Diprospan Injection (5+2) Mg/ml Merck treat muscle and soft tissue, allergies (1 tube x 1ml)

Dosage form Bottle
Specifications Betamethasone disodium phosphate, betamethasone dipropionate

Ingredient

Composition information	Content
Betamethasone disodium phosphate	2mg
Betamethasone dipropionate	5mg

Uses

indications

Diprospan Injection is indicated in the following cases:

Treatment of acute and chronic diseases that respond to corticosteroids. Corticosteroid hormone treatment is only supportive, not replaced for conventional treatment.

allergic disease: Chronic bronchial asthma (including treatment for asthma), dry grass fever, neurological angio, allergic bronchitis, seasonal or chronic allergic rhinitis, drug reactions, serum, insect burning. Neuritis (Lichen Simplex localized); Multi -functional exposure due to sunlight; medal; Lichen wide wide necrosis of diabetes, hair loss in each area, lupus erythema in form of disc, psoriasis, keloid scars; Pemphigus disease; Herpes dermatitis, cystic acne. inflammatory dermatitis; Around the nodules.

Property disease: Temporary control of leukemia and lymphoma in adults, acute leukemia in children. Foot diseases (active inflammation with hard, hard toe, five toes inward), diseases that need to be injected under the conjunctiva, hematitis disorders respond to corticosteroids, nephritis and nephrotic syndrome.

Diprospan Injection is recommended

intramuscularly in diseases that respond to corticosteroids used in the body.

Inject directly into soft tissue when indicated.

Injected into joints and around joints in joint disease.

Injected into the injury name in other skin diseases.

Local injection in some inflammatory and follicular diseases.

Pharmacology

Corticosteroid's exact mechanisms are still not clearly understood. At the pharmacius, natural glucocorticoids and synthetic glucocorticoids, such as betamethasone, are mainly used for anti -inflammatory and/or immunosuppressive effects.

Betamethasone does not affect the activity of mineralocorticosteroid hormone, so in cases of adrenal insufficiency may occur, treatment with individually betamethasone is incomplete.

Similar synthetic substances of the adrenal hormone, including betamethasone diprodionate and betamethasone disodium phosphate is absorbed right from the injection site, helps bring local and body treatment effects as well as other pharmacological effects.

Diprospan Injection is a preparation that combines the ester of Betamethasone soluble and soluble very little in water for strong anti -inflammatory, anti -rheumatic and anti -allergic effect in the treatment of diseases responding to corticosteroids. The quick treatment effect is due to the soluble ester in water, betamethasone disodium phosphate, absorbed quickly after injection. The prolonged effect of the drug is due to Betamethasone Dipropionate, which is a soluble substance in water and becomes a reserve warehouse for gradual absorption, thus helping to control symptoms for a long time. With the small crystal size of Betamethasone Dipropionate allows the use of small needles (up to 26) for injection in the skin and injected into the injury area.

Glucocorticosteroids such as betamethasone cause strong, diverse metabolic effects and reduce the body's immune response to different stimuli.

Betamethasone has high glucocorticosteroid properties and weak mineralocorticosteroid properties.

pharmacokinetics

as well as other glucocorticosteroids, betamethasone is metabolized in the liver. Chemically, Betamethasone is significantly different from natural corticosteroids, which explains its metabolic difference. Betamethasone's plasma sale time or oral or injected is> 300 minutes, while the sale time of hydrocortisone is approximately 90 minutes. In patients with liver disease, Betamethasone clearance rate is slower than patients with normal liver.

It seems that the biological effect of corticosteroids is more affected by free corticosteroids rather than the total corticosteroid concentration in plasma. Betamethasone linked to plasma proteins significantly (on average about 62.5%); However, in normal plasma concentrations, the protein bonding rate of hydrocortisone is 89%. Although the plasma concentration of Betamethasone is 100 times higher than Hydrocortisone, it does not affect the link of hydrocortisone, because Betamethasone is linked mainly with albumin.

There is no specific relationship between the concentration of corticosteroids in the blood (all -form or free form) and the treatment effect, due to the pharmaceutical effect of corticosteroids is extended after the time of corticosteroids detected in plasma. While the sale time of betamethasone when used in the whole body is> 300 minutes, the selling time for bioactivity is 36 to 54 hours.

Before taking Diprospan Injection (5+2) Mg/ml Merck treat muscle and soft tissue, allergies (1 tube x 1ml)

How to use

Diprospan Injection drugs for injection.

