Indications

Dexamethasone can be used for all forms of general and local glucocorticoid injection therapy and all acute conditions in which intravenous glucocorticoids may be life-saving.

Dosage and Administration

Dosage: Dosage must be individualized on the basis of the disease and the response of the patient. Adults: Usual adult initial dosage is 0.5 mg-20 mg a day.

Usage:I.M. / I.V.

Precautions & Warning:

1. Adrenal suppression: May cause hypercorticisni. or suppression of hypothalamic-pituitary adrenal (HP A) axis, particularly in younger children or in patients receiving high doses for prolonged periods.

2. Immunosuppression: Prolonged use of corticosteroids may also increase the incidence of secondary infection, mask acute infection (including fungal infections), prolong or exacerbate viral infections, or limit response to vaccines.

3. Diabetes: Use with caution in patients with diabetes mellitus; may alter glucose production or regulation leading to hyperglycemia. Gastrointestinal disease: Use with caution in patients with GI diseases (peptic ulcer, ulcerative colitis) due to perforation risk.

4. Use with caution in patients with Diabetes, Cardiovascular disease, Hepatic Impairment, Cirrhosis, Myasthenia gravis, Myocardial infarction (MI), Ocular disease, Osteoporosis, Renal impairment, a history of seizure disorder, Elderly, .

5. Thyroid disease: Changes in thyroid status may necessitate dosage adjustments; metabolic clearance of corticosteroids increases in hyperthyroid patients and decreases in hypothyroid ones.

6. Discontinuation of therapy: Withdraw therapy with gradual tapering of dose.

7. Pediatrics: May affect growth velocity; growth should be routinely monitored in pediatric patients.

Adverse Reactions:

1. Cardiovascular: Arrhythmia, bradycardia, cardiac arrest, cardiomyopathy, CHF, circulatory collapse, edema, hypertension, myocardial rupture (post-MI), syncope, thromboembolism, vasculitis.

2. Central nervous system: Depression, emotional instability, euphoria, headache, intracranial pressure increased, insomnia, malaise, mood swings, neuritis, personality changes, pseudotumor cerebr (usually following discontinuation), psychic disorders, seizure, vertigo.

3. Dermatologic: Acne, allergic dermatitis, alopecia, angioedema, bruising, dry skin, erythema, fragile skin, hirsutism, perianal pruritus (following LV. injection), petechiae, rash, skin atrophy, urticaria, wound healing impaired. Endocrine & metabolic: Adrenal suppression, carbohydrate tolerance decreased, Cushing's syndrome, diabetes mellitus, glucose intolerance decreased, growth suppression (children),hyperglycemia, hypokalemic alkalosis, menstrual irregularities, negative nitrogen balance,pituitary-adrenal axis suppression, protein catabolism, sodium retention

4. Gastrointestinal: Abdominal distention, appetite increased, gastrointestinal haemorrhage,gastrointestinal perforation, nausea, pancreatitis, peptic ulcer, ulcerative esophagitis, weight gain.

5. Genitourinary : Altered (increased or decreased) spermatogenesis

6.  Local: Post injection flare (intra-articular use), thrombophlebitis Neuromuscular & skeletal: Arthropathy, aseptic necrosis (femoral and humoral heads), fractures, muscle mass loss, myopathy (particularly in conjunction with neuromuscular disease or neuromuscular-blocking agents), neuropathy, osteoporosis, parasthesia, tendon rupture, vertebral compression fractures, weakness.

7. Ocular: Cataracts, exophthalmos, glaucoma, and intraocular pressure increased.

Storage instructions:

Store below 30°C. Protect from light.