After dexamethasone, muscles hurt. Side effects of dexamethasone. Busya Active user

Dexamethasone is one of the most powerful glucocorticoid drugs. It is produced in the form of drops, tablets or injection solutions.

This drug is characterized by pronounced antiallergic, anti-inflammatory, desensitizing, and immunosuppressive effects. Dexamethasone is prescribed both as an independent treatment and in combination with other medications.

This remedy is used for a number of diseases, including pathologies of the musculoskeletal system.

Let's look at patient reviews about this drug.

Reviews from patients who took dexamethasone

“I have had problems with my spine for quite some time. I recently went to the doctor, because I couldn’t stand it all anymore, he prescribed dexamethasone. It seems that it needed to be injected to relieve the inflammatory process.

After the fifth injection, I noticed that I had gained noticeable weight, especially in the abdominal area. However, the back pain has also eased a little.”

“I was prescribed dexamethasone to treat rheumatoid arthritis. Everything would be fine, but no one warned that canceling it would not be so easy. The doctor somehow didn’t say how long I should inject this medicine, so I used it until I decided that I was already cured.

Since sitting on it all the time is an extremely dubious pleasure, I simply didn’t get an injection one day. After which dizziness, nausea, and weakness appeared. Returned to injections.

I started reading the instructions. It turned out that this medicine needs to be discontinued gradually. After a while I tried to “jump” off the hormone again. This time I seem to have succeeded; I’ve been feeling good for a couple of days now. Although today nausea and weakness began to appear, although much easier than the first time.

The drug is generally effective and reliable, but I strongly recommend that you contact competent doctors and gradually discontinue the medicine under the supervision of a specialist.”

“I took it for exacerbation of osteochondrosis. This drug has become a real salvation for me. Quickly relieved me of pain and returned me to normal life. I know it’s a hormonal drug, but if it’s necessary, then it’s necessary.”

“I quite often have to inject dexamethasone to eliminate inflammation in the joints. I can’t help but do this, since pain in the joints somehow provokes the development of Quincke’s edema.

Dexamethasone is a hormonal drug with a bunch of contraindications and side effects. An increase in blood pressure is even beneficial for me, since my blood pressure is usually low.

A slight weight gain is also good for me, although it does not last long. But I don’t like the development of osteoporosis and problems with the functioning of the nervous system at all.

With frequent use of the drug, these complications may develop. This drug is strong and effective, but some side effects are frightening.”

“I took dexamethasone tablets for 3 weeks. I have rheumatoid arthritis. After undergoing treatment, I was able to walk again. This is really happiness for me, I didn’t even expect that the effect could be so strong in just 3 weeks of treatment.”

“Do not self-medicate or use dexamethasone for too long. A friend of mine prescribed this medicine for herself to treat her joints. It all ended with excess weight, non-healing wounds and a significant decrease in immunity.”

“My left elbow hurts a lot. The doctor prescribed dexamethasone in combination with ketorol. I forgot about the pain in my elbow after the third injection, as my stomach and somewhere in the liver area began to hurt. Due to constant nausea and pain, I stopped injecting dexamethasone. Now I’m treating everything else except the diseased joint.”

“A month ago I had severe pain in the lumbar region. The doctor diagnosed osteochondrosis and prescribed treatment for a week. There was no effect at all, I just suffered in vain. Then she called a neurologist to the house. He gave one injection with 4 drugs, which was very surprising: nicotinic acid, dexamethasone, lidocaine and cyanocobalamin.

After just one such injection I was able to turn on my side. The next morning I even got out of bed. The course of treatment is 5 injections. I really hope that after them I can finally go to work.

By the way, I also took ranitidine three times a day. It was recommended at the pharmacy to protect the stomach from the effects of the medicine.”

“I’ve been working hard on weightlifting for more than six months. The main load falls on my knees, since I mainly do squats with a barbell.

But recently I have found it impossible to perform these exercises due to serious pain in the knee area. In addition, the ligaments on the outer side of the thigh are strongly pulled when I perform a deep squat.

I regularly took Chondratin, but the effect was minimal. I tried other drugs, but they were even less helpful. If you take a break from squats, the pain disappears, but I can’t give up training for a long time, because there are important competitions ahead. I started taking dexamethasone, injecting it under the knee, and the pain went away as if it had never happened.”

“I took dexamethasone for some time, but had to stop due to the development of Itsenko-Cushing syndrome, myastic syndrome, and so that life doesn’t seem like raspberries, a year after stopping taking it, bilateral necrosis of the right head of the femoral bone occurred.

I haven’t taken it for two years, but I can’t get rid of the side effects.”

“A year ago, I complained to the trainer at the gym about constant pain in my joints, and he advised me on a proven remedy - dexamethasone. Now, as soon as they start to hurt, I prick one cube into the painful place and the pain goes away as if by hand.

Another advantage of the drug is rapid weight gain, especially if you drink proteins at the same time. The main condition is not to exceed the dosage, otherwise side effects will occur.”

Anatoly

“For many years I suffered from arthritis in my elbow, until a friend recommended a hormonal remedy that instantly relieved pain. I started injecting dexamethasone into the elbow joint and the pain disappeared. However, without reading the instructions, I made a terrible mistake.

Due to frequent injections of dexamethasone into the joint, the joint became severely weakened, and doctors diagnosed osteonecrosis. As they explained to me, the medicine in large quantities begins to destroy joint tissue.”

Katerina

“I took dexamethasone to generally strengthen the body and fight rheumatism. However, as a result of taking it, I gained 15 kilograms in the first month, hair began to grow on my chest, and on the top of my head, on the contrary, it began to fall out. I had to stop taking the medicine, but the hair didn’t go away.”

“I am 31 years old and recently my knees and spine started to hurt. I had to see a doctor, who prescribed dexamethasone.

I completed the course without any problems, but after finishing it was terribly all over my face. Now I don’t know how to get rid of this purulent rash.”

“For a year and a half I regularly injected myself intramuscularly with half a milliliter of dexamethasone. A couple of months ago I decided to “get off” the drug and live without it.

Oddly enough, everything went painlessly - first I reduced the dosage, and then stopped completely. I didn’t notice any withdrawal symptoms, but a couple of weeks ago I started to rapidly gain weight (12 kg in a week). And a week later the temperature rose sharply and now remains at 37.7.

In addition, strange pigment spots appear on the skin, hair falls out on the head, appetite disappears and the spine ache. Now I don’t know, maybe I should start taking the drug again.”

“The doctor prescribed me to take dexamethasone tablets. I had a rash on my face and body, and also had lower back pain. I took two courses and my acne disappeared.

Only now strange black hairs have appeared in different parts of the body and I have gained 7 kg. But the worst thing is that my breasts decreased by 1 size and problems with libido developed. I’m not getting along with the guy, I’m constantly freaking out and angry that I was so worried about some kind of rash.”

“The rheumatologist prescribed dexamethasone intramuscularly to solve problems with the spine. The effect of the injections began to appear literally after the first injections.

The pain has disappeared, my body is in good shape, I feel like I was young, my men’s health has improved. Of course, the bald spot on my head is now larger, but that’s not a problem, because women like me even more.”

Gregory

“I took dexamethasone after knee surgery. The stitches healed very quickly, I feel just great, but my periods have disappeared. Doctors say that my balance of male and female hormones is imbalanced, so I need to continue taking the drug.

After repeating the course, I began to recover and gained 24 kg in just 3-4 months. Now I don't know how to get them off. After stopping dexamethasone, the weight was not restored.”

Cure arthrosis without drugs? It's possible!

Get the free book “Step-by-step plan for restoring mobility of the knee and hip joints with arthrosis” and start recovering without expensive treatment and surgery!

Get the book

Injections for arthritis are given mainly in the later stages of the disease, when there are pronounced signs of a degenerative process in the joints. At the beginning of the development of the disease, as a rule, the use of topical medications in the form of ointments and tablets is sufficient.

Intramuscular injections

Depending on the severity of the disease and the severity of the clinical manifestations of the disease, intramuscular injections for arthritis are included in the complex treatment.

For this purpose, the following groups of drugs are actively used:

1. NSAIDs. They have an anti-inflammatory effect, influencing the pathological focus. In addition, they provide a pronounced analgesic, decongestant and antipyretic effect. By relieving the main symptoms of the disease (pain, tissue swelling and limitation of movement in the affected joint), an improvement in the patient’s condition can be achieved. For rheumatoid arthritis, injections should be prescribed by a doctor. This is due to the fact that drugs from the NSAID group have a fairly large list of contraindications that must be taken into account. Mostly drugs based on diclofenac or ibuprofen are used. The required dosage, frequency of use and duration of treatment should be determined by the doctor based on an examination of the patient and the severity of the clinical manifestations of the disease.
2. Analgesics. They can slightly improve the patient’s well-being, but do not relieve inflammation and swelling of tissues. For this purpose, Analgin, Baralgin, etc. are mainly used.
3. Antispasmodics and muscle lactants. Indicated for use in case of severe pain caused by muscle spasm. By relaxing the muscles, a person calms down and discomfort decreases. The most popular drug from this group of drugs is Mydocalm.
4. Glucocorticosteroids. They have a strong anti-inflammatory, analgesic, anti-edematous, antipyretic effect. The use of these drugs is possible only as prescribed by a doctor, since there is a high risk of complications. In no case should you exceed the recommended dosage and duration of treatment. The ideal option is a combination drug Ambene, which in addition to dexamethasone includes lidocaine, vitamin B1, B6, B12.

Intra-articular administration of glucocorticosteroids

For rheumatoid arthritis, injections are also given inside the joint capsule. Thanks to this, the medicine gets directly into the pathological focus. As a result, the therapeutic effect is achieved in a short time.

Intra-articular administration of glucocorticosteroids is used in the absence of a positive result from other treatment methods. The main goal is to remove severe inflammation and make the patient feel better. After all, the use of other important stages of complex treatment of rheumatoid arthritis is impossible during an exacerbation of the disease.

The following glucocorticosteroids are mainly used for intra-articular use:

• Kenalog;
• Celeston;
• Diprospan;
• Hydrocortisone, etc.

Intra-articular administration of drugs is carried out only in a medical institution, since this requires certain knowledge and professional skills. Otherwise, you can damage the capsule and provoke the development of complications.

The course of treatment ranges from 1 to 5 injections. For each patient this is an individual indicator, since everything depends on the severity of the pathological process. Injections are given after 7-12 days. This is necessary in order to adequately assess the presence or absence of the positive effect of glucocorticosteroids. As a rule, the result is clearly visible after the first use. Therefore, if the drug is not suitable for the patient, its use should be discontinued.

Despite the fact that glucocorticosteroids do not have a systemic effect when administered intra-articularly, they must be used very carefully due to a large number of contraindications and side effects.

Repeated use of the drug can provoke a reverse reaction - further worsen metabolic processes in cartilage tissue. And also aggravate the general condition of patients suffering from diabetes, gastric and duodenal ulcers, and renal failure.

Intra-articular injection of hyaluronic acid

For arthritis of the knee joint, intra-articular injection of hyaluronic acid is increasingly used. This is a unique remedy that is a kind of substitute for natural synovial fluid. Another name for it is “liquid prosthesis”. Hyaluronic acid prevents friction between bones and helps increase range of motion in the affected joint. Helps restore normal quantity and quality of synovial fluid.

The sooner you start treatment with hyaluronic acid, the higher its effectiveness. In the later stages of the disease, the use of the drug will help get rid of unpleasant symptoms, but the results will not be so noticeable.

For intra-articular administration, the following preparations, which include hyaluronic acid, are mainly used: Crespin - gel, Sinokrom, Ostenil.

The lubricant acts almost instantly. Once in the joint capsule, the medicine is quickly distributed over all surfaces, preventing them from rubbing against each other. Activates metabolic processes, thereby improving the supply of all necessary components to the cartilage tissue.

Hyaluronic acid is successfully used in the treatment of arthritis of the knee joint, as well as other joints: elbow, hip, shoulder. In some cases, it is advisable to use it in the treatment of pathologies of small joints. The main condition for the successful use of hyaluronic acid is that it is administered only after the severity of the inflammatory process has subsided and stable remission has been achieved.

The course of treatment with this drug ranges from 1 to 5 injections, depending on the doctor’s prescription. It is necessary to observe the recommended intervals between injections - at least 6 - 10 days. The therapeutic course should be repeated annually for several years. There is no need to wait for the next deterioration in your health to see a doctor and get treatment.

The main disadvantage of hyaluronic acid is its high price, but it is worth it. Moreover, even with long-term use, the drug does not have a negative effect on cartilage tissue.

