From which pole is diprospan administered? After what time does diprospan begin to act. Instructions for use

Composition and form of release

in transparent glass ampoules of 1 ml; in a cardboard box 1 or 5 ampoules.

Dosage and administration

Diprospan ® is recommended to be administered i/m if necessary, systemic intake of glucocorticoids in the body; directly into the affected soft tissue or in the form of intra-articular and peri-articular injections for arthritis, in the form VC injections for various dermatological diseases and in the form of injections into the lesion for some diseases of the foot.

The dosage regimen and method of administration are set individually, depending on the indications, the severity of the disease and the patient's response.

With systemic therapy, the initial dose of Diprospan in most cases is 1-2 ml. The introduction is repeated as necessary, depending on the condition of the patient.

The drug is administered intramuscularly, deeply:

- in severe conditions requiring emergency measures, the initial dose is 2 ml;

- for various dermatological diseases, as a rule, it is enough to introduce 1 ml of Diprospan ® suspension;

- in diseases of the respiratory system; the onset of action of the drug occurs within a few hours after the / m injection of the suspension; with bronchial asthma, hay fever, allergic bronchitis and allergic rhinitis, a significant improvement in the condition is achieved after the introduction of 1-2 ml of Diprospan ® ;

- in acute and chronic bursitis, the initial dose for intramuscular injection is 1-2 ml of suspension. If necessary, carry out several repeated injections.

If a satisfactory clinical response does not occur after a certain period of time, Diprospan ® should be discontinued and another therapy prescribed.

With local administration, the simultaneous use of a local anesthetic drug is necessary only in rare cases. If desired, use 1 or 2% solutions of procaine hydrochloride or lidocaine, free of methylparaben, propylparaben, phenol and other similar substances. In this case, mixing is carried out in a syringe, first drawing the required dose of Diprospan ® suspension into the syringe from the vial. Then, the required amount of local anesthetic is taken from the ampoule into the same syringe and shaken for a short period of time.

In acute bursitis (subdeltoid, subscapular, elbow and prepatellar), the introduction of 1-2 ml of the suspension into the synovial bag after a few hours relieves pain and restores joint mobility. After relief of exacerbation in chronic bursitis, smaller doses of the drug are used.

In acute tenosynovitis, tendonitis and peritendinitis, 1 injection of Diprospan ® improves the patient's condition; in chronic cases, the injection is repeated depending on the patient's response. Avoid injecting the drug directly into the tendon.

Intra-articular administration of Diprospan at a dose of 0.5-2 ml relieves pain, limitation of joint mobility in rheumatoid arthritis and osteoarthritis within 2-4 hours after administration. The duration of the therapeutic effect varies considerably and can be 4 or more weeks.

In some dermatological diseases, the intravenous administration of Diprospan ® directly into the lesion is effective, the dose is 0.2 ml/cm 2 . The lesion is punctured uniformly using a tuberculin syringe and a needle about 0.9 mm in diameter. The total amount of the injected drug in all areas should not exceed 1 ml for 1 week.

Recommended single doses of the drug (with an interval between injections of 1 week) for bursitis: with callus 0.25-0.5 ml (usually 2 injections are effective), with a spur - 0.5 ml, with limited mobility of the big toe - 0 .5 ml, with a synovial cyst - 0.25-0.5 ml, with tendosynovitis - 0.5 ml, with acute gouty arthritis - 0.5-1.0 ml. For injection, it is recommended to use a tuberculin syringe with a needle with a diameter of about 1 mm.

After achieving a therapeutic effect, the maintenance dose is selected by gradually reducing the initial dose by reducing the concentration of betamethasone in the solution administered at appropriate time intervals. The reduction is continued until the minimum effective dose is reached.

If a stressful situation (not associated with a disease) occurs or is threatened, it may be necessary to increase the dose of Diprospan ® .

Cancellation of the drug after prolonged therapy is carried out by gradually reducing the dose.

Monitoring of the patient's condition is carried out for at least a year after the end of long-term therapy or after use in high doses.

Manufacturer

Schering-Plough Labo N.B., Belgium.

Storage conditions of Diprospan ®

Keep out of the reach of children.

Shelf life of Diprospan ®

Do not use after the expiry date stated on the packaging.

Synonyms of nosological groups

In this article, you can read the instructions for using the drug Diprospan. Reviews of site visitors - consumers of this medicine, as well as opinions of doctors of specialists on the use of Diprospan in their practice are presented. We kindly ask you to actively add your reviews about the drug: the medicine helped or did not help get rid of the disease, what complications and side effects were observed, perhaps not declared by the manufacturer in the annotation. Analogues of Diprospan in the presence of existing structural analogues. Use for the treatment of inflammatory diseases in adults, children, as well as during pregnancy and lactation.

