Dexamin
Generic Name
Dexamethasone
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| dexamin 01 eye drop | ৳ 45.00 | N/A |
| dexamin 05 mg tablet | ৳ 1.00 | ৳ 10.00 |
| dexamin 5 mg injection | ৳ 18.05 | N/A |
Description
Overview of the medicine
Dexamin (Dexamethasone) is a potent synthetic glucocorticoid with anti-inflammatory and immunosuppressive properties. It is used to treat various conditions, including allergic disorders, skin conditions, ulcerative colitis, arthritis, lupus, psoriasis, and breathing disorders. It also finds use in certain cancers and cerebral edema.
Uses & Indications
Dosage
Adults
Initial dosage varies from 0.5 mg to 9 mg daily, depending on the disease being treated and patient response. It may be given in single or divided doses. For anti-inflammatory, 0.75-9 mg/day.
Elderly
No specific dose adjustments are usually required, but caution is advised due to increased susceptibility to adverse effects. Start with the lowest effective dose.
Renal_impairment
No specific dose adjustment is generally required for renal impairment, as dexamethasone is primarily metabolized by the liver.
How to Take
Oral tablets should be taken with food or milk to minimize gastrointestinal irritation. Injections can be given intravenously (IV), intramuscularly (IM), or intra-articularly. Follow physician's instructions carefully.
Mechanism of Action
Dexamethasone acts by binding to specific glucocorticoid receptors in the cytoplasm, forming a steroid-receptor complex that translocates into the nucleus. This complex then modulates gene expression, leading to the synthesis of anti-inflammatory proteins and inhibition of pro-inflammatory mediators. It also stabilizes lysosomal membranes, reduces capillary permeability, and suppresses leukocyte migration.
Pharmacokinetics
Onset
Oral: 1-2 hours; Intravenous: within minutes.
Excretion
Excreted primarily in the urine as inactive metabolites.
Half life
Plasma elimination half-life is 3-4.5 hours, but biological half-life is 36-54 hours.
Absorption
Rapidly and almost completely absorbed after oral administration. Peak plasma concentrations are achieved within 1-2 hours.
Metabolism
Primarily metabolized in the liver, mainly by the cytochrome P450 3A4 (CYP3A4) enzyme system.
Side Effects
Contraindications
- Systemic fungal infections
- Known hypersensitivity to dexamethasone or any component of the formulation
- Live virus vaccines administration during immunosuppressive doses of corticosteroids
Drug Interactions
NSAIDs
Increased risk of gastrointestinal ulcers and bleeding.
Diuretics
Potassium-depleting diuretics may enhance potassium loss.
Antidiabetics
May increase blood glucose levels, requiring adjustment of antidiabetic medication.
Anticoagulants
May alter anticoagulant effects; monitor INR.
CYP3A4 Inducers (e.g., Phenytoin, Rifampicin)
May decrease dexamethasone efficacy.
CYP3A4 Inhibitors (e.g., Ketoconazole, Ritonavir)
May increase dexamethasone levels and effects.
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Acute overdose is rarely life-threatening. Chronic overdose can lead to signs and symptoms of Cushing's syndrome, including fluid retention, hypertension, hyperglycemia, and adrenal suppression. Treatment is symptomatic and supportive; gradual withdrawal of the drug may be necessary.
Pregnancy & Lactation
Pregnancy Category C. Should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Dexamethasone is excreted in breast milk and may cause adverse effects in nursing infants; a decision should be made whether to discontinue nursing or the drug, considering the importance of the drug to the mother.
Side Effects
Contraindications
- Systemic fungal infections
- Known hypersensitivity to dexamethasone or any component of the formulation
- Live virus vaccines administration during immunosuppressive doses of corticosteroids
Drug Interactions
NSAIDs
Increased risk of gastrointestinal ulcers and bleeding.
Diuretics
Potassium-depleting diuretics may enhance potassium loss.
Antidiabetics
May increase blood glucose levels, requiring adjustment of antidiabetic medication.
Anticoagulants
May alter anticoagulant effects; monitor INR.
CYP3A4 Inducers (e.g., Phenytoin, Rifampicin)
May decrease dexamethasone efficacy.
CYP3A4 Inhibitors (e.g., Ketoconazole, Ritonavir)
May increase dexamethasone levels and effects.
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Acute overdose is rarely life-threatening. Chronic overdose can lead to signs and symptoms of Cushing's syndrome, including fluid retention, hypertension, hyperglycemia, and adrenal suppression. Treatment is symptomatic and supportive; gradual withdrawal of the drug may be necessary.
Pregnancy & Lactation
Pregnancy Category C. Should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Dexamethasone is excreted in breast milk and may cause adverse effects in nursing infants; a decision should be made whether to discontinue nursing or the drug, considering the importance of the drug to the mother.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
3 years from manufacturing date.
Availability
Pharmacies, Hospitals
Approval Status
Approved worldwide
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Dexamethasone has been extensively studied in various clinical trials for its efficacy in inflammatory, autoimmune, and oncological conditions. Notably, it showed significant benefit in severe COVID-19 patients, reducing mortality.
Lab Monitoring
- Blood glucose levels
- Electrolyte levels (especially potassium)
- Blood pressure
- Bone mineral density (for long-term use)
- Intraocular pressure (for long-term use)
Doctor Notes
- Educate patients on the importance of gradual tapering to avoid adrenal crisis.
- Monitor patients for signs of infection, hyperglycemia, and hypertension.
- Consider bone protection strategies (calcium, vitamin D, bisphosphonates) for long-term users.
- Regular ophthalmological examinations are recommended for prolonged therapy.
Patient Guidelines
- Take exactly as prescribed by your doctor.
- Do not stop taking the medicine suddenly without consulting your doctor, as this can lead to serious withdrawal symptoms.
- Report any unusual side effects or worsening of your condition to your doctor.
- Take with food or milk to reduce stomach upset.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
Dexamethasone may cause dizziness, headaches, or visual disturbances in some individuals. If you experience these symptoms, avoid driving or operating machinery.
Lifestyle Advice
- Maintain a healthy diet rich in calcium and vitamin D to support bone health.
- Engage in regular, moderate exercise, if advised by your doctor.
- Avoid excessive alcohol consumption.
- Monitor blood sugar and blood pressure regularly if on long-term therapy.
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