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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 a brain tumour, neuro-surgical, bacterial meningitis, brain abscess. Pulmonary and respiratory diseases Sever acute asthma attack. Dermatology Oral initial treatment of extensive, severe, acute 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 nature and severity of the disease and the individual response of the patient to treatment. In general, relatively high initial doses are administered, and they should be significantly higher in acute severe forms than in chronic diseases.
, followed by 16–24 mg (up to 48 mg)/ day orally, divided into 3-4 (up to 6) individual doses for 4–8 days. A longer- term, lower-dose administration of Dexamethasone may be required during irradiation and in the conservative treatment of inoperable brain tumours.
4 mg/kg body weight every 12 hours for 2 days, starting before the first antibiotics. 3 mg / kg body weight. − Acute skin diseases: -Depending on the nature and extent of the disease, daily doses of 8-40 mg. Followed by treatment with decreasing doses.
− Active phase of rheumatic system disorders: -Systemic lupus erythematosus 6 -16 mg/day. − Severe progressive form of active rheumatoid arthritis: -In rapidly destructive forms 12-16 mg / day, with extra-articular manifestations 6 - 12 mg/day.
g. tuberculosis, typhoid): 4–20 mg for a few days, only with concomitant anti-infective therapy. − Palliative treatment of malignant tumours: Initially 8-16 mg/day, in prolong treatment 4 -12 mg/day. 75 mg/day as a single dose. If necessary, addition of a mineralcorticoid (fludrocortisone).
g. g. birth) a 10 fold increase.
Treatment of Covid-19:
Adult patients 6 mg IV or PO, 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 IV or PO once a day for up to 10 days. Duration of treatment should be guided by clinical response and individual patient requirements.
Elderly, renal impairment, hepatic impairment:
No dose adjustment is needed. Method of administration The tablets should be taken during or after meal They should be swallowed whole, with a sufficient amount of liquid. The daily dose should be administered as a single dose in the morning, if possible (circadian therapy).
In patients who require a high-dose therapy because of their disease, multiple daily dosing is 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.
Very common (≥ 1/10) - Common (≥ 1/100 to < 1/10) - Uncommon (≥ 1/1,000 to < 1/100) - Rare (≥ 1/10,000 to < 1/1,000) - Very rare (< 1/10,000) - Not known (cannot be estimated from the available data) Hormone replacement therapy: Low risk of undesirable effects with the use of recommended doses.
Pharmacotherapy:
The following undesirable effects may occur; they are highly dependent on the dose and duration of treatment, so their frequency cannot be specified: Tabulated list of adverse reactions Not known Infections and infestations Masking of infection, manifestation and exacerbation of viral infection, fungal infections, bacterial , parasitic and opportunistic infections, activation of strongyloidiasis.
Blood and lymphatic system disorders Moderate leukocytosis, lymphopenia, eosinopenia, polycythemia. g. drug eruption), severe anaphylaxis reaction, 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, plethora,), Metabolism and nutrition disorders Sodium retention with oedema, increase potassium excretion (risk of rhythmias) Weight gain, reduce glucose tolerance, diabetes mellitus, hypercholesterolemia and hypertriglyceridaemia, increased appetite, Psychiatric disorders Depression, irritability, euphoria, increased drive, psychoses, mania, hallucination, emotional liability, anxiety, sleep disorder, suicidality.
4) Vascular disorders Hypertension, increased risk of atherosclerosis and thrombosis, vasculitis (also as withdrawal syndrome after long-term therapy), increase capillary fragility . Gastrointestinal disorders Gastrointestinal ulcers, Gastrointestinal bleeding, pancreatitis, stomach discomfort, hiccups Skin and subcutaneous tissue disorders Striaerubra, atrophy, telangiectasia, petechiae, ecchymosis, Hypertrichosis, steroid acne, Rosacea-like (perioral) dermatitis, changes in skin pigmentation.
Depending on the dose and duration of therapy, an adrenocortical insufficiency caused by glucocorticoid therapy can continue for serveral months, and in individual cases more than a year, after cessation of therapy. ) during treatment with dexamethasone, a temporary increase in dose may be required.
Because of the potential risk in stressful situation, patients on extended therapy should be issued a steroid card. Also in cases of prolonged adrenal insufficiency after cessation of treatment, the administration of glucocorticoids may be necessary in physically stressful situations.
In case case of intended withdrawal, treatment -induced acute adrenal insufficiency may be minimized by slow dose reduction. 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 threadworm ), glucocorticoids can lead to lead activation and mass proliferation of these parasites.
• Poliomyelitis • Lymphadenitis after BCG vaccination • Acute and chronic bacterial infections • In a history of tuberculosis (reactivation risk) use only under tuberculostatic protection In addition, treatment with dexamethasone should only be implemented under strong indications and, if necessary, additional specific treatment must be implemented for: • Gastrointestinal ulcers • Oosteoporosis • Severe cardiac insufficiency • High blood pressure that is difficult to regulate • Difficult to regulate diabetes mellitus • Psychiatric disorders (also in the past), including suicidality: neurological or psychiatric monitoring is recommended • Narrow and wide-angle glaucoma ophthalmic monitoring and adjunctive therapy are recommended • Corneal ulcerations and corneal injuries, ophthalmic monitoring and adjunctive therapy are recommended Because of the risk of an intestinal perforation, dexamethasone must only be used under urgent indication and under appropriate monitoring for: • Severe ulcerative colitis with threatened perforation, possibly without peritoneal irritation • Diverticulitis • Entero-anastomosis (immediately postoperatively) Signs of peritoneal irritation after gastrointestinal perforation may be absent in patients receiving high doses of glucocorticoids.
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Not medical advice. Always read the patient information leaflet and follow your prescriber or pharmacist.
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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.
Musculoskeletal and connective tissue disorders Myopathy, muscle atrophy and weakness, osteoporosis (dose-dependent, possible also in short-term administration), aseptic bone necrosis, endon disorders, tendinitis, tendon rupture, epidural lipomatosis, growth inhibition in children, 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. uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.
The possibility of a higher need for insulin, or oral antidiabetics, must be taken into consideration when administering dexamethasone to diabetics. Regular blood pressure monitoring is necessary during treatment with dexamethasone, particularly during administration of higher doses and in patients with high blood pressure that 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. Serious anaphylactic reactions may occur. The risk of tendon disorder, tendinitis and tendon rupture is when glucocorticoids and fluoroquinolones are administered together.
A concurrent myasthenia gravis may initially worsen during treatment with Dexamethasone . Vaccinations with inactivated vaccine are always possible. However, it should be noted that the immune response and thus the vaccine may be compromised at higher doses of corticosteroids.
During long-term treatment with dexamethasone, regular check-ups with doctors (including opthalmologic 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 the treatment, a negative influence on calcium metabolism can be expected, therfore, the prevention of osteoporosis is recommended. This applies especially to patients with concomitant risk factors, such as familial predisposition, advance age, postmenopausal, 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 glucocorticoid, the following risk must be taken account: exacerbation or relapse of the underlying disease, acute adrenal insufficiency, corticosteroid 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 people have contact with people infected with measles or chickenpox while undergoing treatment with dexamethasone, a preventative treatment should be introduced if necessary.
In post marketing experience tumour lysis syndrome (TLS) has been reported in patients with haematological malignancies following the use of dexamethasone alone or in combination with other chemotherapeutic agents. Patient at high risk of TLS, such as patients with high proliferative rate, high tumour burden, and high sensitivity to cytotoxic agents, should be monitored closely and appropriate precaution taken.
Visual disturbance Visual disturbance may be reported with systemic and topical […]