Dosage

The dose is not fixed and should be adjusted based on each disease, the severity of the disease and the patient's response.

should maintain or adjust the starting dose until there is a good response. If the clinical response is not good after a suitable time, it is advisable to stop using Diprospan Injection and replace it with other appropriate treatments.

Using body

To use the whole body, in most cases of treatment usually starts from 1 to 2 ml and repeat if necessary. Deep intramuscular injection (IM) into the buttocks. Dosage and distance between doses depending on the severity of the disease and response to treatment may need a starting dose of 2 ml in case of severe illness such as erythema lupus or asthma, when it is necessary to treat with the appropriate regimen to save the patient's life.

used on the spot

rarely use in combination with a local anesthetic. If used in combination with local anesthetic, Diprospan Injection can be used (in the syringe, not mixed in the vial) with Procaine Hydrochloride or 1% or 2% Lidocaine, using non -paraben -free drugs. Similar anesthetic can be used. Do not use with anesthesia containing methylparaben, propylparaben, pherol, etc.. Firstly, the dipan Injection's offer should be drawn from the vial into the syringe, then draw anesthetic into the syringe and shake well.

In acute inflammation of Delta, under the same shoulder, elbow and front of the patella bone, Diprospan Injection 1 - 2 ml injection into the epidemic bag can relieve pain and restore dynamics completely for a few hours. It is possible to treat chronic active inflammation in lower doses when you have control over acute symptoms. Can reduce acute tendonitis, tendonitis and surround inflammation with a Diprospan Injection injection. For the chronic forms of the above diseases, depending on the patient's condition to consider the injection repeat.

Can relieve pain, reduce aches and stiffness in rheumatoid arthritis and osteoarthritis for 2 to 4 hours after injection 0.5 ml to 2 ml of Dippran Injection into the joint. In most cases, the remission time with different degrees in both diseases is 4 weeks or more.

Diprospan Injection is well tolerated into the joint and the mine around the joint when injected into the joint. Dosage for injection in the joint: large joints (knees, groin, shoulders) are 1 to 2 ml, medium joint (elbows, wrists, ankles) is 0.5 to 1 ml, small joints (feet, hands, chest) is 0.25 to 0.5 ml.

Dermatological diseases can respond to Diprospan Injection injection into the lesion. Due to the systemic effect of weak drugs, some lesions are not directly treated. In the treatment of lesions, the dipan Injection doses in the proposed skin are 0.2 ml/cm2. The total dose of Diprospan Injection is injected in all positions that should not exceed 1 ml per week.

Can use diprospan Injection effectively in foot diseases that respond to corticosteroid treatment. It is possible to control the inflammation of the bar under the hardened bottle by injection 0.25 mg at a time and 2 times in a row. The recommended dose with the gap between the dose is 1 week as follows: Inflammation of the bar under the hard or soft bottle is 0.25 to 0.5 ml, inflammation of the fluid under the heel bone convex is 0.5 ml; Inflammation caused by hard toe is 0.5 ml; Inflammation of the epidemic caused by 5 toes to each other is 0, 5 ml; The joint capsule is 0.25 to 0.5 ml; Morton neuralgia (boring table aches) is 0.25 to 0.5 ml; Inflammation around the tendon is 0.5 ml; Membrane inflammation surrounding the box is 0.5 ml and acute arthritis is 0.5 to 1 ml.

After good response, the appropriate maintenance dose should be determined by reducing the small amount of doses from the head in appropriate spaces until the lowest dose reaches and still maintaining appropriate clinical response.

If the patient is in contact with a stressful environment that is not related to the disease, it may increase the dose of Diprospan Injection. If the medication is needed after prolonged treatment, the dose should be reduced slowly.

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 to do when overdose?

Symptoms

Extremely acute due to glucocoticosteroids, including betamethasone, often not life -threatening. Except for severe overdose, glucocorticosteroid overdose within a few days is almost no serious harm, except for special contraindications, such as diabetics, glaucomes, or progressive stomach ulcers, or patients taking digitals, anticoagulants of Coumarine or diuretics that lose Kail.

Treatment

Complications due to metabolic effects of corticosteroids or from the harmful effects of the main disease or combined disease or from drug interactions should be properly treated.

Maintain adequate amounts of drinking water and control electrolytes in serum and urine, paying special attention to sodium and potassium balance. If necessary, adjust the electrolyte imbalance.

What to do when forgetting a dose?

The drug is only used under monitoring and monitoring by medical staff, so there is no case of forgetting the dose.

Side Effects

When using Diprospan Injection, you may experience unwanted effects (ADR).