Intra-articular administration of chondroprotectors

In severe cases of rheumatoid arthritis and severe degenerative-dystrophic processes in the joints, the doctor may prescribe intra-articular administration of chondroprotectors.

The following drugs are mainly used:

• Alflutop;
• Chondrolone;
• Target-T.

These drugs are administered for arthritis of the shoulder joint and other joints. Thanks to this method of use, the medicine has a pronounced therapeutic effect. Prevents further damage to cartilage tissue, promotes its restoration and regeneration. The use of chondroprotectors in the form of tablets is much less effective, even with long-term administration.

The composition of chondroprotectors includes glucosamine and chondroitin sulfate. The course of treatment is about 5 procedures. Each injection should be carried out with a break of 1 - 2 weeks, after which the patient is transferred to oral administration of drugs. The cycle should be repeated annually. This is the only way to preserve cartilage tissue as much as possible and restore the functionality of the joint.

The use of injections in the treatment of rheumatoid arthritis is an unpleasant procedure. However, in severe cases of the disease, this is the only treatment method that can achieve significant results and improve the patient’s well-being.

Drug treatment of gout: a review of medications

To eliminate pain in the legs due to gout, diclofenac, ibuprofen, nise, meloxicam as injections, ointments or tablets, dimexide for lotions and compresses, as well as dexamethasone, movalis, diprospan are used.

In order to correctly determine what kind of drug treatment for gout is needed, what drugs are prescribed and why, whether diclofenac, ibuprofen, Nise or Movalis are more suitable, whether they should be supplemented with dexamethasone or dimexide, you should first understand what this disease is.

Gouty arthritis is changes in joint tissue caused by deposits of urate, uric acid salts. The causes of the pathology are mainly metabolic disorders associated with age-related changes in the body and poor nutrition.

Men suffer from gout several times more often than women, but drugs such as dexamethasone or movalis and dimexide are used in treatment regardless of gender.

Clinical picture and features of the disease

The first symptoms of gout usually appear after the age of forty. Salts can be deposited in all joints, but most often and most of all they accumulate in the legs and hands.

The patient experiences sharp pain in the legs or arms, the joints swell and become hot. Mobility becomes very limited.

Gout is often accompanied by:

• Acute arthritis;
• Tophi.

If the disease is not treated, it will progress, affecting other organs, and here it is necessary to immediately take either movalis and dimexide, or dexamethasone.

Comprehensive treatment of gout

This disease, despite the threatening symptoms and complications, is quite treatable, but provided that the patient consults a doctor as early as possible and adheres to his recommendations. An integrated approach is required; the basic program consists of the following stages:

1. Reducing pain.
2. Elimination of the inflammatory process; dexamethasone or movalis are suitable for this.
3. Dissolution and removal of uric acid salts.
4. Restoring joint functionality.
5. Relapse prevention.

If the disease is at a stage where complete recovery is no longer possible, then it is necessary to at least stop its further development, that is, the destruction of the joints. For this purpose, various drugs are first prescribed, such as movalis, dimexide or dexamethasone.

Treatment of gout with medications

Medicines in the treatment of gout are used at almost every stage.

Non-steroidal anti-inflammatory drugs. These medications act in several directions at once, effectively relieving pain, eliminating swelling and fever, and stopping inflammation. The most common drugs from this group:

• Indomethacin,
• Ibuprofen,
• Nise.

They all have different active substances in their composition; which ones are best is always assessed by the doctor on an individual basis. It should be remembered that these medications cause a number of side effects, so treatment should always be carried out under medical supervision. It is strictly prohibited to independently increase the dosage or increase the duration of the course of treatment.

It must be remembered that diclofenac, indomethacin, Nise and other similar medications are also available in the form of ointments and gels for external use. If they are used simultaneously with tablets containing the same active substance, the dosage increases accordingly.

Nonsteroidal drugs are not as dangerous as steroids or antibiotics, but they can also cause serious complications, primarily from the digestive system.

In addition, drugs containing acetylsalicylic acid have a negative effect on gout - it prevents the excretion of urates from the body. Very popular, if you study the reviews, is a new generation drug such as Colchicine. Patients suffering from even an advanced form of gout feel significant relief the very next day after starting treatment.

It can also be used to prevent disease, but with great caution. If side effects are observed, the doctor reduces the dosage or selects other medications.

Analgesics. Non-steroidal anti-inflammatory drugs relieve pain, but if they are very severe, analgesics may also be included in the drug treatment. The medication regimen is then compiled and adjusted only by the doctor. As soon as the patient's condition improves, one type of medication is removed.

Products that promote the resorption and removal of salt deposits. This:

• allopurinol,
• thiopurinol,
• milurite,
• olorotic acid.

They reduce the synthesis of uric acid in the body, prevent the deposition of salts and thus prevent the development of the disease. Salts are better dissolved and excreted, and the patient’s well-being improves significantly.

Some of these drugs may need to be taken for a long time. Therefore, even when the acute attack of gout has passed and diclofenac, indomethacin, ibuprofen, Nise or meloxicam are no longer prescribed, allopurinol or thiopurinol remains in the treatment program.

At the same time, medications are taken that stimulate kidney function - this helps to quickly get rid of salt deposits and prevents their further formation.

Antibiotics are necessary if the disease is accompanied by infections. These can be injections or systemic tablets. Be sure to take vitamins during this period to normalize metabolism and maintain immunity.

Dimexide is used externally for compresses, treatment is complemented by classical medications for gout - movalis, dexamethasone, diprospan.

Diet therapy for gout

The effect of the medications will be faster and the result will be lasting if the patient suffering from gout adheres to proper nutrition. This point is very important and should not be overlooked.

The first thing to do during an exacerbation of the disease is to exclude all meat and offal from the diet. This is a protein that promotes the production of uric acid if poorly absorbed by the body. The diet for gout implies that the following are prohibited:

1. Any canned and smoked foods;
2. Fried fish;
3. Legumes – lentils, peas, beans;
4. Meat and mushroom broths;
5. Spices;
6. Cheeses with a sharp or salty taste;
7. Coffee and black tea;
8. Alcoholic drinks, especially wine and beer;
9. Confectionery and chocolate.

Vitamins are needed during this period in large quantities, so you need to consume as many boiled or fresh vegetables and fruits as possible, you only need to limit the consumption of cabbage of any variety, celery, bell pepper, radish and radish. Berries and nuts in any quantity will be useful.

Sweets are allowed only in the form of jam, preserves or marshmallows; if they are sweets, then without chocolate. As for dairy products, kefir, cottage cheese, sour cream, yogurt, unsalted and low-fat cheeses are allowed.

If you have taken ibuprofen, indomethacin, diclofenac, Nise or meloxicam for a long time, the mucous membrane of the stomach and intestines is severely affected. Milk can protect it, but not whole milk. It is better to use it diluted as a base for viscous porridges and jelly. Any cereals and pasta can be included in the diet.

Dexamethasone is a systemic glucocorticosteroid. This is a synthetic hormonal drug that is similar to hormones produced by the adrenal cortex. It has strong anti-inflammatory, anti-shock and anti-allergic effects. It is used for many pathologies accompanied by serious disorders. When used correctly, Dexamethasone quickly relieves inflammation and allergic reactions, improving the patient's condition. But the problem is that for this you need to choose the exact dosage. If treatment is carried out without a doctor’s prescription or the patient violates medical recommendations, serious side effects may occur.

Features of application

Dexamethasone is very popular among other hormonal agents due to its low cost and high effectiveness. Its action is based on the fact that the drug binds to glucocorticoid receptors of cells and penetrates them. It blocks the production of certain enzymes, interferes with metabolic processes, and inhibits the activity of the immune system. The result of this is a decrease in inflammation and pain, the disappearance of itching, swelling and redness of the skin, and easier breathing.

This drug is effective in many pathologies; its timely administration can save the patient’s life or significantly improve his condition. But it should be used only as prescribed by a doctor after examination. Sometimes careful monitoring of the patient during treatment is required. After all, some chronic pathologies may worsen due to the use of the drug or provoke side effects.

Caution when treating with this drug and the use of the lowest possible doses is necessary for the following pathologies:

• osteoporosis;
• hypertonic disease;
• heart failure;
• tuberculosis;
• diabetes;
• peptic ulcers;
• glaucoma;
• hypothyroidism;
• ulcerative colitis;
• epilepsy;
• psychosis.

Dexamethasone is also prescribed with caution to elderly patients and children. After myocardial infarction, they try not to prescribe the drug, as it slows down the formation of scar tissue and can accelerate the development of necrosis. And if long-term use is necessary, it is necessary to constantly monitor the level of potassium and glucose in the blood.

Contraindications

Sometimes Dexamethasone is prescribed in emergency cases, for example, in case of anaphylactic shock or Quincke's edema. In this case, the drug can save the patient’s life, so they usually do not pay attention to the presence of contraindications. This use of this medicine is short-term and therefore rarely causes negative reactions. But, if the situation is not critical, a full examination is necessary.

Attention: the doctor prescribes treatment only taking into account the presence of chronic diseases in the patient. This helps to avoid serious consequences.

There are the following contraindications to the use of Dexamethasone:

• myocardial infarction;
• internal bleeding;
• diabetes;
• pregnancy and breastfeeding;
• severe obesity;
• immunodeficiency;
• osteoporosis;
• mental illness;
• ulcers on the mucous membrane of the digestive tract;
• renal failure;
• infectious diseases.

It is not advisable to use Dexamethasone during pregnancy.

Vaccinations are contraindicated during treatment with Dexamethasone. In addition to the fact that they will be useless due to a decrease in the functions of the patient’s immune system, vaccination with a live vaccine can lead to the development of the disease. Therefore, the drug can be used no earlier than 2 weeks after vaccination, when antibodies have already formed. And after the course of treatment, at least 2 months must pass before starting Dexamethasone therapy.

Side effects

When choosing the correct dosage of the drug, it is well tolerated by all patients. Therefore, it is prescribed to everyone, regardless of age, even newborns. Dexamethasone causes side effects most often when used incorrectly. This happens when a patient uses a drug without a doctor’s prescription, does not take into account contraindications, or exceeds the recommended dosage. In this case, you should stop using the drug and consult a doctor.

Some people may have individual intolerance to the active ingredient of the drug. Moreover, after its administration or ingestion, an allergic reaction soon appears. It could be urticaria or even bronchospasm. Often the drug also affects the immune system. This usually manifests itself in increased susceptibility to infections. The patient is susceptible to bacterial, viral and fungal diseases. And infectious diseases such as measles or chickenpox are very severe.

If side effects occur, even if they are not severe, it is not advisable to use Dexamethasone. After all, it acts at the cellular level and accumulates in the body, affecting the functioning of various organs for several weeks. And the more the drug enters the cells, the more severe the negative reactions will be later. Therefore, even if you experience slight malaise, nausea or discomfort, you must inform your doctor. You may need to replace the drug with another one. But this also needs to be done correctly. Often the cause of side effects is sudden withdrawal of the drug.

Dexamethasone acts at the cellular level by binding to glucocorticoid receptors. And they are present in all organs and tissues of the body. Therefore, the side effects of Dexamethasone may vary. They can affect the functioning of the cardiovascular, endocrine and nervous systems; when taken orally, the digestive organs are most often affected; when administered by injection, local reactions may develop. This drug also has a strong effect on metabolic processes, often leading to the accumulation of fat deposits, increased sugar levels, and loss of calcium and potassium.

Attention: it is not advisable to use Dexamethasone after fractures and other injuries, although severe pain and shock are indications for its use. But this drug can slow down regeneration processes and impair the rate of wound healing.

When using Dexamethasone injections, negative local reactions often develop. This usually results in skin redness, swelling, burning or soreness at the injection site. Pigmentation disorders, subcutaneous tissue atrophy, and scar formation may also appear.

Endocrine system

The most dangerous consequence of using Dexamethasone is suppression of adrenal function. Moreover, this condition may not develop immediately, but a couple of months after treatment. The risk of this disorder is especially high with long-term use of the drug in high doses.

Dexamethasone also has a strong effect on carbohydrate metabolism. This is most evident in decreased glucose tolerance. Because of this condition, the development of steroid diabetes mellitus or an exacerbation of its latent form is possible, as hyperglycemia develops.

The drug affects fat metabolism. Dexmethasone binds to lipids and increases their digestibility, which accelerates the accumulation of fatty deposits. Therefore, weight gain may be a consequence of treatment with this drug.

Obesity is often a consequence of Dexamethasone treatment.

One of the rare, but still possible side effects is Cushing's syndrome. It manifests itself with the following symptoms:

• increased blood pressure;
• moon-shaped face;
• muscle weakness;
• obesity;
• dysmenorrhea.

