Dexamethasone injection solution 4mg/1ml Vinphaco treat asthma, severe allergic disease (10 tubes x 1ml)
Dosage form Box of 1 blister x 10 tubes
Specifications Dexamethasone
Ingredient Vinh Phuc Pharmaceutical Joint Stock Company (Vinphaco)
Ingredient
Thành phần cho 1 ống
| Composition information | Content |
| Dexamethasone | 4mg |
Uses
indicated
Dexamethasone injection solution 4mg indicated treatment in the following cases:
The drug is indicated in emergency cases or when the patient cannot drink.
Non -specific therapy with steroids, when needed to be active, such as asthma treatment, severe allergic disease, post -blood transfusion reaction, laryngitis.
Used in combination with other treatments in the brain edema, in shock due to various causes.
Steroid prevention during surgery when storing glucocorticoid is considered insufficient, except for the elongated radio failure (Addison disease).
Use dexamethason before birth during labor before term (between 24 and 34 weeks) to promote the process of adults (eg lungs, brain blood vessels).
Dexamethasone support therapy in the treatment of pneumococcal meningitis.
Prevent nausea and vomiting caused by cancer chemotherapy.
Local treatment: weight and joint injection in patients with rheumatoid arthritis, osteoarthritis, arthritis, convex inflammation.
Pharmacology
ATC code: A01AC02
dexamethason is fluomethylprednisolon, synthetic glucocorticoid. Glucocorticoids act by binding to the receptor in the cell, transferring into the cell nucleus and there affects some translated genes.
Glucocorticoids also have some direct effects, may not be intermediaries attached to the receptor. Dexamethasone has the main effects of glucocorticoids are anti -inflammatory, anti -allergy and immunosuppressive, while the effect of electrolyte balance is very small.
About anti -inflammatory activity, dexamethason is 30 times stronger than hydrocortison, 7 times stronger than prednisolon.
With pharmacological dose, dexamethason used body inhibits the pituitary gland release corticotropin (ACTH), causing the adrenal shell to stop the endogenous corticosteroid hormone (causing secondary adrenal implants).
If it is necessary to treat with long -term glucocorticoids, use only the drug at the lowest possible doses and usually only use as a drug that supports other treatment. When the body therapy is stopped with pharmacological doses, it is necessary to reduce the dose gradually, until the function of the hill - pituitary - the adrenal gland is recovered.
Dynamic pharmacokinetics
After injection, dexamethasone sodium phosphate hydrolyzes quickly into dexamethasone. The drug allocated into all tissues in the body, through the placenta and a small amount of milk.
When intramuscularly, the time to reach the peak concentration in plasma is about 8 hours, when intravenously at a dose of 20mg, the peak concentration appears in plasma after 5 minutes. The drug is also associated with plasma proteins (up to 77%) and mainly albumin.
The drug is highly absorbed in the liver, kidneys and adrenal glands. Metabolism in the liver slowly and excreted mainly through urine (65% of the dose of excretion through the urine within 24 hours), most of the form of non -conjugated steroids.
Dexamethasone's sale time is 36 - 54 hours, so the drug is especially suitable for diseases that need glucocorticoid -acting glucocorticoids.
Before taking Dexamethasone injection solution 4mg/1ml Vinphaco treat asthma, severe allergic disease (10 tubes x 1ml)
How to use
dexamethasone sodium phosphate: injected in the joint, in the epidemic bag, in soft tissue lesions, intramuscular or intravenous or intravenous.
The drug is indicated for intramuscularly or intravenously in emergency cases or when the patient cannot drink.
It should be noted that although the sodium phosphate dexamethasone is absorbed quickly at the intramuscular position, the absorption rate of the drug is still slower than intravenous injection.
When intravenous infusion, the drug can be diluted in the Dextrose or Sodium Chloride injection solution.
Dosage
Dexamethasone sodium phosphate dosage is calculated according to dexamethasone phosphate.
Injecting or intramved dose depends on the disease and the response of the patient, but the initial dose is usually within 0.5 to 24 mg/day.
Children can use 6 - 40 micrograms/kg or 0.235 - 1.2 mg/batch, intramuscularly or intravenously, 1 or 2 times/day.
shock (due to reasons)
The dose of 1 - 6 mg/kg dexamethasone phosphate is intravenous 1 time or 40 mg intravenous intravenously 2-6 hours apart, if necessary. Another way, at first intravenously 20 mg, then continuous intravenous infusion 3 mg/kg/24 hours.