Side effects of Diprospan Injection are the same as the side effects reported when using other corticosteroids, related to the dose and treatment time. Usually these side effects can recover or minimize by reducing the dose; General stopping the drug is the most appropriate.

Water and electrolyte disorders

Keep sodium, potassium loss, alkaline hypotension, water retention, congestive heart failure in sensitive patients, high blood pressure.

Muscle system

Myasture, muscle disease caused by corticosteroids, reduced muscle mass; worsen the symptoms of myasthenia gravis in severe myasthenia gravis; osteoporosis; broken spine subsidence; Aseptic necrosis of the femur and arm bone; Demons with long bones; tendon broken; joint instability (due to the injection repeated in the joints).

digestive system

hiccup; Stomach ulcers may later cause perforation and hemorrhage; pancreatitis; bloating; esophageal ulcer.

Slow wound healing; Skin atrophy; thin skin, hemorrhagic spots and hemorrhagic spots; Red rash on the face; increase sweating, eyes reactions to skin tests; Reactions such as atopic dermatitis, jute sesame, nerveemia.

Neurology

convulsions; Increased intracranial pressure with thorny gai (fake brain tumor) often after treatment, dizziness; headache.

Endocrine

abnormal menstrual periods; expression like Cushing; inhibit the development of the embryo inside the uterus or the growth of the child; Do not respond secondary to the adrenal and pituitary gland, especially in the stress stage such as trauma, surgery or disease; Reduce carbohydrate intolerance, outbreaks of potential diabetes, increased insulin demand or hypoglycemic drugs in diabetes.

Eyes

cataracts under the bag; Increased internal pressure, glaucome; Eye bulging.

Metabolism

Negative nitrogen balance due to catabolism of protein.

Mental

refreshed, feeling suspended; severe depression until true mental manifestations; Change personality; Eye sleep.

Other side effects

Anaphylaxis or hypersensory reaction and hypotension or shock -like reaction.

Other side effects related to corticosteroid treatment, but rarely include blinds due to injection inside the face and head lesions, hyperpigmentation or hypogonotic, skin atrophy and subcutaneous tissue atrophy, abscess aseptic, skin redness after injection (after injection in joints) and joints like Charcot.

ADR management direction

When experiencing side effects of the drug, it is necessary 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

Diprospan Injection is contraindicated in the following cases:

Patients with body fungal infection, virus infection and in patients with hypersensitivity to betamethasone or other corticosteroids, or any component of the drug.

Be cautious when using

do not inject diprospan injection or subcutaneously.

Serious neurological events, sometimes lead to death, have been reported when injected with epidural corticosteroids. Specific events have been reported, but not limited, spinal infarction, paralysis of lower limbs, paralysis of limbs, brain blindness, and stroke. These serious events have been reported or not together with fluorescence. The safety and effectiveness of the outer fleet name with corticosteroids has not been set up, and corticosteroids are not approved for this procedure.

Should strictly follow aseptic technique when injecting Diprospan Injection.

Diprospan Injection contains 2 ester betamethasone in which betamethasone disodium phosphate is dispersed quickly from the injection site. The doctor should note when using Diprospan Injection because the drug contains water -soluble ingredients that can cause systemic effect.

Be cautious when intramuscularly Diprospan Injection for patients with spontaneous thrombocytopenia. Corticosteroids should be injected into a large muscle mass to avoid local tissue atrophy.

Inject corticosteroids into soft tissue, in damage and in joints can cause systemic effects as well as local effects.

Should check the joint fluid to eliminate the possibility of infection, should not be injected into the joints that have been infected. Significantly increasing the symptoms of pain and swelling in the spot, limiting joint movement, fever and fatigue are signs of suggestive of bacterial arthritis. Should be treated with appropriate antibiotics when diagnosed with a bacterial infection.

Do not inject corticosteroids into non -fixed joints, infected areas or into the area between the vertebrae. Injecting many times into joints in osteoarthritis can increase osteoarthritis. Avoid getting corticosteroid directly into the tendon because it will cause a sprain later.

After injecting corticosteroids into the joints, patients should be cautious, avoid excessive joint movement to achieve treatment effect.

Should be cautious before injection, in patients with a history of drug allergy due to some rare cases of anaphylactic reaction after treatment with injected corticosteroids.

When needed for prolonged treatment with corticosteroids, it is advisable to consider passing from the injection form to oral form after considering the benefits and risks.

may need to adjust the dose when the disease is improved or worse depending on the patient's response to the patient's treatment or contact method with mental or physical stress such as severe infections, surgery or trauma. May need to be monitored up to 1 year after stopping for prolonged treatment or high doses of corticosteroids.

corticosteroids can cover some of the infections and may appear new bacterial infections during treatment. When using corticosteroids may appear reduced resistance and cannot be localized.

