Wymesone Injection
Dexamethasone Sodium Phosphate
Wyeth
Pack size | 2ml |
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Indications
Wymesone Injection is used for:
Ulcerative colitis, Rheumatoid arthritis, Multiple sclerosis, Nausea and vomiting, Multiple myeloma, Cerebral oedema, Shock, Inflammatory joint diseases, Idiopathic thrombocytopenic purpura, Dental surgery, Allergic anaphylactic shock, Brain tumors, Status asthmaticus
Adult Dose
Dexamethasone sodium phosphate injection, – For intravenous, intramuscular, intra-articular, intralesional, and soft tissue injection.
Dexamethasone can be given parenterally at doses of 0.5-20 mg daily, either as a single IV/IM injection or by IV infusion.
Cerebral Edema
10 mg IV, then 4 mg IM q6hr until clinical improvement is observed; may be reduced after 2-4 days and gradually discontinued over 5-7 days
Shock
1-6 mg/kg IV once or 40 mg IV q2-6hr PRN
Alternative: 20 mg IV, then 3 mg/kg/day by continuous IV infusion
High-dose treatment not to be continued beyond 48-72 hours
Child Dose
Airway Edema
0.5-2 mg/kg/day IV/IM divided q6hr, starting 24 hours before extubation and continued for 4-6 doses afterward
Croup
0.6 mg/kg IV/IM once; not to exceed 16 mg
Inflammation
0.08-0.3 mg/kg/day IV/IM divided q6hr or q12hr
Meningitis
>6 weeks: 0.6 mg/kg/day IV divided q6hr for first 2-4 days of antibiotic therapy, starting 10-20 minutes before or simultaneously with first antibiotic dose
Cerebral Edema Associated With Brain Tumor
1-2 mg/kg IV/IM once; maintenance: 1-1.5 mg/kg/day IV/IM divided q4-6hr; not to exceed 16 mg/day
Spinal Cord Compression
2 mg/kg/day IV divided q6hr
Renal Dose
Administration
IV Preparation
Standard diluent: 4 mg/50 mL D5W or 10 mg/50 mL D5W
Minimum volume: 50 mL D5W
IV/IM Administration
Dexamethasone sodium phosphate: Administered by IV push, continuous or intermittent IV infusion, or IM
Contra Indications
Systemic fungal infections . Hypersensitivity to any component of this product, including sulfites
Precautions
This product, like many other steroid formulations, is sensitive to heat. Therefore, it should not be autoclaved when it is desirable to sterilize the exterior of the vial.
Following prolonged therapy, withdrawal of corticosteroids may result in symptoms of the corticosteroid withdrawal syndrome including fever, myalgia, arthralgia, and malaise. This may occur in patients even without evidence of adrenal insufficiency.
There is an enhanced effect of corticosteroids in patients with hypothyroidism and in those with cirrhosis.
Corticosteroids should be used cautiously in patients with ocular herpes simplex for fear of corneal perforation.
The lowest possible dose of corticosteroid should be used to control the condition under treatment, and when reduction in dosage is possible, the reduction must be gradual.
Psychic derangements may appear when corticosteroids are used, ranging from euphoria, insomnia, mood swings, personality changes, and severe depression to frank psychotic manifestations. Also, existing emotional instability or psychotic tendencies may be aggravated by corticosteroids.
Aspirin should be used cautiously in conjunction with corticosteroids in hypoprothrombinemia.
Steroids should be used with caution in nonspecific ulcerative colitis, if there is a probability of impending perforation, abscess, or other pyogenic infection, also in diverticulitis, fresh intestinal anastomoses, active or latent peptic ulcer, renal insufficiency, hypertension, osteoporosis, and myasthenia gravis.
When large doses are given, some authorities advise that antacids be administered between meals to help to prevent peptic ulcer.
Growth and development of infants and children on prolonged corticosteroid therapy should be carefully followed.
Steroids may increase or decrease motility and number of spermatozoa in some patients.
Phenytoin, phenobarbital, ephedrine, and rifampin may enhance the metabolic clearance of corticosteroids resulting in decreased blood levels and lessened physiologic activity, thus requiring adjustment in corticosteroid dosage. These interactions may interfere with dexamethasone suppression tests which should be interpreted with caution during administration of these drugs.
When corticosteroids are administered concomitantly with potassium-depleting diuretics, patients should be observed closely for development of hypokalemia.
Intra-articular injection of a corticosteroid may produce systemic as well as local effects.
Lactation: Drug excreted in breast milk; not recommended
Pregnancy-Lactation
Interactions
Increased risk of hypokalaemia when used concurrently with potassium-depleting drugs such as amphotericin B and loop diuretics. Reduces efficacy of isoniazid, salicylates, vaccines and toxoids. Increased activity of dexamethasone and cyclosporin when used together. Concurrent use with aspirin or ethanol may lead to increased GI side effects.
Potentially Fatal: Reduced efficacy in combination with ephedrine, cholestyramine, phenytoin, phenobarbital and rifampicin.
Adverse Effects
Side effects of Dexamethasone Sodium Phosphate :
Acne,Adrenal suppression,Arrhythmia,Bradycardia,Cardiac arrest,Cataracts,Change in spermatogenesis,Delayed wound healing,Depression,Diabetes mellitus,Diaphoresis,Emotional instability,Erythema,Euphoria,Exophthalmos,GI perforation,Glaucoma,Glucose intolerance,Glucosuria,Hepatomegaly,Hypokalemic alkalosis,Increased intracranial pressure,Increased transaminases,Insomnia,Kaposi's sarcoma,Menstrual irregularity,Moon face,Myopathy,Neuritis,Osteoporosis,Peptic ulcer,Perianal pruritus,Petechia,Perianal pruritus,Pituitary adrenal axis suppression,Pseudotumor cerebri (on withdrawal),Psychosis,Pulmonary edema,Rash,Seizure,Spermatogenesis altered (increased or decreased),Ulcerative esophagitis,Urticaria,Vertigo,Weight gain
Mechanism of Action
Dexamethasone is a synthetic glucocorticoid which decreases inflammation by inhibiting the migration of leukocytes and reversal of increased capillary permeability. It suppresses normal immune response.
Note
Wymesone Injection manufactured by Wyeth. Its generic name is Dexamethasone Sodium Phosphate. Wymesone is availble in Nepal.
Farmaco Nepal drug index information on Wymesone Injection is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.