Severe shock treatment is used 2 - 6 mg/kg dexamethasone phosphate intravenous intravenously, minimum injection time is 3-5 minutes. High dose therapy must be continued until the patient stabilizes and usually does not exceed 48 - 72 hours.
cerebral blessing
Intravenous injection initially corresponds to 10 mg of dexamethasone phosphate, followed by 4 mg intramuscular injections 6 hours/time, until the symptoms of cerebral edema are gone.
The response is usually clearly within 12 -24 hours and the dosage may decrease after 2 -4 days and stop gradually over 5 -7 days. When possible, replace intramuscularly with oral dexamethasone (1 - 3 mg/time, drink 3 times daily).
It is possible to use a much higher dosage regimen in acute brain edema threatening, initially corresponding to 50 mg of dexamethasone phosphate intravenously, while gradually reducing every 8 mg decrease in intravenous dose for 7 to 13 days. For patients with unable to open or recurrent brain tumors, the maintenance dose of dexamethasone phosphate 2 mg, intramuscularly or intravenously, 2 or 3 times daily, can be effective reducing symptoms of intracranial pressure.
Child dosage: Intravenous injection of initial dose 1 - 2 mg/kg/day (a single dose), maintenance dose 1 - 1.5 mg/kg/day (maximum 16 mg/day), divided into several doses 4-6 hours apart, stop gradually over 1-6 weeks.
Preventing hearing loss and neurological sequelae in H. Influenzae or pneumococcal
Take the dose of 10mg dexamethasone phosphate, intravenously 4 times/day, injection at the same time or within 20 minutes before taking the first antibiotic dose and continue for 4 days.
Prevention of infant's breathing syndrome
Intramuscularly for the mother, starting at least 24 hours or earlier (preferably 48 - 72 hours) before early labor: 4 mg/time 8 hours apart, 2 days.
Allergy
Acute allergy stabilizes or exacerbations of chronic allergies.
The first day, intramuscularly dexamethasone phosphate 4 - 8 mg; On the 2nd and 3rd day, drink dexamethasone 3 mg divided into 2 doses; Wednesday, oral 1.5 mg divided into 2 doses; On Thursday and Friday, take a single dose daily 0.75 mg, then stop.
Inflammation disease:
injection in joints:
Prevention of vomiting and nausea due to cancer chemotherapy
Prophylaxis: Angeling 10 - 20 mg before chemotherapy 15 - 30 minutes per day for treatment.
Continuous infusion mode: intravenous injection 10 mg/12 hours at every treatment day.
Chemotherapy is slightly: intramuscularly, intravenously 4 mg every 4 - 6 hours.
Children with anti -vomiting (before chemotherapy): intravenous injection of 10 mg/mº (starting dose), followed by a dose of 5 mg/m/6 hours when needed either or 5 - 20mg before chemotherapy 15 - 30 minutes.
Draw or edema when managing
intramuscular injection, intravenous injection 0.5 - 2 mg/kg/day divided into several times 6 hours apart, before withdrawing 24 hours and then continuing to use 4-6 doses.
General principles
Dosage should vary depending on the patient, the degree of inflammation, wide inflammation, inflammatory position and response of the patient.
To minimize the side effects, the smallest dose should be used to effectively treat.
The drug has a long time (36 - 54 hours), so when using the doses of Japan, there is no time to recover the adrenal gland between the doses.
Secondary adrenal insufficiency because of the drug, may be due to stopping the drug too fast, and may be limited by reducing the dose slowly after weeks or months depending on the dose, treatment time, but it may still exist for months after stopping the drug.
Patients should avoid drinking alcohol, restricting caffeine, do not reduce the dose or stop the drug without the doctor's approval, avoid exposure to measles, chickenpox; If exposed, the physician should be notified immediately, notify the physician if there is an acute physical pain including fever and other symptoms of infection. Patients need to notify the physician that they are taking corticosteroid therapy before a certain surgery or injury.
Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.What do
do when overdose? There is no specific antidote.
There is no indication for the treatment of chronic poisoning, unless the patient is too sensitive to corticosteroids, causing pathology; At that time, it is necessary to treat symptoms.