The prolonged corticosteroid use can lead to lower cataracts (especially in children), glaucome with the ability to waste the wire of the visual body and can increase secondary infections in the eye due to grasping or viruses.

medium or high doses of corticosteroids can cause blood pressure, water and salt to increase potassium elimination. These effects are almost not appearing with synthetic derivatives unless high doses. Eat salt limit and add potassium supplements. All corticosteroids cause increased calcium elimination.

Do not vaccine in the seasons during corticosteroid treatment. Immune therapy should not be applied to patients who are taking corticosteroids, especially when taking high doses because they can cause neurological complications and lack of antibodies. However, immunotherapy can be used for patients who are taking corticosteroids such as alternative treatments, such as Addison.

Patients who are taking corticosteroids to inhibit immunosuppression should not be exposed to the source of chickenpox or measles, if exposed, medical examination should be examined. This is especially important for children.

Should use the lowest dosage corticosteroid to control the condition; When the dose is needed, it should be reduced slowly.

Secondary adrenal energy due to drugs may be the result of corticosteroid stopping too fast, which can be minimized by reducing the dose slowly. Disabled due to drugs may last for months after stopping the drug; Therefore, if stress appears during this period, Corticosteroid reuse. If the patient is taking corticosteroids, the dose may be increased. Because the secretion of mineralocorticosterod may be impaired, it should be used simultaneously with salt and/or a mineralocorticosteroid.

The effect of corticosteroids increases in patients with hypothyroidism or cirrhosis.

Be careful when taking corticosteroids for eye -peoples of eye herpes because it is likely to cause corneal puncture.

may appear disordered when treated with corticosteroids. Corticosteroids can cause more emotional balance or mental disorder.

Be cautious when using corticosteroids in the following cases: Non -specific colon ulcers, can cause perforation, apxe or other pus infections; excess bag inflammation; connect new circuits in the intestine; Stomach ulcers are active or hidden; renal failure; hypertension; osteoporosis and severe muscle weakness.

The complications caused by glucorticosteroid treatment depend on the dosage and therapeutic time, so it should be considered between the risk/benefit for the patient.

Should monitor kidneys in growth and development in children with prolonged treatment because corticosteroids can affect endogenous growth and inhibition of endogenous corticosteroid production in children and emulsion.

corticosteroid may change the movement and quantity of sperm in some patients.

The ability to drive and operate machinery

Until now there is no information showing that Diprospan Injection has affected driving, operating machinery, as well as the ability to work under dangerous conditions.

Pregnancy

Because the research has not been controlled with the effects of corticosteroids on human fertility, the use of Diprospan Injection during pregnancy or for women of children with children needs to consider the benefits of the drug for the mother and the risk of the fetus. Should monitor kidneys signs of adrenal insufficiency in children of mothers who have used corticosteroids during pregnancy.

The period of breastfeeding

because Diprospan Injection can cause side effects for breastfed babies, should consider or stop the drug or stop breastfeeding and have to grace the importance of the drug for the mother.

Drug interaction

simultaneously used with phenobarbital, phenytoin, rifampin or ephedrine may increase corticosteroid chemistry, so it reduces the treatment effect.

Should monitor the excessive impact of corticosteroids when patients use corticosteroids along with estrogen.

Concentrated corticosteroids with diuretics that cause potassium loss can lead to hypokalemia. Concomitance corticosteroid use with heart glycosides capable of increasing arrhythmia or digitalis toxicity accompanied by hypokalemia. Corticosteroids can cause potassium loss due to amphotericin B. Should quantify the serum in a close way, especially the potassium concentration in all patients who use a combination of one of the above drugs.

Corticosteroids simultaneously with cumarine anticoagulants may increase or decrease the anticoagulant effect, so the dose adjustments need to be adjusted.

Effects due to a combination of nonsteroidal or alcoholic drugs with glucocorticosteroids may increase the event or increase the severity of the gastrointestinal ulcer.

corticosteroids may reduce bloodlate concentration in the blood, so be cautious when using acetylsalicylic acid along with corticosteroids in case of reducing blood prothrombine.

may need to adjust the dose of diabetes when taking corticosteroids for people with diabetes.

corticosteroids may affect the Nitroblue Tetrazolium test in bacterial infections and for false negative results.

Storage

Shake thoroughly before use. Store under 30 ° C. Avoid light and avoid freezing.

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