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Dexamethasone injections for how many days can you inject. Instructions for use of the drug dexamethasone - composition, indications for use, side effects and analogues Brain tumor bleeding, can dexamethasone be stopped

Dexamethasone injections for how many days can you inject. Instructions for use of the drug dexamethasone - composition, indications for use, side effects and analogues Brain tumor bleeding, can dexamethasone be stopped

03.10.2023 Drugs

Dexamethasone is used for brain tumors as one of the principles of treatment.
If a patient has signs of increased ICP on CT scan, and an intracranial formation with edema is detected, then dexamethasone is prescribed without waiting for the results of a histological examination.

Dexamethasone in brain oncology reduces perifocal edema, this leads to a partial reduction in focal symptoms and a decrease in ICP. In patients with brain tumors, symptoms of intracranial hypertension and focal disorders decrease within two days after dexamethasone therapy. After five days, patients show complete improvement.

But it is prohibited to prescribe it for a long period, as this can lead to complications: facial edema or proximal myopathy. It is recommended to gradually discontinue the drug over the course of a month. However, if the medication is abruptly discontinued, an increase in ICP with characteristic symptoms may be observed. In such cases, it is necessary to increase the dose of the medicine again.

The reaction to drug withdrawal may vary in intensity: in some people it is faster, in others it is slower.

Contraindication for the drug: diabetes, severe hypertension, bleeding ulcer of the digestive tract.

Other treatments

  • The use of osmotic agents. To urgently reduce ICP, mannitol is prescribed. The administration of the drug reduces the water content in the brain tissue.
  • . Recommended for patients with secondary brain tumors.
    Patients who may benefit from radiation therapy include those with radiosensitive tumors and multiple secondary tumor sites and those who benefit from dexamethasone.
  • Surgical method. This method can be recommended for young patients if they have single metastases and in the absence of signs of an extensive tumor process.
  • . To carry out this method, drugs of natural origin, synthetic and semi-synthetic drugs, antibiotics, and antimetabolites are used. This method consists of using one or more drugs according to a regimen.
  • Endoscopic intervention. Recommended for pathological diseases after traumatic brain injuries. The method avoids injury to nerves and blood vessels.

Multiple myeloma is an oncological disease that has several names. For example, if you see the term “generalized plasmacytoma” or “multiple myeloma,” you will know that they are the same disease. Just like Rustitsky-Kahlen disease. It belongs to the group of chronic leukemias.

The disease is a malignant tumor consisting of plasma cells (B-lymphocytes, elements responsible for the production of antibodies). A tumor develops through the proliferation (division) of B-lymphocytes.

The predominant site of localization of the oncological process is the bone marrow. Less often it has an extraosseous location. The disease is accompanied by bone marrow infiltration, bone tissue dissolution (osteolysis) and immunodeficiency.

Quite often, the first sign of the disease is bone pain and unexpected fractures. Then renal failure, hemorrhagic diathesis, polyneuropathy and amyloidosis develop. In the last stage, lymphoid tissue, intestines, and spleen may be affected.

Types of disease

According to international standards, there are several types of this pathology. The classification is based on clinical manifestations, biochemical blood tests and biopsy results. It is customary to highlight:

  • Asymptomatic or smoldering myeloma.
  • Symptomatic.
  • MGUS (monoclonal gammopathy).

The most severe is symptomatic myeloma. Accompanied by renal failure, bone lesions, anemia, production of large amounts of monoclonal immunoglobulin and other symptoms.

When a B lymphocyte encounters an antigen, immunoglobulin is produced. When plasmacytoma develops, clonal B lymphocytes produce huge amounts of this globulin (called monoclonal globulin). It is this that is detected in a biochemical blood test.

The first and last types of myeloma do not have organic lesions characteristic of symptomatic myeloma. They are determined by the content of paraprotein in the blood plasma and punctate containing clonal plasmacytes (that is, B-lymphocytes formed by cell division).

Symptomatic myeloma progresses through 3 stages (I, II, IIIA, IIIB). The transition from one stage to another is justified by an increase in the mass of the tumor focus. The first stage describes the condition for any of these types of myeloma lesions. It is considered relatively mild, since there is no damage to bone tissue or internal organs, hemoglobin is slightly reduced, and the level of calcium in the blood is within normal limits. By the third stage, the bones begin to melt - this is a characteristic feature of the myeloma process.

Low hemoglobin levels, high calcium levels in the blood and kidney failure are all signs of the third stage of the process. Depending on the level of creatine in the blood, substages A and B are distinguished.

Myeloma is characterized not by bone destruction, but by lytic lesions (melting, resorption) of bone tissue.

Other classification

This disease is classified not only by severity and type of course, but also by several other criteria. So, myeloma is distinguished:

  • Based on the composition of the cells involved in the tumor process, it is customary to distinguish between small cell, polymorphic, plasmablastic, and plasmacytic myeloma.
  • Based on the ability to secrete paraproteins, they are distinguished: non-secreting tumors, diclon, Ben-Jones and G-, A-, M-myelomas. The last two types account for about 70% of all cases of plasmacytoma.
  • According to the prevalence of the process.

Based on the degree of infiltration of bone marrow tissue, focal (nodular), diffuse-focal (diffuse-nodular) and diffuse (diffuse) myeloma are distinguished.

Rustetsky-Kahlen disease is characterized by a large number of lesions. But there are situations when degenerated plasma cells are concentrated in one place - this pathology is called solitary myeloma (plasmacytoma). In this case, monoclonal immunoglobulin is produced in extremely large quantities. And over time, such patients, even with treatment of the disease, develop symptoms of multiple myeloma.

Causes

Multiple myeloma, like most cancer pathologies (Ewing's sarcoma), does not have a clearly identified cause. This means that only a few factors have been identified that trigger or stimulate the tumor process.

The oncological process itself is considered low-malignant. That is, the disease takes a long time (20–30 years) from the moment of degeneration of the first progenitor cell to the appearance of clear symptoms.

Presumably the following factors lead to the development of the disease:

  • Hereditary predisposition.
  • Ionizing radiation.
  • Environmental factors (chemical and physical carcinogens).

People get sick more often when they reach old age. Men are more susceptible to this disease than women. There are known cases of familial plasmacytoma.

The most common myeloma disease is believed to be caused by ionizing radiation and mutation of B lymphocytes. An indirect connection between this disease and work environment factors has been identified. As a result, it most often affects people associated with work in the oil refining industry, tanners, woodworkers and farmers.

Development

B-lymphocytes degenerate when they are mature, at the stage of their differentiation. Myeloma lesions are characterized by the presence of atypical plasma cells of varying degrees of maturity. Some have several nuclei and nucleoli, some are abnormally large. Pale colored plasma cells are found. But all are characterized by uncontrolled self-reproduction through division.

When such pathological tissue grows, it inhibits normal healthy hematopoietic tissue. This leads to a decrease in the blood's formed elements (erythrocytes, platelets and leukocytes). The level of certain chemicals that provide the body's immune response (for example, lysozyme, etc.) decreases.

Tumor cells are not able to provide a full protective function of the body, because normal antibodies are either not produced or are quickly destroyed.

The favorite localization of the myeloma tumor process is flat bones. These include:

  • Scull.
  • Pelvic bones and bone tissue of the ribs.
  • Spinal tissues.
  • Infiltrates containing tumor cells can also be found in other organs.

The x-ray image clearly shows the cavities formed in the areas where the tumor grows. Cavities are formed due to lysis (dissolution of cells) and resorption (reabsorption) of bone tissue. This type of resorption is called axillary.

The general clinical picture of the disease is caused by the proliferation of degenerated plasma cells and hypersecretion of monoclonal immunoglobulin.

Symptoms

The onset of the disease, the so-called preclinical period, proceeds without complaints, there are no subjective symptoms. The disease is detected randomly during a laboratory blood test.

As the disease progresses, symptoms associated with tumor damage to bones and internal organs appear. The most characteristic are:

  1. Bone symptoms.
  2. Nephropathy.
  3. Changes in the blood system (anemia, coagulation disorders, increased ESR).
  4. Immunodeficiency.

The first symptoms are, as a rule, complaints of pain in the spine, sternum, pelvic bones, ribs and clavicular area. Pain syndrome occurs first with palpation (pressure with fingers), then simply with movement.

Plasmocytosis of bone tissue, osteolysis and osteoporosis lead to the appearance of so-called spontaneous fractures, and those bones that normally break infrequently even with injuries and bruises. The first to be affected are the flat bones (ribs, clavicle fracture).

Fractures can also affect some parts of the spine. Most often, compression (non-displacement) fractures occur in the lumbar spine; the second most common fractures are the thoracic vertebrae.

Spinal fractures are fraught with serious consequences. Their symptoms depend on the damage done to the spinal cord. There may be shortening of growth and compression of the spinal cord. The latter leads to the appearance of symptoms of radiculopathy, impaired sensitivity, and the functioning of the pelvic organs (intestinal motility and bladder function) is inhibited. In addition to the spine and flat bones, joints are affected.

Amyloidosis is a disorder of protein metabolism that leads to the deposition of a specific complex, amyloid, in tissues. With amyloidosis of myeloma nature, patients complain of symptoms associated with damage to one or another organ (heart, kidneys, gastrointestinal tract, eyes). You may also develop:

  • Heart or kidney failure.
  • Dyspepsia.
  • Mental disorders.
  • Neuropathies.
  • Sensory disturbances like stockings or gloves (although peripheral neuropathies are rare).
  • Skin infiltrates appear.
  • In rare cases, patients fall into a coma.

Disturbances in the blood system lead to hemorrhagic diathesis. These are capillary bleeding on the mucous membrane of the gums, nasopharynx, gastrointestinal tract, and uterus. Visually, bruises (hematomas) can be seen on the accessible mucous membranes. Anemia is characteristic of myeloma.

Due to paraprotein hypersecretion, ESR levels increase significantly (up to 80 mm/h) and blood viscosity increases. As a result, microcirculation in the most important organs of the human body is disrupted. These phenomena explain many neurological symptoms (including increased drowsiness, dizziness, headaches).

Generalized plasmacytoma leads to disturbances in the functioning of the organ of vision or to complete loss of vision. When the pathoprocess is localized in the bones of the skull, the cranial nerves, including the optic and oculomotor nerves, may also be affected. This leads to ophthalmoplegia (paralysis of the eye muscles).

Vision loss is associated with myeloma retinopathy (damage to the retina of the eyeball). In this case, thrombosis of the retinal venous network develops, and the optic nerve itself swells, up to its atrophy. The person gradually becomes blind.

The ability of the immune system to fight infectious agents (herpetic infections, coccal infections) decreases almost with the onset of the disease. It only intensifies with its development. Almost 50% of patients with multiple myeloma suffer from severe infectious complications. This condition, associated with increased sensitivity to bacterial infections, leads to the development of pyelonephritis, pneumonia and other inflammatory processes.

It is severe illnesses that often lead to the death of the patient, and not myeloma as such.

Diagnostics

The study for any disease begins with a general detailed blood test and a general urinalysis. A blood test can reveal changes in the content of formed elements. But the main indicator that can indicate further direction of research is the ESR level. A specific protein (serum paraprotein) is detected in the urine.

Diagnosis of multiple myeloma also includes:

  • Blood tests (bio- and immunochemical).
  • Biopsy analysis.
  • Radiography.
  • MRI, CT.

Biochemical analysis reveals increased concentrations in the blood of certain chemical compounds (creatinine, total protein, urea and some others). Immunochemistry determines the pathological paraprotein. X-rays reveal areas of bone tissue melting.