Anaphylaxis or hypersensic reactions can be treated with epinephrin, artificial respiration and aminophylin.
Patients should be kept warm and quiet.
In an emergency, call the 115 emergency center immediately or go to the nearest local health station.
What to do when you forget 1 dose? However, if the time to relax with the next dose is too short, skip the dose and continue the calendar of the drug. Do not use double dose to compensate for missed dose.
Side Effects
Unwanted effects (ADR) when using Dexamethasone 4mg that you may encounter.
Common: ADR> 1/100
electrolyte disorders:
Endocrine and metabolism:
Gastrointestinal tract:
Skin:
Eyes:
Hypersensitivity includes anaphylactic reaction that has been reported. Leukemia, thrombosis.
Symptoms and signs of drug stops
Reduce too fast the drug after prolonged treatment can lead to acute adrenal insufficiency, hypotension and death. Stop stopping is sometimes like relapse. Symptoms of cessation include fever, muscle pain, joint pain, rhinitis, conjunctivitis, weight loss, nodules on the skin.
When experiencing side effects of the drug, patients need to stop using and notify the doctor or go to the nearest medical facility for timely treatment.
Warnings
Before using the drug you need to read the instructions carefully and refer to the information below.
Contraindicated
Dexamethasone injection solution 4mg contraindicated in the following cases:
Be cautious when using
Should use the lowest dose to work in the shortest time, use a single dose in the morning or daily treatment mode to minimize unwanted effects.
Monitor patients regularly to adjust the dose accordingly.
After the injection of Dexamethason may occur serious anaphylactic reactions such as laryngeal edema, urticaria, special bronchial spasms in patients with a history of allergies.
If anaphylactic reaction occurs, treat patients with adrenalin and positive pressure ventilation.
Using dexamethason in patients with mental problems can make the disease progress more seriously. The signs that start after a few days or a few weeks of medication, usually occur in high doses and most of the signs will disappear when reducing the dose or stopping the drug.
However, if they occur, they may need treatment. Need to immediately notify health workers if the patient has any mental signs, especially depressed or intended to commit suicide.
In the process of taking the drug if an infection appears or suspected infection, special attention and treatment with specific antibacterial drugs are necessary first, due to immunosuppressive effects, dexamethasone can cause infections and spread. However, infected meningitis people need to use dexamethasone before taking specific antibacterial drugs to prevent encephalitis due to reaction to the bacterial body pieces that have been destroyed by antibacterial drugs.
Do not use corticosteroids in patients with head injuries or strokes due to no evidence of the beneficial effects of drugs in these patients.
Patients who are using dexamethasone should avoid contact with measles, chickenpox or herpes virus. If the exposure occurs, it is necessary to immediately notify health workers.
Do not use live vaccines for patients with immunodeficiency due to response to the vaccine.
Be cautious when using systemic corticosteroids in patients with problems such as osteoporosis (especially postmenopausal women), hypertension, congestive heart failure, history of mental disorders, diabetes, a history of tuberculosis, glaucoma or a family of glaucoma, myasthenia map, liver failure, kidney failure, epilepsy, stomach ulcers, cuding pain.
When using, it is necessary to closely monitor the patient condition.
Using dexamethason in patients with high risk of tumor syndrome (TLS) should be closely monitored and have appropriate preventive measures.
Use in children:
dexamethasone causes developmental retardation in children. Be careful to monitor the development of children when using this drug on a regular basis, especially premature babies.
There has been evidence that after early treatment (
Used in the elderly: The unexpected effects of dexamethasone may be more serious in elderly patients, especially osteoporosis, hypertension, hypokalemia, diabetes, sensitive to infections, thin skin. It is necessary to be monitored with clinical symptoms when taking drugs on this object to avoid life -threatening reactions.
Do not stop the drug suddenly. Dexamethasone dose should be reduced from before stopping completely to avoid acute adrenal failure.
In dexamethasone injection contains sodium metabisulfit. This substance can cause allergic reactions including hypersensitivity symptoms such as bronchospasm and anaphylactic shock, especially people with bronchial asthma. Therefore, be cautious when taking drugs in these patients.
Women during pregnancy and lactation
Pregnant women:
The drug can pass through the placenta. Glucocorticoid has the potential to cause monsters in animals. However, that is not entirely true for people.