Diprospan- glucocorticosteroid (GCS) drug, has high glucocorticoid and insignificant mineralocorticoid activity. The drug has anti-inflammatory, anti-allergic and immunosuppressive effects, and also has a pronounced and diverse effect on various types of metabolism.

Pharmacokinetics

Betamethasone sodium phosphate (the active substance of the drug Diprospan) is highly soluble in water and, after i / m administration, is rapidly hydrolyzed and absorbed almost immediately from the injection site, which ensures a rapid onset of therapeutic action. Almost completely eliminated within one day after administration. It is excreted mainly by the kidneys.

Indications

Treatment in adults of conditions and diseases in which corticosteroid therapy achieves the desired clinical effect (it should be borne in mind that in some diseases of corticosteroid therapy, therapy is additional and does not replace standard therapy):

• diseases of the musculoskeletal system and soft tissues, incl. rheumatoid arthritis, osteoarthritis, bursitis, ankylosing spondylitis, epicondylitis, coccygodynia, torticollis, ganglion cyst, fasciitis;
• allergic diseases, incl. bronchial asthma, hay fever (pollinosis), allergic bronchitis, seasonal or year-round rhinitis, drug allergy, serum sickness, reactions to insect bites;
• dermatological diseases, including atopic dermatitis, nummular eczema, neurodermatitis, contact dermatitis, severe photodermatitis, urticaria, lichen planus, alopecia areata, discoid lupus erythematosus, psoriasis, keloid scars, pemphigus vulgaris, cystic acne;
• systemic connective tissue diseases, including systemic lupus erythematosus, scleroderma, dermatomyositis, periarteritis nodosa;
• hemoblastosis (palliative therapy for leukemia and lymphomas in adults; acute leukemia in children);
• primary or secondary insufficiency of the adrenal cortex (with the mandatory simultaneous use of mineralocorticoids);
• other diseases and pathological conditions requiring systemic corticosteroid therapy (adrenogenital syndrome, regional ileitis, pathological changes in the blood, if necessary, the use of corticosteroids).

Release forms

Suspension for injection (including for injection into the joint).

Solution for injection (injections in ampoules).

Instructions for use and method of use

Intramuscular, intraarticular, periarticular, intrabursal, intradermal, interstitial and intralesional injections. The small size of betamethasone dipropionate crystals allows the use of small diameter needles (up to 26 gauge) for intradermal injection and injection directly into the lesion.

The drug is administered using a disposable syringe using needles (0.5x25 mm and 0.8x50 mm in size) included in the kit.

DO NOT ENTER INTRAVENOUSLY! DO NOT ENTER SUBCUTANEOUSLY!

Strict observance of asepsis rules is mandatory when using Diprospan. The syringe should be shaken before use.

With systemic therapy, the initial dose of Diprospan in most cases is 1-2 ml. The introduction is repeated as necessary, depending on the condition of the patient.

I / m administration of GCS should be carried out deep into the muscle, while choosing large muscles and avoiding contact with other tissues (to prevent tissue atrophy).

The drug is administered intramuscularly:

• in severe conditions requiring emergency measures; the initial dose is 2 ml;
• with various dermatological diseases; as a rule, it is enough to introduce 1 ml of Diprospan suspension;
• in diseases of the respiratory system. The onset of action of the drug occurs within a few hours after the / m injection of the suspension. With bronchial asthma, hay fever, allergic bronchitis and allergic rhinitis, a significant improvement in the condition is achieved after the introduction of 1-2 ml of Diprospan;
• in acute and chronic bursitis, the initial dose for i / m administration is 1-2 ml of suspension. If necessary, carry out several repeated injections.

If a satisfactory clinical response does not occur after a certain period of time, Diprospan should be discontinued and another therapy prescribed.

With local administration, the simultaneous use of a local anesthetic drug is necessary only in rare cases. If desired, 1% or 2% solutions of procaine hydrochloride or lidocaine, free of methylparaben, propylparaben, phenol and other similar substances, are used. In this case, mixing is carried out in a syringe, first drawing the required dose of Diprospan suspension into the syringe from the vial. Then, the required amount of local anesthetic is taken from the ampoule into the same syringe and shaken for a short period of time.