When using the drug in childhood, there is a high risk of delaying the child's growth and development. It especially strongly affects the growth of bone tissue, so the development of skeletal deformities is possible. The sexual development of children also slows down.

The cardiovascular system

Especially often, such side effects develop after using the drug in injections. If you do not follow the correct dosage and administration of the solution, they may appear immediately. This is an increase in blood pressure, a rush of blood to the face, and disruption of the heart muscle. This happens when large doses of the drug are administered quickly, and this can lead to cardiac arrest.

But even with proper use and compliance with the dosages recommended by the doctor, the development of disorders of the cardiovascular system is possible. Most often this is an increase in pressure and the development of arrhythmia. Bradycardia may develop, and the slowing of the heart rate can be so strong that it threatens to stop it. Thrombosis and increased blood clotting are also possible.

Patients predisposed to heart disease often develop heart failure. But this can happen even in healthy people. After all, Dexamethasone has a strong effect on electrolyte metabolism in the body, reducing the amount of potassium in the blood. And hypokalemia negatively affects the functioning of the heart.

Attention: it is especially dangerous to use this drug for treatment in patients who have had a myocardial infarction. Dexamethasone slows down the processes of tissue regeneration; on the contrary, its use may cause the area of ​​necrosis to expand. This can damage the heart muscle.

Nervous system

After Dexamethasone injections and tablets, the patient’s nervous system and psyche also suffer greatly. Therefore, it is not recommended to use this steroid drug if you have any problems, as they may worsen. Typically, disruption of the nervous system appears almost immediately after the start of treatment. Most often it is mood instability and insomnia. But then, if the dosage is exceeded, the consequences can become more serious.

Most often, during treatment, patients experience headaches, dizziness, and insomnia. Convulsions are possible, which most often occur with an overdose, as well as increased intracranial pressure.

Sometimes mental disorders develop in patients after stopping treatment, especially if this happened abruptly. This may cause nervousness, hallucinations, disorientation, fear and anxiety. The serious consequences of Dexamethasone treatment also include paranoia, depression, manic-depressive neurosis, euphoria, mood swings and even thoughts of suicide.

Digestive system

The digestive organs most often suffer after using the drug in tablets. But injections can also damage the gastrointestinal tract, especially if there are any violations of its functions. Most often, nausea, vomiting, flatulence appear, appetite is disturbed, and digestion slows down.

But more serious consequences may develop:

• pancreatitis;
• peptic ulcer of the stomach and duodenum;
• esophagitis;
• erosive gastritis;
• perforation of the walls of the gastrointestinal tract;
• stomach bleeding;
• liver dysfunction.

Organs of vision

Dexamethasone is often used for various ophthalmological pathologies. For this purpose, a special form of the drug is usually used - eye drops. But it is also possible to use Dexamethasone in ampoules for intramuscular injection. This treatment is effective for various infectious, allergic and inflammatory eye diseases.

But the use of Dexamethasone can be harmful to the organ of vision. Incorrect dosage or long-term treatment sometimes leads to the development of cataracts, glaucoma, and retinopathy. This drug may cause increased intraocular pressure and the development of secondary infections.

Often Dexamethasone negatively affects the organ of vision

Musculoskeletal system

Despite the fact that the main indications for the use of Dexamethasone are various pathologies of the spine and joints, many of its side effects manifest themselves in this area. This drug affects metabolic processes and greatly reduces calcium absorption. This leads to decreased bone density. With long-term therapy with this drug, the risk of developing osteoporosis and resulting fractures increases. The tubular bones and vertebrae most often suffer from this.

Attention: when using Dexamethasone in large doses or with long-term treatment, aseptic bone necrosis may develop. This pathology most often affects the femur or humerus.

Frequent intra-articular injections of Dexamethasone can lead to the destruction of cartilage tissue. Therefore, it is better not to use this drug for the treatment of arthrosis. Tendons are also damaged and may even rupture. And the ligaments soften, stretch, and cease to perform their functions.

But the most common side effect of treatment with this drug is muscle weakening. The reason for this is a violation of metabolic processes in muscle tissue. This leads to a decrease in their tone and even atrophy. This condition is called steroid.

Withdrawal syndrome

If, after long-term treatment with the drug, you suddenly stop taking it, withdrawal syndrome develops. In the most serious cases, it manifests itself as a rapid drop in blood pressure, slow heart rate, and adrenal insufficiency. This condition can lead to death.

But this rarely happens. Most often, withdrawal syndrome manifests itself in the fact that the underlying disease that was treated with Dexamethasone “exacerbates.” For example, with rheumatoid arthritis, a relapse may occur: inflammation increases, joints become swollen and painful. Often, improper cessation of treatment is also manifested by disruption of the digestive system, loss of appetite, headaches, and weakness. Sometimes a febrile state develops, conjunctivitis, runny nose, arthralgia, and convulsions appear.

Therefore, the withdrawal of Dexamethasone should be gradual - over 1-2 weeks. The doctor will advise you on how to reduce the dosage so that it does not have negative consequences.

Overdose

Dexamethasone should only be used under the guidance of a doctor, as it is very important to choose the right dosage. It depends on the age of the patient, the severity of his condition and the type of pathology. This drug is usually used in the lowest possible doses. This avoids side effects.

But some patients use the drug on their own, without consulting a doctor. Others independently exceed the recommended dosage, believing that this will improve the effectiveness of treatment. But this approach leads to serious consequences.

An overdose of Dexamethasone is most often manifested by the appearance of edema and a strong increase in blood pressure. This happens because the drug causes fluid and sodium salts to be retained in the tissues. It is also possible to increase blood sugar levels, develop heart failure, and develop peptic ulcers.

Severely exceeding the dose of the drug threatens a sharp increase in blood pressure, the appearance of tachycardia, and nausea. The patient feels anxious and disoriented. He develops psychosis, confusion, and seizures. If you notice such symptoms, it is important to call an ambulance as soon as possible.

Drug interactions

Sometimes the side effects of Dexamethasone appear due to the fact that it is used as part of a complex treatment. But this drug is not compatible with all medications. This must be taken into account when prescribing treatment.

Most often, the occurrence of negative reactions is associated with the peculiarities of the drug’s action. Some diuretics remove potassium from the body. And when treated with Dexamethasone, its level already decreases, so the risk of developing heart failure increases. It is also undesirable to use sodium-containing drugs together with it, as this will lead to edema and increased blood pressure.

When used together with cardiac glycosides, the risk of developing extrasystole increases. And anticoagulants and thrombolytics together with Dexamethasone can lead to internal bleeding. Non-steroidal anti-inflammatory drugs become more toxic and more damaging to the gastrointestinal mucosa.

You cannot use other hormonal drugs together with Dexamethasone, as this will increase the risk of side effects. It is also undesirable to combine it with Indomethacin, Cyclosporine, Ketoconazole, Paracetamol, Azathioprine and some other drugs.

conclusions

Despite the effectiveness of Dexamethasone in many pathologies, it should be used only in the most extreme cases. After all, a large number of side effects can negate the positive effect of treatment or even worsen the patient’s condition. In addition, it is very important to use this remedy in the lowest possible doses, this will help reduce the risk of developing negative reactions.

Video on the topic

11.06.2017, 12:26

Hello Dear Doctors.
Please help me in my difficult situation.
Male, 45 years old, height 165 cm, weight 67 kg before illness (now 54).

In December 2016, he underwent surgery for an inguinal hernia, after which health problems began to grow like a snowball... After the operation, a complication emerged - varicose veins of the penis, while running to the doctors, the urologist checked the hernia through the scrotum from the side of the operation - something happened, wild pains began... against the background of these pains, for some reason problems with the joints emerged - specifically entosopathies, which were diagnosed in Chelyabinsk at the regional hospital.
At the moment, I can’t walk, I’m lying at home... there is a very rapid atrophy of muscles... legs, feet, hands, arms, pelvic muscles, abdomen, back, neck and throat, as well as in the area
It all started with squats, where I overloaded apparently weakened ligaments and joints with arthralgic pain over the last 4 months. I had pain in my knee when going down the stairs, thinking that it was the meniscus, I went to the traumatologist. They took a picture and the meniscus was not so bad, so I was diagnosed with arthrosis and prescribed treatment. Then the pain in the knee began to progress and the tendons on the left side of the thigh began to ache, the muscles began to swell, and a strong spasm appeared in the popliteal fossa. My lower leg and foot began to swell. I began to walk on the other leg, on crutches... After the load of the whole body began to fall on one leg... after a while it started to get sick in the same way. Some kind of symmetry appeared... Against this background, night attacks on the tendons returned with pain, heat and temperature, almost all the joints and nearby tendons were twisting, I think I call them correctly. Then they brought me a walker and I began to walk leaning on it, saving my bad leg, and began to lean all my weight on my hands. After some time, I also disabled my arms in this way... mostly my hands were damaged, then a little on my elbows and shoulders.
The pain began to bother me so much, I couldn’t really move... that I decided to be hospitalized at the clinic, but they didn’t admit me there, citing the fact that there were no rheumatology specialists... and that I needed to be examined. The doctor from the emergency room prescribed me 5 injections of dexamethasone, saying that this would get me back on my feet and I would be able to at least walk and get examined. I injected half the ampoule, which is 2 mg.
After the injection, after a while I felt bad... the pressure stayed around 190/125 all day and did not fall... in the evening the pressure dropped and the worst thing began... I noticed how the ligaments in my legs began to weaken first, then the muscle on the lower leg began to weaken, then in front near the bone began to push down...
And from that day on, the muscle mass began to thin out... the skin began to stretch... became dry and thin...
It became especially scary when the stomach began to weaken... first on the sides... the center was still holding, a downward sag appeared between the pubic part and where the navel was. Belly fat started to accumulate...
As a result, I ended up in the city hospital... there they kept me for a week, saying that I didn’t look like Cushing... TSH was normal - they checked for parateriosis and that was all... The examinations were very slow... and their main verdict was that I was not enough I'm walking. They didn’t believe my story about dexamethasone... that he gave me such a picture.
I was discharged home... hoping that here I could do something faster, because muscle mass was being lost every day, and at night there were constant attacks with sweating, pain and burning in the affected tissues near the joints, pressure + copious discharge of cloudy urine, well this is mostly during the day.
Being already at home... I seemed to feel at least a little bit better... and in one of the tests I took, I discovered that I had a vitamin D deficiency, about 8 with a lower norm of 30. After consulting with an endocrinologist, it was recommended to take vitamin D3 20 (10000ME) drops 2 times per week. However, I didn’t dare take such a dose... and took 10 drops... and again... I felt bad again... the symptoms are almost the same as after dexamethasone... the pressure of 170/110 practically did not drop for a day... increased urination (cloudy urine 300 ml at a time) . And at night the loss of muscle mass began to progress again. My teeth started to hurt...
Immediately the next day I passed phosphorus and calcium. They turned out to be elevated Ca (ionis) - 1.35 (1.17-1.29), Mb, P -1.51 (0.81-1.45). This is the only thing I could identify from the deviations that were clearly striking. When I was in the city hospital, these indicators were normal.
In the urine there is mucus +++, oxalates +++, hyaline casts 4-6 (normally there should not be), no protein and no leukocytes...

At the moment, the loss of muscle mass continues, and something also happens to the skin... as if subcutaneous fat is being destroyed, the skin becomes thin, wrinkled and dry. The temperature is almost always 37, in the morning it is normal. Very cloudy urine continues to flow... I have never had this before. It happens with attacks, especially after physical exertion. burning in the whole body, pain, aching sensation, bones... teeth.
Some kind of vicious circle... I understand that you can’t lie down, but the slightest attempts to put stress on the muscles leads to even greater aggravation... pain in the muscles and joints, and after a while, as the inflammation subsides a little, you realize that you have lost more muscles.
What to do? How to get examined, what to do? And why is it so aggressive...
I apologize for the long text.
There are a lot of tests, if you need something I can post it or submit it quickly.

11.06.2017, 18:00

How specifically (literally) was the diagnosis of enthesopathy formulated in Chelyabinsk? Better scan.
Dexamethasone was removed a long time ago, this is not the reason. Creatine kinase (CK), LDH, albumin, globulins?
Neurologist examination? Rheumatologist? Muscle biopsy, EMG done?

