecting the solution: numbness, burning, paresthesia, pain, infection at the injection site, scarring at the injection site, hypo- or hyperpigmentation. When administered intramuscularly, the process of atrophy of the subcutaneous tissue and skin may begin.

Reactions to the use of ophthalmic forms: long-term (more than 3 weeks in a row) use of eye drops may be accompanied by an increase in intraocular pressure, the formation glaucoma with damage to the optic nerve fibers, posterior subcapsular (cup-shaped) cataract , visual impairment (for example, loss of its fields), thinning/perforation of the cornea, spread of infection (bacterial or herpetic).

With increased sensitivity to benzalkonium chloride or dexamethasone possible blepharitis And conjunctivitis .

Local reactions are manifested by burning and itching of the skin, irritation, dermatitis .

Instructions for use of Dexamethasone (Method and dosage)

Dexamethasone injections: instructions for use

Methods of administration of Dexamethasone: intravenous, intramuscular, local.

The daily dose is equivalent to 1/3-01/2 of the oral dose and ranges from 0.5 to 24 mg. It should be given for 2 injections. Treatment is carried out in the minimum effective dose and for the shortest possible course. The drug is discontinued gradually. For long-term use, the highest dose is 0.5 mg/day.

Injections are prescribed for emergency conditions, as well as in cases where oral administration is not possible. In emergency conditions, higher doses of the drug (4-20 mg) are allowed, and the dose is repeated until the required therapeutic effect is achieved. The daily dose in rare cases exceeds 80 mg.

Once the required results are achieved, treatment is continued at a dose of 2-4 mg, gradually reducing it until the drug is completely discontinued.

To maintain a long-term effect, injections are indicated at intervals of 3-4 hours. It is also possible to administer Dexamethasone intravenously by long-term drip infusion.

After completion of the acute phase of the disease, the patient is transferred to taking the drug orally.

No more than 2 ml of the product can be injected into the muscle at the same place.

The treatment regimen depends on the indications:

• for shock - 2-6 mg/kg IV bolus; repeated injections - every 2-6 hours or as a long-term infusion using a dose of 3 mg/kg/day. GCS is prescribed as an addition to the main antishock therapy. The administration of these doses is permissible only for conditions that threaten the patient’s life, and, as a rule, this period lasts up to 72 hours.
• At cerebral edema (OGM) treatment begins with a dose of 10 mg (iv), then - until symptoms are relieved (within 12-24 hours) - 4 mg is administered every 6 hours. After 2-4 days, the dose is reduced and Dexamethasone administration is stopped within 5-7 days. At oncological diseases Maintenance therapy may be required - 2 mg IV or IM 2 or 3 times a day.
• In case of acute AMG, the patient requires short-term intensive therapy. The loading dose of the drug for an adult is 50 mg, for a child weighing up to 35 kg - 20 mg (injected into a vein). After this, the dose is gradually reduced while increasing the intervals between drug administrations.
• At allergies (in particular, with exacerbation of chronic diseases of an allergic nature and with acute self-limiting reactions), parenteral administration is combined with oral administration of the drug. Allergy injections are given only on the first day, injecting the patient with 4 to 8 mg of Dexamethasone into a vein. On days 2-3, take 1 mg of the drug orally 2 times, on days 4-5 - 2 times 0.5 mg, on days 6-7 - 0.5 mg (once). On day 8, the effectiveness of treatment is assessed.

In case of asthmatic status requiring immediate intravenous administration of GCS, the combination “ and Dexamethasone”: GCS reduces the release of mediators (heparin, histamine, serotonin) from the cell, protects tissues from destructive processes, prevents the formation of arachidonic acid metabolites, and Eufillin reduces blood vessel resistance, relieves bronchospasm , inhibits platelet aggregation and dilates coronary vessels.

Instructions for Dexamethasone in ampoules for topical use

When applying the solution topically, 2 to 4 mg is injected into large joints, and 0.8 to 1 mg into small joints. Treatment of soft tissue infiltrates involves the use of 2-6 mg of the drug. 1-2 mg of the drug should be injected into the nerve ganglia, 2 to 3 mg into the joint capsules, and 0.4 to 1 mg into the synovial vagina. The dose is administered once. The course lasts from 3-5 to 14-20 days.

For children, the drug is administered in minimally effective doses.

Use of Dexamethasone in ampoules for inhalation

Inhaled use of Dexamethasone is indicated for acute inflammatory diseases of the respiratory tract (for example, or laryngitis , and also when bronchial obstruction ).

Inhalations with Dexamethasone for children should be done 3 times a day, mixing 0.5 ml of the drug with 2-3 ml of saline solution. As a rule, treatment is continued for 3 to 7 days.

You can dilute the drug in saline in a ratio of 1:6, and then use 3-4 ml of the prepared solution for inhalation.

Dexamethasone tablets: instructions for use

The dose for oral administration is selected individually depending on the type of disease, the activity of its course and the nature of the patient’s response to the prescribed treatment.

The average daily dose ranges from 0.75 to 9 mg. For severe diseases, the dose can be increased, and it is divided into several doses. The highest dose is 15 mg/day.

The optimal dosage for children is selected depending on age, and usually ranges from 2.5 to 10 mg/m2/day. It must be divided into 3 or 4 doses.

The duration of the course is determined by the nature of the pathological process and the patient’s body’s response to treatment. In some cases, Dexamethasone is continued for several months.

Liddle's test

The test with Dexamethasone is carried out in the form of small and large tests.

A small test involves prescribing the patient 0.5 mg of Dexamethasone 4 times a day at regular intervals (6 hours). Urine to determine free should be collected from 8:00 to 8:00 on the second day before the drug is prescribed and at the same time intervals after taking the required dose.

2 mg of Dexamethasone taken during the day suppresses the production corticosteroids almost every healthy person. Content cortisol 6 hours after taking the last 0.5 mg of the drug does not exceed 135-138 nmol/l. Decreased daily excretion of free cortisol below 55 nmol, and 17‑OX below 3 mg/day. eliminates hyperfunction of the adrenal cortex.

At hypercortisolism syndrome no changes in GCS secretion are observed.

A large test involves prescribing 2 mg once every 6 hours for 48 hours. Diagnose hypercortisolism syndrome allows a decrease in free cortisol and 17-OX by 50 (or more) percent.