In acute bursitis (subdeltoid, subscapular, elbow and prepatellar), the introduction of 1-2 ml of the suspension into the synovial bag relieves pain and restores joint mobility within a few hours. After relief of exacerbation in chronic bursitis, smaller doses of the drug are used.

In acute tendosynovitis, tendonitis and peritendinitis, one injection of Diprospan improves the patient's condition; in chronic cases, the injection is repeated depending on the patient's response. Avoid injecting the drug directly into the tendon.

Intra-articular administration of Diprospan at a dose of 0.5-2 ml relieves pain, limitation of joint mobility in rheumatoid arthritis and osteoarthritis within 2-4 hours after administration. The duration of the therapeutic effect varies considerably and can be 4 or more weeks. The recommended doses of the drug when administered to large joints are from 1 to 2 ml; in the middle - 0.5-1 ml; in small ones - 0.25-0.5 ml.

Recommended single doses of the drug (with an interval between injections of 1 week) for bursitis: with callus 0.25-0.5 ml (usually 2 injections are effective), with spur - 0.5 ml, with limited mobility of the big toe - 0.5 ml, with synovial cyst - 0.25-0.5 ml, with tendosynovitis - 0.5 ml, with acute gouty arthritis - 0.5-1.0 ml. For most injections, a tuberculin syringe with a 25-gauge needle is suitable. After achieving a therapeutic effect, the maintenance dose is selected by gradually reducing the dose of betamethasone administered at appropriate intervals. The reduction is continued until the minimum effective dose is reached.

Side effect

• fluid retention in tissues;
• chronic heart failure (in predisposed patients);
• increased blood pressure;
• muscle weakness;
• loss of muscle mass;
• osteoporosis;
• compression fracture of the spine;
• aseptic necrosis of the head of the femur or humerus;
• pathological fractures of tubular bones;
• tendon ruptures;
• erosive and ulcerative lesions of the gastrointestinal tract with possible subsequent perforation and bleeding;
• flatulence;
• impaired wound healing;
• atrophy and thinning of the skin;
• petechiae, ecchymosis;
• increased sweating;
• steroid acne;
• striae;
• tendency to develop pyoderma and candidiasis;
• convulsions;
• increased intracranial pressure with edema of the optic disc (more often at the end of therapy);
• dizziness;
• headache;
• euphoria;
• mood changes;
• depression (with severe psychotic reactions);
• increased irritability;
• insomnia;
• violation of the menstrual cycle;
• secondary adrenal insufficiency (especially during the period of stress due to illness, injury, surgery);
• Itsenko-Cushing's syndrome;
• decreased carbohydrate tolerance;
• violation of intrauterine development;
• growth retardation and sexual development in children;
• increased intraocular pressure;
• glaucoma;
• weight gain;
• anaphylactic reactions;
• angioedema;
• lowering blood pressure;
• a rush of blood to the face after an injection (or intra-articular injection).

Contraindications

• hypersensitivity to betamethasone or other components of the drug, or other corticosteroids;
• systemic mycoses;
• intravenous or subcutaneous administration;
• with intra-articular injection: unstable joint, infectious arthritis;
• introduction into infected cavities and into the intervertebral space;
• children's age up to 3 years (the presence of benzyl alcohol in the composition);
• coagulation disorders (including treatment with anticoagulants).

Use during pregnancy and lactation

Due to the lack of controlled studies on the safety of Diprospan during pregnancy, the use of the drug in pregnant women or in women of childbearing age requires a preliminary assessment of the intended benefits and potential risks to the mother and fetus. Newborns whose mothers received therapeutic doses of corticosteroids during pregnancy should be under medical supervision (for early detection of signs of adrenal insufficiency).

If it is necessary to prescribe Diprospan during lactation, the issue of stopping breastfeeding should be decided, taking into account the importance of therapy for the mother (due to possible side effects in children).

special instructions

The dosage regimen and method of administration are set individually, depending on the indications, the severity of the disease and the patient's response.

The dose should be as low as possible and the period of application as short as possible. The initial dose is selected until the desired therapeutic effect is achieved. If after a sufficient period of time a therapeutic effect is not observed, the drug is discontinued by gradually reducing the dose of Diprospan and another appropriate method of treatment is selected.

After achieving a therapeutic effect, the maintenance dose is selected by gradually reducing the dose of betamethasone administered at appropriate intervals. The reduction is continued until the minimum effective dose is reached.

If a stressful situation (not associated with a disease) occurs or is threatened, it may be necessary to increase the dose of Diprospan. Cancellation of the drug after prolonged therapy is carried out by gradually reducing the dose.

