Instruction for use: Dexason

Active substance: Dexamethasone

ATX Code H02AB02 Dexamethasone

Pharmacological group

Glucocorticosteroid

The nosological classification (ICD-10)

A41.9 Septicemia, unspecified

Septic diseases, Septicemia / bacteremia, Toxico-infectious shock, Endotoxin shock, Bacterial septicemia, Bacterial infections of severe course, Generalized infections, Generalized systemic infections, Infections generalized, Wound sepsis, Septiccopymia, Septic-toxic complications, Septicemia, Septic conditions, Septic shock, Septic condition, Septic shock

C81-C96 Malignant neoplasms of lymphoid, hematopoietic and related tissues

Hematoblastosis, Hematosarcoma, Leukemia, Lymphoma of the malignant, Tumors of the lymphoid, hematopoietic and related tissues

C85 Other and unspecified types of non-Hodgkin's lymphoma

Lymphoma of mixed type, Lymphomas from cells of the mantle zone, Malignant lymphoma, Lymphoma non-Hodgkin's disease, Lymphocytic lymphoma

C95 Leukemia of unspecified cell type

Acute non-lymphocytic leukemia, Leukemia undifferentiated, Undifferentiated leukemia, Non-lymphocytic leukemia, Acute leukemia in adults, Non-lymphocytic leukemia

D55-D59 Hemolytic anemia

D64 Other anemia

Erythrocyte anemia, Erythroid hypoplastic anemia, Anemia due to erythropoietin deficiency, Anemia in metabolic disorders of erythrocytes, Anemia, Autoimmune anemia, Idiopathic anemia

D69.3 Idiopathic thrombocytopenic purpura

Werlhof's disease, Idiopathic autoimmune thrombocytopenia, Idiopathic thrombocytopenic purpura of adults, Idiopathic thrombocytopenic purpura in adults, Immune idiopathic thrombocytopenic purpura, Immune thrombocytopenia, Bleeding in patients with thrombocytopenic purpura, Evans Syndrome, Thrombocytopenic purpura, Thrombocytopenia of immune origin, Chronic idiopathic thrombocytopenic purpura, Essential thrombocytopenia, Autoimmune thrombocytopenic purpura in pregnancy, Posttransfusion purpura

D70 Agranulocytosis

Agranulocytosis is hereditary, Aleicia, Aleykocytosis, Agranulocytic angina, Angina agranulocytic, Primary cytopenia

E06 Thyroiditis

Pulmonary thyroiditis

E27.4 Other and unspecified adrenocortical insufficiency

Hypocorticism, Hypoaldosteronism, Adrenal insufficiency, Insufficiency of the adrenal cortex, Insufficiency of the adrenal cortex, Secondary adrenocortical insufficiency, Secondary adrenal insufficiency, Secondary insufficiency of the adrenal cortex, Temporary decrease in the function of the adrenal cortex, Dysfunction of the adrenal cortex

E83.5.0 * Hypercalcemia

Hypercalcemic crisis, Idiopathic hypercalcemia of newborns, Milk-alkaline syndrome

G00 Bacterial meningitis, not elsewhere classified

Meningitis, Meningeal infections, Meningitis of bacterial etiology, Pachymeningitis external, Epiduritis purulent

G04 Encephalitis, myelitis and encephalomyelitis

Disseminated acute encephalomyelitis, Leukoencephalitis, Meningomielitis, Myelitis, Acute encephalitis, Acute encephalomyelitis, Chronic encephalitis, Chronic encephalomyelitis, Encephalitis, Encephalomyelitis, Inflammation of meninges

G93.6 Edema of the brain

Intraoperative cerebral edema, Cerebral edema, Post-traumatic swelling of the brain, Brain edema associated with radiation therapy, Brain edema associated with head trauma, Post-traumatic cerebral edema, Edema of the brain in poisoning

H01.0 Blepharitis

Blepharitis, Inflammation of the eyelids, Inflammatory diseases of the eyelids, Demodectic blepharitis, Superficial bacterial infection of the eyes, Superficial infection of the eye, Scaly blepharitis