11.06.2017, 19:24

I agree that it disappeared a long time ago... but the process started precisely after it. And very suddenly, by the end of the day the right shin was already hanging in a rag and the tendon on the heel became like a rope...
I thought that it was some kind of side effect and waited for 3 days for it to “dissipate.” But the process went further... did not stop. Maybe he gave way to something by lowering his immunity? I don’t know what to think... but judging by my skin, it’s something hormonal...
Before the injection, I suffered from pain in the joints... or rather, not even in them, but in the periarticular tissues and tendons, and after the injection, I definitely began to suffer from polyuria... 300-400 ml of urine at a time. and very cloudy... if there is a white sediment right at the bottom, the skin... the skin has become abnormal, on the palms it is dry, thin, after 3 minutes in water it wrinkles like a child’s, subcutaneous fat has begun to disappear in some places... I probably understand. If earlier there was a body on my forearms... now there is wrinkled paper in thickness.
All this is accompanied by some kind of inflammation... that is, it does not look neurological.

I enclose an ultrasound examination (March, Chelyabinsk) and an examination by a rheumatologist. But then I suffered from night attacks on the tendons near the joints. I remember the rheumatologist said you don’t have rheumatoid or other arthritis... your joints are calm - look for an infection with urologists.

The neurologist and our local endocrinologist at the city hospital came to the conclusion that I had simply been lying there for a long time and had normal atrophy. I’m tired of proving to them that this is not so and that it’s not just atrophy that torments me... well, in general, that’s how it is...
Well, in a paid clinic they looked at me and noticed that my testosterone was 9.0 and my vitamin D was low - 8.75. Well, in general, the urologist made a diagnosis that all my problems are due to testosterone, sarcopenia has developed and I need replacement therapy + rocking chairs and walking.
I bought all the medications, but... I think it’s some kind of nonsense, everything around my joints is inflamed, what does testosterone have to do with it? I have friends who have lower hormone levels than me... but no one has wild muscle wasting.

By the way, I can add my subjective opinion that to the touch the affected areas are there, as if the structure of the tissue is enlarged... individual swollen fibers, large to the touch and very flabby.

I myself am from Kostanay, our town is not big and a biopsy with EMG cannot be done here... Coming to Chelyabinsk in person... now of course it’s a problem, since I can’t stand on them... immediately all the tendons become inflamed, not just the legs... yes and the muscles have already atrophied - weak...

But the vicious circle needs to be broken somehow...

According to analyses:
KFK - 47 (0-192)
LDH - 124 (0-232)

Yes... and also the osteoporosis marker beta-cross labs - 0.807 (0.06-0.7)

No albumin or globulins... I'll do it tomorrow...

Ultrasound (They did only the elbows, but I complained about them more):

11.06.2017, 19:37

You have lost 13 kg. Do you have fresh blood sugar and TSH? They probably tested for HIV before the operation.
I couldn’t find the date of donation of general blood. It would also be fresh...
How much fluid do you drink and excrete?

11.06.2017, 19:56

All analyzes are very recent... ok from 06/08/2017.
There is sugar and TSH... but they are from May 26, that is, after the dexamethasone injection (was given on May 6, 2017), but before taking vitamin D, if it could change something:
[Only registered and activated users can see links]
[Only registered and activated users can see links]

I would like to note that since January I have had a lot of tests... but after the injection they changed... not critical, but hemoglobin dropped in the blood (it was 145), red blood cells (it was about 5, a little less), immediately after the injection there were monocytes, a little more 10.
My sugar was high... 5.6 almost always...
Now it collapsed by 4... also some misunderstandings with phosphorus and calcium...
The problem with urine is major...
Well, this is what I noticed... I’m not a doctor, maybe this is not particularly important.

11.06.2017, 20:00

The problem with urine is major...
Details!!!

11.06.2017, 20:02

I didn’t measure the fluid... but the urine output at one time is up to 400 ml maximum... if the pressure is pressing, then I go often... the urine is always light and very cloudy. There is no polyuria at night, I go 1-2 times maximum, in the morning the urine is a little more concentrated...
I drink 1.5-2 liters. But it seems to me that the total allocation, if it exceeds it, is not by much.
There are days when the pressure rises to 170/110 and nothing gets in the way... then it starts pouring off me... but I still think no more than 2.5-3 liters...
There is no thirst... if you cling to diabetes.
I drink water... but this is how I tried to remove all the calcium from myself...)))

11.06.2017, 20:05

I wrote in detail about urine... it comes out very cloudy... as if it was taken from a dirty puddle... whitish dust... it settles if it stands for a long time. I’ve never seen anything like this before... and what’s interesting is that this dregs doesn’t stop at all... at least sometimes it becomes clear...

11.06.2017, 20:10

Since what age have you suffered from arterial hypertension and what medications do you constantly take? Did you quit your job due to illness?

11.06.2017, 20:16

I've had hypertension for about 15 years... maybe more. I take 10 mg Equator in the morning. In normal life this is enough, the pressure is well controlled. At the moment I am a pensioner (military) for a year already. He left due to health reasons... he was also diagnosed with hypertension...

11.06.2017, 20:24

Did your arterial hypertension become so severe that you had to leave? Perhaps you are forgetting to mention something?

11.06.2017, 20:30

The main health issue was hypertension, but of course it was not that severe, although there were crises up to 200.

11.06.2017, 20:33

I would like to add that I have lost 13 kg since the New Year, approximately, after the operation. And after the hormonal injection, 5-6 kg have already gone away in a month.

11.06.2017, 20:47

Judging by the topics from past years, you have experienced similar conditions with polyuria, weight loss with decreased appetite and increased blood pressure more than once and endocrine pathology has been excluded. New symptoms include muscle weakness and atrophy. I think that the only option is to find the opportunity to come to the Chelyabinsk Regional Clinical Hospital and visit a rheumatologist and psychotherapist to rule out fibromyalgia (as an option.)

11.06.2017, 22:18

Yes... in 2013 something similar happened to me... pressure, weakness... muscle pain...
But there were no hormonal injections and there was no muscle atrophy...
Now for some reason I woke up, at night... both thighs on top were inflamed... pressure 180/120. It’s some kind of nonsense, like I didn’t put any weight on my legs...
Well, thanks for that...
By the way, my appetite is absolutely not reduced... I eat, it seems not bad... but it makes no sense.

11.06.2017, 22:20

Once again, dexamethasone 2 mg once did not affect your condition.

12.06.2017, 05:50

Yesterday’s drinking regime was measured:
Total liquids drunk - 2.0 liters
Went to the toilet - 2.3 liters

The minimum portion is 300 ml, the maximum is 450. Which is a lot for me.

Maybe I don’t understand my situation correctly, but something is happening to me. And such an aggressive loss and atrophy of muscle mass in the near future threatens disaster

For now, I’ll take additional tests and look for the opportunity to travel to Chelyabinsk.

12.06.2017, 07:38

There will be no muscle atrophy with one dose of dexamethasone.
If in doubt, check your blood cortisol at 8 am.

12.06.2017, 07:44

I tested blood cortisol 2 times... once I felt pretty good: 376.6 (171-536)
One time worse: 814.9 (200-600)(09.00-11.00)
Today I collected my daily urine... I went and passed it...

12.06.2017, 14:07

Dear doctors, please comment on the situation with possible osteoporosis... which also developed after dexamethasone, or became pronounced.

Among the complaints - periodic pain in the bones, when palpating some bones they became not smooth, but like a “washboard”, not even... more like a battery... or it’s the periosteum rolling over the bone and the whole thing has become loose.. Well, yes, you can guess, but I feel changes... this didn’t happen a month ago.
The enamel of the teeth has also become painful, all of them... and some teeth have shifted, the bite has changed, I think my legs are growing from here.

According to the tests, PTH is normal, vitamin D is deficiency, calcium and phosphorus are at the upper limit (before taking vitamin D, 10 drops were normal), the bone resorption marker is greatly increased, bone formation markers are closer to the lower limit. Total testosterone 9.15. Well, accordingly, I’m also lying down... I just sit up and roll around in bed, sit on chairs... I’m not in the sun... that’s all.

Why are calcium and phosphorus at the top when vitamin D is low? And they were also promoted.

12.06.2017, 14:35

Sharp weight loss and bone loss are inextricably linked. I have carefully read your topics over the years and have caught a clear pattern: You are prescribed some kind of drug (corticosteroid, vitamin D, antidepressant - you take them for no more than a week, then tell the episode that occurred panic attack, and give up, while making deeply false conclusions about cause-and-effect relationships!
Go to Chelyabinsk, specifically to a psychotherapist and rheumatologist, and try to carry out at least one full course of treatment!

12.06.2017, 14:45

Regarding panic attacks, this is of course a controversial issue... but you definitely noticed about medications... I just have some kind of intolerance to many drugs, I don’t know why, this has never happened before.

As I understand it, I don’t need to do anything regarding endocrinology?

12.06.2017, 14:53

No. And you described panic attacks four times in this topic alone and very colorfully.

13.06.2017, 21:23

I still want to raise my topic and draw attention to my problem again...
I took a test for cortisol in 24-hour urine...
Here's the result:
[Only registered and activated users can see links]

In severe cases, when it is necessary to relieve inflammation or stop swelling, and conventional medications do not have the desired effect, the doctor prescribes the steroid drug Dexamethasone. But sometimes, after treatment with a glucocorticosteroid, the symptoms of the disease return. The patient's condition sharply worsens, and the clinical picture is much more pronounced than before the start of therapy. If the patient is not provided with timely assistance, coma and death may develop due to cardiac arrest. This is how Dexamethasone withdrawal syndrome manifests itself when the drug is abruptly stopped.

Glucocorticoids are hormones produced by the adrenal cortex (the most active are hydrocortisone and cortisone). Brain structures - the pituitary gland and hypothalamus - are responsible for their production. Steroids affect many processes in the body, regulate all types of metabolism, the endocrine system, blood pressure, and urine flow. They also have an effect on muscle mass, are responsible for inflammatory and allergic reactions and immunity.

Due to the peculiarities of the effects of hormones of this group, systemic and local glucocorticosteroid preparations (GCS) were created, which are analogues of endogenous hormones, which include Dexamethasone. The active use of these drugs in medicine is justified by their ability to stop the entire chain of clinical and allergic inflammation and influence autoimmune reactions, with processes often occurring at the cellular level. Glucocorticosteroids have the following effects:

• Relieves symptoms of inflammation, eliminating redness and swelling, exudate, spasm and itching.
• They reduce the sensitivity of cells due to the strengthening of their internal structures and membranes, which prevents the release of histamine and other mediators of allergic reactions.
• They spasm the capillaries, preventing excessive penetration of plasma into them, counteracting edema.
• They increase blood pressure and the level of catecholamines, which helps fight shock and blood loss and activate the heart.
• Inhibits the release of immune cells of leukocytes, which helps treat autoimmune pathologies.
• Stimulate the enzymatic activity of the liver, promote the elimination of poisons and toxins.

All these properties of hormonal drugs help cope with a wide range of health problems, which is important if the patient’s condition is threatening. Medicines are prescribed in the form of local and systemic therapy, they are administered by intramuscular or intradermal injections, intravenous administration, or a short course to quickly eliminate negative symptoms. Long-term treatment is carried out according to indications. When a therapeutic effect is achieved, the dosage is reduced gradually.

Along with the elimination of many pathological processes in the human body, glucocorticosteroid therapy is characterized by a negative effect on the system, especially with a long course of treatment. This is due to a negative impact on metabolic processes, since the active breakdown of protein leads to a decrease in growth rates in children and a decrease in muscle mass in adults, causing ulcers in the stomach and redistribution of fat deposits on the body.

The ability to inhibit the division of atypical cells affects the difficulty of regeneration of healthy tissue, immunosuppression leads to susceptibility to infectious diseases. The dissimilation of fats and protein structures is accompanied by gluconeogenesis, which maintains high levels of glucose in the blood. Water-salt metabolism suffers, as a result, sodium and fluid are retained in the body, and potassium and calcium are actively washed out, which is manifested by edema, increased blood pressure, heart rhythm disturbances, and osteoporosis. Also noted:

• nosebleeds;
• muscle dystrophy;
• nervous excitability;
• hair loss;
• stretch marks on the skin;
• menstrual irregularities in women;
• fungal infections of mucous membranes;
• increased blood pressure;
• muscle weakness.

Therefore, the peculiarities of medications should be taken into account, because an overdose of a drug can have serious consequences. Drugs are not prescribed:

• with individual intolerance;
• for diabetes and thrombosis;
• with neuroendocrine pathologies associated with increased production of adrenal hormones;
• for stomach ulcers;
• for thrombosis;
• for mental illness;
• with systemic infection by mycoses and exacerbation of herpes virus infection;
• with renal and liver failure;
• immediately before or immediately after vaccination;
• for syphilis, purulent processes and pulmonary tuberculosis.

