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DEXAMETHASONE is a brand name for Dexamethasone. The medicine, its uses, side effects and dosage are the same regardless of brand.
Used for: Neurology Cerebral oedema caused by brain tumours, neurosurgery, bacterial meningitis, brain abscesses. Pulmonary and respiratory diseases Severe acute asthma attacks. Dermatology Oral initial treatment of extensive, acute, severe skin diseases that respond to glucocorticoids, such as erythroderma, pemphigus vulgaris…
Verbatim from this product's MHRA label. Tap a section to expand.
Posology Dosage depends on the type and severity of the disease and the individual patient's response to the therapy. In general, relatively high initial doses are used, which must be significantly higher in acute severe courses than in chronic diseases.
, followed by 16 - 24 mg (up to 48 mg)/day orally, divided into 3 - 4 (up to 6) single doses over 4 - 8 days. A longer term, lower- dose administration of Dexamethasone tablets may be necessary during radiotherapy and in the conservative therapy of inoperable brain tumours.
15 mg/kg bodyweight, every 6 hours for 4 days. 4 mg/kg body weight every 12 hours for 2 days, starting before the first antibiotic administration. • Severe acute asthma attacks Adults: 8 - 20 mg, then if required, 8 mg every 4 hours.
3 mg/kg bodyweight. • Acute skin conditions Depending on the type and extent of the disease, daily doses of 8- 40 mg. Followed by treatment with decreasing doses. • Active phases of systemic rheumatic diseases Systemic lupus erythematosus: 6 – 16 mg daily.
• Severely progressive form of Active rheumatoid arthritis In rapidly destructive forms 12-16mg/day, in extra-articular manifestations: 6 - 12 mg/day. g. tuberculosis, typhoid fever) 4 - 20 mg/day for a few days, only with concomitant anti-infective therapy.
• Palliative treatment of malignant tumours Initially 8 - 16 mg/day, for prolonged treatment 4 - 12 mg/day. 75 mg/day, taken as a single dose. If necessary, additional administration of a mineralocorticoid (fludrocortisone). g. g. childbirth) a 10- fold increase.
•For the treatment of Covid-19 Adult patients: 6 mg, intravenously or orally, once a day for up to 10 days.
Paediatric population:
Paediatric patients (adolescents aged 12 years and older) are recommended to take 6 mg/dose, intravenously or orally, once a day for up to 10 days. The duration of treatment should be guided by the clinical response and the individual patient requirements.
Elderly, renal impairment, hepatic impairment:
No dose adjustment is needed. • Prophylaxis and therapy of cytostatic-induced vomiting in the context of antiemetic treatment plans: 0 - 20 mg before starting chemotherapy, then 4 - 8 mg up to 2 to 3 times a day for 1 - 3 days (moderately emetogenic chemotherapy) or up to 6 days (highly emetogenic chemotherapy) if necessary.
Hormone replacement therapy Low risk of side effects if recommended dosages are followed. Pharmacotherapy The following side effects may occur, which depend very much on the dose and duration of therapy and whose frequency cannot therefore be stated.
Infections and infestations Masking of infections, manifestation and exacerbation of viral infections, fungal infections, bacterial, parasitic and opportunistic infections, activation of strongyloidiasis. Blood and lymphatic system disorders Moderate leukocytosis, lymphocytopenia, eosinopenia, polycythemia.
g. drug eruption), severe anaphylactic reactions, such as arrhythmias, bronchospasm, hypo- or hypertension, circulatory collapse, cardiac arrest, weakening of the immune system. Endocrine disorders Adrenal suppression and induction of Cushing’s syndrome (typical symptoms: moon face, central obesity and plethora).
Metabolism and nutrition disorders Sodium retention with oedema, increased potassium excretion (risk of arrhythmias), weight gain, reduced glucose tolerance, diabetes mellitus, hypercholesterolemia and hypertriglyceridemia, increased appetite.
Psychiatric disorders Depression, irritability, euphoria, increased drive, psychoses, mania, hallucinations, emotional lability, anxiety, sleep disorders, suicidality. Nervous system disorders Pseudotumor cerebri, manifestation of latent epilepsy, increase in seizure susceptibility in manifest epilepsy.
4). Vascular disorders Hypertension, increased risk of atherosclerosis and thrombosis, vasculitis (also as withdrawal syndrome after long-term therapy), increased capillary fragility. Gastrointestinal disorders Gastrointestinal ulcers, gastrointestinal bleeding, pancreatitis, stomach discomfort, hiccups.
Skin and subcutaneous tissue disorders Striae rubra, atrophy, telangiectasias, petechiae, ecchymosis, hypertrichosis, steroid acne, rosacea-like (perioral) dermatitis, changes in skin pigmentation. Musculoskeletal and connective tissue disorders Myopathy, muscle atrophy and weakness, osteoporosis (dose-dependent, possible also in short-term administration), aseptic bone necrosis, tendon disorders, tendinitis, tendon rupture, epidural lipomatosis, growth inhibition in children.
Depending on the dose and duration of therapy, adrenalcortical insufficiency caused by glucocorticoid therapy may continue for several months and in individual cases more than a year after cessation of therapy. ) during treatment with Dexamethasone tablets, a temporary increase in dose may be required.
Because of the potential risk in stress situations, patients on extended therapy should be issued a steroid card. Also in prolonged adrenal insufficiency after cessation of treatment, the administration of glucocorticoids may be necessary in physical stress situations.