In patients with ACTH-ectopic syndrome And adrenal tumors GCS excretion rates do not change. In some cases, when ACTH-ectopic syndrome they do not change even when taking 32 mg of Dexamethasone per day.

Dexamethasone eye drops: instructions for use

Eye drops are intended for topical use. In case of severe inflammation, in the first day or two of treatment, 1-2 drops are instilled into the conjunctival sac. every 2 hours. Then the intervals between instillations are extended to 4-6 hours.

To prevent the development of inflammation in the first 24 hours after injury or surgery, the patient is instilled 4 times a day. 1-2 drops, then treatment is continued at the same dose, but with a smaller frequency of applications (usually the procedure is repeated 3 times a day). The course lasts 14 days.

As an alternative to drops, Dexamethasone ointment can be used. It is squeezed out into a 1-1.5 cm strip and placed behind the lower eyelid. The frequency of procedures is 2-3 during the day. You can combine the use of ointment and drops (for example, drops during the day and ointment before bed).

For treatment otitis the drug is injected into the ear canal of the diseased ear 2-3 times/day. 3-4 drops each.

Overdose

In case of an overdose of solution and tablets, side effects that are dose-dependent may increase. The situation requires a reduction in the dose of the drug. Therapy: symptomatic.

The dropper bottle is configured in such a way that accidental overdose when instilling eye drops is considered unlikely (there is no information on cases of overdose). If the dose is exceeded when applied topically, the excess medication is washed out of the eye with warm water.

Interaction

The drug is incompatible with other drugs, since it can form insoluble compounds with them.

The injection solution can only be mixed with 5% glucose solution and 0.9% NaCl solution.

Terms of sale

On prescription.

Recipe in Latin (sample):
Rp: Sol. Dexamethasoni phosphatis 0.04
D.t.d. N 25 in amp.
S. IM 1 ml

Storage conditions

Keep away from children. The optimal storage temperature for drops and solution is up to 15°C (freezing solutions is prohibited), for tablets - up to 25°C.

Best before date

2 years. Eye drops are suitable for use within 28 days after opening the bottle.

special instructions

Dexamethasone in veterinary medicine

In veterinary medicine the drug is used as an active anti-shock , anti-allergenic And anti-inflammatory agent .

Why is Dexamethasone prescribed to cats and dogs? The drug is used to treat shock conditions, injuries, , bursitis ,allergic diseases , edematous disease , poisoning, ketosis And acute mastitis .

The therapeutic dose for dogs and cats is 0.1-1 ml (depending on the size of the animal and indications).

Application in bodybuilding

Taking Dexamethasone provokes a shift in metabolism towards anabolism, which, despite the use of even a small dose, anabolic steroids can accelerate muscle growth and make it more significant.

In addition, by suppressing the secretion catabolic hormones , the drug helps increase endurance, accelerates the athlete's recovery after training, suppresses pain and inflammation when ligaments and joints are damaged.

Since GCS belong to the group of stress hormones, their use in sports is allowed only for short-term courses.

Dexamethasone analogs

Level 4 ATX code matches:

Analogues of solution and tablets: , Dexamethasone-Vial , Dexamed , Megadexane , Dexamethasone-Ferrain .

Similar preparations for eye drops: Dexamethasone-LENS , Dexapos , Ozurdex , , Dexamethasonelong .

The drug Maxidez, unlike other analogues, has 2 dosage forms: drops and eye ointment. Dexamethasone ointment can be replaced with ointment .

Which is better - Prednisolone or Dexamethasone?

- this is a synthetic analogue hydrocortisone , which is considered a standard agent with an average duration of action and is most often used in clinical practice.

Compared to hydrocortisone its glucocorticoid activity is 4 times higher, but its mineralocorticoid activity is prednisolone inferior hydrocortisone .

Dexamethasone is a long-acting corticosteroid. Unlike its analogue, the drug is fluoridated. The glucocorticoid activity of the drug is 7 times higher, which is why prednisone . However, it does not have a mineralocorticoid effect.

To a greater extent than other corticosteroids, it provokes inhibition of the hypothalamic-pituitary-adrenal axis, causes severe disturbances in calcium, lipid and carbohydrate metabolism, and has a psychostimulating effect, and therefore is not recommended for long-term use.

Alcohol compatibility

During treatment with GCS, you should avoid drinking alcohol.

Dexamethasone during pregnancy and when planning pregnancy

Tablets: do not use during treatment and breastfeeding.

Injections during pregnancy are used only for health reasons (especially in the 1st trimester).

When planning pregnancy, Dexamethasone can be used in situations where the reason for the inability to get pregnant/bear a child is hyperandrogenism . During pregnancy, it is most often prescribed when there is a threat of miscarriage, when the immune system perceives the embryo as a foreign body (the drug helps suppress immune activity).

From this medical article you can find out why the drug Dexamethasone is prescribed. The instructions for use will explain in what cases the medicine can be taken, what it helps with, what are the indications for use, contraindications and side effects. The annotation presents the forms of release of the drug and its composition.

In the article, doctors and consumers can only leave real reviews about Dexamethasone, from which you can find out whether the medicine helped in the treatment of inflammatory and systemic diseases, including the eyes, in children and adults. The instructions list Dexamethasone analogs, prices of the drug in pharmacies, as well as its use during pregnancy.

Dexamethasone is a potent synthetic glucocorticoid. The instructions for use indicate that the medicine contains adrenal hormones and their synthetic analogues. What is it prescribed for? Dexamethasone is used to regulate protein, carbohydrate and mineral metabolism.

Release forms and composition

Dexamethasone is produced in dosage forms:

1. Tablets 0.5 mg.
2. Solution in ampoules for intravenous and intramuscular administration (injections for injections) 4 mg/ml.
3. Oftan eye drops 0.1%.
4. Ophthalmic suspension 0.1%.

Composition of Dexamethasone in ampoules: Dexamethasone sodium phosphate (4 mg/ml), glycerin, propylene glycol, disodium edetate, phosphate buffer solution (7.5 pH), methyl and propyl parahydroxybenzoate, water for injection.

Dexamethasone eye drops: Dexamethasone sodium phosphate (1 mg/ml), boric acid, benzalkonium chloride (preservative), sodium tetraborate, Trilon B, water d/i.