The patient's condition is monitored for at least a year after the end of long-term therapy or high doses.

The introduction of the drug into soft tissues, into the lesion and into the joint, with a pronounced local effect, can simultaneously lead to a systemic effect. Given the likelihood of developing anaphylactoid reactions with parenteral administration of GCS, the necessary precautions should be taken before administering the drug, especially if the patient has a history of allergic reactions to drugs.

Diprospan contains two active substances - derivatives of betamethasone, one of which - betamethasone sodium phosphate - quickly penetrates into the systemic circulation. When prescribing Diprospan, one should take into account the possible systemic effect of the rapidly soluble fraction of the drug.

Against the background of the use of Diprospan, mental disorders are possible (especially in patients with emotional instability or a tendency to psychosis).

When prescribing Diprospan to patients with diabetes mellitus, correction of hypoglycemic therapy may be required.

Patients receiving glucocorticosteroids should not be vaccinated against smallpox. Other immunizations should not be carried out in patients receiving corticosteroids (especially in high doses), due to the possibility of developing neurological complications and a low immune response (lack of antibody formation). However, immunization is possible during replacement therapy (for example, with primary insufficiency of the adrenal cortex).

Patients receiving Diprospan in doses that suppress immunity should be warned about the need to avoid contact with patients with chickenpox and measles (especially important when prescribing the drug to children).

When using Diprospan, it should be borne in mind that corticosteroids can mask signs of an infectious disease, as well as reduce the body's resistance to infections. The appointment of Diprospan in active tuberculosis is possible only in cases of fulminant or disseminated tuberculosis in combination with adequate anti-tuberculosis therapy. When prescribing Diprospan to patients with latent tuberculosis or with a positive reaction to tuberculin, the issue of prophylactic anti-tuberculosis therapy should be decided. Prophylactic use of rifampin should take into account the acceleration of hepatic clearance of betamethasone (dose adjustment may be required).

In the presence of fluid in the joint cavity, a septic process should be excluded. A noticeable increase in soreness, swelling, an increase in the temperature of the surrounding tissues and a further restriction of joint mobility indicate infectious arthritis. When confirming the diagnosis, it is necessary to prescribe antibiotic therapy.

Repeated injections into a joint for osteoarthritis may increase the risk of joint destruction. The introduction of GCS into the tendon tissue gradually leads to tendon rupture. After successful intra-articular therapy, the patient should avoid overloading the joint.

Prolonged use of corticosteroids can lead to posterior subcapsular cataracts (especially in children), glaucoma with possible damage to the optic nerve, and may contribute to the development of a secondary ocular infection (fungal or viral). It is necessary to periodically conduct an ophthalmological examination, especially in patients receiving Diprospan for more than 6 months.

With an increase in blood pressure, fluid retention and sodium chloride in the tissues and an increase in the excretion of potassium from the body (less likely than with other corticosteroids), patients are recommended a diet with salt restriction and additionally prescribe potassium-containing drugs. All corticosteroids increase the excretion of calcium.

With the simultaneous use of Diprospan and cardiac glycosides or drugs that affect the electrolyte composition of the plasma, control of the water and electrolyte balance is required.

With caution, acetylsalicylic acid is prescribed in combination with Diprospan for hypoprothrombinemia.

The development of secondary adrenal insufficiency due to too rapid withdrawal of GCS is possible within a few months after the end of therapy. If a stressful situation occurs or threatens to occur during this period, Diprospan therapy should be resumed and a mineralocorticoid drug should be prescribed at the same time (due to a possible violation of mineralocorticoid secretion). The gradual cancellation of GCS can reduce the risk of developing secondary adrenal insufficiency.

Against the background of the use of GCS, a change in the mobility and number of spermatozoa is possible. With long-term therapy with corticosteroids, it is advisable to consider the possibility of switching from parenteral to oral corticosteroids, taking into account the assessment of the benefit / risk ratio.

Application in pediatrics

Children who are treated with Diprospan (especially long-term) should be under close medical supervision for possible growth retardation and the development of secondary adrenal insufficiency.

drug interaction

With the simultaneous appointment of phenobarbital, rifampin, phenytoin or ephedrine, it is possible to accelerate the metabolism of the drug while reducing its therapeutic activity.

With the simultaneous use of corticosteroids and estrogens, dose adjustment of the drugs may be required (due to the risk of their overdose).

With the combined use of Diprospan and potassium-removing diuretics, the likelihood of developing hypokalemia increases.