Steroid drugs require medical prescription only according to indications, as well as monitoring during administration and strict adherence to dosage.

Treatment with a glucocorticosteroid drug group causes withdrawal syndrome, which develops when the drug is abruptly stopped or the dosage is reduced. The situation arises against the background of suppression of the adrenal function of producing endogenous hormones due to the use of replacement therapy. The body does not have time to adapt to changes in hormonal status, and as a result, hypocortisolism develops. In some cases, the appearance of the reaction is influenced by the developed dependence on the drug.

The condition manifests itself in various symptoms, the severity of which depends on the type of drug, dosage, adrenal insufficiency, as well as the age and concomitant pathologies of the patient.

The onset of a symptom complex does not always occur immediately after abrupt cessation of drug administration. When hormonal therapy continues for 30 days or more, then in a stressful situation the risk of developing the condition will persist for up to 3-6 months due to functional adrenal deficiency.

The drug belongs to synthetic glucocorticoids. This is a methylated fluoroprednisolone product with the active ingredient sodium orthophosphate. Dexamethasone is a powerful medicine, its effectiveness is 34 times greater than cortisone, and is available in the form of injections, tablets and eye drops. It has a wide range of effects and is prescribed:

• with insufficiency of the adrenal cortex;
• in shock conditions;
• with cerebral edema;
• for rheumatoid diseases;
• for endocrine disorders;
• for systemic pathologies of connective tissue and acute dermatoses;
• for diseases of the blood, gastrointestinal tract and respiratory organs;
• during oncological processes.

For children, inhalation of the solution can be used. Drops are used for eye injuries and diseases and allergies. When taken orally, the substance is absorbed by 80%, the therapeutic effect occurs within an hour, maximum two, after administration. A single dose remains in the body for almost three days. The drug is metabolized in the liver, disintegrated in cells, the main part is excreted by the kidneys. It should be discontinued gradually, gradually reducing the dosage.

A sudden cessation of the drug, especially when high doses are prescribed, leads to the appearance of symptoms of Dexamethasone withdrawal syndrome, which are expressed in the following:

• nausea;
• general malaise;
• anorexia;
• mental depression;
• temperature increase;
• blood pressure changes;
• generalized muscle and joint pain;
• severe relapses of the disease.

When complicated by acute diseases - injuries, infectious processes, heart attack - the patient experiences a sharp deterioration in his condition, up to an adrenal crisis, which is accompanied by convulsions, vomiting, and a critical drop in blood pressure.

The drug is also part of the group of glucosteroid hormones, available in ampoules for injection, in the form of a suspension or solution, the active substance is betamethasone. In addition to glucocorticoid activity, it is expressed in a slight mineralocorticoid effect. The main component of Diprosan is a combination of salts:

• Sodium phosphate. It is quickly absorbed, provides a therapeutic effect immediately after entering the body and is eliminated after a day.
• Dipropionate. Provides a long-lasting effect, is slowly absorbed and eliminated up to 10 days.

Prescribed as part of primary and additional therapy for the following conditions:

• diseases of soft tissues and the musculoskeletal system;
• manifestations of allergies;
• dermatological pathologies of non-microbial origin;
• hemoblastoses;
• GCS deficiency.

Diprospan withdrawal syndrome manifests itself depending on the area of ​​application in the following:

• muscle weakness;
• fever;
• skin itching;
• drop in blood pressure;
• hair loss;
• swelling and increased pain in the joints;
• convulsions.

A sign of the condition may be activation of the inflammatory process.

The drug is a GABA-B agonist and has a muscle relaxant effect by inhibiting neurotransmission of impulses and reducing tension in muscle fibers. The active ingredient is baclofen. The drug is prescribed for spasms, convulsive manifestations and muscle tension in pathologies of the central nervous system or musculoskeletal system. But with long-term use of Baklosan, dependence develops, so independent treatment is unacceptable, and the dosage is gradually reduced over 10–14 days. Otherwise, a withdrawal state is observed. Baklosan withdrawal syndrome is expressed as follows:

• depression and depression;
• sweating and tremors;
• apathy and suicidal feelings;
• anxiety and fear;
• decreased mobility of the limbs and spine.

It seems to the patient that the pain has become stronger, although it remains the same. Usually the cause of addiction is an incorrect dose, mental illness, or other addictions. For mentally unstable individuals, it is impossible to overcome the problem on their own; it is necessary to contact a narcologist or psychiatrist, since, most likely, the problems will worsen.

The drug is part of the GCS group and is available for external use in the form of an ointment. It has an antiallergic effect, reduces the secretion of exudate, eliminates inflammation and itching. Prescribed in complex therapy for adults and with caution for children with skin dermatoses: psoriasis and eczema, atopic dermatitis, neurodermatitis. Used to treat discoid lupus erythematosus, burns and insect bites. Reviews about its effectiveness are mostly positive. The ointment should not be used during pregnancy.

The therapeutic effect is provided by the active substance - fluocinolone acetonide, which interacts with plasma proteins. Absorbed into the body through the skin, the drug breaks down in the liver and is excreted in the urine. Low concentrations of the substance do not harm the adrenal glands, but uncontrolled use of the ointment for more than 5–10 days is addictive. With Sinaflan withdrawal syndrome, the following phenomena are observed:

• exacerbation of the process;
• the appearance of new rashes;

The medicine contains fluoride and is an old generation medicine. Not all doctors have an unambiguous attitude towards it. But many new means can compete with Sinolfan in speed and efficiency, so it is often prescribed when other methods are ineffective.

To eliminate allergies, skin rashes and hyperemia, other ointments based on corticosteroids are used. Their action differs in the degree of effectiveness and concentration of the active substance, but withdrawal syndrome with prolonged and uncontrolled use is inherent in everyone. In this case, a reaction occurs that resembles an allergy and inflammation, accompanied by swelling, redness, activation of acne, and the return of the original symptoms.

When used on the face for a long time, hormonal ointments not only cause addictive symptoms, but also thinning of the deep layers of the skin leads to rapid aging.

The main way to reduce the risk of withdrawal and addiction syndrome when using glucocorticoids and antidepressants is to take medications only as prescribed by a specialist. Since schemes for gradually reducing the dose of these drugs have been developed, the human body gradually adapts to the reduction in the volume of exogenous hormone, restoring the production of its own steroids.

But if negative signs appear due to stressful situations after a long course or when you stop hormonal therapy on your own, you should immediately consult a doctor. Usually, the administration of the hormonal agent is resumed, and mineralocorticoid therapy is also additionally recommended due to the likelihood of a failure in the production of the mineralocorticoid group responsible for water-salt metabolism.

Glucocorticosteroid drugs can fight severe manifestations of inflammation and allergies, restore health to the skin and joint mobility, and cope with shock conditions. But the prerogative of choosing a drug, dosage and duration of use belongs only to the doctor. Otherwise, the development of withdrawal syndrome can become a serious problem, even leading to the death of the patient.

source

Dexamethasone is a systemic glucocorticosteroid. This is a synthetic hormonal drug that is similar to hormones produced by the adrenal cortex. It has strong anti-inflammatory, anti-shock and anti-allergic effects. It is used for many pathologies accompanied by serious disorders. When used correctly, Dexamethasone quickly relieves inflammation and allergic reactions, improving the patient's condition. But the problem is that for this you need to choose the exact dosage. If treatment is carried out without a doctor’s prescription or the patient violates medical recommendations, serious side effects may occur.

Dexamethasone is very popular among other hormonal agents due to its low cost and high effectiveness. Its action is based on the fact that the drug binds to glucocorticoid receptors of cells and penetrates them. It blocks the production of certain enzymes, interferes with metabolic processes, and inhibits the activity of the immune system. The result of this is a decrease in inflammation and pain, the disappearance of itching, swelling and redness of the skin, and easier breathing.

This drug is effective in many pathologies; its timely administration can save the patient’s life or significantly improve his condition. But it should be used only as prescribed by a doctor after examination. Sometimes careful monitoring of the patient during treatment is required. After all, some chronic pathologies may worsen due to the use of the drug or provoke side effects.

Caution when treating with this drug and the use of the lowest possible doses is necessary for the following pathologies:

• osteoporosis;
• hypertonic disease;
• heart failure;
• tuberculosis;
• diabetes;
• peptic ulcers;
• glaucoma;
• hypothyroidism;
• ulcerative colitis;
• epilepsy;
• psychosis.

Dexamethasone is also prescribed with caution to elderly patients and children. After myocardial infarction, they try not to prescribe the drug, as it slows down the formation of scar tissue and can accelerate the development of necrosis. And if long-term use is necessary, it is necessary to constantly monitor the level of potassium and glucose in the blood.

Sometimes Dexamethasone is prescribed in emergency cases, for example, in case of anaphylactic shock or Quincke's edema. In this case, the drug can save the patient’s life, so they usually do not pay attention to the presence of contraindications. This use of this medicine is short-term and therefore rarely causes negative reactions. But, if the situation is not critical, a full examination is necessary.

There are the following contraindications to the use of Dexamethasone:

• myocardial infarction;
• internal bleeding;
• diabetes;
• pregnancy and breastfeeding;
• severe obesity;
• immunodeficiency;
• osteoporosis;
• mental illness;
• ulcers on the mucous membrane of the digestive tract;
• renal failure;
• infectious diseases.

Vaccinations are contraindicated during treatment with Dexamethasone. In addition to the fact that they will be useless due to a decrease in the functions of the patient’s immune system, vaccination with a live vaccine can lead to the development of the disease. Therefore, the drug can be used no earlier than 2 weeks after vaccination, when antibodies have already formed. And after the course of treatment, at least 2 months must pass before starting Dexamethasone therapy.

When choosing the correct dosage of the drug, it is well tolerated by all patients. Therefore, it is prescribed to everyone, regardless of age, even newborns. Dexamethasone causes side effects most often when used incorrectly. This happens when a patient uses a drug without a doctor’s prescription, does not take into account contraindications, or exceeds the recommended dosage. In this case, you should stop using the drug and consult a doctor.

Some people may have individual intolerance to the active ingredient of the drug. Moreover, after its administration or ingestion, an allergic reaction soon appears. It could be urticaria or even bronchospasm. Often the drug also affects the immune system. This usually manifests itself in increased susceptibility to infections. The patient is susceptible to bacterial, viral and fungal diseases. And infectious diseases such as measles or chickenpox are very severe.

If side effects occur, even if they are not severe, it is not advisable to use Dexamethasone. After all, it acts at the cellular level and accumulates in the body, affecting the functioning of various organs for several weeks. And the more the drug enters the cells, the more severe the negative reactions will be later. Therefore, even if you experience slight malaise, nausea or discomfort, you must inform your doctor. You may need to replace the drug with another one. But this also needs to be done correctly. Often the cause of side effects is sudden withdrawal of the drug.

Dexamethasone acts at the cellular level by binding to glucocorticoid receptors. And they are present in all organs and tissues of the body. Therefore, the side effects of Dexamethasone may vary. They can affect the functioning of the cardiovascular, endocrine and nervous systems; when taken orally, the digestive organs are most often affected; when administered by injection, local reactions may develop. This drug also has a strong effect on metabolic processes, often leading to the accumulation of fat deposits, increased sugar levels, and loss of calcium and potassium.

When using Dexamethasone injections, negative local reactions often develop. This usually results in skin redness, swelling, burning or soreness at the injection site. Pigmentation disorders, subcutaneous tissue atrophy, and scar formation may also appear.

The most dangerous consequence of using Dexamethasone is suppression of adrenal function. Moreover, this condition may not develop immediately, but a couple of months after treatment. The risk of this disorder is especially high with long-term use of the drug in high doses.

Dexamethasone also has a strong effect on carbohydrate metabolism. This is most evident in decreased glucose tolerance. Because of this condition, the development of steroid diabetes mellitus or an exacerbation of its latent form is possible, as hyperglycemia develops.

The drug affects fat metabolism. Dexmethasone binds to lipids and increases their digestibility, which accelerates the accumulation of fatty deposits. Therefore, weight gain may be a consequence of treatment with this drug.

One of the rare, but still possible side effects is Cushing's syndrome. It manifests itself with the following symptoms:

• increased blood pressure;
• moon-shaped face;
• muscle weakness;
• obesity;
• dysmenorrhea.

When using the drug in childhood, there is a high risk of delaying the child's growth and development. It especially strongly affects the growth of bone tissue, so the development of skeletal deformities is possible. The sexual development of children also slows down.

source

Dexamethasone withdrawal syndrome is a very dangerous condition that is a consequence of addiction to the drug and can threaten the patient’s life. Therefore, before starting treatment with this medicine, you should familiarize yourself with its characteristics and rules of use.