Pharmacological properties

Dexamethasone has anti-inflammatory, desensitizing (reduces sensitivity to allergens), antiallergic, antishock, immunosuppressive (suppresses or reduces immunity) and antitoxic properties.

The use of the drug allows you to increase the sensitivity of the proteins of the outer cell membrane (beta-adrenergic receptors) to endogenous catecholamines (mediators of intercellular interaction). The drug regulates protein metabolism, reducing synthesis and increasing protein catabolism in muscle tissue, reducing the amount of globulins in plasma, increasing albumin synthesis in the liver and kidneys.

By influencing carbohydrate metabolism, Dexamethasone, the instructions for use informs about this, promotes the absorption of carbohydrates from the digestive tract, increases the flow of glucose into the blood from the liver, and the development of hyperglycemia, which in turn activates the production of insulin.

Participation in water-electrolyte metabolism is manifested in a decrease in bone mineralization, sodium and water retention in the body, and a decrease in calcium absorption from the gastrointestinal tract. The anti-inflammatory and antiallergic properties of the drug are 35 times more active than the similar effects of cortisone.

What does Dexamethasone help with?

Indications for use include diseases requiring the administration of fast-acting corticosteroids, as well as cases when oral administration of the drug is impossible:

• local application (in the area of ​​pathological formation): keloids, discoid lupus erythematosus, granuloma annulare;
• cerebral edema (with a brain tumor, traumatic brain injury, neurosurgical intervention, cerebral hemorrhage, encephalitis, meningitis, radiation injury);
• severe bronchospasm (exacerbation of bronchial asthma, chronic obstructive bronchitis);
• acute severe dermatoses;
• rheumatic diseases;
• status asthmaticus;
• systemic connective tissue diseases;
• shock (burn, traumatic, surgical, toxic) - if vasoconstrictors, plasma replacement drugs and other symptomatic therapy are ineffective;
• severe allergic reactions, anaphylactic shock;
• endocrine diseases: acute adrenal insufficiency, primary or secondary adrenal insufficiency, congenital adrenal hyperplasia, subacute thyroiditis;
• blood diseases: acute hemolytic anemia, agranulocytosis, idiopathic thrombocytopenic purpura in adults;
• severe infectious diseases (in combination with antibiotics);
• malignant diseases: palliative treatment of leukemia and lymphoma in adult patients; acute leukemia in children; hypercalcemia in patients suffering from malignant tumors when oral treatment is not possible.

Why is Dexamethasone prescribed in ophthalmic practice:

• allergic conjunctivitis;
• keratoconjunctivitis without damage to the epithelium;
• clerite;
• blepharitis;
• keratitis;
• inflammatory process after eye injuries and surgical interventions;
• iridocyclitis;
• immunosuppressive treatment after corneal transplantation;
• iritis;
• sympathetic ophthalmia;
• blepharoconjunctivitis;
• episcleritis.

Instructions for use

The dosage regimen for Dexamethasone is individual and depends on the indications, the patient's condition and his response to therapy.

Application of the solution

The drug is administered intravenously slowly in a stream or drip (for acute and emergency conditions); intramuscularly; local (into the pathological formation) administration is also possible. To prepare a solution for intravenous drip infusion (dropper), you should use an isotonic sodium chloride solution or a 5% dextrose solution.

In the acute period for various diseases and at the beginning of therapy, Dexamethasone is used in higher doses. During the day, you can administer from 4 to 20 mg of solution 3-4 times. Use for 3-4 days, followed by switching to tablets.

Doses of Dexamethasone for children (intramuscular injections)

The dose of the drug during replacement therapy (for adrenal insufficiency) is 0.0233 mg/kg body weight or 0.67 mg/m2 body surface area, divided into 3 doses, every 3rd day or 0.00776 - 0.01165 mg/kg body weight or 0.233 - 0.335 mg/m2 body surface area daily.

When the effect is achieved, the dose is reduced to maintenance or until treatment is stopped. The duration of parenteral use is usually 3-4 days, then they switch to maintenance therapy with dexamethasone tablets. Long-term use of high doses of the drug requires a gradual dose reduction in order to prevent the development of acute adrenal insufficiency.

Pills

Oral use of tablets involves prescribing 1-9 mg of the drug per day at the initial stage of treatment, followed by a reduction in the daily dose to 0.5-3 mg during maintenance therapy.

The instructions recommend dividing the daily dose of Dexamethasone into 2-3 doses (after or during meals). Maintenance small doses should be taken once a day, preferably in the morning.

Dexamethasone eye drops

Eye drops are intended for topical use. In case of severe inflammation, in the first day or two of treatment, 1-2 drops are instilled into the conjunctival sac. every 2 hours. Then the intervals between instillations are extended to 4-6 hours.

To prevent the development of inflammation in the first 24 hours after injury or surgery, the patient is instilled 4 times a day. 1-2 drops, then treatment is continued at the same dose, but with a smaller frequency of applications (usually the procedure is repeated 3 times a day). The course lasts 14 days.

As an alternative to drops, Dexamethasone ointment can be used. It is squeezed out into a 1-1.5 cm strip and placed behind the lower eyelid. The frequency of procedures is 2-3 during the day. You can combine the use of ointment and drops (for example, drops during the day, and ointment before bed).

To treat otitis media, the drug is injected into the ear canal of the diseased ear 2-3 times a day. 3-4 drops each.

Children from 6 to 12 years old with allergic inflammatory conditions: 1 drop 2-3 times a day for 7-10 days, if necessary, treatment is continued after monitoring the condition of the cornea on the 10th day.

