Dexamethasone is a hormone drug (glucocorticoid for systemic and local usage). It is similar to the natural hormone which is produced by our adrenal glands. Therefore, it is quite often used to replace this chemical in case the body doesn't make enough amount of it. Dexamethasone is used locally in cases of rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, Reiter's disease, osteoarthritis (in the presence of pronounced signs of joint inflammation, synovitis) to reduce the inflammation, swelling and pain.
Also, it can be used for the treatment of shock (burn, anaphylactic, posttraumatic, postoperative, toxic, cardiogenic, blood transfusion, etc.), cerebral edema (including tumors, brain trauma, neurosurgical intervention, brain hemorrhage, encephalitis, meningitis), bronchial asthma, systemic connective tissue diseases (including systemic lupus erythematosus, rheumatoid arthritis, scleroderma, dermatomyositis), acute and chronic inflammatory joint diseases, including gout and psoriatic arthritis, osteoarthritis (including post-traumatic).
Dexamethasone inhibits the function of leukocytes and tissue macrophages and limits the migration of leukocytes to the area of inflammation. The use of this drug helps to stabilize the lysosome membranes, thereby reducing the concentration of proteolytic enzymes in the area of inflammation. The active ingredient inhibits fibroblast activity and collagen formation.
The drug has a pronounced dose-dependent effect on the metabolism of carbohydrates, proteins and fats. It stimulates gluconeogenesis, promotes the uptake of amino acids by the liver and kidneys, and increases the activity of gluconeogenesis enzymes. In the liver, it enhances the storage of glycogen, stimulating the activity of glycogen synthetize and the synthesis of glucose from the products of protein metabolism.
In high doses, the drug can increase the excitability of brain tissue and help to lower the seizure threshold. It stimulates the excess production of hydrochloric acid and pepsin in the stomach, which contributes to the development of peptic ulcers.
With systemic intakes, the therapeutic activity of the drug is due to its anti-inflammatory, anti-allergic, immunosuppressive and anti-proliferative effects. In small amounts, it is excreted in the breast milk.
Dexamethasone is contraindicated in some cases. It is not allowed to use this medicine in the following cases: hypersensitivity to any drug’s components, systemic fungal infections, parasitic infections of viral or bacterial origin, including herpes simplex, herpes zoster, chicken pox, measles, amoebiasis, and strongyloidiasis. This medicine should not be used in the patients, suffering from the active form of tuberculosis, immunodeficiency (including AIDS or HIV infection), at the period before and after vaccination (especially antiviral), systemic osteoporosis, myasthenia gravis, etc.
Taking Dexamethasone may cause the occurrence of some side-effects. They greatly depend on the dosage and longitude of the drug intake but some that are reported most commonly include the following: stomach irritation, dizziness, vomiting, insomnia, anxiety, acne, easy bruising, irregular menstrual periods, and increased hair growth. If you encounter these side effects and they do not go away, then you should notify your doctor and follow his recommendations.
The side effects from the endocrine system may include: decreased glucose tolerance, steroid diabetes mellitus or manifestation of latent diabetes mellitus, suppression of adrenal function, delayed sexual development in children.
From the side of metabolism the following side reactions may occur: increased excretion of calcium ions, hypocalcaemia, increased body weight, negative nitrogen balance.
The method of application and the dosage of a particular drug depend on its form of release and other factors. The optimal dose regimen is determined by the doctor. It is necessary to strictly observe the prescribed dosage according to the indications for use and the dosage regimen.
Each prescription is individual. For parenteral administration, it is injected in a slow stream or drip (in acute and urgent conditions); per-articular and intra-articular injection is also possible. During the day, you can use 4-20 mg of Dexamethasone 3-4 times. The duration of the drug application is usually 3-4 days, and then it is usually exchanged into maintenance therapy with the oral form. In the acute period for various diseases and at the beginning of the treatment, Dexamethasone is used in higher doses. When the effect is achieved, the dose is usually reduced at the intervals of several days until a maintenance dose is reached or until the treatment is discontinued.
The information described in the article is generalized and cannot be used to make a decision on the possibility of using a particular medicinal product. Before using any drug you should consult with your doctor.