Criston
Generic Name
Dexamethasone
Manufacturer
Acme Laboratories Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| criston 1 mg injection | ৳ 350.00 | N/A |
Description
Overview of the medicine
Criston 1 mg Injection contains Dexamethasone, a synthetic glucocorticoid with potent anti-inflammatory and immunosuppressive properties. It is used to treat a wide range of conditions caused by inflammation or an overactive immune system.
Uses & Indications
Dosage
Adults
Dosage varies widely depending on the condition being treated. Typical doses range from 0.5 mg to 24 mg daily, given as a single dose or in divided doses. For acute severe conditions, 4 mg to 20 mg may be administered intravenously or intramuscularly.
Elderly
Use with caution. Lower initial doses may be required due to increased sensitivity and potential for severe side effects. Close monitoring is recommended.
Renal_impairment
Generally, no dose adjustment is required in renal impairment, but caution is advised in severe cases due to potential fluid retention and electrolyte imbalances.
How to Take
Criston 1 mg Injection should be administered intravenously (IV), intramuscularly (IM), or locally (e.g., intra-articular) by a healthcare professional. Do not self-administer. The injection should be prepared and given in a sterile environment.
Mechanism of Action
Dexamethasone acts by binding to intracellular glucocorticoid receptors, forming a complex that translocates to the nucleus and modulates gene expression. This leads to the inhibition of inflammatory mediators and immune cell function, resulting in its anti-inflammatory and immunosuppressive effects.
Pharmacokinetics
Onset
Anti-inflammatory effects typically begin within hours, with maximal effects often seen within 1-2 days, depending on the route and condition.
Excretion
Excreted predominantly via the kidneys as inactive metabolites.
Half life
Plasma half-life is approximately 3-4 hours; however, its biological half-life is much longer, ranging from 36-54 hours.
Absorption
Rapid and almost complete absorption after intramuscular or intravenous administration.
Metabolism
Primarily metabolized in the liver, mainly by the CYP3A4 enzyme.
Side Effects
Contraindications
- Systemic fungal infections (unless used as anti-inflammatory in severe infection)
- Known hypersensitivity to dexamethasone or any component of the formulation
- Administration of live or live-attenuated vaccines during immunosuppressive doses of corticosteroids
Drug Interactions
Anticoagulants (e.g., Warfarin)
Dexamethasone may alter the effects of anticoagulants, requiring careful monitoring of INR and dose adjustment.
Diuretics (e.g., Thiazides, Loop diuretics)
Concurrent use may enhance potassium depletion, increasing the risk of hypokalemia.
NSAIDs (Nonsteroidal Anti-inflammatory Drugs)
Increased risk of gastrointestinal ulceration and bleeding when co-administered with dexamethasone.
Antidiabetic agents (e.g., Insulin, Metformin)
Dexamethasone can increase blood glucose levels, necessitating an adjustment in antidiabetic medication dosage.
CYP3A4 Inducers (e.g., Phenytoin, Phenobarbital, Rifampicin)
These drugs can increase the metabolism of dexamethasone, leading to decreased plasma concentrations and reduced efficacy.
Storage
Store below 30°C. Protect from light. Do not freeze. Keep out of reach of children.
Overdose
Acute overdose with dexamethasone is rare and generally does not require specific treatment beyond symptomatic and supportive measures. Symptoms may include fluid retention, hyperglycemia, and hypertension. Long-term overdose or abuse can lead to severe side effects such as Cushing's syndrome and adrenal suppression.
Pregnancy & Lactation
Pregnancy Category C. Use in pregnancy only if the potential benefit justifies the potential risk to the fetus. Dexamethasone is excreted into breast milk; caution is advised during lactation, and infants should be monitored for adverse effects.
Side Effects
Contraindications
- Systemic fungal infections (unless used as anti-inflammatory in severe infection)
- Known hypersensitivity to dexamethasone or any component of the formulation
- Administration of live or live-attenuated vaccines during immunosuppressive doses of corticosteroids
Drug Interactions
Anticoagulants (e.g., Warfarin)
Dexamethasone may alter the effects of anticoagulants, requiring careful monitoring of INR and dose adjustment.
Diuretics (e.g., Thiazides, Loop diuretics)
Concurrent use may enhance potassium depletion, increasing the risk of hypokalemia.
NSAIDs (Nonsteroidal Anti-inflammatory Drugs)
Increased risk of gastrointestinal ulceration and bleeding when co-administered with dexamethasone.
Antidiabetic agents (e.g., Insulin, Metformin)
Dexamethasone can increase blood glucose levels, necessitating an adjustment in antidiabetic medication dosage.
CYP3A4 Inducers (e.g., Phenytoin, Phenobarbital, Rifampicin)
These drugs can increase the metabolism of dexamethasone, leading to decreased plasma concentrations and reduced efficacy.
Storage
Store below 30°C. Protect from light. Do not freeze. Keep out of reach of children.
Overdose
Acute overdose with dexamethasone is rare and generally does not require specific treatment beyond symptomatic and supportive measures. Symptoms may include fluid retention, hyperglycemia, and hypertension. Long-term overdose or abuse can lead to severe side effects such as Cushing's syndrome and adrenal suppression.
Pregnancy & Lactation
Pregnancy Category C. Use in pregnancy only if the potential benefit justifies the potential risk to the fetus. Dexamethasone is excreted into breast milk; caution is advised during lactation, and infants should be monitored for adverse effects.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24 to 36 months from the date of manufacture, when stored under recommended conditions.
Availability
Pharmacies, Hospitals
Approval Status
Approved
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Dexamethasone has been a cornerstone in numerous clinical trials across various inflammatory and autoimmune conditions. Notably, the RECOVERY trial demonstrated its significant benefit in reducing mortality in hospitalized COVID-19 patients requiring respiratory support.
Lab Monitoring
- Regular monitoring of blood glucose levels, especially in diabetic patients.
- Electrolyte levels (particularly potassium) to prevent hypokalemia.
- Blood pressure measurements.
- Bone mineral density scans for patients on long-term therapy.
- Eye exams (for cataracts/glaucoma) during prolonged use.
- Growth monitoring in children.
Doctor Notes
- Emphasize the importance of gradual dose tapering to prevent adrenal crisis, especially after prolonged therapy.
- Monitor patients for signs of infection, hyperglycemia, hypertension, and electrolyte imbalances during treatment.
- Educate patients on potential side effects and the necessity of reporting any unusual symptoms promptly.
Patient Guidelines
- Do not stop the medication abruptly without consulting your doctor, especially after prolonged use, as this can lead to serious withdrawal symptoms.
- Report any signs of infection (fever, sore throat), unusual swelling, severe mood changes, or vision problems to your doctor immediately.
- Follow your doctor's instructions strictly regarding dosage, duration, and method of administration.
- Carry a steroid warning card if you are on long-term therapy.
Missed Dose Advice
If you miss a scheduled dose, contact your doctor or nurse for advice. Do not double the dose to catch up. Regular dosing is important, especially for prolonged treatment.
Driving Precautions
Dexamethasone may cause side effects such as dizziness, vision changes, or muscle weakness in some individuals. Patients should exercise caution when driving or operating machinery until they know how the medicine affects them.
Lifestyle Advice
- Maintain a balanced diet, potentially low in sodium and high in potassium, to manage fluid retention and electrolyte balance.
- Consider calcium and Vitamin D supplementation, along with regular weight-bearing exercise, for long-term users to maintain bone health.
- Avoid exposure to people with infections, especially chickenpox or measles, as corticosteroids can increase susceptibility to severe infections.
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