This glucocorticosteroid is a hormonal agent that has the following effects:

1. Anti-inflammatory.
2. Antiallergic.
3. Antitoxic.
4. Desensitizing.
5. Anti-shock.
6. Immunosuppressive.

It is used in various areas of medicine. Indicated for the treatment of the following diseases:

• Endocrine disorders associated with insufficient functionality of the adrenal glands;
• Arthritis;
• Connective tissue pathologies;
• Dermatitis, psoriasis, lichen;
• Ophthalmia;
• Ulcerative colitis;
• Hepatitis;
• Aplastic anemia;
• Glomerulonephritis;
• Leukemia;
• Tuberculous meningitis;
• Nasal polyps;
• Brain swelling;
• Allergic diseases, including bronchial asthma.

This list is only a small part of the complete list of problems for which Dexamethasone is prescribed. It is also used in gynecology, even during pregnancy, if the need for treatment outweighs the possible risk of taking the drug.

The product also has many contraindications, for example, autoimmune conditions - AIDS, HIV. It is prohibited to use any form of the drug for infections. Side effects from taking the drug also appear in various systems and organs.

Withdrawal syndrome is indicated in the official instructions for Dexamethasone as a deadly condition.

The drug is sometimes used in childhood. There must be compelling reasons to prescribe it, and the dosage is calculated based on the condition and parameters of the child.

A painful reaction of the body to the withdrawal of a drug indicates that addiction has formed. Addiction to a drug is a consequence of its introduction into metabolic processes. The body needs hormones to carry out certain actions. When the corresponding substance comes in large quantities and for a long time from the outside and covers the needs of the body, then it ceases to be produced independently. If you abruptly stop providing the drug, then there is nothing to fill the functions of this hormone, since the body has not had time to rebuild, and a serious condition occurs - total endocrine failure. When vital processes are affected, the result can be death.

Those who are prescribed small doses of the drug that do not cover the natural needs of the body should not be alarmed. In this case, the medicine acts as an aid to normalize its own processes. Injection blockades into the spine or joint do not cause dependence.

The syndrome is a symptom complex that consists of the following symptoms:

• Changes in blood pressure;
• Exacerbation of inflammation, which is treated with this drug;
• Nausea and vomiting;
• Depressed psycho-emotional state;
• Nasal discharge;
• Fever;
• Headache;
• Redness of the conjunctiva;
• Drowsiness;
• Dizziness;
• Aches in joints and muscles;
• Irritability;
• Loss of body weight;
• Convulsions;
• Arterial hypotension;
• Death.

When using the drug by injection, the syndrome is manifested by the following symptoms:

• Numbness, burning and pain at the injection site;
• Tissue necrosis in the area of ​​injection;
• Infection;
• Scar formation;
• Atrophy.

The main measure to prevent the syndrome is to correctly determine the dosage of the drug, which will not lead to addiction. Unfortunately, this is not always possible. The doctor should take care of the gradual withdrawal and draw up a scheme for reducing the one-time amount of the drug. The duration of the period can be from 2 weeks to a month, depending on the initial daily volume of the drug. Usually the dose is divided in half, after 5-7 days the same, reaching 1/8 or 1/16.

Attention! Abrupt cessation of use is justified if serious side effects are detected. Then the medicine is replaced with another one so as not to get manifestations of the syndrome.

When the drug has just been discontinued, and the phenomenon is already noted, the medicine should be returned in a reduced dosage. When several days have already passed, it is better to consult a doctor, because the condition is too dangerous, and hormones are very unpredictable substances. It is impossible to select steroids on your own, as well as to correct unsuccessful therapy. How long you will have to endure the symptomatic manifestations of the syndrome depends on many factors: the patient’s condition, duration of treatment, dosage of the drug, etc.

It is impossible to predict the appearance of withdrawal syndrome and get rid of it on your own in the case of hormonal drugs. The help of an experienced specialist is needed. If you do not trust your doctor, you should undergo additional diagnostics from other doctors.

source

Hello. I have PCOS, androgenital syndrome. I have been taking dexamethasone since November. Now I'm slowly canceling it. Cortisol was almost doubled, and 17 OH and LH were also increased. I took 1 tablet in the morning. As a result, in 2 months I gained 6 kg and grew so much hair that it became scary to look in the mirror. Regarding the side effects of Dex, I talked to the doctor, she said it should remove all andrenogenital signs, including hair coming out of all places, reduce testosterone, but for some reason it’s the other way around for me. The only plus is that cortisol has decreased. Now it is even less than normal. I also take duphaston according to the regimen from days 16 to 25 of the cycle. At the beginning of January I did folliculometry - there was no ovulation. The gynecologist persistently sends for laparoscopy, not seeing the point of further stimulation. I'm afraid to have surgery, or even go outside in general. There was a problem with my hair; instead of the fluff, huge black hair appeared on my lips and neck. Girls, how to deal with them? Okay, you can shave your legs, but your face. Yesterday I seriously asked my husband for a razor, he laughed and sympathized, but I didn’t find it funny.

Hello everyone. So I got better from this medicine. And my face became moon-shaped and the hairs came out on my beard. And I was covered with acne. Now I don’t know what to do. Will all this recover?

I had Quincke's edema on drops in the nose against the backdrop of an exacerbation of my allergies. Half of my face was swollen, my right eye was not visible at all. She called an ambulance, she gave me 8 ml of Dex and suggested that I go to the hospital. I have small daughters and I can’t go to bed. She suggested go for a hike. At the hospital they infused me with 250 ml. I took the tests and went home. They prescribed 2 injections of 8 ml per day for 3 days. Today is the last day. I have no allergies. But I don’t really like the condition after the injection. My head is in a fog, but it’s better than dying from anaphelactic shock.

People, help, since February I have been put on dexamethasone at a horse dose, drinking 14 tablets of 0.5 mg per day. Now we are going down according to the scheme. from size 46 to 52 rub. I look in the mirror and cry, I can’t even talk normally, my cheeks are all tense. face tightens. I can’t step on my heels normally; they hurt like hell. My feet are so swollen, I wear my mother’s winter boots, and she’s a big lady, 60-62 times. I feel like I was pumped full of gel. I don't sleep at night. and yet the doctor says you can’t take a diuretic. Maybe someone has encountered such side effects. very hard and bad.

Anna is a crazy dose! Of course you will be drummed, why so much? See another doctor! I’ve been taking 0.5 tablets at night for more than a week, I haven’t seen any side effects yet, and the results are also significant.

I've been on Dex for 5 years. Asthmatic. I stab him. Gained 13 kg. I’m doing sports now, and in 4 months I’ve only lost 3 kg. Without it because I am hormone dependent and the doctors put me on it. During attacks, I inject him three times a week, 1 mg with Eifullin. I don't know how to get rid of it

Good afternoon After unsuccessfully trying to get pregnant for more than a year, I was diagnosed with infertility (endometriosis) in one clinic. I went to another one, the doctor reassured me and said that there are many ways (at least three) to get pregnant. We started with Dexamethasone therapy. After 3 months - minus 5-6 kg and... 2 stripes))))). The threat of miscarriage haunted the whole pregnancy. The doctor did not completely decide to cancel their appointment. I just reduced the dose. She gave birth to a son on time with 9 points. In 3 weeks we are already 8 years old.))) I consider the doctor who gave life to my son a second mother! Now we are planning a second doll. Tomorrow again on Dexamethasone.))) Good luck to everyone and believe in the best.

Good day! My gynecologist prescribed me dexamethasone - 1 tablet/day, an increased stress hormone - cortisol, for 10 days, then get tested for it. I’ve read so much, it’s terrible, it’s scary not only to buy it, but also to drink it (Tell me, in such a short time as 10 days something can manifest itself? Otherwise I’m really worried.

2 days ago I had an asthma attack, the ambulance injected me with Dex, my appetite disappeared, I don’t want to eat at all. minus 1 kg. And this despite the fact that I did not suffer from lack of appetite. And why did it act like that?

I take 1/2 tablet a day from the 14th to the 25th day of the cycle, pimples and blackheads began to appear with terrible force, and I’ve only been drinking for the first month, I think I’ll take another month and stop, I’ll go to the gynecologist only after 2 months, about the weight I don’t feel any gain

Hello! I was prescribed Dexamethasone tablets, 1/2 tablet every other day, because... The hormone DHEA is increased. I began to rapidly gain weight, my face was covered with acne. The hairiness is not going to go away, so I think it’s worth continuing to take them. (((

Hello))) I was prescribed deesamethasone injections for 5 days, I did them with lidacoin and salcoseryl intramuscularly, now my belly is growing and I’m gaining weight. Tell me how to get rid of excess weight. Someone may have encountered the same purpose. Thank you.

I accidentally entered a women's forum. According to deson, I want to write the following drug of synthetic origin and very difficult for the body. I am 48 years old with a bad back, the doctor naturally prescribed dexamethasone, one dropper every other day. The following happened to the body. The sugar in the blood increased significantly 19.5 and naturally in the urine , insomnia slept for 2 hours a day, the pressure up to 170 upper was not reduced by any tablets, loss of vision in both eyes, the left one was restored, the right one remained 70 percent. The pancreas was very sick, it was not possible to retract the stomach. The vision was affected by a lot of pressure and sugar, the diagnosis was optic nerve orophia. In general, the whole side effect, almost the whole back has come out and it hurts now, the diagnosis is diabetes and vision. If you want to be healthy, don’t take Dexon, think about yourself and your children. The drug is a poison for the body, it helps for a short time, but the damage to the body as a whole is enormous. Use in extreme cases when it is the last line .I am 48 years old and have never been particularly ill with anything.

Keep an eye on your sugar and blood pressure as per the instructions. Everyone’s body has different side effects too. Read the instructions, all the side effects are described there; some women write about weight gain, do tests for sugar in the blood and urine. My wife works in a hospital; some of them have sugar levels up to 30!

Hello girls!
I am 52 kg and want to gain weight up to 60 kg, will dexamethasone help me here?

Hello everyone, I’m 21, I’m very thin, I wanted to improve it a little, one pharmaceutist recommended Dexa-zol. 1/4 tablet at night gave 10 tablets. I’m already scared after reading your comments, what should I do please advise

A very serious drug. It should be accepted only after weighing all the pros and cons. After walking in cold weather last fall, in the morning I discovered that something was wrong with my face. The clinic diagnosed me with facial neuritis and gave me a referral to the hospital. There I was given drips with dexamethasone at a dosage of 24 mg for 14 days. by 51 kg. my weight. As it turned out, this was a fairly serious dose for me. During the treatment itself, problems with sleep arose. At first I slept 6 hours at night, then 4, and then 2. Hair began to grow on my chin. The most “interesting” thing began when the drug was discontinued and prescribed to me. My vision dropped sharply. It was -3, now -4.5. Inability to concentrate your gaze on any object and blurred vision. Complete lack of sleep. Terrible depression. I remember sitting on the couch at home and thinking I was going crazy. Everything was falling apart, I could barely walk and didn’t understand what was wrong with me. The doctors at the clinic didn’t say anything, only one said that it was most likely withdrawal syndrome. A doctor I know said that this happens from Dexa and you just have to wait. All this horror lasted 3 weeks, and then it began to let go a little. The general condition began to improve after about a month, vision began to return little by little after 2 months. A year has already passed, but I still remember all this with a shudder.

source

Dexamethasone(Dexamethasone): 10 doctor reviews, 14 patient reviews, instructions for use, analogues, infographics, 4 release forms.

Reduces intracranial pressure in oncological diseases of the brain, therefore it is prescribed as a symptomatic remedy, 1 tablet 2 times a day. Relieves swelling of the nerve root during radiculopathy.

It has many contraindications for use, among which the most serious are arterial hypertension and stomach ulcers.

I use Dexamethasone in solution to relieve acute allergic reactions such as urticaria, eczema, psoriasis. It is well tolerated by patients and provides a good therapeutic effect. A drug that is accessible and inexpensive for patients.

Some discomfort in the form of a burning sensation in the groin area.

The injection form is most available in the pharmacy chain.

I have been using Dexamethasone for 29 years of practice as a rheumatologist. As a steroid hormone, it has a rapid membrane-stabilizing effect, which is used in the urgent treatment of shock conditions. For painful musculoskeletal syndromes, I use it in the form of combined injections with anesthetics. Quick effect, good tolerability.

Like all steroids, it is used to a limited extent for diabetes mellitus and immunodeficiency. In case of overdose, it causes hormone dependence and hypercorticism syndrome (Itsenko-Cushing).

Included in combination drugs for the treatment of pain syndromes in neurology and rheumatology (Ambene, Germany, Merckle).