The simultaneous use of corticosteroids and cardiac glycosides increases the risk of arrhythmia or digitalis intoxication (due to hypokalemia). Diprospan may increase the excretion of potassium caused by amphotericin B. With the combined use of Diprospan and indirect anticoagulants, changes in blood coagulability are possible, requiring dose adjustment.

With the combined use of corticosteroids with non-steroidal anti-inflammatory drugs or with ethanol and ethanol-containing drugs, it is possible to increase the incidence or intensity of erosive and ulcerative lesions of the gastrointestinal tract.

With the combined use of corticosteroids, they can reduce the concentration of salicylates in the blood plasma.

Simultaneous administration of GCS and somatotropin can lead to a slowdown in the absorption of the latter (doses of betamethasone in excess of 0.3-0.45 mg / m2 of body surface per day should be avoided).

Diprospan's analogues

Structural analogues for the active substance:

• Akriderm;
• Beloderm;
• Betazon;
• Betamethasone;
• Betamethasone valerate;
• Betamethasone dipropionate;
• Betliben;
• Betnovate;
• Kuterid;
• Flosteron;
• Celestoderm-B;
• Celeston.

In the absence of analogues of the drug for the active substance, you can follow the links below to the diseases that the corresponding drug helps with and see the available analogues for the therapeutic effect.

Steroid anti-inflammatory drugs are widely used in medicine. Diprospan eye drops belong to this class of drugs. Due to its pronounced effect, it copes even in difficult clinical situations.

But you have to pay for this with a large number of side effects and contraindications. To obtain proper treatment from Diprospan, we recommend that you carefully read the instructions below.

Allergic conjunctivitis is one of the indications for Diprospan eye drops

The international name of the active drug substance recommended by WHO is the glucocorticoid betamethasone, which is represented by: betamethasone sodium phosphate and betamethasone dipropionate. A colorless substrate, odorless and tasteless, containing a precipitate, when shaken, the components are mixed, forming a suspension:

Additional substances:

• Trilon B is a chelating agent that forms strong complexes with heavy metal cations.
• Acid salt - used as a stabilizer.
• Polysorbate-80 is a monooleate used to create emulsions from immiscible substances.
• Benzyl alcohol - used for aromatization.
• Methyl parahydroxybenzoate, propyl parahydroxybenzoate (0.20 mg) are food preservatives, safe compounds in the food, cosmetic and pharmacological industries.
• Carmellose sodium is an ophthalmic agent.
• Macrogol-4000 is an ethylene glycol polymer, a binder.
• Hydrochloric acid - hydrochloric acid, provides an acidic environment.

As can be seen from the characteristics, all elements of the drug are safe and licensed.

What diseases are prescribed Diprospan?

Glucocorticosteroid is used to eliminate inflammation and allergies and other pathological conditions, it is excreted by the kidneys from the body in a period of up to ten days.

The action of the drug is a synergism of two phases, slow and fast. Betamethasone phosphate instantly spreads with the bloodstream and after half an hour leads to a full therapeutic effect. Dipropionate is absorbed for a very long time, slowly assimilated, excreted for a long time.

• Chronic inflammation during an exacerbation.
• Regeneration in the period after surgery (cataract extraction, anti-glaucomatous surgery, etc.).
• Therapy for penetrating wounds.
• Removing the condition of allergic conjunctivitis.
• Treatment of pastosity after rhinoplasty.

In most cases, the drug is prescribed as part of complex therapy.

The introduction of the drug is almost painless. The drug does not affect the coordination of movements, attentiveness and speed of reaction.

Dosage regimen and method of application

If you use the form in the form of eye drops, then 1-2 drops are instilled into each every 1-2 hours until the desired effect is achieved, after which the frequency of instillation can be reduced.

The concentration of the drug in the tissues of the eye depends on the method of administration; when injected into the eye, it is better to use local anesthesia.

The introduction into the eyeball by injection is carried out in two ways: parabulbar (injection into the sub-shadow space surrounding the eyeball, injection depth from 0.5-1.5 cm) and retrobulbar (for the eyeball injection 2-4 cm), the optimal dosage is considered to be no more than 1, 00 ml.

If tissue changes occur in the area of ​​administration, the drug should be discontinued.

For those who wear soft, this drug is not prescribed. It is also important to control intraocular pressure during the period of Diprospan use.

What are the possible side effects?