H10.1 Acute atopic conjunctivitis

Allergic conjunctivitis, Allergic eye disease, Allergic conjunctivitis, Allergic conjunctivitis is caused by chemical and physical factors, Allergic rhinoconjunctivitis,Allergic inflammation of the eye, Spring catarrh, Spring keratitis, Spring conjunctivitis, allergic Conjunctivitis, Perennial allergic conjunctivitis,Exacerbation of pollen allergy in the form of Syndrome rinokonyunktivalnogo, Acute allergic keratoconjunctivitis, Acute allergic conjunctivitis,Superficial bacterial eye infections,rhinoconjunctivitis, Seasonal allergic conjunctivitis, Seasonal conjunctivitis, Sennoz, Chronic allergic keratoconjunctivitis, Chronic allergic conjunctivitis

H10.5 blepharoconjunctivitis

Chronic blepharoconjunctivitis, blepharoconjunctivitis, stafillokokk blepharoconjunctivitis

H15.0 Sclerite

Acute scleritis, Chronic scleritis, Diffuse scleritis, Sclerite

H15.1 Episcleritis

Acute episcleritis, Chronic episcleritis

H16 Keratitis

Adenoviral keratitis, Bacterial keratitis, Spring keratitis, Deep keratitis without epithelial damage, Discoid keratitis, Dendritic keratitis, Keratitis rosacea, Keratitis with destruction of the cornea, Superficial keratitis, Point keratitis, Traumatic keratitis, Superficial point keratitis

H16.2 Keratoconjunctivitis

Chronic allergic keratoconjunctivitis, Bacterial keratoconjunctivitis, Deep forms of adenovirus keratoconjunctivitis, Infectious conjunctivitis and keratoconjunctivitis caused by Chlamydia trachomatis, Acute allergic keratoconjunctivitis, Spring keratoconjunctivitis, Phlyctenular keratoconjunctivitis

H20 Iridocyclitis

recurrent iritis, sympathetic iridocyclitis, Sluggish posterior uveitis, Sluggish posterior uveitis, Posterior uveitis, the posterior segment of the eye Iridocyclitis, Iridocyclitis and other uveitis, Irit, Keratoiridotsiklit, Acute iritis, uveitis, cycle of Acute iridocyclitis, Acute non-infectious uveitis

H44.1 Other endophthalmitis

Ophthalmic sympathetic, Egyptian ophthalmia,Endophthalmitis

I00 Rheumatic fever without mention of cardiac involvement

Acute rheumatism, Rheumatic arthritis acute, Rheumatism is active, Rheumatic fever, Acute attack of rheumatic joint disease

I61 Intracerebral haemorrhage

Apoplexic shock, Apoplexy of the brain, Hematoma subduralnoy, Hematoma epidural, Hemorrhagic stroke, Stroke apoplexy, Hemorrhagic stroke, Hemorrhage in the brain, Intra cerebral hemorrhage, Postponed hemorrhagic stroke, Subdural hematoma chronic, Epidural hematomas

J41 Simple and mucopurulent chronic bronchitis

Disease of the bronchi, Purulent bronchitis, Chronic purulent-obstructive bronchitis, Chronic purulent bronchitis

J44.8 Other specified chronic obstructive pulmonary disease

Chronic emphysema bronchitis

J45 Asthma

Asthma physical effort, status asthmaticus, Bronchial asthma, Asthma lung flow, Bronchial asthma with obstruction of sputum discharge, Bronchial asthma heavy currents, Bronchial asthma physical effort, hypersecretory asthma, Hormone-dependent form of bronchial asthma, Relief of asthma attacks in bronchial asthma, Non-allergic asthma, nocturnal asthma, Exacerbation of asthma, Asthma attacks, Endogenous forms of asthma, Night asthma, Cough with bronchial asthma

J46 Status asthmaticus

Asthmatic attack, status asthmaticus, Bronchospasm in bronchial asthma

J98.8.0 * Bronchospasm

Bronchospasm in bronchial asthma, Bronchospasm when exposed to an allergen, bronchospastic reactions, bronchospastic status, bronhospastichesky syndrome, Diseases accompanied by bronchospastic syndrome, reversible bronchospasm, spasmodic cough