MRI allows one to differentiate generalized plasmacytoma from other bone lesions and identify lesions in other organs and tissues. The material obtained by puncture reveals a large number of pasmocytes.

The diagnosis is made based on 3 main criteria:

  • Detection of plasma cells in the myelogram.
  • Detection of monoclonal immunoglobulin in blood and urine tests.
  • Organ damage associated with the development of the tumor process.

The main importance in diagnosis is the examination of a biopsy specimen and the detection of a tumor process in the organs and tissues of the human body. It allows you to identify patients with a symptomatic form of the oncological process.

Treatment

Today, treatment of multiple myeloma involves its control. A cure, at least a potential one, can only be discussed with a bone marrow transplant.

Plasmacytoma is a well-controlled disease; with early detection and proper treatment, long-term remission is possible. The initial stages of smoldering forms of the disease do not require immediate intervention. Conversely, the last stage requires rapid and intensive therapy to prolong the patient’s life.

Treatment of Rustitsky-Kahlen disease involves:

  • Initial therapy.
  • Supportive.
  • Treatment of relapses and persistent forms.

The main method of treatment is chemotherapy (monochemotherapy, polychemotherapy). But this does not exclude the use of other methods:

  • Stem cell transplantation (auto- and alletransplantation, that is, transplantation of one’s own or donor cells).
  • Surgical intervention.
  • Radiation therapy.
  • Symptomatic measures.

Let's look at these treatment methods in more detail.

Operation

Surgery is performed when there is compression of internal organs or the spinal cord, which leads to severe disruption of the functioning of internal organs.

For spinal cord compression, lamyectomy (removal of the vertebral arch) and kyphoplasty in combination with treatment with Dexamethasone are practiced. In the case of a localized lesion (with solitary myeloma), surgery is also recommended, this time to remove the tumor.

Irradiation

The use of radiation therapy may be justified in cases of limited bone tissue lesions and high tumor resistance to chemotherapeutic agents. It is also recommended as palliative measures (maintaining quality of life) in patients who cannot take chemotherapy.

In what cases is radiation therapy prohibited:

  1. In severe renal failure.
  2. In older people.
  3. Physically weakened patients.

This method is often used to treat a pathological process localized in the facial bones of the skull.

Treatment of symptoms

Symptomatic therapy is designed to improve the patient’s quality of life and, if possible, eliminate the consequences of the tumor. It includes orthopedic care, medications: analgesics, hemostatics, drugs for correcting hypercalcemia. For acute anemia - erythropoietin or red blood cell transfusion.

Modern chemotherapy

It involves the use of several drug options for the treatment of generalized plasmacytomas. In some cases, one remedy is used, in others a combination of them is used.

The main medications are:

  • Drugs for the treatment of multiple myeloma.
  • Corticosteroids.
  • Apoptosis inducers (drugs that trigger the self-destruction mechanism of tumor cells).
  • Agents that stimulate immune cells and inhibit tumor cells.

Specific drugs for the treatment of plasmacytoma (Melphalan) are used as monotherapy or in combination with corticosteroids (Prednisolone). They are effective only in half of the cases.

Alkating cytostatics (Cyclophosphamide) give good results in combination therapy with the latest antitumor drugs and hormones. Their mechanism of action is based on the addition of a certain group to DNA, which is called alkyl. This prevents the altered cell from dividing and slows down the growth of the tumor.

Apoptosis inducers (Bortezomib) are used either alone or in combination with an antitumor agent and cortecosteroids. Its use does not eliminate the need for transplantation.

New cytostatics (Lenalidamide) combine antitumor properties with the ability to stimulate the body's immune cells. Their use in combination with hormones and alkalizing agents gives quite good results.

Treatment with Lenalidamide with other drugs extends the patient’s life by 4–5 years, while life expectancy with standard therapy averages from 1.5 to 3.5 years.

Thalidomide is considered a popular means of controlling generalized plasmacytomas. This drug is aimed at inhibiting pathological angiogenesis (the growth of blood vessels through the tumor, the formation of the oncological tissue’s own blood supply system). Good results are obtained by using Thalidomide with standard chemotherapy regimens.

Stages of treatment

The initial stage of therapy depends on the age of the patient and his condition. If the patient is under 65 years old and his general health allows, therapy is usually carried out in several steps:

  • Preparation.
  • High-dose chemotherapy.
  • Transplantation of your own stem cells.

The first stage consists of induction therapy using new cytostatics (Bortezomib, Lenalidamide). Then high doses of Melphalan are administered and only then the transplantation is done.

Not all patients can tolerate such treatment. Elderly, physically weakened or people with severe somatic illnesses are not able to withstand high doses of chemicals. They are prescribed low-dose combination therapy (Melfan + Prednisolone).

Maintenance therapy is designed to prolong the life of patients who have received high-dose therapy and undergone transplantation. Usually, new cytostatics are used for this, the same as those used at the preparatory stage of treatment.

Relapses of the disease occur in any case. Their treatment can be a repetition of the first course completed, including the use of transplantation. Or medications are prescribed that were not used in first-line therapy, that is, medications that have a different mechanism of influence on the cancer cell. Or the use of stronger agents that are aggressive to resistant pathological cells (Pomalidomide) is practiced.

As a rule, for therapy-resistant forms of Rustitsky-Kahlen disease, combined chemotherapy methods are used: cytostatics with Dexamethasone.

Forecast

If myeloma is in the first stage or smoldering or monoclonal gammopathy is diagnosed, patients live a long time (20–30 years) even without intensive courses of treatment. When diagnosed in the last stage of symptomatic myeloma, patients, even with treatment, live about 3–3.5 years. Recent innovations in pharmacology can extend this period to 5 years.

Unfortunately, to date, multiple myeloma has no effective treatment. So only timely diagnosis of the disease will allow a person to enjoy life longer.

Main symptoms of spinal cancer and diagnostic methods

Like any malignant tumor, spinal cancer is characterized by rapid growth of atypical cells. As a result, the symptoms of spinal cancer progress rapidly. The patient experiences not only pain, but also severe motor and neurological disorders.

The essence of pathology

As a matter of fact, from a medical point of view, in relation to the spine, the term “cancer” is not entirely appropriate. The fact is that cancer formation occurs from epithelial tissue cells, i.e. from the skin and mucous membranes. The spinal column is connective tissue - bones, cartilage, ligaments. Here there is a slightly different histological type of tumor - sarcoma. It can develop from both bones (osteosarcoma) and cartilage (chondrosarcoma).

In addition, in the lumen of the spinal canal formed by the vertebrae there is the spinal cord and its membranes. Various blastomas can form from the nervous tissue of the spinal cord - medulloblastomas, glioblastomas. Malignant spinal tumors can grow both from the substance of the spinal cord itself (intramedullary) and penetrate from the spinal membranes (extramedullary).

However, all these histological subtleties have almost no effect on the essence of the pathological process. Therefore, we will call all malignant tumors of the spine with the common term “cancer.” It should also be noted that sometimes the penetration of cancer into the spine is secondary, metastatic. This means that cancer cells are brought here by blood or lymph flow from other organs - stomach, lungs, liver, etc.

General manifestations

The insidiousness of spinal cancer is that the signs of this disease develop gradually, gradually. And the patient does not attach due importance to them until a certain time. He believes that he has osteochondrosis, lumbosacral radiculitis, and fatigue. As a result, precious time is lost, and in this case, delay is literally like death. The sooner you start treatment, the greater the chances of a favorable outcome.

Signs of spinal cancer include general and local manifestations, as well as neurological symptoms. General manifestations are weakness, decreased performance, often a moderate increase in temperature to subfebrile levels (370 - 380C). In later stages, the so-called cancer cachexia - exhaustion. The patient loses weight, muscle atrophy occurs, and the subcutaneous fat layer thins. Cachexia is accompanied by disruption of the functioning of all respiratory, circulatory, digestive, and internal secretion systems.

Local manifestations of spinal cancer are, first of all, pain. The pain is moderate at first, but in the final stages it becomes so unbearable that only drugs can eliminate it. In addition to pain, visible deformation of individual vertebrae and their spinous processes can be determined. Deformation of the vertebrae is sometimes accompanied by curvature of the entire spine - scoliosis. Often (but not always) a cancerous tumor can be determined by palpation (feeling) of the spine. Unlike benign tumors of the spine, cancer has an irregular shape, unclear contours, and is tightly fused to the surrounding tissues.

Neurological symptoms of cancer are caused by damage to the spinal cord, as well as the sensory and motor roots of the spinal nerves. These symptoms are characterized by neurological disorders of varying degrees - paresis and paralysis. Paresis (not to be confused with an incised wound or cut) is a partial, incomplete impairment of sensitivity and movement in a certain limb or area of ​​the body. Characterized by limited range of motion, a feeling of numbness, and crawling. Paralysis or plegia is a complete lack of movement and sensitivity in the affected area. Simply put, paresis and plegia are different stages of the same process, in this case cancer.

Symptoms at different locations

Cervical region

The higher the malignant tumor of the spine is located, the wider the area of ​​neurological disorders and the more pronounced the symptoms of cancer. In this regard, cancer of the cervical spine is most severe. Here, neurological disorders develop in all areas of the body located below the cervical tumor. First of all, this is paresis or plegia in all four limbs - the so-called. tetraparesis (tetraplegia). In the final stages of neck cancer, the thoracic intercostal muscles are paralyzed. As a result, it becomes difficult for the patient to breathe, and he is transferred to artificial ventilation (ALV), when breathing is carried out using a machine.

Due to compression of the spinal cord by the tumor, the circulation of the cerebrospinal fluid (CSF) is disrupted. As a result, cerebrospinal fluid accumulates in the ventricles of the brain, and intracranial pressure increases. This is accompanied by a severe headache, nausea, vomiting, impaired swallowing, varying degrees of loss of consciousness, even coma. For the cervical localization of the tumor, the so-called a symptom of a cerebrospinal fluid push - when pressing on the jugular veins of the neck, pain occurs at the location of the cancer. Another nonspecific sign of a violation of the outflow of cerebrospinal fluid is the occurrence of a headache when tilting the head forward.

Thoracic region

With thoracic cancer, paresis of the upper limbs, respiratory disorders, and disturbances in the functioning of the chest organs may develop. Here, too, much depends on the level of the tumor. Due to damage to the spinal cord and spinal nerve roots, the innervation of the heart, lungs, and diaphragm is disrupted. This is accompanied by palpitations, irregular heart rhythm, shortness of breath, and various digestive disorders. The back muscles in the area of ​​the cancerous tumor are reflexively tense. Often such patients also need to be transferred to mechanical ventilation.

Lumbar region

With lumbar cancer, the pelvic organs, lower back and lower limbs are affected. Classic for this location of cancer is the so-called. cauda equina syndrome. The fact is that the spinal cord is shorter than the spinal canal - it ends somewhere at the level of the first lumbar vertebra. Below this level, the nerves passing through the spinal canal have the appearance of a bundle, resembling a horse's tail.

Sometimes the tumor can affect the fibers of the cauda equina. This is accompanied by symptoms such as:

  • Intense burning pain in the lower back, radiating to the lower extremities
  • Decreased muscle tone, paresis or plegia in both lower extremities
  • Urinary incontinence
  • Spontaneous defecation.

In addition, lumbar tumor leads to dysfunction of the genital organs. In men, this is manifested by difficulty in erection and ejaculation, in women – by various types of menstrual irregularities.