Doctors note a direct dependence of side effects, on the volume of the serving and the duration of the intake and the duration of the suspension, if the dose is noticeably changed, they are easily eliminated. Symptoms of side effects from the body systems:

• , subcapsular .
• Changes in the rhythm of the heartbeat, myocardial contractility.
• Inflammatory processes in the intestines with the formation of erosions, up to perforations.
• Candidiasis, urticaria.
• Convulsive conditions, neuritis.
• Mood volatility, sleep disturbances.
• Adrenal insufficiency, Cushing's syndrome, steroid diabetes, rapid weight gain.

If side effects occur, report them to your doctor immediately. The doctor will decide, based on the effectiveness of the drug, whether to stop it completely or reduce the dose.

Contraindications for use

In the following common situations, the use of the drug is prohibited:

• ulcerative lesions of the gastrointestinal tract;
• diabetes;
• individual sensitivity to the drug substance;
• active form of tuberculosis;
• osteoporosis;
• thrombophlebitis.

But do not take the drug without the knowledge of your doctor! Only after a comprehensive examination by a specialist, the question of the advisability of using the drug is decided.

Drugs similar to Diprospan

Medicines-analogues, preparations containing various active substances that differ in the brand name, but have a beneficial effect on the suppression of the negative symptoms of the disease.

There are no complete analogues of Diprospan.

Drugs are synonyms, drugs containing the same active substances, but differ in different auxiliary substances, and have different brand names.

Medicines synonymous with the drug Diprospan are Flosteron (a drug produced in Russia), Celeston (produced in Belgium), Betaspan (production - Ukraine).

Despite a wide range of side effects, Diprospan has proven to be an effective and long-term beneficial therapeutic agent used in the postoperative period in patients undergoing surgery on the eyeball.

Expert opinion

Darina Dikunova

Ophthalmologist.

Diprospan is a fairly strong drug, therefore it is used, as a rule, in the form of injections into the sub-Tenon space in serious situations, for example, in Irwin-Gass syndrome after cataract phacoemulsification.

There are not many situations in the clinic when it is advisable to prescribe diprospan or its analogues epibulbarno.

There are many glucocorticoids or other anti-inflammatory drugs with similar efficacy but fewer side effects.

What is important to know about allergies in the eyes, says the doctor:

Diprospan is a glucocorticoid agent with a wide range of effects and is used in medical practice for the treatment of diseases of the musculoskeletal system, including the spine.

The composition of the drug contains the active ingredient betamethasone disodium phosphate (2 mg), which provides the speed of action, and betamethasone propionate (5 mg), which provides a prolonging effect of diprospan.

Diprospan during therapy has anti-inflammatory, anti-allergic, immunomodulatory, anti-shock and desensitizing effects on the body.

The speed of action of diprospan is from 10 to 20 minutes, so the drug has found wide application for the treatment of acute conditions, as an anti-shock agent. The speed of action of diprospan largely depends on a substance called betamethasone, which is a synthetic glucocorticoid. After one injection of the drug, the effect persists for 72 hours.

In what cases is diprospan used?

For the drug diprospan, the instructions for use should be carefully studied before the patient takes the appointment. The fact is that the spectrum of action of the drug is very wide and the drug diprospan is used in the following cases:

• Inflammatory diseases of the muscles, ligaments and tendons of the musculoskeletal system (myositis, tendovaginitis, fibrositis, synovitis).
• Specific rheumatoid and psoriatic polyarthritis.
• Lumbago, sciatica, pain in the lumbar region, torticollis.
• Pain after injury.
• Gouty arthrosis.
• Osteochondrosis of all parts of the spine.
• Allergic conditions and attacks of bronchial asthma (allergic rhinitis, hay fever, allergy to insect bites).
• Shock of various origins (after burns, trauma, blood transfusion, drug administration, cardiogenic).
• Cerebral edema and pulmonary edema.
• Various skin lesions (atopic dermatitis, psoriasis, dermatosis, neurodermatitis, urticaria, acne, pink lichen, common pemphigus).
• Systemic connective tissue diseases (systemic lupus erythematosus, dermatomyositis, scleroderma, periarteritis nodosa).
• Palliative treatment for various forms of leukemia in children and adults.
• Liver disease and hepatic coma.
• Acute adrenal insufficiency.
• Benign malignant neoplasms.

