DECADRON ® a drug based on Dexamethasone
THERAPEUTIC GROUP: Unassociated corticosteroids
Indications DECADRON ® Dexamethasone
DECADRON ® is indicated in the treatment of all those inflammatory and allergic manifestations that require hormone therapy based on corticosteroid hormones.
Particularly intense allergic manifestations, rheumatic, dermatological, ophthalmological diseases, endocrine disorders of the adrenal gland, pathologies of the respiratory system, haematological and neoplastic diseases represent the main fields of clinical application of dexamethasone.
Mechanism of action DECADRON ® Dexamethasone
Dexamethasone is a synthetic corticosteroid, functionally analogous to the endogenous hormones cortisol and cortisone, but characterized by more targeted pharmacokinetic and therapeutic properties, with more modest side effects.
The application in the clinical field of these molecules is justified by the important anti-inflammatory activity that is carried out through the induction of the enzyme lipocortin, capable of inhibiting phospholipase A2 and the downstream cascade that leads, through lipooxygenase and cycle oxygenase enzymes, to the production of inflammatory mediators, and antiallergic activity, probably due to the ability of dexamethasone to inhibit protein synthesis, resulting in a significant decrease in the production of antibodies and in the number of lymphocytes, eosinophils and basophils.
The rapid gastro-intestinal absorption, and the relative bio-distribution concentrated above all at the vascular and platelet level, makes therapy with dexamethasone particularly easy and decidedly effective, although responsible for various side effects associated with the complex biological mechanism of action.
Studies carried out and clinical efficacy
1. DESAMETHASONE AND RESTENOSIS
Expert Rev Cardiovasc Ther. 2004 Sep; 2: 653-60.
Dexamethasone-eluting stent: an anti-inflammatory approach to inhibit coronary restenosis.
Liu X, De Scheerder I, Desmet W.
Restenosis is a very frequent pathophysiological event, probably due to an exaggerated inflammatory reaction associated with vascular damage, which reduces the effectiveness of coronary interventions. This preliminary study shows how local dexamethasone can reduce the inflammatory process, preventing the appearance of restenosis.
2. DESAMETHASONE AND INFLAMMATORY MYOSITIS
Neuromuscul Disord. 2010 Jun; 20: 382-9. Epub 2010 Apr 25.
Oral dexamethasone pulse therapy versus daily prednisolone in sub-acute onset myositis, a randomized clinical trial.
van de Vlekkert J, Hoogendijk JE, de Haan RJ, Algra A, van der Tweel I, van der Pol WL, Uijtendaal EV, de Visser M; Dexa Myositis Trial.
The use of therapeutic protocols at high pulsed doses of dexamethasone in the treatment of inflammatory myositis was found to be as effective as conventional therapy but characterized by a reduced number of side effects.
3. DESAMETHASONE AND VARIABILITY "OF THE THERAPEUTIC SCHEME
Platelets. 2010; 21: 270-3.
High dose dexamethasone therapy shows better responses in acute immune thrombocytopenia than in chronic immune thrombocytopenia.
Naithani R, Mahapatra M, Kumar R, Mishra P, Saxena R.
Example study showing how different dosages and therapeutic regimens based on dexamethasone can be more or less effective in different clinical conditions. Also from these evidences arises the need to formulate a specific dosage for each case.
Method of use and dosage
DECADRON ® tablets of 0.5 - 0.75 mg of dexamethasone
the definition of the correct dosage is a highly specialized task, which is up to the doctor after having carefully assessed the patient's state of health, his clinical picture, the ability to respond to hormonal therapy and after having defined the therapeutic objectives.
The range of application is very varied, including dosages ranging from 0.5 mg of dexamethasone per day up to 10 mg / day, and above all variable over time based on the therapeutic response observed in the patient and the possible presence of side effects.
For this reason, medical supervision is essential not only in the initial stages of treatment but throughout the therapeutic process.
Warnings DECADRON ® Dexamethasone
The entire duration of therapy, from the definition of the dosage to the suspension of the intake, must be carefully monitored by a doctor, to minimize the appearance of side effects and safeguard the patient's state of health.
Periodic monitoring of blood pressure, saline concentrations, glucose metabolism, prothrombin time, liver and kidney function, and gastrointestinal health status may be necessary to assess the safety of drug treatment.
The intake of dexamethasone could worsen the symptoms of neurological and psychiatric patients, contribute to the conditions of hyperglycemia in diabetic patients and reduce the preventive efficacy of immunizing protocols.
The numerous adverse reactions affecting the nervous system, such as to significantly reduce the patient's perceptive abilities, could make the use of machinery, driving cars and all other possible activities that require an intellectual commitment dangerous.
PREGNANCY AND BREASTFEEDING
The absence of studies concerning the potential effects of corticosteroid therapy on the health of the fetus, when taken during pregnancy, does not yet allow to establish the real risk profile of these drugs.
However, the use of these hormones during pregnancy, which should take place in case of real need and under strict specialist medical supervision, must necessarily be followed by careful checks and tests useful to exclude any hypoadrenalism in the newborn.
Interactions
Various anticonvulsants, antibiotics, anticoagulants, bronchodilators, antacids and non-systemic anti-inflammatories are partly responsible for pharmacokinetic changes in corticosteroid hormones such as to require dosage adjustment.
On the other hand, monitoring of blood potassium concentrations becomes necessary following the concomitant intake of non-potassium-sparing diuretics.
Contraindications DECADRON ® Dexamethasone
DECADRON ® is contraindicated in case of hypersensitivity to the active substance or to one of its excipients, in case of active tuberculosis, peptic ulcer, ocular herpes simplex, systemic fungal infections and psychosis.
Undesirable Effects - Side Effects
The side effects of dexamethasone, as well as for most of the corticosteroid hormones, are observed following prolonged use.
In addition to adrenal insufficiency, which represents the most frequent endocrine aspect among the side effects, the aforementioned hormone therapy can cause a very wide range of adverse reactions, affecting various systems and systems such as:
- The musculoskeletal system, increasing the risk of pathological fractures and muscle injuries;
- The gastro-intestinal system, with a significant increase in the risk of ulcers and bleeding;
- The nervous system, with the appearance of changes in behavior and mood as well as headache, nausea, dizziness and restlessness;
- The endocrine-metabolic structure, with a negativization of the nitrogen balance and significant alterations in the glycemic balance;
- The cardiovascular system, with the onset of hypertension, heart failure and hypokalemic alkalosis.
Note
DECADRON ® sold only under medical prescription.
The use of DECADRON ® without therapeutic need during sports competitions constitutes doping.
The information on DECADRON ® Dexamethasone published on this page may be out of date or incomplete. For a correct use of this information, see the Disclaimer and useful information page.
.jpg)