Diagnostic tests

Diagnosis of spinal cancer, like any disease, begins with an examination and interview of the patient. Already at this stage, the characteristic appearance (cachexia), complaints (pain in the spine) and neurological symptoms may lead the doctor to think about the presence of spinal cancer. But the clinical picture is not always so bright. As already mentioned regarding cancer, this disease is not only dangerous, but also insidious.

Therefore, special research methods are needed. Traditional radiography in 3 projections (direct, oblique and lateral) does not always allow recognizing a malignant process. Much more informative is layer-by-layer radiography performed on a computed tomograph (CT). However, even CT scans cannot always detect small tumors located deep within the spinal cord. In such cases, the most effective diagnostic method is nuclear magnetic resonance.

To clarify the nature of the tumor, a puncture (puncture) of the spinal canal is performed and cerebrospinal fluid is taken for laboratory tests. However, spinal puncture is possible only in the lumbar region, and in the overlying sections this intervention is associated with technical difficulties and a risk to the patient’s health. The prognosis for spinal cancer is always serious - the percentage of cases of disability and death is too high. It is believed that the outcome of cancer is favorable in cases where the patient, after timely and comprehensive treatment (chemotherapy, radiation therapy, surgery), lives for 5 years or more.

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Tenosynovitis of the tendon: long head of the biceps, popliteus and biceps brachii

Orthopedists and traumatologists often encounter a specific lesion, which is defined as tendon tenosynovitis. The pathology is characterized by a long latent course, which reduces the likelihood of timely consultation with a doctor. The disease causes excessive tendon stiffness, swelling, and pain. Treatment is complicated if the presence of microcrystals of salts in the tendons is confirmed, and they themselves have undergone fiber disintegration.

Causes

The active development of the disease is facilitated by infection of adjacent tissues or the penetration of pathogenic microflora into the tendon structure. In 80% of cases this occurs due to a puncture or other violation of the integrity of the tendons. Main routes of damage:

  1. Existing infections, especially STIs (in 90% of cases of identified infectious tenosynovitis, the patient suffered from gonorrhea).
  2. Physical trauma, after which the acquired acute infection is divided into monomicrobial and polymicrobial. Each of them progresses depending on the nature and extent of the damage.
  3. Physiological aging process (common cause of patellar tenosynovitis).
  4. Staphylococcus aureus migrating from the epidermis, with which the patient was previously infected.
  5. Animal bite and subsequent suppuration of the bite wound.
  6. Intravenous use of hard drugs (tenosynovitis of the long head of the biceps tendon is likely to occur).
  7. Open damage to the skin, the surface of which was exposed to fresh or salt water with the presence of mycobacteria.

Any of the above methods leads to tenosynovitis. This includes situations where the patient has not completed the full course of treatment for rheumatoid or reactive arthritis.

Symptoms

An examination is enough for a doctor to make a preliminary diagnosis. And using diagnostic methods, the doctor confirms it, determining the nuances of the pathology.

Tenosynovitis of the tendon of the long head of the biceps brachii muscle is a stenotic disease that manifests itself as a specific pulling pain. In 9 out of 10 cases, the patient complains that an unpleasant sensation covers the shoulder and spreads along the front surface of the arm (along the biceps muscle). Palpation of the affected area gives a painful sensation: its localization is the groove between the tubercles of the humerus and in the direction below, where the tendon is even better accessible to palpation. Due to the pain, the patient has difficulty abducting his arm.

Tenosynovitis of the popliteus tendon is manifested by the following distinctive features:

  • increase in pain after minor physical activity;
  • extensive swelling around the knee joint;
  • a clear hyperemia of the skin is visible.

Symptoms may be supplemented depending on the period of limitation of the lesion.

Diagnostics

Diagnosis of tendon tenosynovitis is difficult only because of the premature prescription of antibacterial therapy, which 60% of doctors carry out even before the final diagnosis is made. Laboratory research regarding the pathology in question is of secondary importance.

Methods for identifying tendon pathology are as follows:

  1. Laboratory research. In the blood, an increase in the content of leukocytes and an increase in ESR are established as indicators of an active inflammatory process.
  2. X-ray examination. The main goal of the method is to confirm the presence of tenosynovitis and exclude the concomitant development of osteomyelitis, bursitis, and arthritis.
  3. Ultrasound research. The method is informative and has advantages over MRI: low price, technical simplicity. Ultrasound does not involve the use of magnetic field energy. The procedure is safer for health and does not affect devices implanted inside the body (heart rate drivers). Ultrasound helps to study in detail the structures of tendons and ligaments, making it possible to differentiate tenosynovitis, including through the use of color Doppler mapping (CDC).
  4. MRI. The method provides an image of the entire joint, including the capsule with the glenohumeral ligaments, the articular cartilage on the head of the humerus. The muscles and tendons surrounding the joint and the synovial bursae are also visualized.

MRI and ultrasound of the shoulder or knee joint are not interchangeable diagnostic methods. The implementation of each of them involves specific goals and objectives.

Treatment

Delay in going to the hospital does not promise a positive prognosis - the disease progresses to an even more aggravated stage. Then the patient loses the opportunity to even self-care, and there is no need to talk about the implementation of work activity. One of the options for wasting time is the desire to normalize health using unofficial methods. Traditional medicine does not contain a single recipe that can restore the tendon-ligament apparatus. And patients taking decoctions and applying compresses to the body waste time, increasing the risk of developing disability.

Conservative

If the diagnostic results confirm that the existing disorder is tenosynovitis of the long head of the biceps tendon, treatment with conservative methods involves the following:

Type of treatment, prescribed group of drugs Purpose and features Possible side effects
Non-steroidal anti-inflammatory drugs.

Diclofenac, Nimesulide (Nise), Ibuprofen

 They reduce the spectrum of the inflammatory process and minimize pain. The listed medications are administered once a day for 10 days. Gastropathy
Painkillers.

Ketanov, Ketarol, Dexalgin, Analgin

 Analgesics are administered when NSAIDs are insufficiently effective, when pain in the limb persists. The drugs eliminate attacks of pain for 4-5 hours, which allows you to normalize your well-being and helps you cope with post-operative recovery. Gastropathy, sleep disturbance, arrhythmia
Diuretics

Furosemide, Lasix

 Therapy, the purpose of which is to reduce swelling. The dosage depends on the patient’s weight, the severity of edema Lower back pain at the level of the kidneys
Antibiotic therapy

Ceftriaxone, Ceftazidime

 Broad-spectrum antibiotics are prescribed if there is a proven relationship between tenosynovitis and an existing infection. The goal is to eliminate pathogenic microflora Intestinal disorder

To implement hormonal treatment, drugs from the glucocorticoid group are used - Dexamethasone and Prednisolone.

Injection of hormonal drugs, especially in chronic processes, does not provide a complete cure, increases the rate of collagen degradation, and negatively affects the production of new collagen (reduces its synthesis by 3 times).

The doctor expands general prescriptions with the active use of immunomodulatory agents and vitamin therapy.

More details

During conservative therapy, it is important not to load the affected joint; for this purpose, immobilization is performed with an orthosis. Local application of ointments is recommended: Nise, Dolobene, Ketonal.

Physiotherapy

Physiotherapeutic methods help normalize blood circulation, relieve or minimize pain, and improve metabolic processes in the affected area. Procedures that are advisable to prescribe if tenosynovitis of the biceps brachii tendon, popliteal fossa or other part is confirmed include magnetic therapy; laser therapy; applying thermal applications. The use of electrophoresis with novocaine will improve limb abduction and reduce pain.

Recently, radon baths have been actively used.

After the documented recognition of the safety of radon in the treatment of joint pathologies, interest in this gas is growing. The element’s demand is explained by its unique therapeutic capabilities.

Radon is an inert gas that is colorless and odorless. It is 7.5 times heavier than air, has 3 isotopes, the most important of which is 222 Yal with a half-life of 3.82 days.

Before performing radon baths, the doctor makes sure that the patient has no contraindications to the medical technology:

Among them:

  1. Fever of unknown origin.
  2. Oncological processes (confirmed) – the presence of malignant neoplasms, benign tumors that have a tendency to grow.
  3. All blood diseases.
  4. Heart rhythm disturbances (atrial fibrillation, extrasystole).
  5. Psycho-emotional disorders (epilepsy, neuroses, schizophrenia).
  6. Previous large-focal or multiple small-focal cerebral infarction.
  7. Professional activities associated with prolonged exposure to radioactive or electromagnetic radiation.
  8. The period of pregnancy and breastfeeding.
  9. Violation of the functional activity of the thyroid gland, high predisposition to its hyperfunction.
  10. Condition on the eve of surgery.
  11. Severe gynecological conditions - fibrocystic mastopathy, uterine fibroids, fibroids, adenomyosis, endometriosis.
  12. In men - prostate adenoma.
  13. Cholelithiasis.
  14. The presence of stones in any segment of the urinary system.
  15. Confirmed retinal detachment.
  16. The presence of defects on the skin, areas of weeping dermatitis, pathologies of fungal origin.
  17. Confirmed osteoporosis.

To determine the radon concentration for the procedure, the doctor is guided by the dominant pain manifestations. Dry air baths and traditional water baths are performed. The effect of the procedure is improved blood supply to the tissues adjacent to the joint; high probability of long-term pain relief (in 90% of cases).

Anton Epifanov about physiotherapy:

Surgery

Surgical intervention is performed in extreme cases when it is not possible to restore the limb using conservative methods. Surgical treatment is aggravated by the patient's age over 45 years, the presence of insulin-dependent diabetes mellitus, and if the etiology of tenosynovitis is the progression of a polymicrobial infection.

Tendon plastic surgery is a multi-stage, delicate operation. It involves subsequent long-term recovery and has a high price.

Treatment of joints Read more >>

The introduction of antibiotics a day before surgery and active intraoperative antibiotic therapy help eliminate the risk of complications in the postoperative period.

Features of anesthesia during surgery for tendon tenosynovitis:

  • in the choice of anesthesia, the short duration of the intervention, the absence of the need for deep relaxation, and the presence of adequate hemostatic measures are important;
  • modern medications provide adequate pain relief without threatening the patient’s life;
  • A common complication after surgery is short-term post-anesthesia depression. It provides the possibility of early transfer of the patient from the ICU (intensive care ward) with patient activation;
  • The depth of immersion in anesthesia is ensured by narcotic analgesics. In clinics with high financial support, they practice the most successful combination for anesthesia during short operations - Diprivan + narcotic analgesics (in 68% of cases). But the high cost of Diprivan limits its use in clinical practice. Hospitals with less funding use Ketamine for anesthesia. Its difference from Diprivan is specific: as patients recover from anesthesia, they need sedative therapy (carried out in standard dosages). It is important for the specialist to monitor the main vital signs - they must be stable throughout the entire surgical intervention.
  • In 23.3% of cases, barbiturates were used for anesthesia, mainly sodium thiopental in standard dosages. If the depth of anesthesia was sufficient, “controllability” of anesthesia causes certain difficulties. Long-term post-anesthesia depression is possible, requiring constant monitoring of the patient.

The prognosis for recovery is favorable (subject to early seeking of medical help). However, the patient should prepare: full recovery will take 3-4 months.

Conclusion

Tenosynovitis of the tendon can only be cured in a hospital setting, and therefore by the methods of official medicine. It is not safe to rely on alternative options. The most common cause of pathology is chronic damage. Orthopedists and traumatologists are involved in eliminating the disease. If tenosynovitis is of infectious origin, a venereologist is involved in drawing up a treatment plan.