Side effect

Dexamethasone is usually well tolerated. It has low mineralocorticoid activity, i.e. its effect on water-electrolyte metabolism is small. As a rule, low and medium doses do not cause sodium and water retention in the body or increased potassium excretion. The following side effects are described:

• muscle tendon rupture;
• exophthalmos;
• delayed wound healing;
• steroid ulcer of the stomach and duodenum;
• sudden loss of vision (with parenteral administration in the head, neck, nasal turbinates, scalp, deposition of drug crystals in the vessels of the eye is possible);
• nausea, vomiting;
• hypocalcemia;
• weight gain;
• thrombosis;
• tendency to develop secondary bacterial, fungal or viral eye infections;
• hypercoagulability;
• increased blood pressure;
• dizziness;
• nervousness or restlessness;
• anaphylactic shock;
• paranoia;
• steroid acne;
• delayed sexual development in children;
• gastrointestinal bleeding and perforation of the wall of the gastrointestinal tract;
• bradycardia (up to cardiac arrest);
• indigestion;
• convulsions;
• suppression of adrenal function;
• skin rash;
• erosive esophagitis;
• euphoria;
• trophic changes in the cornea;
• steroid diabetes mellitus or manifestation of latent diabetes mellitus;
• affective insanity;
• negative nitrogen balance (increased protein breakdown);
• osteoporosis (very rarely - pathological bone fractures, aseptic necrosis of the head of the humerus and femur);
• slower growth and ossification processes in children (premature closure of epiphyseal growth zones);
• hallucinations;
• insomnia;
• decreased glucose tolerance;
• tendency to develop pyoderma and candidiasis;
• increased sweating;
• fluid and sodium retention (peripheral edema);
• pancreatitis;
• arrhythmias;
• Itsenko-Cushing syndrome (moon face, pituitary obesity, hirsutism, increased blood pressure, dysmenorrhea, amenorrhea, muscle weakness, stretch marks);
• flatulence;
• local allergic reactions;
• depression;
• increased intracranial pressure;
• increased intraocular pressure with possible damage to the optic nerve;
• increased or decreased appetite;
• striae;
• headache.

Contraindications

According to the instructions, Dexamethasone is not prescribed to patients with hypersensitivity to the components of the drug. Use with caution when:

Tablets: do not use during treatment and breastfeeding.

Injections during pregnancy are used only for health reasons (especially in the 1st trimester).

Interaction

The drug is incompatible with other drugs, since it can form insoluble compounds with them.

The injection solution can only be mixed with 5% glucose solution and 0.9% NaCl solution.

Analogues of the drug Dexamethasone

Complete analogues for the active substance:

1. Dexamethasone phosphate.
2. Dexamethasonelong.
3. Dexaven.
4. Dexamethasone sodium phosphate.
5. Dexapos.
6. Dexamed.
7. Dexon.
8. Maxidex.
9. Fortecortin.
10. Decadron.
11. Dexafar.
12. Oftan Dexamethasone.
13. Dexamethasone bufus (Nycomed; -Betalek; -Vial; -LENS; -Ferein).
14. Dexazone.

Price

In pharmacies the price of DEXAMETHASONE, tablets (Moscow), is 45 rubles. You can buy injections for 200 rubles. This is the price of 25 ampoules of 1 ml. Eye drops 0.1% are sold for 57 rubles per 10 ml.

Dexamethasone is a hormonal drug, which in modern medicine is considered as one of the vital pharmaceuticals belonging to the group of synthetic glucocorticosteroids. Dexamethasone is able to penetrate the tissues of all organs and systems, including the brain and nervous system, and affect the entire body. In severe conditions - shock, acute systemic allergies, severe inflammation, pathological immune reactions, the medicine can save lives.

For the treatment of various types of diseases, Dexamethasone is produced in 4 dosage forms, the therapeutic basis of which is dexamethasone sodium phosphate.

This substance is a synthetic analogue of a natural steroid hormone that is produced in the body by the adrenal glands.

Basic forms:

1. Tablets of 0.5 mg (0.5 mg of active ingredient) in a pack of 10 units.
2. Injection solution (0.4%) in 1 ml ampoules containing 4 mg of active substance (5 or 25 units per package). It is used for injection into a muscle, vein (stream or drip), inside a joint, into the soft tissue surrounding it, into the tissue of the eyeball.
3. Dexamethasone eye drops (ear) 10 ml with an active substance concentration of 0.1% (1 mg per 1 ml).
4. Eye ointment – ​​tube 2.5 g.

All forms of the drug contain, as auxiliary components, substances that are necessary for stabilization, shaping and transport of dexamethasone to the painful site, as well as preservatives and additives that facilitate the absorption of the drug.

Each therapeutic form has its own purpose in use, certain indications and contraindications, so you should not engage in treatment on your own - only a specialist can develop the necessary treatment regimen, calculate doses and frequency of use.

The medicine is available by prescription, where the name of the drug in Latin is Dexamethasoni.

Pharmacological properties and pharmacokinetics

Medicinal properties

The mechanism of the therapeutic effect of the drug is based on its ability to create a high concentration of the component in the blood and foci of inflammation, penetrate into all tissues and have an effect at the cellular level.

This allows the active substance to work in brain and nerve tissues, relieve swelling of the brain and lungs during hemorrhage, poisoning, injuries, tumors, removing the patient from a life-threatening state of shock, slow down the course of cancer processes, and eliminate manifestations of acute allergies.

The glucocorticosteroid activates a series of processes that lead to a decrease in the permeability of vascular walls, strengthening the protection of cell membranes and blocking inflammation at any stage of development.

By suppressing the acute reaction of the immune system to allergens, the drug stops the development of an allergic reaction, including anaphylactic shock, reduces the degree of swelling of the mucous membrane of the respiratory organs and bronchi, restoring the flow of air during swelling of the larynx or an asthmatic attack.

At the same time, the medicine inhibits the production of histamine, stopping the pathological manifestations of allergies.

Slows down the formation of scar changes in the tissues of various organs.

Absorption and excretion from the body

The corticosteroid is actively and almost completely absorbed not only after injection, but also after internal administration. Bioavailability or the amount of medicinal substance reaching the site of action is 77 - 79%, due to which the therapeutic effect of the drug is maximum.

In the blood, 65–70% of dexamethasone binds to the transport protein transcortin, which ensures a high concentration of the drug in the blood. With the bloodstream, the protein delivers dexamethasone throughout the body, penetrating into the intracellular spaces of tissues.

The largest amount of active substance in the blood, which provides the maximum therapeutic effect, is observed within the range from 40 to 90 minutes, depending on the method of application.

The active substance is processed by liver enzymes to inactive intermediate substances. It is removed from the body along with urine and is excreted in small quantities (about 10%) by the intestines. A small amount of dexamethasone passes into human milk, which should be taken into account when prescribing the drug to a nursing mother.