L20 Atopic dermatitis

Itchy atopic eczema, Common neurodermatitis, Allergic skin diseases, Allergic skin diseases of non-infectious etiology, Allergic skin diseases of non-microbial etiology, Allergic skin diseases, Allergic skin lesions, Allergic manifestations on the skin, Allergic dermatitis, Allergic diathesis, Allergic itching dermatosis, Allergic Skin Disease, Allergic skin irritation, Dermatitis allergic, Atopic dermatitis, Dermatosis allergic, Diathesis exudative, Skin Allergic Disease, Skin allergic reaction to medicinal and chemical preparations, Skin reaction to medication, Skin and allergic disease, Acute eczema, Chronic atopic dermatitis, Exudative diathesis, Itching allergic dermatosis

L26 Exfoliative dermatitis

Dermatitis exfoliative, Exfoliative dermatitis generalized

L58 Radiation dermatitis radiation

Radiation injury of the skin, Radiation skin lesions, Radiation damage to the skin and mucous membranes, Skin lesion with radiation therapy, Irritation after exposure to X-rays, Radiation damage to the skin, Radio-epileleitis, Radiation acute syndrome

L91.0 Keloid cicatrix

Hyperlusculation, Keloid, Keloid cicatrix, Kelloid scars

L92.0 Granuloma annular

Ring-shaped granuloma

L93.0 Discoid lupus erythematosus

Chronic discoid lupus erythematosus, Red discoid lupus, Discoid lupus, Discoid erythematosis

L94.0 Localized scleroderma [morphea]

Scleroderma limited, Systemic scleroderma, Cutaneous scleroderma, Teardrop scleroderma, Limited scleroderma, Focal scleroderma

M06.9 Other specified rheumatoid arthritis

Rheumatoid arthritis,Pain syndrome in rheumatic diseases, Pain in rheumatoid arthritis, Inflammation in rheumatoid arthritis, Degenerative forms of rheumatoid arthritis, Children's rheumatoid arthritis, Exacerbation of rheumatoid arthritis, Acute articular rheumatism, Rheumatic arthritis, Rheumatic polyarthritis, Rheumatoid arthritis, Rheumatic polyarthritis, Rheumatoid arthritis, Rheumatoid arthritis of active course, Rheumatoid arthritis, Rheumatoid polyarthritis, Acute rheumatoid arthritis, Acute rheumatism

M13.9 Arthritis, unspecified

Arthritis,Purulent arthritis (non-infectious), acute Arthritis,Pain in acute inflammatory diseases of the musculoskeletal system,Pain in chronic inflammatory diseases of the musculoskeletal system,The pain in osteoarthritis, Inflammation in osteoarthritis, Inflammatory arthropathy, Inflammatory and degenerative joint diseases, Inflammatory disease of the musculoskeletal system, Inflammatory joint disease, Inflammatory diseases of the musculoskeletal system, destructive arthritis, The disease of the musculoskeletal system, Diseases of the musculoskeletal system, Diseases of the musculoskeletal system and connective tissue, Infections musculoskeletal system, monoartrit, Non-infectious arthritis, rheumatic arthritis, Osteoarthritis, Acute inflammation of the musculoskeletal tissue, Acute inflammatory diseases of the musculoskeletal system, Acute inflammatory condition of the musculoskeletal system, Acute arthritis, Acute osteoarthritis, Post-traumatic osteoarthritis, Reactive arthritis, Chronic inflammatory diseases of the joints, Chronic arthritis, Chronic inflammatory arthritis, Chronic inflammation of the inner layer of the joint capsule, Chronic inflammation of the joint capsule,Chronic inflammatory disease of the joints, Exudative arthritis

M15-M19 Osteoarthritis

M32 Systemic lupus erythematosus

Lupus erythematosus red disseminated, Disseminated lupus erythematosus, Chronic lupus erythematosus

M35 Other systemic involvement of connective tissue

M65 Synovitis and tendosynovitis

Acute tenosynovitis, Tendovaginitis (tenovaginitis), Tendosinovit (tenosynovitis), Tendovaginitis, Osteoarthritis in musculo-articular diseases, Inflammatory disease of soft tissues, Nonspecific tenosynovitis, Tendosinovit