Contraindications to the appointment of diprospan

The medicine diprospan has, like any other drug, its contraindications:

• The main contraindication is the increased sensitivity of people to the drug.
• It is also undesirable to inject diprospan into the joint in the presence of an infected area or infiltrate due to infection.
• It is not recommended to administer the drug in cases where there is a violation of the blood coagulation process, as well as after arthroplasty.
• If the patient has skin lesions (dermatosis, dermatitis, psoriasis, eczema), it is recommended to administer the drug only intramuscularly or intradermally, but in no case as a local therapy inside the joint.
• The drug diprospan has contraindications during pregnancy and lactation. You can not use the drug for pregnant women, and also during breastfeeding. If, nevertheless, it is necessary to conduct a course of therapy with diprospan during feeding, then the child is weaned for the duration of therapy.
• Diprospan should not be used in complex therapy for tuberculosis and peptic ulcer, as well as in the case of an existing chronic infection (viruses, bacteria, fungi).
• You can not use the drug in chronic renal failure and diabetes mellitus type 1 and 2, as well as in the presence of cholelithiasis.
• You can not enter diprospan with ulcerative lesions of the stomach and intestines.
• It is strictly forbidden to administer the drug for mental disorders and during vaccination with various vaccines.

Dosage and administration

Treatment with diprospan must be agreed with the attending physician, who selects the dose of the drug in accordance with the form and severity of the disease. The drug is available in ampoules for parenteral administration, 1 ml in one ampoule.

With systemic therapy with diprospan, the following requirements must be observed:

• If the patient's condition is severe and requires urgent action, then the initial dose of the drug may be 2 ml.
• For skin diseases, the therapeutic dose of the drug usually does not exceed 1 ml.
• In chronic lung diseases (bronchial asthma) and various allergic conditions, the drug can be administered at a dose of 1-2 ml. The effect of therapy occurs within a few hours. If necessary, you can divide the intake of diprospan by 1 ml with a break of 4-5 hours.
• In acute and chronic inflammation of the joint capsule, the initial dose of diprospan can be 1-2 ml. Further doses of the drug are prescribed based on the individual condition and well-being of the patient.

How to inject diprospan? Diprospan in the form of injections is injected deep into the gluteal muscle at a dose of 1-2 ml. For intradermal injection in the affected area of ​​the joint, the dose of the drug is 0.2 ml per square centimeter, and the total number of intradermal injections should not be more than 2 ml per week.

Also, diprospan injections are administered into the joint or periarticular sac as a local therapy. The dose of the drug in this case varies from 0.2 to 2 ml, and the total amount should not exceed 1 time per week.

Diprospan is injected into the joint for a variety of inflammatory diseases, and the dosage is used depending on the size of the infiltrate. The larger the size of the infiltrate, the more the drug is injected, but a single dose should not exceed 2 ml. The therapeutic effect of the drug begins immediately after the introduction of diprospan into the joint, the pain goes away, and mobility returns to the joint again.

Diprospan injections are painless, but in some cases the drug can be administered with an anesthetic drug (novocaine, lidocaine, procaine), which is mixed with the main drug in one syringe. To do this, first, the main drug (diprospan) is drawn into the syringe, and then the anesthetic is drawn up and shaken for 1-2 minutes.

Side effects of the drug and overdose

The medicine diprospan can have side effects from different systems:

• From the endocrine system - weight gain and metabolic disorders, as well as growth and developmental delay in children. Also, a violation of the menstrual cycle in women may develop, an increase in the need for hypoglycemic drugs in the treatment of diabetes mellitus.
• On the part of the musculoskeletal system, it can cause osteoporosis, aseptic necrosis of the head of the humerus or femur, muscle weakness, myopathy, and bone fractures.
• On the part of the immune system, it can cause its weakening and, as a result, the addition of a secondary infection.
• From the side of the central nervous system, it can cause excitation, alternating with drowsiness, as well as a feeling of anxiety and fear, a depressive state, and various neuroses. There may be tonic convulsions and increased intracranial pressure.
• From the gastrointestinal tract - an increase or decrease in appetite, esophageal ulcers, erosive and ulcerative lesions of the gastric and intestinal mucosa, pancreatitis, bloating, as well as stool upset and nausea.
• When using diprospan during pregnancy, the fetus may have various deformities and developmental abnormalities.
• On the part of the urinary system - fluid retention in the tissues, increased excretion of calcium and potassium from the body, an increase in the sodium content in the blood plasma.
• From the side of the cardiovascular system - arterial hypertension, the phenomena of congestive heart failure.
• On the part of the skin - a violation of the healing of skin wounds, thinning and atrophy of the skin, redness of the skin of the face, angioedema, skin rash.
• On the part of the organs of vision - glaucoma, exophthalmos, increased intraocular pressure.