Why is the drug prescribed?

The action of the medicine is used for many diseases of internal organs, systemic, autoimmune pathologies, diseases of the joints, eyes, skin and in many other areas of medicine.

The list of pathological conditions that require Dexamethasone injections or tablets includes:

• life-threatening shock conditions of all forms, including painful shock, toxic, cardiogenic, allergic, postoperative, blood transfusion (after blood transfusions);
• swelling of brain tissue (with hemorrhage, meningitis, tumor, encephalitis, trauma, surgery);
• an attack of bronchial asthma or long-term status asthmaticus;
• lung pathologies: berylliosis, tuberculosis, alveolitis, pneumonia, Loeffler's syndrome (resistant to other medications);
• allergic reactions: urticaria, Quincke's edema, hay fever, allergies to medications and products, serum sickness;
• endocrine disorders - adrenal insufficiency, thyroid disease, thyrotoxic crisis, thyroiditis, adrenogenital syndrome;
• autoimmune diseases – rheumatic carditis, multiple sclerosis, systemic lupus erythematosus, pemphigus, scleroderma, systemic vasculitis;
• pain due to inflammation of the reproductive organs, including prostatitis; various types of myositis;
• intractable skin diseases - eczema, various types of dermatitis, psoriasis, toxicerma, Lyell and Stevens-Johnson syndromes, discoid lupus erythematosus, keloid scars (topical application);
• eye lesions of an allergic and inflammatory nature: scleritis, corneal ulcer, various types of conjunctivitis (except purulent), uveitis, keratitis, blepharitis, inflammation of the optic nerve, ophthalmopathy due to diabetes mellitus;
• swelling of the larynx and glottis in acute croup;
• inflammation of the joints of various types: arthritis of various forms, osteoarthritis, polyarthritis, ankylosing spondylitis, bursitis, tenosynovitis and others;
• hematopoietic disorders: Addison's disease, lymphoma, agranulocytosis, anemia of various origins, thrombocytopenia;
• critical conditions with damage to the gastrointestinal system: enteritis, including granulomatous, hepatitis and hepatic coma, ulcerative colitis;
• allergic-toxic reaction with massive helminthic aggression;
• damage to the esophagus and stomach due to poisoning with alkalis, acids to suppress inflammation and prevent scarring;
• acute renal pathologies - glomerulonephritis, nephrotic syndrome;
• malignant processes in the lungs, leukemia, lymphocytic leukemia, myeloma;
• nausea and vomiting while taking cytostatics.

Instructions for use of Dexamethasone

The Dexamethasone treatment regimen and dosage regimen are established only by the attending physician in order to obtain the maximum therapeutic effect with minimal risk of unwanted side reactions.

Pills

Usually prescribed for the chronic course of the pathology or after the removal of an acute condition.

The dose is determined for each patient separately, taking into account the nature and severity of the disease, the planned duration of the course, age, drug tolerance and the patient’s response.

The usual minimum effective dose for adults per day is 0.5 – 9 mg. A small dose is taken at a time, a large dose is divided into 3–4 doses. The largest amount of dexamethasone per day should not exceed 10–15 mg.

The average maintenance dose per day is 0.5 - 3 mg.

With long-term use of the medication in a large dose, the medication is combined with food. In this case, it is advisable to use drugs that reduce gastric acidity (antacids) between meals.

After the patient's condition improves, the dose should be gradually reduced - every 3 days by 0.5 mg to a maintenance dose.

The duration of the course of application ranges from 3–5 days to several months.

It is unacceptable to abruptly stop treatment with Dexamethasone, so as not to cause withdrawal syndrome,

which is expressed in exacerbation of the underlying disease and painful manifestations of withdrawal syndrome (weakness, weight loss, vomiting, diarrhea, drop in blood sugar and pressure, muscle pain, fever).

Dosing for children

Young patients are prescribed according to body weight or body area, age and severity of the pathological process.

The approximate daily dose for children is 0.0833 – 0.333 mg per 1 kilogram of child’s body weight. Thus, according to calculations, a child weighing 25 kg can receive a maximum of 0.333 x 25 = 8.36 mg of the drug per day, divided into 3 to 4 doses. The minimum dose that will give a therapeutic effect for a small patient with this weight is 0.0833 x 25 = 2.08 mg.

More precisely, the pediatric dose is calculated based on the surface area of ​​the child’s body at the rate of 0.0025 - 0.0001 mg per 1 square meter per day in 3 - 4 doses, depending on age.

Injections

Dexamethasone injections for systemic diseases are given inside the muscle or administered intravenously, which is preferable in life-threatening situations when the risk to the patient’s life is high. The solution immediately enters the bloodstream, providing a rapid therapeutic effect.

For emergency short-term or one-time use of the drug, only intolerance to any of the substances in Dexamethasone is considered a contraindication. In critical situations, the side effects of the drug are neglected.

For adults in acute and emergency conditions, 4–20 mg can be administered 3–4 times per day. In the acute phase of the pathology, as well as at the beginning of therapy, higher doses of corticosteroid are used. The highest dose is 80 mg, but in critical cases it is higher.

Pediatric doses for intramuscular administration are calculated based on the child’s weight at the rate of 0.02776 - 0.16665 mg per kilogram of body weight after 12 - 24 hours.

The duration of injection with a gradual dose reduction usually does not exceed 3–4 days, after which the patient is transferred to taking tablets in a maintenance dose.

Eye and ear drops

For acute inflammation, patients over 12 years of age receive 1 to 2 drops of ophthalmic solution behind the lower eyelid for 48 hours, 4 to 5 times a day. When the degree of inflammation decreases, treatment is continued for another 4–6 days, reducing the frequency of instillation to 3 times a day.

For chronic processes, the product is used twice a day for no longer than 20–40 days.

For allergic eye damage, similar doses are used up to 5 times a day for 48 hours, then gradually reduce the frequency of instillation to 2 times a day and discontinue treatment for 7–12 days.

For patients aged 6–12 years, to eliminate inflammatory and allergic phenomena, 1 drop is administered behind the eyelid up to 4 times a day for no longer than 10 days.

The solution is used from the 8th day after surgery to eliminate cataracts, retinal detachment, strabismus up to 4 times a day for 2 - 4 weeks.