There are several types of Dexamethasone - liquid forms (injections and eye drops) and tablets. They can all complement each other.

Solution for injection: main component - dexamethasone sodium phosphate, auxiliary components - glycerin, disodium phosphate dihydrate, disodium edetate, water for injection. It looks like a clear or light yellow liquid.

Tablets: the main component is dexamethasone, additional components are potato starch, sucrose and ancient acid. Description – white, round, flat tablets with a bevel.

Suspension for instillation into the eyes: the main component is dexamethasone sodium phosphate, additional components are water for injection, disodium edetate, borax, boric acid. Sold in the form of a white liquid ophthalmic suspension, in a five-milliliter bottle.

Dexamethasone is available in several dosage forms. The solution for injection is a clear liquid without any odor or impurities, colorless or with a slightly yellowish tint. The solution is available in brown glass ampoules with a volume of 1 or 2 ml, 25 pieces in a cardboard box with a detailed description for use.

The main active ingredient of the drug is dexamethasone sodium phosphate, as well as auxiliary components: methylparaben, water for injection, sodium metabisulfate, sodium hydroxide, disodium edetate.

  • 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).
  1. In ampoules of 1 ml or 2 ml in package No. 10,
  2. In ampoules of 1 ml or 2 ml in blister packs No. 5×1, No. 5×2.

Operating principle

Injections with the drug Dexamethasone are given both into a vein and into a muscle. It should be noted that the effect on the body occurs in different ways. With intravenous administration, the maximum effect of the drug on the blood plasma is achieved within five minutes, while after an intramuscular injection, a similar concentration will occur only after one hour.

Injecting the medicine into a vein gives a much greater therapeutic effect in the treatment of diseases than using injections into muscles or joint tissues, since absorption occurs several times slower.

There is also a difference in the duration of action of the drug after different uses:

  • Intramuscularly – from 18-27 days;
  • Local administration – 3 - 21 days.

Dexamethasone has a half-life of 23 to 72 hours. Metabolization occurs to a greater extent in the liver, less in the kidneys and other tissue structures. The main route of excretion is the kidneys.

Dexamethasone is made by changing the structure of a glucocorticoid called hydrocortisone. The product is widely used in various areas of medicine due to the fact that it has many effects. The course of treatment and dose are determined by the doctor.

The principle of action of the drug is associated with the following effects

Dexamethasone injection solution is a glucocorticosteroid of synthetic origin. The drug has a pronounced anti-inflammatory, immunosuppressive, antiallergic and decongestant effect.

After the injection of the drug, the therapeutic effect develops almost instantly and persists for a long time.

When a patient is simultaneously given injections of Dexamethasone and phenobarbital, ephedrine, and rifampicin, a decrease in the therapeutic effect of the hormones is observed.

When injections are prescribed simultaneously with diuretics, patients experience increased excretion of potassium from the body, which can cause the development of severe heart failure.

When concomitantly prescribing dexamethasone with sodium-containing medications, the risk of developing severe edema and increased blood pressure increases.

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

Eye drops with dexamethasone have antiallergic, antiexudative and anti-inflammatory effects.

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.

Dexamethasone is a hormonal drug with antiallergic, anti-inflammatory, immunosuppressive, desensitizing, antitoxic, and antishock activity.

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

The injection solution can be mixed in the following cases:

  1. only with 5% glucose solution;
  2. NaCl solution 0.9%.

Method of administration and dosage of the drug

Ampoules: Dexamethasone injections are given both intramuscularly and intravenously. The consumption rate of the drug is about 4-20 milligrams per day.

You need to inject it three to four times a day, for 4 days. Then they switch to Dexamethasone tablets.

The dosage is determined only by a doctor; it is highly not recommended to do this on your own. If you experience pain during a Dexamethasone injection, you should apply topically lidocaine in a spray or use lidocaine ointment.

Dexamethasone is also used when injections are given into the joint. A single dose can range from 0.4 to 4 mg. Injections are given no more than 3-4 times a year.

For the treatment of children, intramuscular administration is usually prescribed. They require special doses of injections, which will be approved by the attending physician. Depending on age and disease, dosages range from 7.5 to 167 mcg/kg per day. Typically, Dexamethasone injections are used for the first three days, then continue to be taken in tablet form.

The injection solution is also used to prepare compresses to relieve joint pain. To do this, you need to prepare a mixture of 50 ml of distilled water (or saline solution), 50 ml of Demixide and 1 ampoule (1 ml) of Dexamethasone, in which it is good to moisten a bandage folded in 3-4 layers and apply it to the sore joint.

Wrap the top with a plastic bag, then with a woolen scarf and secure the structure with an elastic bandage. Keep for 20 to 60 minutes.

Repeat the procedure for 7-14 days, no more than once a day.

Tablets: For an adult, ten milligrams of medication is prescribed once every 24 hours at the beginning of therapy. Later there is a decrease to four to two milligrams. For effective therapy, it is recommended to drink the norm in three equal parts - for better absorption of Dexamethasone. An individual dosage is also selected for children, which usually ranges from 8-3 mcg/kg per day.

Ophthalmic suspension (eye drops): They can be used every two hours, one drop after the patient feels better, every four or six hours. Children are recommended to use drops for 10 days, one drop 2-3 times a day.

The drug Dexamethasone in the form of an injection solution is intended for intravenous jet administration, intravenous drip infusions, and intramuscular injections. In addition, local injection of the solution into the pathological focus is allowed if necessary and according to indications.

The dose of the drug is determined by the doctor strictly on an individual basis for each individual patient, depending on the indications and his general condition. To prepare a solution for intravenous infusion, physiological sodium chloride solution or 5% dextrose solution is used as a solvent.

The dose of the drug for the treatment of acute allergic reactions in children is calculated individually, based on the body weight and general condition of the patient.

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.
  • For cerebral edema (CBE), 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. For cancer, 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.
  • For 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.

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

Inhalation use of Dexamethasone is indicated for acute inflammatory diseases of the respiratory tract (for example, bronchitis or laryngitis, as well as 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 from 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 cortisol 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.

Overdose

Usually manifests itself with pronounced side effects, listed below. With these negative consequences of therapy, treatment of individual symptoms is used, in which it is important to maintain the normal functioning of the human body. There were no reports of deaths or poisoning from overdoses.

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.

Excessive administration of the drug can cause an overdose, which is manifested by increased side effects, as well as hypercortisolism syndrome (Cushing's syndrome).

Therapy is symptomatic; at the same time, a dose reduction or discontinuation of the drug for a while is required.

Contraindications

Particular attention should be paid to the list of health conditions and diseases for which the use of this medication is extremely undesirable, these include:

  • Hypersensitivity to one of the ingredients of the medicine;
  • The presence of any fungal infections, if there is no therapeutic treatment;
  • Not for Cushing's syndrome;
  • If the patient has poor blood clotting;
  • When vaccinated with a live vaccine;
  • For stomach and duodenal ulcers;
  • For osteoporotic phenomena;
  • During pregnancy and breastfeeding;
  • For mental disorders and epilepsy;
  • For various eye ailments;
  • If you have kidney failure, hepatitis or cirrhosis;
  • For sexually transmitted diseases and tuberculosis.

Reviews from doctors and patients are mostly positive, except in cases where there is no compatibility with the excipients of the drug. Patients claim that this drug acts quickly, but causes addiction to the body and severe withdrawal from the substance.

Contraindications:

  • alcohol during treatment;
  • individual intolerance to the main component or its excipients;
  • galactosemia, lactase deficiency.

Side effects

Side effects:

  • increased appetite, weight gain;
  • potassium and calcium are removed from the body;
  • complex consequences - withdrawal syndrome (the hormone acts like a drug for the body, you need to stop taking the drug slowly, gradually);
  • symptoms of poisoning, ulcers, pancreatitis appear in case of overdose;
  • increased intraocular pressure;
  • amyotrophy.

When taking a large dose of Dexamethasone, there is nothing left to do but remove it from the body by rinsing and enema. You can call an ambulance.

This drug is indicated for many diseases, but most often for the treatment of allergic reactions and joints, for this reason the latter need to be considered in more detail and separately.

Other indications

If you need help with shock and Quincke's edema, the only contraindication that you should pay attention to is the body's intolerance to the drug.

Also, when a person needs to use systemic treatment with Dexamethasone, he should pay attention to all contraindications.

According to the instructions for use, the following contraindications exist:

Reviews from doctors are always positive (if the drug is used as it should be).

Contraindicated in case of individual hypersensitivity, glaucoma, severe generalized infections.

It should also not be prescribed if testosterone is high.

Despite the wide range of diseases for which Dexamethasone is used, it also has numerous contraindications. So, the drug should not be taken if the patient has:

  • intolerance to the components of the drug;
  • diseases caused by viruses, infections, fungi: common herpes, amoebiasis, fungal skin lesions, overt or dormant tuberculosis;
  • diseases of the digestive system: stomach or duodenal ulcers, inflammation of the esophagus, gastritis, consequences of surgery, ulcerative colitis, diverticulitis;
  • immunodeficiency states of the body;
  • diseases of the endocrine system: diabetes mellitus, hypothyroidism, Itsenko-Cushing syndrome;
  • heart and vascular diseases: post-infarction condition, heart failure;
  • severe chronic kidney/liver failure;
  • diseases of the skeletal system: systemic osteoporosis, poliomyelitis;
  • other diseases: nephroulitiasis, hypoalbuminemia, glaucoma.

Dexamethasone can be used for treatment only as prescribed by a specialist. Before starting therapy, the patient should carefully read the accompanying instructions, since Dexamethasone has some contraindications and restrictions for use.

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

The use of Dexamethasone is contraindicated in those patients who have very hypersensitivity to the components of the drug.

Today, pharmacological companies have learned to create hormonal drugs that are used to treat chronic and acute diseases; one of these drugs is Dexamethasone injections. Drugs of this type are synthesized analogues of those hormones produced by the body.

Overdose

There are several ways to use the medicine:

  • Intravenously;
  • Intramuscularly;
  • Inside the joints;
  • Periarticular method;
  • Retrobulbar.

The dosage and the regimen itself according to which therapy is carried out are strictly individual and depend on the condition and indicators of each patient, as well as on the personal reaction to the drug.

For droppers and intravenous administration of the drug, the solution is usually prepared using an isotonic sodium chloride solution; you can also take a five percent dextrose solution. For adult patients who are in a serious or acute condition requiring immediate assistance, the medicine is injected into a vein in different ways: drip, jet or slow.

The dose can be different, from 4 to 20 mg up to three or four times throughout the day. The highest dose reaches 80 mg.

To maintain a stable condition, you can use from 0.2 to 9 mg per day, with a course of no more than four days, after which you need to switch to Dexamethasone tablets.

For children, there is a dose several times smaller, it is limited to 0.02776 - 0.16665 mg per kilogram of the child’s weight. It is administered in periods of 12 or 24 hours.

If we talk about local therapy, then various doses are also used here, which are recommended by the attending physician, based on the medical history and general condition of the person. We can only give approximate figures that may correspond to various pathological conditions:

  • For diseases of large joints, such as knees, you can give injections with the medicine in a dose of 2 to 4 mg;
  • If smaller joints, such as the interphalangeal parts, hurt, then the dosage is lower, from 0.9 to 1 mg;
  • For pain in the joint capsules – 2-3 mg;
  • For tendon lesions - 0.4 – 1 mg;
  • For soft tissues – 2-6 mg.