M71 Other bursopathies

Bursitis, Bursopathy, Diseases of soft tissues, Osteoarthritis in musculo-articular diseases, Inflammatory disease of soft tissues, Subacute bursitis

M77.0 Medial epicondylitis

Epicondylitis medial, Epicondylitis, Epicondylitis traumatic medial

M77.1 Lateral epicondylitis

Epicondylitis lateral, Epicondylitis, Epicondylitis traumatic lateral

M79.0 Other unspecified rheumatism

Degenerative rheumatic disease, Degenerative and rheumatic diseases of the tendons, Degenerative rheumatic diseases, Localized forms of rheumatism of soft tissues, Rheumatism, Rheumatism with a pronounced allergic component, Rheumatism of the articular and extraarticular, Rheumatic attack, Rheumatic complaints, Rheumatic diseases, Rheumatic disease of the spine, Relapses of rheumatism, Articular and extra-articular rheumatism, Articular and muscular rheumatism, Articular rheumatism, Articular syndrome with rheumatism, Chronic rheumatic pain, Chronic articular rheumatism, Rheumatoid diseases, Rheumatic diseases of the intervertebral disc

R57 Shock, not elsewhere classified

Obstructive shock

S06 Intracranial injury

Traumatic brain injury, Traumatic brain injury with a predominantly stem lesion level, Condition after traumatic brain injury,Brain Injury, skull Injuries, brain injury, Brain Contusion, Craniocerebral trauma, Traumatic brain injury,TBI, traumatic brain injury, The traumas of head injury, The consequence of traumatic brain injury, The consequence of TBI, Cranial trauma, Traumatic brain injury, Traumatic encephalasthenia, concussion

T66 Unspecified radiation effects

Radiation Disease, Diarrhea radiation, Gastrointestinal syndrome with irradiation, Radiation sickness, Radiation disorders of mucous membranes, Irradiation chronic, Osteoradionecrosis, Acute radiation sickness, Acute and chronic radiation injuries, Acute radiation syndrome with radiation therapy, Subacute and chronic radiation sickness, Radiation Neuropathy, Radiation edema, Radiation damage to the nervous system, Radiation immunodeficiency, Radiation syndrome, Radio-epileleitis, Radiation acute syndrome, State after irradiation, Cytopenia due to previous radiation or chemotherapy, Cytopenia radiation, Cytopenia due to radiation therapy, Cytopenia due to chemotherapy

T78.2 Anaphylactic shock, unspecified

Anaphylactic shock, Anaphylactoid reaction, Anaphylactic shock, Anaphylactic reactions, Anaphylactic shock to drugs

T78.4 Allergy, unspecified

Allergic reactions to insulin, Allergic reactions to insect stings, Allergic reactions similar to systemic lupus erythematosus, Allergic diseases, Allergic diseases of mucous membranes, Allergic diseases and conditions resulting from increased release of histamine, Allergic diseases of mucous membranes, Allergic symptoms, Allergic symptoms in the mucous membranes, Allergic reactions, Allergic reactions caused by insect bites, Allergic reactions, Allergic conditions, Allergic laryngeal edema, allergopathy, allergic conditions, Allergy, House dust allergy, Anaphylaxis, Cutaneous reactions to medications, Skin reaction to insect stings, Cosmetic allergy, Drug allergy, Acute allergic reaction, Laryngeal edema allergic genesis and background radiation, Food and drug allergy

T79.4 Traumatic shock

Hemorrhagic shock, Crush syndrome, hemorrhagic shock, postoperative shock, post-traumatic shock, traumatic shock, hemorrhagic shock and encephalopathy syndrome

T80.5 Anaphylactic shock associated with the administration of serum

T90.4 Consequences of trauma to the eye, near-orbital area

Composition and form of release

Solution for injection 1 ml

Dexamethasone sodium phosphate 4 mg

Auxiliary substances: glycerol; Sodium edetate; Sodium hydroxide; Phosphoric acid; Methylhydroxybenzoate; Propylhydroxybenzoate; water for injections

In ampoules of 1 ml; In the planar cell package 5 ampoules; In a pack of cardboard 5 packages.