For ear inflammation (otitis) of a non-viral nature, 3-4 drops (children 1-2) are instilled warm into the sore ear three times a day.

Lenses are removed before instillation. You can put them on only after 15 minutes.

Dexamethasone eye ointment

Used for the same indications as ophthalmic drops in patients over 6 years of age. A strip of ointment 10–15 mm long is carefully placed behind the lower eyelid 3 times a day. The maximum duration of treatment is no more than 20 days.

Use during pregnancy and lactation

A study on small mammals revealed that Dexamethasone, like many other hormonal agents, penetrates the placenta into the tissues of the embryo and can lead to the death of the embryo at an early stage and fetal deformities. The class of action of the drug on the fetus is C (according to the FDA).

Therefore, Dexamethasone is used during pregnancy only if there is a threat to the life of the mother.

If a pregnant woman has received Dexamethasone, monitoring the baby's health after birth is necessary - since the child may be diagnosed with adrenal dysfunction, which requires immediate intensive treatment.

Since the medicine passes into human milk, nursing mothers need to switch to artificial feeding or abandon the drug.

With long-term use of ointment or drops, the drug is partially absorbed into the blood. Therefore, these dosage forms are allowed to be used by expectant mothers only after the 12th week of gestation, in very short courses of up to 3 days and in minimal doses.

During lactation, treatment with ointment and drops is acceptable for no longer than 7–10 days.

Can I drink alcohol while taking the drug?

Treatment with Dexamethasone is incompatible with alcohol consumption, otherwise the consequences of parallel use will be very serious.

There is a high probability of such severe manifestations as:

• intractable diarrhea;
• partial loss of vision;
• abdominal pain, vomiting;
• acute pain at the injection site;
• redness of the skin on the chest, hives, acne on the face;
• ulceration of the mucous membrane of the digestive organs;
• internal bleeding.

If the patient has a serious alcohol dependence and is not able to give up alcohol during therapy, other medications are required.

Drug interactions with other drugs

The combination of Dexamethasone and non-hormonal anti-inflammatory pharmaceuticals (Aspirin, Paracetamol) increases the likelihood of the formation or deepening of ulcers of the digestive organs.

The effect of the corticosteroid is reduced with parallel use:

• antacids, which reduce the absorption of the medicinal substance in the stomach;
• somatotropin;
• drugs from a series of inducers of the CYP3A4 isoenzyme (for example, phenobarbital, phenobarbital, rifabutin, rifampicin, carbamazepine);
• aminoglutethimide and ephedrine.

When used in parallel, Dexamethasone is capable of:

• reduce the therapeutic effects of Insulin, hypoglycemic drugs, high blood pressure drugs, Praziquantel and diuretics-natriuretics;
• enhance the effect of Heparin, Albendazole.
• increase potassium excretion when combined with diuretics; influence the effect of coumarin-based anticoagulants;

Ketoconazole-based antifungals, birth control pills, and macrolide antibiotics can lengthen the time of excretion of dexamethasone in the urine and increase the frequency and severity of adverse reactions.

Combining the drug with Thalidomide can provoke the development of Lyell's syndrome, with anticholinergic drugs - glaucoma, with antipsychotic drugs and Azathioprine - cataracts; with cardiac glycosides - arrhythmias.

Combination with anabolic steroids, androgens, contraceptives, estrogens can cause increased facial hair, breasts, swelling, and the development of acne.

The use of antiviral vaccines in parallel with Dexamethasone therapy increases viral aggressiveness against the background of decreased immunity.

Contraindications, side effects and overdose

Contraindications

If Dexamethasone is urgently required to save a life, all contraindications (except drug intolerance) and possible adverse reactions are ignored.

For any severe infections, Dexamethasone injections and tablets can be prescribed only with simultaneous specific treatment for these diseases.

Contraindications for intra-articular injections:

• tendency to bleed;
• intra-articular bone fracture;
• infection, osteoporosis, instability, joint deformity, bone destruction, ankylosis;
• surgery (arthroplasty);
• articular bone necrosis;
• low effectiveness after 2 previous injections.

Contraindications for local forms (ointment, drops):

• eye damage from tuberculosis bacillus, fungus, viruses, including herpes;
• glaucoma;
• acute suppuration of the eye structures (if antibiotic treatment is not carried out);
• trauma and ulcer of the cornea, the period after removal of a foreign object;
• hole in the eardrum.

Important! Dexamethasone ointment and drops can reduce the severity of manifestations in the development of bacterial and fungal infections of the ears and eyes.

Therefore, after clarifying the diagnosis and identifying an infection, the drug should be used with appropriate antimicrobial treatment.

Side effects

The hormonal agent has a profound effect on all systems of the body. The task of the attending physician is to minimize the risk, frequency and severity of adverse reactions with a high therapeutic effect of the drug.

Undesirable manifestations depend on the duration of the course, dosage, age and condition of the patient.

Basic side effects:

• allergic rashes, skin itching, urticaria, swelling of the face, respiratory disorders, bronchospasm, anaphylactic shock;
• anxiety, disorientation, depressive, paranoid states or euphoria;
• double vision, visual disturbances, headaches due to increased intracranial pressure, characteristic of rapid dose reduction;
• insomnia, dizziness;
• persistent increase in blood pressure;
• weakening of myocardial function, arrhythmias;
• potassium deficiency and cardiac disorders associated with hypokalemia;
• decreased adrenal function, development of diabetes mellitus, Cushing's syndrome, excess hair growth, menstrual cycle disorder, developmental delay in children;
• a sharp increase in blood viscosity and thrombus formation;
• nausea, vomiting, ulceration of the digestive organs, gastritis, pancreatitis, colitis;
• frequent infections due to immunosuppression;
• osteoporosis, abnormal fractures, joint and muscle pain, necrosis of the femoral head, tendon rupture;
• acne, sweating, dry skin, slow healing of damage;
• swelling of the limbs, weight gain;
• sharp deterioration of vision (with injections in the area of ​​the face, neck and head);
• increased pain when injected into the joint;
• burning, itching of the mucous membrane and skin (ointment and drops); with treatment longer than 20 days, allergies, glaucoma and cataracts, and decreased visual function may develop.

Transport drivers and workers who require increased concentration should be careful when treated with Dexamethasone, as concentration is impaired when taking it.