In case of intended withdrawal, treatment- induced acute adrenal insufficiency may be minimized by slow dose reduction. Infections and vaccinations Through immunosuppression, treatment with Dexamethasone can lead to an increased risk of bacterial, viral, parasitic, opportunistic and fungal infections.
It can mask the symptoms of an existing or developing infection, thereby making a diagnosis more difficult. Latent infections, like tuberculosis or hepatitis B, can be reactivated. g. nematodes) • in patients with suspected or confirmed strongyloidiasis (infection with thread worms, as glucocorticoids may lead to activation and mass proliferation of these parasites • poliomyelitis • lymphadenitis following BCG vaccination • acute and chronic bacterial infections • if there is a history of tuberculosis (reactivation risk), use only under tuberculostatic drugs protection.
In addition, therapy with dexamethasone should only be implemented under strong indications and, if necessary, additional specific treatment must be implemented in the following conditions: • gastrointestinal ulcers • osteoporosis • severe cardiac insufficiency • high blood pressure that is difficult to regulate • diabetes mellitus that is difficult to regulate • psychiatric disorders (including in the past), including suicidality: neurological or psychiatric monitoring is recommended.
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Not medical advice. Always read the patient information leaflet and follow your prescriber or pharmacist.
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5 mg/kg bodyweight (max. 16 mg). Method of administration The tablets should be swallowed whole after a meal and taken with plenty of liquid. The daily dose should be administered as a single dose in the morning if possible (circadian therapy).
In patients who require high-dose therapy because of their disease, multiple daily doses are often required to achieve maximum effect. Depending on the underlying disease, clinical symptoms and response to therapy, the dose can be reduced at a faster or slower rate and the therapy stopped, or the patient is stabilised on a maintenance dose as low as possible and, if necessary, adrenal axis monitored.
Basically, the dose and duration of treatment should be kept as high and long as necessary, but as low and short as possible. In principle, the dose should be reduced gradually. In long-term therapy which is deemed necessary following initial treatment, patients should be switched to prednisone/prednisolone, because this leads to lower adrenal suppression.
In hypothyroidism or liver cirrhosis, low doses may be sufficient or a dose reduction may be necessary.
Note:
Too rapid dose reduction after long-term treatment may cause symptoms such as muscle and joint pain. Reproductive system and breast disorders Disorders of sexual hormone secretion (consequently: irregular menstruation up to amenorrhea, hirsutism, impotence).
General disorders and administration site conditions Delayed wound healing. Reporting of suspected adverse reactions Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product.
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• narrow- and wide-angle glaucoma: ophthalmic monitoring and adjunctive therapy are recommended. • corneal ulcerations and corneal injuries: ophthalmic monitoring and adjunctive therapy are recommended. g. patients with chronic obstructive pulmonary disease) but not requiring supplemental oxygen.
Gastrointestinal disease Because of the risk of intestinal perforation, Dexamethasone tablets should only be used where there are compelling reasons to do so and under appropriate monitoring in: • severe ulcerative colitis with an imminent perforation, this may occur without peritoneal irritation • diverticulitis • enteroanastomosis (immediately after surgery).
The signs of peritoneal irritation following gastrointestinal perforation may be absent in patients receiving high doses of glucocorticoids. Diabetes The possibility of a higher need for insulin or oral antidiabetics must be taken into consideration when administering Dexamethasone tablets to diabetics.
Other conditions:
Regular blood pressure monitoring is necessary during treatment with Dexamethasone tablets, particularly during administration of higher doses and in patients with high blood pressure that is difficult to regulate. Because of the risk of deterioration, patients with severe cardiac insufficiency should be carefully monitored.
With high doses of dexamethasone bradycardia may occur. Severe anaphylactic reactions may occur. The risk of tendon disorders, tendinitis and tendon rupture is increased when fluoroquinolones and glucocorticoids are administered together.
A concurrent myasthenia gravis may initially worsen during treatment with Dexamethasone tablets. Vaccination with inactivated vaccines are possible. However, it should be noted that the immune response and thus the response to the vaccine may be compromised at higher doses of corticosteroids.
During long-term therapy with Dexamethasone tablets, regular medical checks (including ophthalmologic every three months) are indicated. At high doses, sufficient calcium intake and sodium restriction should be ensured and serum potassium levels should be monitored.
Depending on the dose and duration of treatment, a negative effect on calcium metabolism can be expected; therefore, the prevention of osteoporosis is recommended. This applies especially to patients with concomitant risk factors, such as familial predisposition, advanced age, postmenopausal period, insufficient protein and calcium intake, heavy smoking, excessive alcohol consumption and lack of physical activity.
Prevention consists of sufficient calcium and vitamin D intake and physical activity. In already existing osteoporosis, additional drug therapy should be considered. Upon termination of long-term administration of glucocorticoids, the following risks must be taken into account: • exacerbation or relapse of the underlying disease, • acute adrenal insufficiency, • cortisone withdrawal syndrome.
Certain viral diseases (chickenpox, measles) may be very severe in patients treated with glucocorticoids. Immunocompromised patients without previous chickenpox or measles infection are particularly at risk. If these patients have contact with people infected with measles or chickenpox while undergoing treatment with Dexamethasone tablets, a preventative treatment should be introduced, if necessary.
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