The drug can reduce the weight of the placenta and the fetal weight.
The drug can also inhibit the adrenal glands in newborns if the mother uses the drug for a long time. Using glucocorticoid before premature birth has shown to protect against the risk of neonatal respiratory failure and lung -bronchial dysplasia due to premature birth. Medication should only be used for pregnant women when assessing the benefits for mothers who are superior to the risk of the fetus.
breastfeeding women:
dexamethason into breast milk and at risk for breastfed babies. Be careful when using dexamethason in breastfeeding women.
The ability to drive and operate machinery
The drug can cause insomnia, hypertension, hallucinations. Therefore, it is necessary to be cautious when taking drugs in drivers, operating machinery or doing other tasks to be alert.
Drug interaction
Rifampicin, Rifabutin, Ephedrin, Carbamazepin, Phenylbutazon, Phenobarbital, Phenytoin, Primidon and Aminoglutethimid enhances the metabolism of dexamethasone, leading to reduced treatment effects of the drug. Therefore, avoid combining these drugs with dexamethasone.
Dexamethason is a moderate induction CYP 3A4, so it is used simultaneously with drugs that are metabolized by CYP 3A4 (for example, indinavir, erythromycin) that can increase the transformation of drugs into non -active forms that lead to reduced effects of the drug.
The effectiveness of anti -cholinesterase drugs is antagonistic by dexamethasone in the treatment of myasthenia gravis.
Dexamethasone optimizes the effect of hypoglycemic drugs (including insulin), anti -hypertension drugs, cardiac glycosides, diuretics.
corticosteroid increases the hypotension effect of acetazolamid, carbenoxolon.
The effect of anticoagulant coagulants can be increased when used simultaneously with corticosteroids. Need to closely check the blood clotting time or prothrombin to avoid spontaneous bleeding.
corticosteroid increases salicylate clearance. Therefore, corticosteroid stops can lead to salicylate poisoning.
Avoid simultaneous use of dexamethason with the following drugs: Everolimus, Natalizumab,
nilotinib, Nisoldipin, Ranolazin, Totvantan, Living Vaccine.
Increasing toxic effects: Dexamethasone can increase the effects of amphotericin B, acetylcholinininthinines inhibitors, cyclosporin, lenalidomid, strap diuretics, natalizumab, thalidomid, nonsteroidal anti -inflammatory drugs (COX - 2 inhibitors), non -steritis anti -inflammatory drugs (non -selective), live vaccines, warfarin.The effect of dexamethasone may be increased by: Aprilitant, asparaginase, calcium channel blockers (not dihydropyridine); Anti -fungal substances (Azol derivatives, systemic effects); CYP3A4 (medium) inhibitors; CYP3A4 (strong) inhibitors; Estrogen derivatives; Masomacial blocks (non -reducing); p - glycoprotein inhibitors; Quinolon antibiotics; dasatinib, salicylat, trastuzumab.
Dexamethason can reduce the effect of CYP3A4 substrates, p - glucoprotein substrates, anti -diabetic agents, Calcitriol, Caspofungin, Corticorelin, Dabigatran Ethilate, Everolimus, Isoniazid, Maraviroc, Nilotinib, NisoldiPin, Ranolazin, Ranolazin, Censes Salicylat, Sorafenib, Totvartan, inactivated vaccine.
The effect of dexamethasone may be reduced by: barbiturat, bile acid seizure, strong CYP3A4 induction substances, P - Glycoprotein induction substances, antacids, rifamycin derivatives, deferasinox.
Using corticosteroid therapy may need a diet to increase the amount of potassium, vitamin A, vitamin A, C, D, folate, calorpho, zinc and phosphorus and reduce sodium.
Salicylate clearance increases when used simultaneously with corticosteroids, so when corticosteroids are susceptible to salicylate poisoning.
Diuretics reduce potassium (e.g. thiazid, furosemid) and amphotericin B can increase the effect of reducing blood potassium of glucocorticoids.
Cavalry:
dexamethasone sodium phosphate is similar to daunorubicin, doxorubicin, vancomycin, not used in combination with these drugs. Dexamethason is also similar to Doxapram hydrochloride and glycopyrolate in syringes.
Storage
Leave a cool place, avoid light, temperature below 30⁰C.
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