Overdose

Excessive doses of a corticosteroid or long-term treatment can lead to overdose, which manifests itself in increased unwanted side effects.

The drug is immediately discontinued and the symptoms of overdose are eliminated with the help of medications that can relieve certain manifestations.

Long-term therapy requires constant monitoring of children's development, periodic examination of the visual organs, monitoring of intraocular and intracranial pressure, sugar and blood clotting, functions of the adrenal glands and the hypothalamic-pituitary system.

Dexamethasone analogs

Synonyms are drugs with the same active ingredient as Dexamethasone and a similar therapeutic effect: Dexamethasone-Vial, Dexamethasone-Ferein, eye drops - Dexamethasonelong, Maxidex, Oftan Dexamethasone, Ozurdex.

Analogs with a similar effect, but a different composition:

• drops with Dexamethasone and other active ingredients: Sofradex, Dexona;
• Prednisolone is a corticosteroid medication with a similar, but weaker therapeutic effect.

Dexamethasone 0.1 belongs to the group of glucocorticosteroid drugs. Has anti-inflammatory properties. Additionally, it eliminates other negative manifestations. The concentration of the active component (0.1%) is encrypted in the designation of the product.

Release form, composition and packaging

You can purchase the drug in the form of tablets, injection solution, eye drops. The active substance exhibiting anti-inflammatory activity is the compound of the same name - dexamethasone. Used in the form of sodium phosphate. With a concentration of the active component of 0.1%, only one version of the product is available - in the form of eye drops. 1 tablet contains 0.5 mg of dexamethasone. The product is available in packages of 10, 20, 50, 60 and 100 pcs.

Drops

The concentration of the active component in 1 ml of the substance is 1 mg. You can purchase eye drops in bottles of 5 and 10 ml.

Solution

The concentration of the active ingredient in 1 ml of the drug is 4 mg. The solution can be purchased in 1 ml ampoules. Their quantity per package varies from 5 to 25 pcs.

pharmachologic effect

The main properties of the drug: antiexudative, anti-inflammatory, antiallergic. It is intended for local treatment. Dexamethasone is used in the form of drops, only in ophthalmology. The main active ingredient is a synthetic hormone. This component belongs to the group of glucocorticosteroids and is a derivative of fluoroprednisolone.

The drug also exhibits other properties: antishock, desensitizing, antitoxic, immunosuppressive. The mechanism of action of Dexamethasone is based on the ability to interact with receptors. As a result, the main substance penetrates into the cell nucleus, where it activates a number of processes aimed at stimulating protein production. Due to this, other reactions are triggered. In particular, the production of arachidonic acid, prostaglandins, endoperoxides, etc. is suppressed.

Thanks to these processes, inflammation develops less intensely and is soon completely suppressed. A feature of dexamethasone is its effect on the metabolism of proteins and carbohydrates. Thus, the intensity of the protein transformation process increases. At the same time, the production of fatty acids and, at the same time, triglycerides are accelerated. Due to this, more intense accumulation of fat in the body occurs. It is predominantly deposited in the area of ​​the shoulder girdle and abdomen. As a result, hypercholesterolemia develops.

Dexamethasone helps accelerate the delivery of glucose into the blood. At the same time, more intense absorption of carbohydrates is noted, and gluconeogenesis begins. Another feature of the hormone is the retention of fluid and sodium in the body. At the same time, the excretion of potassium and calcium is accelerated.

Anti-inflammatory activity is also manifested by suppressing the ability of eosinophils to release inflammatory mediators. Capillaries become less permeable. As a result, the anti-exudative property of the drug is manifested: biological fluids do not penetrate the walls of blood vessels as intensively, and the amount of exudate decreases.

A number of processes develop as a result of suppression of mast cell release. The drug has an antiallergic effect by reducing the number of histamine basophils. At the same time, the secretion of allergy mediators is inhibited.

The antiallergic effect is achieved by suppressing the process of antibody formation. At the same time, the nature of the body’s response changes as destructive factors increase.

Dexamethasone affects bronchial function. Along with this, there is a decrease in the viscosity of the secretion produced by them. The antitoxic and antishock effect is achieved through the development of a number of processes: an increase in blood pressure is observed, membrane protective properties appear, and liver enzymes are activated. The immunosuppressive effect is achieved by inhibiting the release of cytokines.

The main component penetrates into the structure of the eye tissue when the solution is instilled into the conjunctival sac. The drug is absorbed in the form of eye drops in minimal quantities. Metabolization occurs in the tissues surrounding the organ of vision. The active component does not penetrate the systemic circulation. The duration of action of the drug after use varies from 4 to 8 hours.

Indications for use of Dexamethasone 0.1

• inflammatory processes after eye injuries;
• diseases of the visual organs, provoked by various factors, except infections, if inflammation also develops;
• allergic reactions (allergic keratitis, conjunctivitis) with localization of the lesion in the cornea and conjunctiva;
• glaucoma with damage to the optic nerve;
• restoration of visual function after burns or surgery.

Dosage regimen Dexamethasone 0.1

The product is intended for instillation into the conjunctival sac. For adults, dosage: 1-2 drops for 2 days. Frequency of application - no more than 5 times. The full course of treatment is 6-8 days. For the remaining 4-6 days, it is recommended to instill 1-2 drops no more than 4 times a day.

The treatment regimen for chronic diseases accompanied by damage to the optic nerve is different: eye drops are instilled 2 times a day (standard dosage - 1 or 2 drops at a time), the duration of use of the drug is from 3 to 6 weeks. It must be remembered that therapy using a glucocorticosteroid drug cannot be continued for longer than 6 weeks.

Symptoms of an allergic reaction are eliminated according to a different scheme. So, at the initial stage, a standard dose of the drug is prescribed for 2 days, the frequency of use is up to 5 times a day. Gradually, the frequency of use of the solution is reduced. The duration of the withdrawal period is 1-2 weeks.

Recovery after glaucoma surgery begins the same or next day. For other pathological conditions (cataracts, strabismus, retinal detachment, severe injuries), it is recommended to switch to restorative therapy 1 week after surgery. Frequency of use: 2-4 times a day, duration of therapy is 2-4 weeks.