Dexamethasone is a strong analgesic with a pronounced antihistamine effect that acts very quickly. I prescribe for paravertebral blockades if it is impossible to relieve the pain syndrome with non-steroidal anti-inflammatory drugs and the patient does not have the time or desire to undergo a full course of treatment for the disease causing the pain syndrome.

The drug has serious side effects and taking it without medical supervision is simply dangerous. With long courses, glucose tolerance is developed and steroid diabetes mellitus may develop, as well as weight gain, sweating, and depression.

So when prescribing this drug, I first look for any other solutions, using steroids is the last option.

I use it for radicular syndrome with analgesics and vascular drugs intravenously, it relieves inflammation and pain well. It is used in short courses. A good therapeutic effect is observed within 3-5 days.

Prescribe with caution to patients with hypertension, gastrointestinal ulcers, and diseases of the endocrine system.

An irreplaceable, old, well-known medicine. I use it to relieve pain and inflammation in diseases of the joints and spine. I almost always use it for paravertebral blockades to relieve acute pain due to radiculitis. Unfortunately, it cannot be used for a long time.

It helps perfectly with inflammatory processes and pain syndromes of various origins. It helps very well in the form of injections, including as part of therapeutic blockades.

An appointment under the strict supervision of a doctor is required. Abuse can be very dangerous. Uncontrolled use can lead to various complications.

When used correctly according to indications, it is an excellent remedy.

Quite an effective drug. It is a standard drug for premedication before cytostatic therapy. Effectively used to relieve cerebral edema in tumors of the central nervous system.

It has a wide range of adverse effects. Long-term use causes Cushing's syndrome. Requires a stepwise drug withdrawal regimen.

Difficult to tolerate in elderly patients.

At the moment, it is practically the only drug (injection form) available in pharmacies in the Krasnodar region (specifically in the villages).

A wide range of eye diseases for which the drug is used. Low price, availability in pharmacies. Quite high efficiency. Comparative safety.

Do not use for a long time as side effects may occur.

Cannot be used for corneal and conjunctival erosions, purulent processes, or increased IOP.

My neck hurts, there is a sharp pain when turning, osteochondrosis. She gave 3 injections intravenously, but the pain remained in the neck.

Dexamethasone was used in the treatment of pseudotumor in the left eye. The doctors did not find any other medicine for me. Actually, the drops themselves did not help me at all right away, but in tandem with intravenous injections and Dexamethasone injections into the orbit of the eye. But after 1.5 months of suffering, my left eye became quite similar to my right. Unfortunately, these drops have one huge drawback - they are addictive. And it is very difficult to cancel their use. In my case, I used them for 1.5 months every day, 8-10 times a day. Then she very slowly abandoned them. A year has passed since then, but I still instill eye drops with Dexamethasone diluted in a ratio of 1 to 10 a couple of times a month.

Dexamethasone is a serious drug that aroused my respect; it literally saved my mother and helped me survive until surgery to remove a recurrent brain tumor. There was partial cerebral edema, the tumor progressed quickly and my mother’s condition worsened every day before my eyes, and the operation was postponed and rescheduled: either there was no room, or the doctor was on vacation. When it became clear that we couldn’t just wait any longer, we started giving my mother Dexamethasone in injections. Judging by the change in her behavior, it became almost immediately noticeable that there was a result from taking the hormone. Thanks to the person who suggested what we could do in our situation, and, of course, thanks to the medicine.

My mother developed severe pain in the lumbar region, they tried injecting Voltaren, but it did not help. The neurologist prescribed Dexamethasone in combination with Revmoxicam, No-Spa and vitamins B6/B12. From the very first day the result became noticeable. On the second day, in the morning, severe pain was still noticeable, but after the injections it decreased significantly. And already from the third day, even walking up the stairs became almost painless. The drug is inexpensive, but really effective. Good price/quality ratio.

Hello, I have gout and the attack was such that I couldn’t get out of bed for more than 10 days. Unfortunately, the doctor treating me was on vacation and couldn’t get through to me right away. When I got through, she recommended Dexamethasone intramuscularly 8 mg once a day, 3 injections in total. After the first I started walking around the apartment, and after the third I was (almost young) and healthy. The drug simply works wonders.

Good drug. It’s like first aid for me (after radiation), it brings the whole body back to normal, relieves swelling, pain, and nausea. Take strictly according to the instructions; do not quit abruptly. There are side effects. I gained 28 kg in a month, but then lost it just as quickly.

We got acquainted with this drug because of our favorite cat. Her skin began to peel. The veterinarian said to give dexamethasone injections. And literally within a week the cat recovered. The drug helped a lot. And according to the cat’s reaction, it is not painful. In general, if I need it again, I will definitely buy it without hesitation. Moreover, it is not that expensive.

A 2-year-old child had acute allergosis (urticaria and allergenic conjunctivitis). We were treated for 5 days with Dexamethasone for injection intramuscularly, Tavegil intramuscularly, and Dexamethasone eye drops (they prescribed Maxidex, but it is 10 times more expensive). The swelling of the eyes subsided the next day after the start of use, and the redness of the eye disappeared on the second day, dripping for another 3 days to consolidate the result. Recently, while working with an angle grinder, my father-in-law drove small metal shavings into his eye, they pulled it out in the hospital, but conjunctivitis began, and Dexamethasone saved it again in just 3 days. Dexamethasone is an inexpensive and effective drug.

Dexamethasone drops are a local hormonal drug. Well relieves redness and itching of allergic origin. They have good anti-inflammatory properties. The effect occurs within the first minutes. Prescribed with caution, not indicated for continuous use, as the likelihood of systemic action and suppression of the adrenal cortex, the development of glaucoma, etc. increases. From personal experience I can say that this drug has been my drug of choice for a long time, since it is very inexpensive and perfectly relieved redness and swelling of the eyes due to allergies. But over time I had to give it up, since Dexamethasone drops have a number of contraindications and side effects. For me this manifested itself as increased intraocular pressure.

The doctor prescribed dexamethasone for the child (2.6 years old) in the form of 4 mg intramuscular injections. We've been allergic since birth, but this time it hit me hard. We were first treated with the drugs that helped us during exacerbations, but the treatment took a long time. The rash did not go away, the child scratched the spots until they bled: on his legs, arms, back. Dexamethasone is a hormonal drug, I have a negative attitude towards it, but it saved us. After the first injection, the spots faded, after the 3rd, everything went away completely and there were no adverse reactions. The constant nasal congestion disappeared. The medicine costs a penny, but the results are excellent.

Dexemethasone was prescribed to the child during the postoperative period for the removal of congenital bilateral cataracts, when we were only three months old. No amount of drops helped relieve redness from the eyes, as there was an inflammatory process as a complication after the operation. At first, the doctor prescribed drops three times a day for two weeks, then another two weeks twice a day and another week once a day. The eye inflammation disappeared and was cured. There were no side effects from taking the medication. More than three types of drops were dripped together - no itching, no redness, or other allergic reactions were present.

My job is terrible - I'm an accountant. I spend 12 hours a day either sitting at the computer or doing paperwork. I come home - my eyes are red, red, and when I look far away everything is blurry. They recommended dexamethasone to me and decided to try it. After I put it in my eyes, I feel much better. It dripped for 10 days at night. I was pleased with the result.

Whenever I have a cold, I have a very bad runny nose. This drug was recommended to me by an otorhinolaryngologist; it is mixed with two components, ectericide and mesaton 2:1:1, and produces excellent nasal drops. After two days, all the swelling goes away and the nose begins to breathe. The main thing is that this drug cures. It turns out very cheap and very effective. Now I always buy several ampoules and keep them in the refrigerator.

Dexamethasone helps me out in the summer, as I often suffer from allergic conjunctivitis. A couple of drops and the itching goes away, the inflammation begins to subside. And these drops save my husband when he picks up “bunnies” after welding. Apply drops 2-3 times in the evening, and the pain in the eyes becomes less, and the next day it completely calms down. So dexamethasone constantly takes its place in the refrigerator. The only pity is that it only lasts a month after opening the bottle.

Dexamethasone is a synthetic glucocorticosteroid. It is available in several dosage forms: solution for intravenous and intramuscular administration, eye drops, tablets. Its glucocorticoid activity is 25 times greater than that of hydrocortisone, and 7 times greater than that of prednisolone. Inhibits the activity of white blood cells and resident mononuclear phagocytes. Prevents the migration of the former to the inflammatory focus. Stabilizes lysosome membranes, thereby reducing the level of proteases in the inflammatory focus. It neutralizes the effect of histamine on the walls of capillaries, thereby reducing their permeability. Inhibits the proliferative activity of fibroblasts and suppresses collagen synthesis. Reduces the intensity of formation of inflammatory mediators - prostaglandins and leukotrienes. Inhibits the release of cyclooxygenase-2. Promotes the migration of leukocytes from the blood to the lymph. When interacting directly with blood vessels, it exhibits a vasoconstrictor effect. Effect on protein metabolism: reduces the content of globulins in serum, stimulates the formation of albumin in the kidneys and liver, activates catabolic processes in skeletal muscles. Effect on fat metabolism: promotes the formation of fatty acids, redistributes adipose tissue from the extremities to the abdomen, face, shoulder girdle, increases the level of lipids in the blood. Effect on carbohydrate metabolism: promotes the absorption of carbohydrates from the gastrointestinal tract, increases blood glucose levels. In submaximal doses, it makes brain tissue more excitable and increases the risk of seizures. When used systemically, it exhibits anti-inflammatory, antiallergic effects, suppresses immunity and excessive cell proliferation. Local forms of the drug exhibit anti-inflammatory, antiallergic effects, reduce the intensity of exudate entering the inflammation site (due to the vasoconstrictor effect).

Metabolized by microsomal liver enzymes. Half-life is 2-3 hours. Eliminated by the kidneys.

Bacterial, viral and fungal infections require constant medical monitoring of the patient taking Dexamethasone. Severe forms of infectious diseases allow the drug to be taken only in combination with specific therapy. Diseases and conditions in which the drug should also be taken with caution are: immunodeficiency diseases, BCG vaccination, diseases of the gastrointestinal tract (gastric and duodenal ulcers, inflammation of the esophageal mucosa, inflammation of the diverticulum, etc.), cardiovascular pathology, endocrine diseases. Before starting drug therapy with Dexamethasone, it is necessary to monitor blood counts, glucose and electrolytes in the blood. If you abruptly stop taking the drug (especially if it was taken in submaximal doses), rebound syndrome often develops, the manifestations of which are nausea, loss of appetite, musculoskeletal pain, and chronic fatigue. While taking the drug, it is necessary to monitor blood pressure, water-salt balance, and also be observed by an ophthalmologist.

When combined with certain medications, Dexamethasone can cause a number of unwanted side effects. Thus, taking it together with azathioprine or antipsychotic drugs can provoke cataracts, and with anticholinergics - glaucoma. In combination with oral contraceptives, testosterone preparations, female sex hormones, anabolic steroids, Dexamethasone can cause acne and increased male-pattern hair growth. In combination with non-steroidal anti-inflammatory drugs, taking the drug increases the risk of erosive and ulcerative lesions of the gastrointestinal tract.

GCS. Suppresses the functions of leukocytes and tissue macrophages. Limits the migration of leukocytes to the area of ​​inflammation. It disrupts the ability of macrophages to phagocytose, as well as to form interleukin-1. Helps stabilize lysosomal membranes, thereby reducing the concentration of proteolytic enzymes in the area of ​​inflammation. Reduces capillary permeability due to the release of histamine. Suppresses fibroblast activity and collagen formation.

Inhibits the activity of phospholipase A 2, which leads to suppression of the synthesis of prostaglandins and leukotrienes. Suppresses the release of COX (mainly COX-2), which also helps to reduce the production of prostaglandins.

Reduces the number of circulating lymphocytes (T- and B-cells), monocytes, eosinophils and basophils due to their movement from the vascular bed into the lymphoid tissue; suppresses the formation of antibodies.

Dexamethasone suppresses the pituitary release of ACTH and β-lipotropin, but does not reduce the level of circulating β-endorphin. Inhibits the secretion of TSH and FSH.

When directly applied to blood vessels, it has a vasoconstrictor effect.

Dexamethasone has a pronounced dose-dependent effect on the metabolism of carbohydrates, proteins and fats. Stimulates gluconeogenesis, promotes the uptake of amino acids by the liver and kidneys, increases the activity of gluconeogenesis enzymes. In the liver, dexamethasone enhances the deposition of glycogen, stimulating the activity of glycogen synthetase and the synthesis of glucose from protein metabolism products. An increase in blood glucose levels activates the release of insulin.

Dexamethasone inhibits the uptake of glucose into fat cells, which leads to activation of lipolysis. However, due to increased insulin secretion, lipogenesis is stimulated, which leads to fat accumulation.

It has a catabolic effect in lymphoid and connective tissue, muscles, adipose tissue, skin, bone tissue. Osteoporosis and Itsenko-Cushing syndrome are the main factors limiting long-term GCS therapy. As a result of the catabolic effect, growth suppression in children is possible.

In high doses, dexamethasone can increase the excitability of brain tissue and help lower the seizure threshold. Stimulates excess production of hydrochloric acid and pepsin in the stomach, which contributes to the development of peptic ulcers.

When used systemically, the therapeutic activity of dexamethasone is due to its anti-inflammatory, antiallergic, immunosuppressive and antiproliferative effects.

When applied externally and locally, the therapeutic activity of dexamethasone is due to its anti-inflammatory, antiallergic and antiexudative (due to the vasoconstrictor effect) effect.

Its anti-inflammatory activity is 30 times higher than hydrocortisone, but does not have mineralocorticoid activity.

Plasma protein binding - 60-70%. Penetrates histohematic barriers. A small amount is excreted in breast milk.

Metabolized in the liver.

T1/2 is 2-3 hours. Excreted by the kidneys.

When applied topically in ophthalmology, it is absorbed through the cornea with intact epithelium into the moisture of the anterior chamber of the eye. With inflammation of the eye tissue or damage to the mucous membrane and cornea, the rate of absorption of dexamethasone significantly increases.

1 ml - dark glass ampoules (5) - contour cell packaging (5) - cardboard packs.
250 ml - ampoules (50) - blister packaging (5) - cardboard boxes - transport boxes (in bulk)

Individual. Orally for severe diseases at the beginning of treatment, up to 10-15 mg/day is prescribed; the maintenance dose can be 2-4.5 mg or more per day. The daily dose is divided into 2-3 doses. Take small doses 1 time/day in the morning.

For parenteral use, administered intravenously in a slow stream or drip (in acute and emergency conditions); i/m; Periarticular and intra-articular administration is also possible. During the day, you can administer from 4 to 20 mg of dexamethasone 3-4 times. The duration of parenteral use is usually 3-4 days, then switch to maintenance therapy with an oral form. In the acute period for various diseases and at the beginning of treatment, dexamethasone is used in higher doses. When the effect is achieved, the dose is reduced at intervals of several days until the maintenance dose is reached or until treatment is stopped.

When used in ophthalmology for acute conditions, 1-2 drops are instilled into the conjunctival sac. every 1-2 hours, then, when inflammation decreases, every 4-6 hours. The duration of treatment is from 1-2 days to several weeks, depending on the clinical course of the disease.

When used simultaneously with antipsychotics, bucarban, azathioprine, there is a risk of developing cataracts; with drugs that have an anticholinergic effect - the risk of developing glaucoma.

When used simultaneously with dexamethasone, the effectiveness of insulin and oral hypoglycemic drugs is reduced.

When used simultaneously with hormonal contraceptives, androgens, estrogens, and anabolic steroids, hirsutism and acne are possible.

When used simultaneously with diuretics, increased excretion of potassium is possible; with NSAIDs (including acetylsalicylic acid) - the incidence of erosive and ulcerative lesions and bleeding from the gastrointestinal tract increases.

When used simultaneously with oral anticoagulants, the anticoagulant effect may be weakened.

When used simultaneously with cardiac glycosides, the tolerability of cardiac glycosides may deteriorate due to potassium deficiency.

When used simultaneously with aminoglutethimide, the effects of dexamethasone may be reduced or inhibited; with carbamazepine - the effect of dexamethasone may be reduced; with ephedrine - increased excretion of dexamethasone from the body; with imatinib - a decrease in the concentration of imatinib in the blood plasma is possible due to the induction of its metabolism and increased excretion from the body.

When used simultaneously with itraconazole, the effects of dexamethasone are enhanced; with methotrexate - increased hepatotoxicity is possible; with praziquantel - a decrease in the concentration of praziquantel in the blood is possible.

When used simultaneously with rifampicin, phenytoin, and barbiturates, the effects of dexamethasone may be weakened due to increased excretion from the body.

From the endocrine system: decreased glucose tolerance, steroid diabetes mellitus or manifestation of latent diabetes mellitus, suppression of adrenal function, Itsenko-Cushing syndrome (including moon face, pituitary type obesity, hirsutism, increased blood pressure, dysmenorrhea, amenorrhea, myasthenia gravis , striae), delayed sexual development in children.

Metabolism: increased excretion of calcium ions, hypocalcemia, increased body weight, negative nitrogen balance (increased protein breakdown), increased sweating, hypernatremia, hypokalemia.

From the central nervous system: delirium, disorientation, euphoria, hallucinations, manic-depressive psychosis, depression, paranoia, increased intracranial pressure, nervousness or anxiety, insomnia, dizziness, vertigo, pseudotumor of the cerebellum, headache, convulsions.

From the cardiovascular system: arrhythmias, bradycardia (up to cardiac arrest); development (in predisposed patients) or increased severity of chronic heart failure, ECG changes characteristic of hypokalemia, increased blood pressure, hypercoagulation, thrombosis. In patients with acute and subacute myocardial infarction - the spread of necrosis, slowing down the formation of scar tissue, which can lead to rupture of the heart muscle; with intracranial administration - nosebleeds.

From the digestive system: nausea, vomiting, pancreatitis, steroid ulcer of the stomach and duodenum, erosive esophagitis, bleeding and perforation of the gastrointestinal tract, increased or decreased appetite, flatulence, hiccups; rarely - increased activity of liver transaminases and alkaline phosphatase.

From the senses: posterior subcapsular cataract, increased intraocular pressure with possible damage to the optic nerve, a tendency to develop secondary bacterial, fungal or viral eye infections, trophic changes in the cornea, exophthalmos.

From the musculoskeletal system: slower growth and ossification processes in children (premature closure of epiphyseal growth plates), osteoporosis (very rarely - pathological bone fractures, aseptic necrosis of the head of the humerus and femur), rupture of muscle tendons, steroid myopathy, decreased muscle mass (atrophy).

Dermatological reactions: delayed wound healing, petechiae, ecchymosis, skin thinning, hyper- or hypopigmentation, steroid acne, stretch marks, tendency to develop pyoderma and candidiasis.

Allergic reactions: generalized (including skin rash, skin itching, anaphylactic shock) and when applied topically.

Effects associated with immunosuppressive effects: development or exacerbation of infections (the appearance of this side effect is facilitated by jointly used immunosuppressants and vaccination).

Local reactions: with parenteral administration - tissue necrosis.

For external use: rarely - itching, hyperemia, burning, dryness, folliculitis, acne, hypopigmentation, perioral dermatitis, allergic dermatitis, skin maceration, secondary infection, skin atrophy, stretch marks, prickly heat. With long-term use or application to large areas of skin, systemic side effects characteristic of GCS may develop.

For oral administration: Addison-Biermer disease; acute and subacute thyroiditis, hypothyroidism, progressive ophthalmopathy associated with thyrotoxicosis; bronchial asthma; rheumatoid arthritis in the acute phase; UC; connective tissue diseases; autoimmune hemolytic anemia, thrombocytopenia, aplasia and hypoplasia of hematopoiesis, agranulocytosis, serum sickness; acute erythroderma, pemphigus (common), acute eczema (at the beginning of treatment); malignant tumors (as palliative therapy); congenital adrenogenital syndrome; cerebral edema (usually after preliminary parenteral use of GCS).

For parenteral administration: shock of various origins; cerebral edema (with a brain tumor, traumatic brain injury, neurosurgical intervention, cerebral hemorrhage, encephalitis, meningitis, radiation injury); status asthmaticus; severe allergic reactions (Quincke's edema, bronchospasm, dermatosis, acute anaphylactic reaction to drugs, serum transfusion, pyrogenic reactions); acute hemolytic anemia, thrombocytopenia, acute lymphoblastic leukemia, agranulocytosis; severe infectious diseases (in combination with antibiotics); acute adrenal insufficiency; acute croup; joint diseases (humeral periarthritis, epicondylitis, styloiditis, bursitis, tendovaginitis, compression neuropathy, osteochondrosis, arthritis of various etiologies, osteoarthritis).

For use in ophthalmic practice: non-purulent and allergic conjunctivitis, keratitis, keratoconjunctivitis without damage to the epithelium, iritis, iridocyclitis, blepharoconjunctivitis, blepharitis, episcleritis, scleritis, inflammatory process after eye injuries and surgical interventions, sympathetic ophthalmia.

For short-term use for health reasons - hypersensitivity to dexamethasone.

For intra-articular injection and injection directly into the lesion: previous arthroplasty, pathological bleeding (endogenous or caused by the use of anticoagulants), intra-articular bone fracture, infectious (septic) inflammatory process in the joint and periarticular infections (including a history), as well as general infectious disease, severe periarticular osteoporosis, absence of signs of inflammation in the joint (“dry” joint, for example, in osteoarthritis without synovitis), severe bone destruction and joint deformation (sharp narrowing of the joint space, ankylosis), joint instability as a result of arthritis, aseptic necrosis of the forming epiphyseal joint of bones.

For external use: bacterial, viral, fungal skin diseases, skin tuberculosis, skin manifestations of syphilis, skin tumors, post-vaccination period, violation of the integrity of the skin (ulcers, wounds), children's age (up to 2 years, with itching in the anus - up to 12 years), rosacea, acne vulgaris, perioral dermatitis.

For use in ophthalmology: bacterial, viral, fungal diseases of the eyes, tuberculosis of the eyes, disruption of the integrity of the ocular epithelium, acute form of purulent eye infection in the absence of specific therapy, diseases of the cornea combined with epithelial defects, trachoma, glaucoma.

It should be used with caution within 8 weeks before and 2 weeks after vaccination, with lymphadenitis after BCG vaccination, with immunodeficiency conditions (including AIDS or HIV infection).

Use with caution in diseases of the gastrointestinal tract: gastric and duodenal ulcers, esophagitis, gastritis, acute or latent peptic ulcers, recently created intestinal anastomosis, nonspecific ulcerative colitis with the threat of perforation or abscess formation, diverticulitis.

Should be used with caution for diseases of the cardiovascular system, incl. after a recent myocardial infarction (in patients with acute and subacute myocardial infarction, the necrotic focus may spread, slowing down the formation of scar tissue and, as a result, rupture of the heart muscle), with decompensated chronic heart failure, arterial hypertension, hyperlipidemia), with endocrine diseases - diabetes mellitus ( including impaired tolerance to carbohydrates), thyrotoxicosis, hypothyroidism, Itsenko-Cushing's disease, with severe chronic renal and/or liver failure, nephrourolithiasis, with hypoalbuminemia and conditions predisposing to its occurrence, with systemic osteoporosis, myasthenia gravis, acute psychosis , obesity (III-IV degree), with poliomyelitis (with the exception of the form of bulbar encephalitis), open- and closed-angle glaucoma.

If intra-articular administration is necessary, it should be used with caution in patients with a general severe condition, ineffectiveness (or short duration) of the action of 2 previous injections (taking into account the individual properties of the GCS used).

Before and during GCS therapy, it is necessary to monitor a general blood count, glycemic levels and plasma electrolyte levels.

For intercurrent infections, septic conditions and tuberculosis, simultaneous antibiotic therapy is necessary.

Relative adrenal insufficiency caused by dexamethasone may persist for several months after its discontinuation. Taking this into account, in stressful situations that arise during this period, hormonal therapy is resumed with the simultaneous administration of salts and/or mineralocorticoids.

When using dexamethasone in patients with corneal herpes, the possibility of corneal perforation should be kept in mind. During treatment, it is necessary to monitor intraocular pressure and the condition of the cornea.

With the sudden withdrawal of dexamethasone, especially in the case of previous use in high doses, a so-called withdrawal syndrome occurs (not caused by hypocortisolism), manifested by anorexia, nausea, lethargy, generalized musculoskeletal pain, and general weakness. After discontinuation of dexamethasone, relative adrenal insufficiency may persist for several months. If stressful situations arise during this period, GCS is prescribed (according to indications), if necessary in combination with mineralocorticoids.

During the treatment period, monitoring of blood pressure, water and electrolyte balance, peripheral blood picture and glycemic level, as well as observation by an ophthalmologist is required.

In children, during long-term treatment, careful monitoring of the dynamics of growth and development is necessary. Children who during the treatment period were in contact with patients with measles or chickenpox are prescribed specific immunoglobulins prophylactically.