When an adult patient has shock of any origin, a single dose of up to 20 mg into a vein is required.

With subsequent administration in the same way but at a lower dose - 3 mg by continuous infusion throughout the day or a single dose of 40 mg every 6 hours.

If an adult patient is affected by cerebral edema, first administer 10 mg, followed by 4 mg each for the next six hours until the acute symptoms disappear. After a period of 3 to 4 days, the dose is reduced and then the drug is stopped.

For allergies in the acute stage or chronic allergic disease, Dexamethasone is prescribed with a combination of oral and injection use according to a special schedule:

  • First day: injections from 1 to 8 mg and tablets 0.75 mg;
  • On the second day, two tablets twice a day;
  • The third day is the same;
  • Fourth day, two tablets twice;
  • On the fifth and sixth days, take a tablet 2 times a day;
  • Next observation.

It should be noted that independent use of tablets, and especially self-medication, is strictly prohibited, since this medicine can cause the most severe health consequences, exacerbations and complications that are life-threatening to the patient.

The dosage must be strictly observed, especially when it comes to children, as they are more sensitive. A reaction to an exceeded dose will not be long in coming in the form of negative side effects and an unpredictable reaction of the body.

Dexamethasone during pregnancy

This medicine can be prescribed during pregnancy only if the therapeutic effect is much higher than the risk to pregnancy. The type of medicine and dosage is determined by a specialist. However, with long-term therapy, it has previously been observed that the possibility of fetal growth retardation cannot be ruled out.

In the third trimester, the prescribed drug may cause developmental delays or the appearance of pathologies in the unborn child.

If treatment with this medication is required during lactation, it should be stopped and the child should be switched to dry formula.

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).

Content

If a person has health problems, he immediately turns to pharmacological agents, so each of us must have a good understanding of what one or another of them is intended for. For example, Dexamethasone tablets have several areas of application, in addition, this medicine has many analogues. Read about the cases in which this drug can be prescribed, how it acts on the body and what substances it contains.

What is Dexamethasone

The drug belongs to the category of synthetic glucocorticoids. Available in tablets, eye drops, ampoules. The trade name and international nonproprietary name (INN) in the register of medicines (RMN) are the same - Dexamethazon. The medicine is intended to regulate carbohydrate, protein and mineral metabolism. The pharmacodynamics of tablets are characterized by the following actions:

  • anti-inflammatory;
  • antitoxic;
  • desensitizing;
  • immunosuppressive;
  • antiallergic;
  • anti-shock.

Compound

One flat round white tablet contains 0.5 mg of the main active ingredient - dexamethasone. They are packaged in 10 pieces in blisters or vials made of darkened glass. In addition, each Dexamethasone tablet contains the following auxiliary components:

  • lactose monohydrate;
  • colloidal anhydrous silica;
  • corn starch;
  • talc;
  • povidone;
  • magnesium stearate.

Indications for use

Dexamethasone can be prescribed for a huge number of diseases, divided into several groups. The tablets help against the following types of acute and chronic diseases of the musculoskeletal system:

  • gouty and polyarthritic joint damage;
  • epicondylitis;
  • polyarthritis;
  • rheumatism;
  • synovitis;
  • osteoarthritis;
  • tenosynovitis;
  • osteochondrosis;
  • humeroscapular periarthritis;
  • bursitis;
  • ankylosing spondylitis;
  • juvenile arthritis.

The hormone Dexamethasone can be prescribed for the following systemic connective lesions:

  • rheumatoid arthritis;
  • systemic lupus erythematosus;
  • periarteritis;
  • scleroderma;
  • dermatomyositis.

If a person has a cold or allergies and has difficulty breathing due to increased mucus production, the doctor may also prescribe Dexamethasone or substitutes. Other tablets are prescribed for the following skin diseases:

  • pemphigus;
  • contact, toxic, seborrheic, bullous herpetiformis, exfoliative, atopic dermatitis;
  • psoriasis;
  • malignant weeping erythema.

Eye pathologies for which tablets are prescribed:

  • allergic corneal ulcers;
  • inflammation of the optic nerve;
  • allergic conjunctivitis;
  • indolent uveitis.

Tablets are prescribed for the following diseases of the hematopoietic system:

  • erythrocyte, hypoplastic, erythroid, autoimmune hemolytic anemia;
  • thrombocytopenic purpura;
  • agranulocytosis;
  • acute leukemia;
  • lymphogranulomatosis.

Other diseases that can be treated with Dexamethasone tablets:

  • congenital proliferation of the adrenal cortex;
  • different types of cerebral edema;
  • differential diagnosis of hyperfunction and tumor process of the adrenal cortex;
  • elevated calcium levels;
  • autoimmune kidney damage;
  • prevention of implant rejection during transplantology;
  • nephrotic syndrome;
  • hepatitis;
  • sarcoidosis;
  • enteritis;
  • fibrosis;
  • Crohn's disease;
  • acute alveolitis;
  • ulcerative colitis;
  • pulmonary forms of tuberculosis;
  • multiple sclerosis;
  • lung tumors;
  • aspiration pneumonia.

Contraindications

According to the annotation, the tablets should not be used for:

  • under 6 years of age;
  • hypersensitivity to the components of the tablets;
  • liver cirrhosis;
  • stomach or duodenal ulcer;
  • chronic hepatitis;
  • osteoporosis;
  • pregnancy, lactation;
  • acute viral, fungal, bacterial infections;
  • active form of tuberculosis;
  • Cushing's syndrome;
  • sore throat;
  • esophagitis;
  • acute psychosis;
  • polio;
  • some heart diseases;
  • severe arterial hypertension;
  • obesity 3-4 degrees;
  • severe renal failure.

Side effects

As a result of taking Dexamethasone tablets, the following diseases and consequences may develop:

  • acute pancreatitis;
  • bronchospastic manifestations;
  • nausea;
  • liver damage;
  • intestinal bleeding;
  • abdominal pain;
  • increased appetite;
  • feces with blood;
  • heartburn;
  • esophagitis;
  • vomit;
  • thinning of the skin;
  • allergy;
  • acne;
  • anaphylactic shock;
  • sexual dysfunction;
  • arrhythmia;
  • increased sweating;
  • adrenal insufficiency;
  • the appearance of excess weight;
  • Itsenko-Cushing syndrome;
  • water retention;
  • disruptions of the menstrual cycle;
  • convulsions;
  • bradycardia;
  • visual and hearing disorders;
  • increased intracranial pressure;
  • psychosis;
  • depression;
  • dizziness;
  • insomnia;
  • irritability.

Dexamethasone - instructions for use

There are different schemes for using a hormonal drug based on what disease you want to overcome with its help. Your doctor should tell you how to take Dexamethasone tablets correctly, after making an accurate diagnosis. General recommendations:

  1. The initial dose of tablets for an adult per day is 0.5-9 mg.
  2. Maintenance intake – 0.5-3 mg per day.
  3. The maximum daily dose is 10-15 mg.
  4. If Dexamethasone tablets have a therapeutic effect, the dose is gradually reduced by 0.5 mg every three days to a maintenance minimum.
  5. The drug should be taken 2-4 times a day with meals.
  6. In case of an overdose of tablets, you should immediately consult a doctor.
  7. Be sure to check how Dexamethasone interacts with other medications prescribed to you, and whether taking it together will cause harm.

For oncology

As a rule, for some types of cancer, Dexamethasone can be prescribed to improve the patient’s general condition, as part of complex therapy. The tablets have relatively few side effects. Dexamethasone for oncology should be taken 7.5-10 mg per day. Taking pills is allowed only as prescribed by a doctor. It is preferable to be hospitalized at an oncology clinic during the admission period.

For bronchitis

Sometimes a drug is prescribed for this disease, but not in tablets. Dexamethasone for bronchitis and exacerbations of bronchial asthma is used in ampoules by inhalation. It helps prevent bronchospasm and relieve severe coughing attacks. 0.5 ml of medication is diluted in 2-3 ml of saline solution. Inhalation of the resulting product is given to adults and children three times a day for a week. This allows you to significantly alleviate the patient’s condition in a relatively short period of time.

For conjunctivitis

The drug is prescribed for many eye diseases, but not in tablets, but in drops. for conjunctivitis and other acute inflammations, treatment lasts two days. 1-2 drops are dropped into the eyes 4-5 times a day. If the disease is chronic, the course of treatment lasts from three to six weeks. In this case, 1-2 drops of Dexamethasone are instilled into the eyes twice a day. If the medicine gets on the cornea, a burning sensation is possible, which quickly passes, but this phenomenon is not considered a side effect.

For children

Depending on the diagnosis, 83-333 mcg of the drug per day is prescribed. The instructions for Dexamethasone recommend that treatment be carried out only according to strict indications and that the processes of development and growth of the child be strictly monitored throughout the entire period, because the pills at any time can provoke a slowdown and even a complete cessation. Therapy should be stopped gradually, reducing the dosage every three days to gradually eliminate hormones.

Dexamethasone analogs

Drugs with similar properties have a similar effect:

  • Megadexane;
  • Dexazone;
  • Dekatron;
  • Fortecortin;
  • Dexaven;
  • Pharmadex;
  • Oftan Dexamethasone;
  • Dexamed;
  • Maxidex;
  • Dexamethasonelong;
  • Dexon;
  • Medexol;
  • Dexacort;
  • Dexapos;
  • Dexafar.

Price

You can purchase the drug only if you have a doctor's prescription. You can buy Dexamethasone at any pharmacy. In addition, the tablets are presented at affordable prices in the catalogs of specialized online stores that sell medicines. How much Dexamethasone costs depends on the form of release, the number of tablets, and the manufacturer. The price of a blister for 10 pieces in Moscow varies from 18 to 45 rubles.

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    Dexamethasone is a very powerful hormonal drug.

    Dexamethasone injections are usually given in emergency situations: severe asthmatic attacks, cerebral edema, severe allergies (anaphylactic shock) and other life-threatening conditions.

    It is rare that these injections are prescribed in courses - only for very severe illnesses and too frequent attacks.

    If you inject Dexamethasone for 10 days in a row, you can slightly disrupt your endocrine system.

    Whatever the doctors say, from the experience of the patients themselves, this drug is so full of side effects that there is nowhere else to go.

    Taking Dexamethasone injections for three days is the safest thing for health.

    A week is tolerable, but you will need a diet, in which it is necessary to exclude carbohydrates from the diet.

    A month is the longest course that can be carried out with Dexamethasone injections and on a strict carbohydrate-free diet.

    It is advisable, after several days of treatment with injections (3 - 5 days), to switch to the tablet form.

    A synthetic glucocorticosteroid called Dexamethasone is used in medicine as an anti-inflammatory drug with an immunosuppressive effect.

    Dexamethasone also has a strong antiallergic effect.

    The duration of treatment with Dexamethasone depends on the disease and its severity.

    In each specific case, the doctor must individually prescribe a treatment regimen, dosage and time for taking the drug.

    For example, for cerebral edema, this drug can be used for up to 7 days, but usually the period of administration of dexamethasone injections should not exceed 4 days.

    Is it possible to take IM Dexamethasone and simultaneously take pain relief with Tromodol or Dolmen? Thank you.

    Injections with the drug dexamethasone are given to treat many diseases. It is necessary to highlight the main indications when starting to use this medicine.

    To determine how long you can inject dexamethasone, be sure to study the instructions.

    Any instructions for the medicine are useful, as they contain all the necessary information on the medicine that needs to be taken. There is a section in the instructions called: Methods of use and doses.

    This section contains the information you need. From the instructions for dexamethasone it follows that the number of injections depends on the type of disease, so I am posting this section here:

    Dexamethasone is a very serious drug, so it should be injected only after the recommendation of a doctor. He also selects the required dosage and number of injections.

    The drug is usually prescribed for injection for no more than four days; in exceptional cases, the course of injections is extended.

    The side effects of this drug are more than serious: confusion, hallucinations, restless behavior, disorientation, depression, decreased muscle mass, osteoporosis, weight gain, disruptions in the menstrual cycle, growth retardation in childhood, increased blood pressure, thrombosis, etc. .

    Dexamethasone removes calcium from the body, so it’s good to take Calcium D3.

Inflammatory processes in modern medicine are treated with the help of hormonal drugs, which are analogues of the hormone of the adrenal cortex. These medications include Dexamethasone injections, which allows them to be used to treat joint diseases and relieve allergic reactions.


Dexamethasone has anti-inflammatory, desensitizing (reduces sensitivity to allergens), antiallergic, antishock and antitoxic properties. The use of Dexamethasone increases the sensitivity of proteins of the outer cell membrane. Properties of the drug and its use

The substance Dexamethasone is a synthetic analogue of the secretion of the adrenal cortex, which is normally produced in humans, and has the following effects on the body:

  1. It reacts with the receptor protein, which allows the substance to penetrate directly into the nuclei of membrane cells.
  2. Activates a number of metabolic processes by inhibiting the enzyme phospholipase.
  3. Blocks mediators of inflammatory processes in the immune system.
  4. Inhibits the production of enzymes that affect protein breakdown, thereby improving the metabolism of bone and cartilage tissue.
  5. Reduces the production of leukocytes.
  6. Reduces vascular permeability, thereby preventing the spread of inflammatory processes.

As a result of the listed properties, the substance Dexamethasone has a powerful antiallergic, anti-inflammatory, anti-shock, and immunosuppressive effect.

Important! A distinctive positive property of the drug is that when administered intravenously, it has an almost instantaneous effect (when administered intramuscularly, after 8 hours).

Dexamethasone in ampoules is used for the systemic treatment of pathologies, in cases where local therapy and internal medication have not produced any results, or their use is impossible.

Dexamethasone 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


Dexamethasone injections can be purchased for 35-60 rubles, or replaced with analogues, including Oftan Dexamethasone, Maxidex, Metazon, Dexasone

Most often, Dexamethasone injections are used to relieve allergic reactions, as well as to treat joint diseases. The description of the drug indicates the following conditions and diseases for which Dexamethasone is used:

  • Development of acute adrenal insufficiency;
  • Rheumatic pathologies;
  • Intestinal diseases of unknown nature;
  • Shock conditions;
  • Acute forms of thrombocytopenia, hemolytic anemia, severe types of diseases of an infectious nature;
  • Skin pathologies: eczema, psoriasis, dermatitis;
  • Bursitis, humeroscapular periarthritis, osteoarthritis, osteochondrosis;
  • Acute laryngotracheitis in children;
  • Multiple sclerosis;
  • Swelling of the brain due to traumatic brain injuries, meningitis, tumors, hemorrhages, radiation injuries, neurosurgical interventions, encephalitis.

Note! Dexamethasone injections have a powerful anti-inflammatory and antiallergic effect, which is 35 times more effective than the use of cortisone.

Dexamethasone injections are used in the development of acute and emergency conditions, when human life depends on the effectiveness and speed of action of the drug. The drug is usually used for a short course, taking into account vital indications.

Dexamethasone instructions indicate that injections can be used starting from the first year of life, not only intramuscularly, but also intravenously. Determination of the dose depends on the form and severity of the disease, the presence and manifestations of side effects, and the age of the patient.


For adults, Dexamethasone can be administered in amounts from 4 mg to 20 mg, while the maximum daily dose should not exceed 80 ml, i.e. The drug is administered three to four times a day. In the event of acute, dangerous situations, the daily dosage can be increased with the consent and under the supervision of a physician.

In the form of injections, Dexamethasone is usually used for no more than 3-4 days, and if it is necessary to continue therapy, they switch to taking the drug in tablet form.

When the expected effect occurs, the dosage of the drug begins to be gradually reduced to a maintenance dose, and discontinuation of the drug is prescribed by the attending physician.

Important! For intravenous and intramuscular use, rapid administration of Dexamethasone in a large dose should not be allowed, because this can lead to heart complications.

For cerebral edema, the dosage of the drug in the initial stage of treatment should be no more than 16 mg. After this, 5 mg of the drug is administered intramuscularly or intravenously every 6 hours until a positive effect occurs.


Dexamethasone injection, 4 mg/ml, is used for acute and emergency conditions in which parenteral administration is vital. The drug is intended for short-term use for health reasons

Dexamethasone is administered to children intramuscularly. The dosage is determined according to the child’s weight - 0.2-0.4 mg per day per kilogram of weight. When treating children, treatment with the drug should not be prolonged, and the dosage should be kept to a minimum depending on the nature and severity of the disease.

Dexamethasone should be used with extreme caution during pregnancy, because active forms of the drug are able to penetrate through any barriers. The medicine can have a negative effect on the fetus and cause complications both in the fetus and in the subsequently born child. Therefore, the doctor decides whether the drug can be used during pregnancy, because this is advisable only when there is a threat to the mother’s life.

Treatment of joint diseases

When therapy for joint diseases using non-steroidal drugs does not bring the expected effect, doctors are forced to use Dexamethasone injections.

The use of Dexamethasone is permissible in the following conditions:

  • Rheumatoid arthritis;
  • Bursitis;
  • Polyarthritis;
  • Ankylosing spondylitis;
  • Lupus;
  • Synovitis;
  • Scleroderma with articular lesions;
  • Still's disease;
  • Joint syndrome in psoriasis.

Note! To eliminate inflammatory processes in the joints, Dexamethasone injections can in some cases be injected directly into the joint capsule. However, long-term use inside joints is unacceptable, because may cause tendon rupture.

The medicine can be administered to the joint area no more than once per course. The drug can be re-administered in this way only after 3-4 months, i.e. per year, the use of intra-articular Dexamethasone should not exceed three to four times. Exceeding this norm can cause destruction of cartilage tissue.


The intra-articular dosage can vary from 0.4 to 4 mg depending on the patient's age, weight, size of the shoulder joint and severity of the pathology.

The drug is used for diseases requiring the administration of a fast-acting glucocorticosteroid, as well as in cases where oral administration of the drug is impossible. Treatment of allergic diseases

If allergies are accompanied by severe inflammatory processes, then conventional antihistamines will not be able to relieve this condition. In these cases, Dexamethasone is used, which is a derivative of prednisolone, which reduces the manifestation of allergic symptoms.

When are injections used:

  • Hives;
  • Dermatitis, eczema and other skin allergic manifestations;
  • Inflammatory allergic reactions on the nasal mucosa;
  • Quincke's edema;
  • Angioedema and anaphylactic shock.

The description of the use of injections indicates that for allergies it is advisable to use injections in conjunction with oral medications. Typically, injections are given only on the first day of therapy - 4-8 mg intravenously. Next, tablets are prescribed for 7-8 days.

Side effects and contraindications

If there are serious complications and the risk of developing severe conditions, the main contraindication to the use of Dexamethasone is the presence of individual intolerance of the patient to the components of the drug.

For chronic pathologies and the use of the drug as prophylaxis, the following contraindications for use are taken into account:


Development of immunodeficiency (acquired and congenital);

  • Severe form of osteoporosis;
  • Esophagitis;
  • Diabetes;
  • Joint fractures;
  • Infectious diseases of viral, fungal and bacterial nature in the active phase;
  • Acute form of tuberculosis;
  • Peptic ulcer;
  • Myocardial infarction;
  • Internal bleeding;
  • Mental disorders.

The advisability of using Dexamethasone in the presence of contraindications should be taken into account in each individual case separately. In some cases, the use of the drug for any contraindication may lead to the development of side effects.

Use during pregnancy is allowed if the expected effect of therapy outweighs the potential risk to the fetus. Breastfeeding should be stopped during treatment. Infants born to mothers who received significant doses of corticosteroids during pregnancy should be closely monitored for signs of adrenal hypofunction.

Dexamethasone has a certain effect on the body, which can cause side effects:

  1. It has a depressing effect on the immune system, which increases the risk of tumors and the development of severe infectious diseases;
  2. Prevents healthy bone formation because inhibits calcium absorption;
  3. Redistributes deposits of fat cells, which causes fat tissue to be deposited on the torso;
  4. Retains sodium ions and water in the kidneys, which interferes with the removal of adrenocorticotropic hormone from the body.

These properties of the drug can cause negative side reactions:

  • Arterial hypertension;
  • Decrease in the level of monocytes and lymphocytes;
  • Insomnia, mental disorders, hallucinations, depression;
  • Stomach ulcer, nausea, vomiting, internal bleeding, hiccups, pancreatitis;
  • Slow healing of wounds, erythema, itching, bruising, increased sweating;
  • Development of impotence;
  • Allergic dermatitis, urticaria, rash;
  • Heart pathologies, heart failure;
  • Encephalopathy;
  • Sleep disorders, convulsions, dizziness;
  • Adrenal atrophy;
  • Swelling of the optic disc;
  • Weight gain, menstrual irregularities, growth problems in children;
  • Osteoporosis, muscle weakness, damage to articular cartilage, tendon rupture;
  • Glaucoma, increased intraocular pressure, cataracts, exacerbations of infectious processes in the eyes.

At the injection site, pain and local symptoms may occur - scarring, atrophy of the skin.

Note! You can reduce the negative impact of the drug by reducing the dosage, but in some cases only stopping the drug helps. In any case, if you feel unwell, you should immediately inform your doctor.

Negative consequences can occur if the course of therapy is abruptly completed without medical consent. In such cases, the development of arterial hypertension, adrenal insufficiency, and sometimes death was observed.

Advantages and disadvantages

Reviews from doctors about the use of Dexamethasone indicate that the danger of hormonal drugs is somewhat exaggerated, and their use is very effective in the treatment of allergic conditions, cerebral edema, and joint lesions.

The main advantages of the drug are:

  • Wide spectrum of action;
  • Low price;
  • Pronounced positive and rapid effect;
  • Possibility of using the drug in complex therapy.

The disadvantages of the drug include:

  • Limited use during pregnancy;
  • The need for monitoring during the period of use of the medicine;
  • Large list of side effects;
  • The need to select the lowest possible dosage.

To avoid the negative effects of the drug, it is enough to take into account the presence or absence of contraindications, and select the dosage taking into account the patient’s age, weight, and test results.

The broad-spectrum drug Dexamethasone is available in the form of a solution used for injection. One ampoule contains 1 ml of liquid that is colorless or slightly yellowish.

Compound

One milliliter of medicine contains the following components:

  • The active substance is dexamethasone sodium phosphate;
  • By-product chemical elements in the form of disodium phosphate dihydrate, disodium edetate, glycerol;
  • Water for preparing injections.

The drug belongs to corticosteroids intended for systemic use, glucocorticosteroids.

pharmachologic effect

Injections with the drug Dexamethasone are given both into a vein and into a muscle. It should be noted that the effect on the body occurs in different ways. With intravenous administration, the maximum effect of the drug on the blood plasma is achieved within five minutes, while after an intramuscular injection, a similar concentration will occur only after one hour.