Children over 12 years of age are recommended to take an adult dose of the drug. Patients in the age category from 6 to 12 years are prescribed 1 drop, the frequency of use is 2-3 times a day. Duration of treatment: from 7 to 10 days. If the improvement in the patient's condition is insignificant, the course of therapy can be extended. The decision on this is made based on the results of the fluorescein test. This measure allows you to control the condition of the cornea.

Side effect

If you do not violate the treatment regimen and do not exceed the dose of the drug, the likelihood of developing negative reactions is minimal, and in most cases the drug is well tolerated. Short-term local reactions:

• burning sensation;
• deterioration of vision (decreased sharpness);
• increased tearfulness.

These symptoms go away quickly. Considering that the drug tends to gradually accumulate in tissues (to a small extent), the risk of side effects increases if Dexamethasone is used for a long period - from 14 days. In this case, more severe complications develop:

• damage to the optic nerve during developing glaucoma;
• increased intraocular pressure;
• the viewing angle may decrease;
• the quality of vision decreases;
• violation of the integrity of the cornea, with its thinning first, then perforation;
• cataracts develop;
• There is an increase in the intensity of the spread of herpetic and bacterial infections, which is a consequence of a violation of the integrity of the eye tissue (conditions are created for the penetration of harmful microorganisms).

In addition, with long-term therapy with this drug, the likelihood of developing systemic side effects characteristic of steroid drugs increases:

• nausea;
• gagging;
• increased intensity of development of diseases of the digestive tract;
• increased or decreased appetite;
• diabetes mellitus of a latent or steroid nature;
• deterioration of glucose tolerance;
• Itsenko-Cushing syndrome;
• dysfunction of the adrenal glands (hormone synthesis slows down);
• changes in the functioning of the cardiovascular system: hypertension, heart rhythm disturbances;
• dizziness;
• headache;
• worsening sleep;
• mild and moderate mental disorders: irritability, anxiety;
• intracranial pressure increases;
• decrease in muscle mass.

Other side effects, the frequency of which has not been established:

• diseases of the visual organs due to developing allergies against the background of hypersensitivity to the active component: blepharitis, conjunctivitis;
• erythema;
• decreased rate of healing of ulcerative formations on the cornea and sclera;
• increased risk of secondary infection.

Contraindications to the use of Dexamethasone 0.1

Pathological conditions for which a hormonal drug is not prescribed:

• infectious diseases caused by viruses, fungi;
• development of purulent processes, provided that no therapy was carried out to eliminate the lesion;
• history of increased intracranial pressure;
• disruption of the structure of the corneal epithelium;
• tuberculosis of the organs of vision;
• connective tissue diseases of the eyes;
• individual intolerance to any component in Dexamethasone.

special instructions

It is prohibited to introduce a solution in the form of eye drops into tissues when performing injections.

To achieve uniform distribution of the drug, it is recommended to shake the bottle before use.

The drug is used for 3-4 days. The patient's condition is then assessed. If there is no improvement, adjuvant therapy with other means may be recommended.

Contact lenses are not recommended to be worn while using Dexamethasone. This is due to the fact that the drug contains an antimicrobial substance, which tends to be absorbed by lenses. To prevent the development of complications, contact lenses must be removed before instillation. They can be installed again 15 minutes after completing the procedure.

Given the aggressive effect of the steroid drug, it should not be used simultaneously with other ophthalmic drugs. The interval between the use of different medications should not be less than 15 minutes.

Dexamethasone therapy can be carried out while taking antimicrobial agents. This need is due to the fact that the drug in question tends to hide the manifestations of a bacterial infection.

When performing a doping test, the use of Dexamethasone may cause a false positive result.

Considering that the drug in question contributes to a number of side effects that reduce the quality of vision, it is not recommended to use it while driving.

Use during pregnancy and breastfeeding

Not prescribed because corticosteroids cause fetal resorption and pass into breast milk.

Use in children

The drug is used to treat patients over 6 years of age.

Use for renal impairment

The medicine is applied topically and is minimally absorbed. For this reason, there is no need to discontinue it if kidney function is impaired.

Overdose

When applied topically, there are no cases of negative reactions due to an increase in the amount of the product.

Drug interactions

A hormonal drug in combination with Idoxuridine provokes the development of destructive processes in the tissues of the organs of vision.

The intensity of the effects of barbiturates on the body increases significantly under the influence of Dexamethasone.

The concentration of Phenytoin decreases.

Under the influence of a combination of Warfarin and Dexamethasone, the risk of bleeding increases.

Heart failure develops in cases where the hormonal drug in question and diuretics are used simultaneously.

Dexamethasone does not improve the tolerability of cardiac glycosides, and the risk of complications in the form of diseases of the gastrointestinal tract increases.

The effectiveness of the drug in question is reduced under the influence of drugs that restore heart rhythm.

Oral contraceptives have a negative effect on the clearance of dexamethasone (the value of this indicator increases), which leads to the development of side effects.

The combination of the drug in question with non-steroidal anti-inflammatory drugs or ethanol causes the development of gastric and intestinal ulcers.

Storage conditions and periods

Dexamethasone in the form of eye drops retains its properties for 3 years. If the integrity of the bottle is damaged, the medicinal substance can be stored for no longer than 4 weeks.

Conditions for dispensing from pharmacies

The drug belongs to the group of prescription drugs.

Price

Average price: 75-100 rub.

Analogs

Instead of Dexamethasone, the following drugs can be used:

• Mexidex;
• Oftan Dexamethasone;
• Ozurdex Implant.

The drug Dexamethasone in the form of tablets is not prescribed instead of eye drops, because it is characterized by a wider range of applications (including used for the treatment of lung cancer and blood diseases), acts systemically and is an aggressive agent.

Dexamethasone | instructions for use (eye drops)

Catad_pgroup Systemic corticosteroids

Catad_pgroup Ophthalmic drugs

Dexamethasone tablets - official instructions for use

INSTRUCTIONS for medical use of the drug

Registration number:

Tradename:

International nonproprietary name:

Dosage form:

Composition per tablet.

Excipients:
- until a tablet weighing 0.15 g is obtained
potato starch -0.0340 g
sucrose (sugar) -0.1140 g
ancient acid -0.0015 g

Description

Pharmacological group:

ATX Code:

Pharmacological properties

Indications for use: