COMPOSITION: Each tablet contains Dex. 0.5 mg. PROPERTIES: A synthetic adrenconrtical steroid. It is stable in air and insoluble in water. It is rapidly absorbed from G.I tract. It has anti-inflammatory, anti-allergic, and immunosuppressive properties. Glucocorticoids have salt- retaining properties and are used as replacement Therapy in adrenocortical deficiency states. They have antiinflammatory, profound and varied metabolic effects and they modify the body, s immune responses to diverse stimuli. INDICATIONS:
endocrine disorders: primary or secondary adrenocortical insufficiency, Congenital adrenal hyperpasia, nonsuppurative thyroiditis, hypercalcalcemia associated with cancer.
rheumatic disorders: as adjunctive therapy for short-term administration
In serious cases of rheumatoid arthritis. Synovitis of osteoarthritis, Ankylosing spondylitis, and zcute gouty arthritis.
collagen disease: during as exacerbation or as maintenance therapy in selected cases of systemic lupus erythematosus, acute rheumatic carditis.
allergic states: allergic rhinintis, bronchial asthma contact dermatitis, atopic dermatitis, serum sickness and drug hypersensitivity reactions.
dermatology: server cases of pemphigus, bullous dermatitis herpetiformis, server erythema multiforme exfoliative dermatitis, mycosis fungoides, server psoriasis and server seborrheic diseases.
ophthalmology: server acute or chronic allergic inflammatory processes
Of the eye, and its adnexa, such as: allergic conjunctivitis iritis and iridocyclitis, chorioretintis, sympathetic ophthalmia and optic neuritis.
gastrointestinal diseases: to induce a remission of ulcerative colitis and regional enteritis.
cardiac diseases: in some cases of pericrditis.
respiratory disease: symptomatic sarcoidosis, loeffler,s syndrome and berylliosis.
hematology and oncology: hemolytic anemia congenital hypoplastic anemia and thrombocytopenia in adults. For palliative management of:
Leukemias and lymphomas in adults and acute leukemia in children
cerebral edema.
CONTRAINDICATIONS:
gastric and duodenal ulcers; 2- systemic fungal infections; 3- glaucoma; 4- hypersensitivity to glucocorticoide.
DOSAGE: It should be given under physician supervision. The initial dosage varies from 0.75-9 mg depending on the disease being treated, and should be maintained or adjusted until the patient's response is satisfactory. The proper maintenance dose is determined by the clinical Response. If the drug is to be stopped after more than a few days of treatment. It should withdrawn gradually. SIDE EFFECTS:
fluid and electrolyte disturbances (sodium retention and fluid retention, Hypertension, and potassium loss).
musculoskeletal effects: myopathy and osteoporoisis.
gastrointestinal effects: peptic ulcer with possible perforation and hemorrhage.
hyoersensitivity reactions may occasionally occur.
immunosuppressive effects: increased susceptibility to infections.
dematologic effects: bruising facial erythema, increased sweating and acne.
Precautions:
use during pregnancy and nursing: it must be given under physician, Supervision during pregnancy. Infants whose mother received substantial doses of glucocrticoids during pregnancy should be carefully observed for signs of adrenal insufficiency. Glucocorticoids appear in breast milk in very small guantities there for it should be advised not to nurse.
glucocorticoids may suppress the immune response of the body. Extra caution should be exercised when give this drug to children and patients Who have asthma or some kind of allergic.
patients of any of the following conditions should be monitored: renal dysfunction, latent or overt cardiac failure, hypothyroidism, cirrhosis Hepatic hypertension and latent tuberculosis: since glucocorticoids may induce reactivation.
if patients undergoing long-term therapy with glucocorticoids are concomitanly given salicylates, any reduction in glucocorticoids dosage should be made with caution.
discontntinuation of prolonged therapy should be carried out by gradual reduction of dosage and under strict medical supervision, since withdrawal May result in acute exacerbation of the disease and acute adrenocortical insufficiency.
when large doses are given, some authorities advise that coticosteroides be taken with meals and antacids to prevent peptic ulcer.
it should be used cautiously in patients with ocular herpes simplex DRUG INTERACTIONS:
Phenytoin, phyenobarbital, rifampicin cause increasing of the product concentration in the blood. It should be used cautiously with potassium-depleting diuretics and anticoagulants. STORAGE: Store in a dry place, below 25 °C. Protect from light and heat .
Keep out of the reach of children.
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