Tablets 1 table.

Dexamethasone 0.5 mg

In polypropylene bottles of 50 pcs .; In a pack of cardboard 1 bottle.

Characteristic

Synthetic glucocorticoid, a derivative of prednisolone.

Indications

Acute insufficiency of the adrenal cortex, primary and secondary adrenal insufficiency, adrenogenital syndrome, subacute thyroiditis, hypercalcemia in malignant neoplasms, bronchial asthma, rheumatoid arthritis in the exacerbation phase, connective tissue and skin diseases, shock resistant to standard therapy, anaphylactic shock; Cerebral edema (with a brain tumor, craniocerebral trauma, neurosurgical intervention, cerebral hemorrhage, encephalitis, meningitis, radiation injury); Asthmatic status, severe bronchospasm (exacerbation of bronchial asthma, chronic obstructive bronchitis); Severe allergic reactions; Rheumatic diseases, systemic connective tissue diseases, acute severe dermatoses; Malignant diseases (palliative treatment of leukemia and lymphoma in adults, acute leukemia in children, hypercalcemia in patients with malignant tumors); Carrying out of test at differential diagnostics of a hyperplasia and tumors of a cortex of adrenals; Acute hemolytic anemia, agranulocytosis, idiopathic thrombocytopenic purpura in adults; Severe infectious diseases (in combination with antibiotics); Allergic conjunctivitis, keratitis, keratoconjunctivitis without epithelial damage, irit, iridocyclitis, blepharitis, blepharoconjunctivitis, scleritis, episcleritis, inflammatory process after eye trauma and surgical interventions, sympathetic ophthalmia, immunosuppressive therapy after corneal transplantation (subconjunctival, retrobulbar or parabulbar injection); Arthritis of various etiologies, osteoarthritis, acute and subacute bursitis, acute tendovaginitis, epicondylitis, synovitis (intraarticular and intrasynovial administration); Keloids, discoid lupus erythematosus, annular granuloma (local application).

Contraindications

Increased individual sensitivity to the drug, systemic mycoses, severe osteoporosis, severe myopathies (with the exception of myasthenia gravis), viral infections, poliomyelitis (with the exception of the bulbar-encephalic form), lymphadenitis after vaccination with BCG, idiopathic thrombocytopenic purpura (with IM injection) Infectious lesions of joints and periarticular tissues.

pregnancy and lactation

During pregnancy (especially in the first trimester) the drug can be applied only when the expected therapeutic effect exceeds the potential risk to the fetus. With prolonged therapy during pregnancy, the possibility of impaired fetal growth is not ruled out. In case of application 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 treatment is necessary during breastfeeding, breast-feeding should be discontinued.

Side effects

The risk of side effects increases with the duration of the course of treatment.

On the part of metabolism: sodium and water retention, hypokalemia, hypokalemic alkalosis, negative nitrogen balance, caused by increased protein catabolism.

From the cardiovascular system and blood (hematopoiesis, hemostasis): a higher risk of thrombus formation (especially in immobilized patients), arterial hypertension, congestive heart failure in patients with heart disease.

From the musculoskeletal system: muscle weakness, steroid myopathy, muscle mass reduction, osteoporosis, compression fractures of the vertebrae, aseptic necrosis of the head of the femoral and humerus bones, pathological fractures of long bones.

On the part of the gastrointestinal tract (gastrointestinal tract): erosive and ulcerative lesions of the gastrointestinal tract (which can be the cause of perforations and bleeding), pancreatitis, ulcerative esophagitis.

From the skin: thinning and vulnerable skin, petechiae and subcutaneous hemorrhages, ecchymosis, striae, steroid acne, delayed healing of wounds, increased sweating.

From the nervous system and sensory organs: dizziness, headaches, mental disorders, convulsions and false symptoms of a brain tumor (increased intracranial pressure with a congestive optic nerve disc).