Injecting the medicine into a vein gives a much greater therapeutic effect in the treatment of diseases than using injections into muscles or joint tissues, since absorption occurs several times slower.

There is also a difference in the duration of action of the drug after different uses:

  • Intramuscularly – from 18-27 days;
  • Local administration – 3 - 21 days.

Dexamethasone has a half-life of 23 to 72 hours. Metabolization occurs to a greater extent in the liver, less in the kidneys and other tissue structures. The main route of excretion is the kidneys.

The biological effect of the drug is such that almost 78% of the active substance is able to bind to albumin (protein), the rest is able to bind to other plasma proteins. It easily dissolves fats and is able to penetrate the cell, thus acting from the inside and between the cells, disintegrating within it.

Peripheral tissues are also susceptible to its action, Dexamethasone binds in them and influences the cytoplasm through membrane receptors.

Pharmacological dynamics

This drug is a synthetic adrenal hormone or corticosteroid. The main effect on the human body is its ability to resist inflammatory processes, immunosuppressive ability, and the ability to influence metabolism and glucose. It affects the pituitary gland and hypothalamus, bringing secretion into an active state.

The mechanism of action of the drug is not fully understood, but an important fact has been confirmed - it is able to influence the cell and act as if from the inside. In this way, glucocorticoid receptors communicate with corticoids, which allows the levels of sodium, potassium, and water-electrolyte balance to be normalized. Due to the connection of hormones with receptors, a unique process occurs that makes them closer to DNA. Considering that receptors are present in almost all types of tissues, we can conclude that the action of glucocorticoids occurs in most cells of the body.

For what diseases is it used?

Dexamethasone is used when it becomes impossible to take the medicine in tablet form, but mainly in cases that require a quick effect of glucocorticosteroids on the body. This help is required:

  • With Addison's disease;
  • For pathologies of the adrenal glands, including congenital ones;
  • For shocks of various origins;
  • During acute arthritis and other ailments of a rheumatoid nature, joint diseases;
  • Asthma, cerebral edema, hemorrhages in the brain area;
  • For injuries, neurosurgical operations;
  • Tuberculosis manifestations, colitis, leukemia, severe respiratory diseases;
  • For swelling caused by infection, dermatitis and psoriasis, as well as other skin diseases and allergic reactions;
  • For children when acute laryngotracheitis is diagnosed.

This is just a small general list of a large list of diseases for which the use of Dexamethasone injections is not only indicated, but also extremely necessary.

This is especially true for conditions where emergency care is vital. The drug is not intended for long-term use, but only for short-term emergency use when the patient’s life is threatened by serious deterioration or even death.

Instructions for use, dosage

There are several ways to use the medicine:

  • Intravenously;
  • Intramuscularly;
  • Inside the joints;
  • Periarticular method;
  • Retrobulbar.

The dosage and the regimen itself according to which therapy is carried out are strictly individual and depend on the condition and indicators of each patient, as well as on the personal reaction to the drug.

For droppers and intravenous administration of the drug, the solution is usually prepared using an isotonic sodium chloride solution; you can also take a five percent dextrose solution. For adult patients who are in a serious or acute condition requiring immediate assistance, the medicine is injected into a vein in different ways: drip, jet or slow. The dose can be different, from 4 to 20 mg up to three or four times throughout the day. The highest dose reaches 80 mg. To maintain a stable condition, you can use from 0.2 to 9 mg per day, with a course of no more than four days, after which you need to switch to Dexamethasone tablets.

For children, there is a dose several times smaller, it is limited to 0.02776 - 0.16665 mg per kilogram of the child’s weight. It is administered in periods of 12 or 24 hours.

If we talk about local therapy, then various doses are also used here, which are recommended by the attending physician, based on the medical history and general condition of the person. We can only give approximate figures that may correspond to various pathological conditions:

  • For diseases of large joints, such as knees, you can give injections with the medicine in a dose of 2 to 4 mg;
  • If smaller joints, such as the interphalangeal parts, hurt, then the dosage is lower, from 0.9 to 1 mg;
  • For pain in the joint capsules – 2-3 mg;
  • For tendon lesions - 0.4 – 1 mg;
  • For soft tissues – 2-6 mg.

When an adult patient has shock of any origin, a single dose of up to 20 mg into a vein is required.

With subsequent administration in the same way but at a lower dose - 3 mg by continuous infusion throughout the day or a single dose of 40 mg every 6 hours.

If an adult patient is affected by cerebral edema, first administer 10 mg, followed by 4 mg each for the next six hours until the acute symptoms disappear. After a period of 3 to 4 days, the dose is reduced and then the drug is stopped.

For allergies in the acute stage or chronic allergic disease, Dexamethasone is prescribed with a combination of oral and injection use according to a special schedule:

  • First day: injections from 1 to 8 mg and tablets 0.75 mg;
  • On the second day, two tablets twice a day;
  • The third day is the same;
  • Fourth day, two tablets twice;
  • On the fifth and sixth days, take a tablet 2 times a day;
  • Next observation.

It should be noted that independent use of tablets, and especially self-medication, is strictly prohibited, since this medicine can cause the most severe health consequences, exacerbations and complications that are life-threatening to the patient.

Without prescription and without supervision from a competent specialist, a drug of such a strong effect is not recommended for use.

The dosage must be strictly observed, especially when it comes to children, as they are more sensitive. A reaction to an exceeded dose will not be long in coming in the form of negative side effects and an unpredictable reaction of the body.

Side effects

  • If the overdose is incorrect, due to retention of fluid in the tissue structures, gastrointestinal lesions of an erosive and ulcerative nature, exacerbations and bleeding may occur, accompanied by vomiting, hiccups, and bloating.
  • A hypersensitivity reaction to the drug may occur in the form of urticaria, dermatitis, and angioedema.
  • Patients who have recently had a heart attack may experience cardiac rupture, cardiac arrest, failure, and many other heart complications.
  • Behavioral changes such as states of euphoria, loss of sleep, psychosis, depressive behavior and paranoia often occur. Hallucinations are not uncommon; exacerbations of the condition are dangerous for people with schizophrenia and epilepsy.
  • Blood and eye pressure may “jump,” cataracts and glaucoma may develop, and infections of the eye organs may be provoked.
  • At high doses, a burning sensation, tissue necrosis, and swelling are felt.

Side effects of VRI intravenous use are often expressed by arrhythmia, convulsions and sudden flushes of blood to the face.

When the medicine is injected into the joint, there is often a feeling of increased pain.

Intracranial administration is often fraught with nosebleeds.

Abrupt cessation or reduction of the previous dose is life-threatening for those people who have been on Dexamethasone for a long time. Adrenal insufficiency can occur, leading to a sharp drop in blood pressure and death.

If the patient has any severe adverse reactions, the drug should be discontinued.

Contraindications

Particular attention should be paid to the list of health conditions and diseases for which the use of this medication is extremely undesirable, these include:

  • Hypersensitivity to one of the ingredients of the medicine;
  • The presence of any fungal infections, if there is no therapeutic treatment;
  • Not for Cushing's syndrome;
  • If the patient has poor blood clotting;
  • When vaccinated with a live vaccine;
  • For stomach and duodenal ulcers;
  • For osteoporotic phenomena;
  • During pregnancy and breastfeeding;
  • For mental disorders and epilepsy;
  • For various eye ailments;
  • If you have kidney failure, hepatitis or cirrhosis;
  • For sexually transmitted diseases and tuberculosis.

A severe overdose inevitably leads to death, this once again confirms what a serious drug this group represents

What you should know

Before starting the treatment process with Dexamethasone injections, special attention should be paid to the fact that allergic reactions are possible; all measures taken will help avoid serious complications.

  • The medicine should be discontinued gradually; the dose should not be sharply reduced, as the body will react in its own way with dizziness, drowsiness, pain in the bones, joints and muscles. Fever, runny nose, and conjunctivitis may be caused.
  • In the postoperative period, for patients who are in a stressful state during the period of therapeutic intervention, it is necessary to slightly increase the dose size, or replace it with drugs such as cortisone or hydrocortisone.
  • Close medical attention is required for those with osteoporosis, diabetes of both types, tuberculosis, gastrointestinal pathologies, and elderly people. They require increased attention and strictly observed doses of the drug.
  • If treatment is continued for a long period, it is necessary to monitor the level of potassium in the blood serum.

Storage and analogues

Ampoules with medicine should be stored at room temperature, but it should not exceed +25 degrees. They should be hidden from the sun and especially from children!

The shelf life of the medicine is no more than two years. The medicine is dispensed strictly according to the prescription prescribed by the doctor.

Analogs include: Prednisolone, Diprospan, Hydrocortisone, Solu-Medrol.

Reviews

Dmitry, 51 years old, Rostov-on-Don“A medicine that has been used for many years. Old but golden. I personally treat joint and spine pain with it. The doctor sometimes puts blockades on him, which helps a lot. But you can’t be treated with it for a long time, since the pressure in the eyes rises only when it’s completely unbearable to walk.”

Olga - doctor, 48 years old, Chelyabinsk“A well-proven medicine. I've been using it for so many years now. Perfectly relieves symptoms of psoriasis, eczema in severe degrees and forms. The main thing is that this drug is effective and inexpensive. The only thing I regret is that older people have a hard time tolerating its components.”

Marina, 35 years old, Moscow“I was pleasantly surprised when I started using Dexamethasone. I am an experienced allergy sufferer. The effect came literally immediately after the injection. Swelling and redness from the face are gone. The doctor said that you can’t use it for a long time, it’s a pity, the medicine is great and isn’t expensive at all, and this is very important for ordinary people.”

In this article you can read the instructions for use of the drug Dexamethasone. Reviews of site visitors - consumers of this medicine, as well as the opinions of specialist doctors on the use of Dexamethasone in their practice are presented. We kindly ask you to actively add your reviews about the drug: whether the medicine helped or did not help get rid of the disease, what complications and side effects were observed, perhaps not stated by the manufacturer in the annotation. Dexamethasone analogues in the presence of existing structural analogues. Use for the treatment of inflammatory and systemic diseases, including the eyes, in adults, children, as well as during pregnancy and lactation.

Dexamethasone- synthetic glucocorticosteroid (GCS), a methylated derivative of fluoroprednisolone. It has anti-inflammatory, antiallergic, immunosuppressive effects, increases the sensitivity of beta-adrenergic receptors to endogenous catecholamines.

Interacts with specific cytoplasmic receptors (receptors for GCS are present in all tissues, especially in the liver) to form a complex that induces the formation of proteins (including enzymes that regulate vital processes in cells.)

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

Lipid metabolism: increases the synthesis of higher fatty acids and triglycerides, redistributes fat (fat accumulation occurs 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 (increasing the flow of glucose from the liver into the blood); increases the activity of phosphoenolpyruvate carboxylase and the synthesis of aminotransferases (activation of gluconeogenesis); promotes the development of hyperglycemia.

Water-electrolyte metabolism: retains Na+ and water in the body, stimulates the excretion of K+ (mineralocorticoid activity), reduces the absorption of Ca+ from the gastrointestinal tract, reduces bone mineralization.

The anti-inflammatory effect is associated with inhibition of the release of inflammatory mediators by eosinophils and mast cells; 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 (especially lysosomal) and organelle membranes. Acts on all stages of the inflammatory process: inhibits the synthesis of prostaglandins (Pg) at the level of arachidonic acid (lipocortin inhibits phospholipase A2, suppresses the liberation of arachidonic acid and inhibits the biosynthesis of endoperoxides, leukotrienes, which contribute to inflammation, allergies, etc.), the synthesis of “proinflammatory cytokines” ( interleukin 1, tumor necrosis factor alpha, etc.); increases the resistance of the cell membrane to the action of various damaging factors.

