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Other brands with the same active ingredient
These brands contain the same active ingredient (Dexamethasone). Strength and form may differ — confirm substitution with your doctor or pharmacist before switching.
Indications & Uses
Stedex is indicated for:
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
In general, glucocorticoid dosage depends on the severity of the condition and the response of the patient. If no favourable response is noted within a couple of days, continuing glucocorticoid therapy is not advisable. In chronic conditions requiring long term therapy, the lowest dosage that gives adequate, though not necessarily complete, relief should be used. For tablets, in adult patients daily oral dosages vary from 1 mg to 10 mg, and in children from 0.03 to 0.20 mg per kg body weight, according to the individual response. In some patients higher dosages may be needed temporarily to control the disease. As soon as circumstances permit, the dosage should be decreased. For a short dexamethasone suppression test, 1 mg of dexamethasone is given at 11 p.m. and plasma cortisol is measured the next morning. Patients who do not show a decrease in cortisol can be given a longer test, in which 0.5 mg of dexamethasone is given at 6 hour intervals for 48 hours, followed by 2 mg every 6 hours for a further 48 hours. Twenty four hour urine collections are made before, during and at the end of the test to determine 17 alpha hydroxycorticoids. For injection, dexamethasone can be given by intravenous, intramuscular or local injection. Dexamethasone injections can also be diluted with an infusion fluid or injected directly into the infusion line. Intravenous injections of large doses should be given slowly, over several minutes. Intramuscular administration should be given by deep intramuscular injection to prevent atrophy of the subcutaneous fatty tissue. Intra articular injections should be given under strictly aseptic conditions, since glucocorticoids reduce resistance to infection. When diluted with these infusion fluids, dexamethasone keeps its potency for at least 24 hours at room temperature and in daylight conditions. Sodium chloride 0.9%, anhydrous glucose 5%, invert sugar 10%, sorbitol 5%, Ringer's solution and Hartman's solution, also known as Ringer lactate, can be used as infusion fluids among others. The dosage of dexamethasone depends on the severity of the condition and the response of the patient. For systemic therapy in adults, daily doses of 0.05 to 0.20 mg per kg body weight are usually sufficient. For emergencies, such as anaphylaxis, acute severe asthma or cerebral edema, substantially higher doses are required. An initial dose of 10 to 20 mg IV is followed by 6 mg IV or IM every 6 hours, until a satisfactory result is obtained, after which the dosage has to be tapered off gradually. For local therapy, the following doses are recommended. Intra articularly, 2 to 4 mg in large joints and 0.8 to 1 mg in small joints. Intrabursally, 2 to 4 mg, and in tendon sheaths, 0.4 to 1 mg. The frequency of these injections may vary from every 3 to 5 days to every 2 to 3 weeks.
Side Effects
Prolonged systemic glucocorticoid therapy has been associated with the following adverse reactions. Endocrine and metabolic effects: Cushing-like syndrome, hirsutism, menstrual irregularities, premature closure of the growth plates, secondary unresponsiveness of the adrenal cortex and pituitary gland, reduced glucose tolerance, and negative nitrogen and calcium balance. Fluid and electrolyte disturbances: retention of sodium and fluid, high blood pressure, loss of potassium, and hypokalaemic alkalosis. Musculoskeletal effects: myopathy, abdominal distension, osteoporosis, and aseptic necrosis of the femoral and humeral heads. Gastrointestinal effects: gastric and duodenal ulceration, perforation, and haemorrhage. Dermatological effects: impaired wound healing, skin atrophy, stretch marks, pinpoint spots and bruise-like discolouration, easy bruising, facial redness, increased sweating, and acne. Central nervous system effects: psychic disturbances ranging from euphoria to overt psychotic symptoms, and convulsions; in children, pseudotumor cerebri (benign intracranial hypertension) with vomiting and swelling of the optic disc. Ophthalmic effects: glaucoma, raised pressure within the eye, and posterior subcapsular cataracts. Immunosuppressive effects: heightened susceptibility to infections, and reduced response to vaccination and skin tests.
Cautions & Contraindications
Warnings & Precautions
General: The lowest possible dose of corticosteroids should be used to control the condition under treatment.The reduction should be gradual.Cardio-renal: These agents should be used with caution in patients with congestive heart failure,hypertension, or renal insufficiency.Endocrine: Drug-induced secondary adrenocortical insufficiency may be minimized by gradual reduction of dosage.Gastrointestinal: Steroids should be used with caution in active or latent peptic ulcers, diverticulitis, intestinal anastomoses, and nonspecific ulcerative colitis, since they may increase the risk of a perforation.Musculoskeletal: Special consideration should be given to patients at increased risk of osteoporosis (e.g.,postmenopausal women) before initiating corticosteroid therapy.Neuro-psychiatric: An acute myopathy has been observed with the use of high doses of corticosteroids, most often occurring in patients with myasthenia gravis or in patients receiving concomitant therapy with neuromuscular blocking drugs (e.g., pancuronium). Psychic derangements may appear ranging from euphoria, insomnia, mood swings, personality changes, and severe depression, to frank psychotic manifestations.
Contraindications
Contraindicated in patients with gastric or duodenal ulcers, systemic or ophthalmic fungal infections, viral infections such as chickenpox and genital herpes, other viral eye infections, glaucoma, or known hypersensitivity to corticosteroids.