On the part of the endocrine system: menstrual irregularities, Itenko-Cushing syndrome, growth retardation in children, a decrease in glucose tolerance, hyperglycemia up to the development of steroid diabetes, an increase in the need for insulin or oral antidiabetics in patients with diabetes mellitus, adrenal insufficiency (especially in Time of stress - with trauma, surgical operations, concomitant diseases).

From the side of the organ of vision: posterior subcapsular cataract, increased intraocular pressure, exophthalmos.

Associated with immunosuppressive action: more frequent occurrence of infections and aggravation of the severity of their course.

Other: allergic reactions.

Local reactions (at the injection site): hyperpigmentation and leukoderma, subcutaneous fat and skin atrophy, aseptic abscess, hyperemia at the injection site, arthropathy.

Interaction

Simultaneous use with phenobarbital, rifampicin, phenytoin or ephedrine can accelerate biotransformation and weaken the effect of the drug. Hormonal contraceptives enhance the action of Dexason. Simultaneous use with diuretics (especially loop) can lead to increased excretion of potassium. With simultaneous use with cardiac glycosides, the possibility of cardiac arrhythmias increases. Weaken (less intensifies) the effect of coumarin derivatives, which requires correction of their dose. Strengthens the side effect of NSAIDs (nonsteroidal anti-inflammatory drugs), especially the effect on the gastrointestinal tract (increased risk of erosive ulcerative lesions and bleeding from the gastrointestinal tract). In addition, it reduces the concentration of NSAIDs in the serum and their effectiveness.

Dosing and Administration

In / in (intravenously), intramuscularly , intraarticularly, intrasynovially, locally (in pathological formation), inside. In acute and urgent conditions, the drug is injected intravenously slowly or driply.

The average daily intake for adults is 2-3 to 6 mg. The maximum daily dose is 10-15 mg, divided into 3 doses. The duration of parenteral treatment is 3-4 days. Then they switch to maintenance therapy with an oral form. After achieving the therapeutic effect, the dose is gradually reduced to 2-4.5 mg / day. Children are prescribed 0.083-0.333 mg / kg or 0.0025-0.0001 mg / m2 in 3-4 divided doses, depending on the age. Treatment is stopped gradually.

Overdose

Symptoms: may increase the side effects (it is necessary to reduce the dose or cancel the drug).

Treatment: symptomatic.

Precautionary measures

With extreme caution should be used with ulcerative colitis, if there is a threat of perforation; With diverticulitis of the intestine; Newly created intestinal anastomosis; With peptic ulcer; Renal failure; AIDS; With arterial hypertension; Diabetes mellitus; Osteoporosis; Myasthenia gravis; Glaucoma; With mental illness in the anamnesis; In children.

During treatment with Dexason, it is necessary to observe the oculist, control AD, peripheral blood and glycemia.

The effect of the drug is increased in patients with hypothyroidism and liver cirrhosis. Can mask the symptoms of infection. Can enhance existing emotional instability or psychotic disorders. In connection with the occurrence of anaphylactic reactions during parenteral therapy, appropriate precautions should be taken before the administration of the drug (especially in patients with a tendency to drug allergy).

In stressful situations during maintenance treatment (for example, surgical operations, trauma or infectious diseases), a correction of the dose of the drug should be made in connection with an increase in the need for glucocorticosteroids.

With long-term treatment should discuss the appropriateness of the transition from parenteral to oral administration. Long-term use of high doses of the drug requires a gradual dose reduction in order to prevent the development of acute adrenocortical insufficiency. It should be carefully monitored for patients within a year after the end of long-term therapy with glucocorticosteroids in connection with the possible development of a relative insufficiency of the adrenal cortex in a stressful situation.

During treatment with glucocorticosteroids, vaccination should not be given due to a decrease in its effectiveness and possible neurological complications. Dexason is not prescribed for 8 weeks before and 2 weeks after vaccination.

If side effects occur on the part of the CNS (central nervous system) (see "Side effects"), work with mechanisms and management of vehicles should be discontinued.

storage conditions

At a temperature of 15-30 ° C.

Keep out of the reach of children.

Shelf Life

Solution for intravenous and intramuscular injection of 4 mg / ml - 3 years.

Tablets 0.5 mg - 5 years.

Do not use after the expiry date printed on the package.