The immunosuppressive effect is caused by the involution of lymphoid tissue, inhibition of the proliferation of lymphocytes (especially T-lymphocytes), suppression of the migration of B cells and the interaction of T and B lymphocytes, inhibition of the release of cytokines (interleukin-1, 2; interferon gamma) from lymphocytes and macrophages and decreased antibody formation.

The antiallergic effect develops as a result of a decrease in 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, T- and B-lymphocytes, mast cells; suppressing the development of lymphoid and connective tissue, reducing the sensitivity of effector cells to allergy mediators, inhibiting antibody formation, changing the body's immune response.

In obstructive diseases of the respiratory tract, the effect is due mainly to inhibition of inflammatory processes, prevention or reduction of the severity of swelling of the mucous membranes, reduction of eosinophilic infiltration of the submucosal layer of the bronchial epithelium and deposition of circulating immune complexes in the bronchial mucosa, as well as inhibition of erosion and desquamation of the mucosa. Increases the sensitivity of beta-adrenergic receptors of small and medium-sized bronchi to endogenous catecholamines and exogenous sympathomimetics, reduces the viscosity of mucus by reducing its production.

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 mineralocorticosteroid activity.

Doses of 1-1.5 mg per day inhibit the function of the adrenal cortex; biological half-life - 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 prednisone (or prednisolone), 15 mg of hydrocortisone or 17.5 mg of cortisone.

Pharmacokinetics

Easily passes through histohematic barriers (including blood-brain and placental). Metabolized in the liver (mainly by conjugation with glucuronic and sulfuric acids) to inactive metabolites. Excreted by the kidneys (a small part by the lactating glands).

Indications

Diseases requiring the administration of fast-acting corticosteroids, as well as cases when oral administration of the drug is impossible:

  • endocrine diseases: acute adrenal insufficiency, primary or secondary adrenal insufficiency, congenital adrenal hyperplasia, subacute thyroiditis;
  • shock (burn, traumatic, surgical, toxic) - if vasoconstrictors, plasma replacement drugs and other symptomatic therapy are ineffective;
  • cerebral edema (with a brain tumor, traumatic brain injury, neurosurgical intervention, cerebral hemorrhage, encephalitis, meningitis, radiation injury);
  • status asthmaticus; severe bronchospasm (exacerbation of bronchial asthma, chronic obstructive bronchitis);
  • severe allergic reactions, anaphylactic shock;
  • rheumatic diseases;
  • systemic connective tissue diseases;
  • acute severe dermatoses;
  • 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;
  • blood diseases: acute hemolytic anemia, agranulocytosis, idiopathic thrombocytopenic purpura in adults;
  • severe infectious diseases (in combination with antibiotics);
  • in ophthalmological practice (subconjunctival, retrobulbar or parabulbar administration): allergic conjunctivitis, keratitis, keratoconjunctivitis without damage to the epithelium, iritis, iridocyclitis, blepharitis, blepharoconjunctivitis, scleritis, episcleritis, inflammatory process after eye injuries and surgical interventions, sympathetic ophthalmia, immunosuppressive treatment after transplantation corneas;
  • local application (in the area of ​​pathological formation): keloids, discoid lupus erythematosus, granuloma annulare.

Release forms

Tablets 0.5 mg.

Solution in ampoules for intravenous and intramuscular administration (injections for injections) 4 mg/ml.

Oftan eye drops 0.1%.

Ophthalmic suspension 0.1%.

Instructions for use and dosage

The dosage regimen is individual and depends on the indications, the patient’s condition and his response to therapy. 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 Dexamethasone 3-4 times.

Doses of the drug for children (intramuscular):

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. For other indications, the recommended dose is from 0.02776 to 0.16665 mg/kg body weight or 0.833 to 5 mg/m2 body surface area every 12-24 hours.

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.

Conjunctivally, adults and children over 12 years of age in acute inflammatory conditions: 1-2 drops 4-5 times a day for 2 days, then 3-4 times a day for 4-6 days.

Chronic conditions: 1-2 drops 2 times a day for a maximum of 4 weeks (no more).

In post-operative and post-traumatic cases: starting from the 8th day after surgery for strabismus, retinal detachment, cataract extraction and from the moment of injury - 1-2 drops 2-4 times a day for 2-4 weeks; for antiglaucoma filtering surgery - on the day of surgery or the day after it.

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 of Dexamethasone do not cause sodium and water retention in the body or increased potassium excretion. The following side effects are described:

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

Local for parenteral administration: burning, numbness, pain, tingling at the injection site, infection at the injection site, rarely - necrosis of surrounding tissues, scarring at the injection site; atrophy of the skin and subcutaneous tissue with intramuscular injection (injection into the deltoid muscle is especially dangerous).

Contraindications

For short-term use for health reasons, the only contraindication is hypersensitivity to dexamethasone or the components of the drug.

In children during the growth period, GCS should be used only according to absolute indications and under the particularly careful supervision of the attending physician.

The drug should be prescribed with caution for the following diseases and conditions:

Use during pregnancy and breastfeeding

During pregnancy (especially in the 1st trimester), the drug can be used only when the expected therapeutic effect outweighs the potential risk to the fetus. With long-term therapy during pregnancy, the possibility of impaired fetal growth cannot be ruled out. If used at the end 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.

special instructions

During treatment with Dexamethasone (especially long-term), observation by an ophthalmologist, monitoring of blood pressure and water-electrolyte balance, as well as peripheral blood patterns and blood glucose levels are necessary.

In order to reduce side effects, antacids can be prescribed, and the intake of K+ into the body should be increased (diet, potassium supplements). Food should be rich in proteins, vitamins, and limit the content of fats, carbohydrates and table salt.

The effect of the drug is enhanced in patients with hypothyroidism and liver cirrhosis. The drug may worsen existing emotional instability or psychotic disorders. If a history of psychosis is indicated, Dexamethasone in high doses is prescribed under the strict supervision of a physician.

It should be used with caution in acute and subacute myocardial infarction - the necrosis focus may spread, the formation of scar tissue may slow down, and the heart muscle may rupture.

In stressful situations during maintenance treatment (for example, surgery, trauma or infectious diseases), the dose of the drug should be adjusted due to an increased need for glucocorticosteroids. Patients should be carefully monitored for a year after the end of long-term therapy with Dexamethasone due to the possible development of relative insufficiency of the adrenal cortex in stressful situations.

With sudden withdrawal, especially in the case of previous use of high doses, the development of withdrawal syndrome (anorexia, nausea, lethargy, generalized musculoskeletal pain, general weakness) is possible, as well as an exacerbation of the disease for which Dexamethasone was prescribed.

During treatment with Dexamethasone, vaccination should not be carried out due to a decrease in its effectiveness (immune response).

When prescribing Dexamethasone for intercurrent infections, septic conditions and tuberculosis, it is necessary to simultaneously treat with bactericidal antibiotics.

In children during long-term treatment with Dexamethasone, careful monitoring of the dynamics of growth and development is necessary. Children who during the treatment period were in contact with patients with measles or chickenpox are prescribed specific immunoglobulins prophylactically.

Due to the weak mineralocorticoid effect, Dexamethasone is used in combination with mineralocorticoids for replacement therapy for adrenal insufficiency.

In patients with diabetes mellitus, blood glucose levels should be monitored and therapy adjusted if necessary.

X-ray monitoring of the osteoarticular system (images of the spine, hand) is indicated.

In patients with latent infectious diseases of the kidneys and urinary tract, Dexamethasone can cause leukocyturia, which may have diagnostic value.

Drug interactions

There may be pharmaceutical incompatibility of dexamethasone with other IV drugs - it is recommended to administer it separately from other drugs (IV bolus, or through another dropper, as a second solution). When mixing a solution of dexamethasone with heparin, a precipitate forms.

Simultaneous administration of dexamethasone with:

  • inducers of hepatic microsomal enzymes (phenobarbital, rifampicin, phenytoin, theophylline, ephedrine) leads to a decrease in its concentration;
  • diuretics (especially thiazide and carbonic anhydrase inhibitors) and amphotericin B - can lead to increased excretion of K+ from the body and an increased risk of developing heart failure;
  • with sodium-containing drugs - to the development of edema and increased blood pressure;
  • cardiac glycosides - their tolerability worsens and the likelihood of developing ventricular extrasytolia increases (due to caused hypokalemia);
  • indirect anticoagulants - weakens (less often enhances) their effect (dose adjustment required);
  • anticoagulants and thrombolytics - the risk of bleeding from ulcers in the gastrointestinal tract increases;
  • ethanol (alcohol) and nonsteroidal anti-inflammatory drugs - increases the risk of erosive and ulcerative lesions in the gastrointestinal tract and the development of bleeding (in combination with NSAIDs in the treatment of arthritis, it is possible to reduce the dose of glucocorticosteroids due to the summation of the therapeutic effect);
  • paracetamol - the risk of developing hepatotoxicity increases (induction of liver enzymes and the formation of a toxic metabolite of paracetamol);
  • acetylsalicylic acid - accelerates its elimination and reduces its concentration in the blood (when dexamethasone is discontinued, the level of salicylates in the blood increases and the risk of side effects increases);
  • insulin and oral hypoglycemic drugs, antihypertensive drugs - their effectiveness decreases;
  • vitamin D - its effect on the absorption of Ca2+ in the intestine is reduced;
  • growth hormone - reduces the effectiveness of the latter, and with praziquantel - its concentration;
  • M-anticholinergics (including antihistamines and tricyclic antidepressants) and nitrates - helps increase intraocular pressure;
  • isoniazid and mexiletine - increases their metabolism (especially in “slow” acetylators), which leads to a decrease in their plasma concentrations.

Carbonic anhydrase inhibitors and loop diuretics may increase the risk of osteoporosis.

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

ACTH enhances the effect of dexamethasone.

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

Cyclosporine and ketoconazole, by slowing down the metabolism of dexamethasone, can in some cases increase its toxicity.

The simultaneous administration of androgens and steroidal anabolic drugs with dexamethasone promotes the development of peripheral edema and hirsutism, and the appearance of acne.

Estrogens and oral contraceptives containing estrogen reduce the clearance of dexamethasone, which may be accompanied by an increase in the severity of its action.

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

Antipsychotics (neuroleptics) and azathioprine increase the risk of developing cataracts when dexamethasone is prescribed.

When used simultaneously with antithyroid drugs, the clearance of dexamethasone decreases and with thyroid hormones increases.

Analogs of the drug Dexamethasone

Structural analogues of the active substance:

  • Decadron;
  • Dexaven;
  • Dexazone;
  • Dexamed;
  • Dexamethasone Bufus;
  • Dexamethasone Nycomed;
  • Dexamethasone-Betalek;
  • Dexamethasone Vial;
  • Dexamethasone-LENS;
  • Dexamethasone-Ferein;
  • Dexamethasone sodium phosphate;
  • Dexamethasone phosphate;
  • Dexamethasonelong;
  • Dexapos;
  • Dexafar;
  • Dexon;
  • Maxidex;
  • Oftan Dexamethasone;
  • Fortecortin.

If there are no analogues of the drug for the active substance, you can follow the links below to the diseases for which the corresponding drug helps and look at the available analogues for the therapeutic effect.


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