D-Cort
Generic Name
Dexamethasone Sodium Phosphate
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| d cort 5 mg injection | ৳ 16.50 | N/A |
Description
Overview of the medicine
D-Cort 5 mg Injection contains Dexamethasone Sodium Phosphate, a potent synthetic corticosteroid. It is used for its anti-inflammatory and immunosuppressive effects in various conditions.
Uses & Indications
Dosage
Adults
Dosage varies widely based on the condition treated and patient response. Typically 0.5 mg to 9 mg daily, given IM or IV. For severe or life-threatening conditions, higher doses may be used initially.
Elderly
Lower initial doses may be considered for elderly patients due to potential reduced hepatic and renal function and increased susceptibility to adverse effects. Closely monitor for side effects.
Renal_impairment
No specific dose adjustment is usually required for renal impairment, but caution is advised in severe cases due to potential fluid retention.
How to Take
Administered by slow intravenous injection or infusion, or by intramuscular injection. The exact route and rate of administration depend on the condition being treated and the patient's status. Do not inject into the epidural space.
Mechanism of Action
Dexamethasone works by binding to glucocorticoid receptors in the cytoplasm, forming a complex that translocates to the nucleus and modulates gene expression. This leads to reduced inflammation and immunosuppression.
Pharmacokinetics
Onset
Rapid onset after IV administration (minutes), typically within an hour for IM administration.
Excretion
Excreted primarily in the urine as inactive metabolites.
Half life
Plasma half-life: 3-4.5 hours; Biological half-life: 36-54 hours.
Absorption
Rapidly and completely absorbed after intramuscular administration. Well absorbed after intravenous administration.
Metabolism
Primarily metabolized in the liver, mainly by the CYP3A4 enzyme.
Side Effects
Contraindications
- Systemic fungal infections (unless anti-fungal therapy is used concurrently)
- Known hypersensitivity to Dexamethasone or any component of the formulation
- Administration of live or live-attenuated vaccines during corticosteroid therapy (due to immunosuppression)
Drug Interactions
Oral hypoglycemics/Insulin
Dexamethasone may increase blood glucose levels, requiring adjustment of antidiabetic medication.
Anticoagulants (e.g., Warfarin)
May alter anticoagulant effects; careful monitoring of INR is required.
Barbiturates, Phenytoin, Rifampin
May decrease Dexamethasone efficacy by increasing its metabolism.
Diuretics (especially potassium-depleting)
Increased risk of hypokalemia (low potassium levels).
NSAIDs (Nonsteroidal Anti-inflammatory Drugs)
Increased risk of gastrointestinal ulceration and bleeding.
Storage
Store below 30°C in a dry place. Protect from light. Do not freeze. Keep out of reach of children.
Overdose
Symptoms of acute overdose are rare. Chronic overdose or rapid withdrawal after prolonged use can lead to symptoms of Cushing's syndrome or adrenal insufficiency, respectively. Treatment is symptomatic and supportive; gradual withdrawal is necessary to avoid adrenal crisis.
Pregnancy & Lactation
Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Studies in animals have shown teratogenic effects. Dexamethasone is excreted in breast milk and may cause adverse effects in infants; caution is advised, and alternative feeding methods may be considered during breastfeeding.
Side Effects
Contraindications
- Systemic fungal infections (unless anti-fungal therapy is used concurrently)
- Known hypersensitivity to Dexamethasone or any component of the formulation
- Administration of live or live-attenuated vaccines during corticosteroid therapy (due to immunosuppression)
Drug Interactions
Oral hypoglycemics/Insulin
Dexamethasone may increase blood glucose levels, requiring adjustment of antidiabetic medication.
Anticoagulants (e.g., Warfarin)
May alter anticoagulant effects; careful monitoring of INR is required.
Barbiturates, Phenytoin, Rifampin
May decrease Dexamethasone efficacy by increasing its metabolism.
Diuretics (especially potassium-depleting)
Increased risk of hypokalemia (low potassium levels).
NSAIDs (Nonsteroidal Anti-inflammatory Drugs)
Increased risk of gastrointestinal ulceration and bleeding.
Storage
Store below 30°C in a dry place. Protect from light. Do not freeze. Keep out of reach of children.
Overdose
Symptoms of acute overdose are rare. Chronic overdose or rapid withdrawal after prolonged use can lead to symptoms of Cushing's syndrome or adrenal insufficiency, respectively. Treatment is symptomatic and supportive; gradual withdrawal is necessary to avoid adrenal crisis.
Pregnancy & Lactation
Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Studies in animals have shown teratogenic effects. Dexamethasone is excreted in breast milk and may cause adverse effects in infants; caution is advised, and alternative feeding methods may be considered during breastfeeding.
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 and Hospitals
Approval Status
Approved by regulatory authorities worldwide
Patent Status
Generic (Off-patent)
WHO Essential Medicine
YesClinical Trials
Dexamethasone has been extensively studied in numerous clinical trials for its efficacy in a broad range of inflammatory, autoimmune, and oncological conditions. Recent significant trials include its use in the management of severe COVID-19 to reduce mortality.
Lab Monitoring
- Blood glucose levels (especially in diabetic patients)
- Electrolyte levels (particularly potassium and sodium)
- Blood pressure monitoring
- Bone mineral density (for long-term use)
- Growth monitoring in children
- Ophthalmic examinations (for long-term use)
Doctor Notes
- Carefully monitor patients for signs of adrenal insufficiency during and after withdrawal of therapy, especially following prolonged high-dose treatment.
- Consider bone protection strategies (e.g., calcium and vitamin D supplementation, bisphosphonates) for patients on long-term corticosteroid therapy.
- Educate patients on the importance of not abruptly discontinuing the medication and recognizing signs of potential side effects or adrenal crisis.
Patient Guidelines
- Do not stop taking this medicine suddenly without consulting your doctor, as abrupt discontinuation can lead to serious withdrawal symptoms.
- Report any unusual or severe side effects, signs of infection, or worsening of your condition to your doctor immediately.
- Avoid contact with people who have infections, especially chickenpox or measles, as Dexamethasone can suppress your immune system.
- Follow a diet low in sodium and rich in potassium, and discuss calcium and vitamin D supplementation with your doctor for long-term use.
Missed Dose Advice
If a dose is missed, administer it as soon as remembered unless it is almost time for the next scheduled dose. Do not take a double dose to make up for a missed one. Contact your doctor for advice if you are unsure.
Driving Precautions
Dexamethasone may cause dizziness, vertigo, or visual disturbances in some patients. If these effects occur, it is advisable to avoid driving or operating machinery until you are certain you can perform such activities safely.
Lifestyle Advice
- Maintain a balanced diet and engage in regular, moderate exercise to help manage weight and bone health.
- Limit sodium intake to help prevent fluid retention and manage blood pressure.
- If diabetic, closely monitor blood sugar levels as Dexamethasone can affect glucose metabolism.
- Avoid alcohol consumption during treatment as it may increase the risk of gastrointestinal irritation.
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