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Endocrine - Glucocorticoids

Fortecortin 8mg/2ml 3 amp. for i.v./i.m. inj.

فورتيكورتين 8مجم/2مل 3 امبولات

Dexamethasone sodium phosphate

15.00 EGP

Unit price: 5.00 EGP

Specifications

Manufacturer
united company for trading & distribution
Units / Box
3
Barcode
6221045001225
Price Updated
Dec 5, 2022

Uses & Indications

Dexamethasone sodium phosphate is a potent synthetic corticosteroid used for its anti-inflammatory and immunosuppressive properties. It is indicated for the treatment of various conditions including severe allergic reactions, inflammatory conditions (such as arthritis, asthma, skin conditions, inflammatory bowel disease), certain cancers (e.g., leukemia, lymphoma, multiple myeloma), cerebral edema due to tumors, adrenal insufficiency (as replacement therapy), and inflammatory conditions of the eye and ear.

How It Works

Dexamethasone is a glucocorticoid that works by binding to specific intracellular glucocorticoid receptors. This binding modulates gene expression, leading to the inhibition of inflammatory mediators such as prostaglandins, leukotrienes, and cytokines. It also suppresses the immune response by decreasing lymphocyte activity and reducing antibody production. Additionally, it stabilizes lysosomal membranes and reduces capillary permeability, thereby decreasing inflammation and swelling. The sodium phosphate ester makes it water-soluble, allowing for rapid onset of action, particularly in injectable forms.

Dosage & Administration

drops

Adults: Ophthalmic: 1-2 drops into the conjunctival sac 4-6 times daily. The frequency may be tapered as the condition improves. Otic: 3-4 drops into the affected ear 2-3 times daily.

Children: Ophthalmic/Otic: Consult a physician. Dosage is typically individualized based on the specific condition, age, and weight of the child.

injectable

Adults: Dosage varies widely depending on the condition being treated. For anti-inflammatory/immunosuppressive effects, typical doses range from 0.5 mg to 20 mg daily, administered intravenously (IV) or intramuscularly (IM) once daily or in divided doses. For severe conditions like cerebral edema, an initial dose of 10 mg IV may be given, followed by 4 mg IV every 6 hours.

Children: Dosage is highly variable and must be determined by a physician based on the child's weight, age, and the specific condition. For anti-inflammatory/immunosuppressive effects, a common range is 0.02-0.3 mg/kg/day in 1-4 divided doses. For conditions like croup, a single dose of 0.6 mg/kg (maximum 16 mg) may be administered. Always consult a physician for pediatric dosing.

Side Effects

  • Insomnia (10-20%)
  • Increased appetite (10-20%)
  • Indigestion or stomach upset (5-15%)
  • Nervousness or restlessness (5-15%)
  • Fluid retention and swelling (5-10%)
  • Mood changes (5-10%)
  • Increased blood sugar levels (with prolonged use)
  • Weight gain (with prolonged use)
  • Thinning of skin (with prolonged use)

Serious Side Effects

  • Adrenal suppression or adrenal crisis (especially upon abrupt withdrawal after long-term use)
  • Severe allergic reactions (anaphylaxis)
  • Gastrointestinal bleeding or perforation
  • Psychiatric disturbances (e.g., psychosis, severe depression)
  • Increased susceptibility to severe infections
  • Osteoporosis and bone fractures (with prolonged use)
  • Cataracts or glaucoma (with prolonged ophthalmic or systemic use)
  • Avascular necrosis (bone death)
  • Cushing's syndrome (with prolonged high doses)

Contraindications

Dexamethasone sodium phosphate is contraindicated in patients with systemic fungal infections, known hypersensitivity to dexamethasone or any component of the formulation. Live or live-attenuated vaccines should generally not be administered to patients receiving immunosuppressive doses of corticosteroids. Ophthalmic preparations are contraindicated in most viral diseases of the cornea and conjunctiva (including herpes simplex keratitis), mycobacterial infection of the eye, and fungal diseases of ocular structures. Otic preparations are contraindicated in untreated bacterial, viral, or fungal infections of the ear.

Drug Interactions

Dexamethasone can interact with several medications. CYP3A4 inducers (e.g., phenytoin, phenobarbital, rifampin) can decrease dexamethasone levels, reducing its effectiveness. CYP3A4 inhibitors (e.g., ketoconazole, macrolide antibiotics) can increase dexamethasone levels, potentially leading to increased side effects. Concomitant use with NSAIDs may increase the risk of gastrointestinal ulceration. Diuretics (thiazide, loop) may increase the risk of hypokalemia. Dexamethasone can alter the effects of anticoagulants like warfarin, requiring close monitoring of INR. It can also increase blood glucose levels, necessitating adjustments in antidiabetic medications. Live vaccines are generally contraindicated during immunosuppressive corticosteroid therapy.

Pregnancy & Lactation

Category: C

Animal reproduction studies have shown an adverse effect on the fetus. There are no adequate and well-controlled studies in pregnant women. Dexamethasone should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Consult your doctor for personalized advice.

Storage

Store dexamethasone sodium phosphate at controlled room temperature, typically between 20-25°C (68-77°F). Protect from light and do not freeze. Keep all medications out of the reach of children. Ophthalmic and otic drops should generally be discarded 28 days after opening, or as per specific manufacturer instructions.

Clinical Tips

It is crucial not to stop dexamethasone abruptly, especially after prolonged use, as this can lead to adrenal insufficiency. The dose should always be tapered under medical supervision. If taking oral forms, administer with food or milk to minimize stomach upset. Patients should report any signs of infection (e.g., fever, sore throat) to their doctor, as corticosteroids can mask infection symptoms. Blood glucose levels should be monitored regularly, particularly in diabetic patients. Regular eye examinations may be necessary during long-term ophthalmic use to screen for glaucoma or cataracts. Always consult your doctor or pharmacist before receiving any vaccinations while on dexamethasone.

Frequently Asked Questions

Can I stop taking dexamethasone suddenly?

No, it is crucial not to stop dexamethasone abruptly, especially after prolonged use. Doing so can lead to adrenal insufficiency, a serious condition. Your doctor will provide a tapering schedule to gradually reduce the dose safely.

Does dexamethasone cause weight gain?

Yes, weight gain is a common side effect, particularly with prolonged use. This can be due to increased appetite and fluid retention. Discuss any concerns about weight changes with your doctor.

How quickly does dexamethasone work?

Dexamethasone sodium phosphate, especially in injectable forms, is designed for rapid action. Its effects can often be noticed within minutes to a few hours, depending on the route of administration and the condition being treated.

Can dexamethasone affect my blood sugar?

Yes, dexamethasone can increase blood sugar levels, even in individuals without diabetes. If you have diabetes, your blood sugar may need to be monitored more closely, and your antidiabetic medication dosage may require adjustment by your doctor.

Is dexamethasone an antibiotic?

No, dexamethasone is not an antibiotic. It is a corticosteroid, which means it reduces inflammation and suppresses the immune system. It does not treat bacterial infections directly, and in some cases, it can even increase the risk of infection.

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Medical Disclaimer

The information provided is for educational purposes only and is not a substitute for professional medical advice. Always consult your doctor or pharmacist before starting or changing any medication.