Special instructions for the use of diprospan

You should not take the drug with habitual dislocation, as in this case, the introduction of the drug will not solve the underlying problem. Also, with a long course of treatment, it is necessary to periodically monitor the level of sugar in the blood plasma. It is not recommended to administer the drug intravenously. It is also not recommended to inject the drug into the intervertebral discs.

Instructions for the use of diprospan also contain warnings that are associated with the simultaneous use of the drug and alcohol, since alcohol and diprospan are incompatible substances. All those who are undergoing treatment with diprospan should remember that during therapy it is not recommended to drink weak and strong alcoholic beverages, since alcohol can increase the side effect of taking diprospan.

If you still receive treatment with diprospan and have consumed alcohol, as well as in case of an overdose of diprospan, then the patient may experience the same side effects, only more pronounced. There is no special antidote for diprospan, therefore, therapy for overdose (or alcohol intake) is symptomatic. It is necessary to carry out detoxification therapy with intravenous administration of glucose and isotonic solution.

Interaction with other drugs

It is not recommended to take diprospan together with non-steroidal anti-inflammatory drugs, since the action of diprospan aggravates the side effect from the gastrointestinal tract in the form of an ulcerative lesion.

Storage conditions and shelf life of diprospan

Diprospan does not need special storage conditions, and it can be stored both in the refrigerator and at normal room temperature, making sure that the temperature is not higher than 25 degrees. Freezing the drug is strictly prohibited. The shelf life of diprospan is at least 3 years from the date of manufacture.

It should be noted that these instructions for the use of diprospan are provided for informational purposes only. For more detailed information, please contact the drug manufacturers. Before using diprospan, you should consult with a specialist.

spina-sustav.ru

Means Diprospan: instructions for the use of injections

Diprospan is a multifunctional remedy. And for diseases of the joints, and for diseases of the joints, and for allergies, and for baldness, diprospan (injections) are prescribed, the instructions for use depend largely on the purpose of prescribing the remedy. It is important to understand that this drug only relieves pain, but does not cure the ailments that cause this pain. In addition, he has serious contraindications.

About the tool: properties, indications, action

Diprospan is the commercial name for betamethasone. It is a glucocorticoid synthetic agent with anti-inflammatory properties, as well as anti-allergic, anti-exudative, anti-polyferative and immunosuppressive properties. It also has anti-shock and desensitizing effects. Betamethasone is available as a suspension for injections, as ointments, as solutions for intramuscular or intramuscular injection, as drops, as tablets. But now we are talking about diprospan injections and instructions for use. The tool is effective and popular due to the fact that it inhibits the synthesis of substances that provoke inflammation, and also inhibits the formation of inflammatory processes at the cellular level.

This medicine has several analogues, the active substance of which is the same betamethasone:

• Betaspan depot;
• Betamethasone Norton;
• Loracort;
• Depos;
• Celeston;
• Flosteron and others.

Diprospan for injections consists of betamethasone disodium phosphate, due to which the action occurs quickly, and betamethasone dipropionate, which prolongs the effect.

• Rheumatoid arthritis;
• Bursitis;
• Lumbago;
• Osteoarthritis;
• Fasciitis;
• epicondylitis;
• Radiculitis;
• foot diseases;
• Torticollis;
• Rhinitis;
• Hay fever;
• Asthma (bronchial);
• Bronchitis of allergic origin;
• Allergies to insect stings and medications (including injections of drugs with a high protein content);
• Various dermatitis;
• Neurodermatitis;
• Acne cystic;
• lichen;
• Pemphigus;
• Hives;
• Psoriasis;
• Eczema;
• scleroderma;
• Dermatomyositis;
• Periarteritis nodular;
• Oncological diseases of the lymph and blood;
• Diseases of the adrenal glands (insufficiency of their cortex);
• Jades;
• nephrotic syndrome;
• Regional ileitis;
• Malabsorption syndrome.

It can also be prescribed for ulcerative colitis, adrenogenital syndrome, etc.

It is important to know! How often to prick this remedy, only the doctor decides. The medicine is hormonal, so no deviations from the rules of application are allowed here.

Application rules, instruction

Instructions for use diprospan says that injections can be done intramuscularly, intradermally, into the joint and periarticularly, that is, around it. It is not allowed to carry out injections into a vein and subcutaneously. The dosage and method of administration is prescribed only by a doctor. Usually the kit includes needles (size 0.8x50 and 0.5x25 mm). The syringe should be used disposable (preferably tuberculin) and shake before use.

Injections are made into the muscle for systemic treatment and in severe conditions. It is important to choose a larger muscle, inject deeply and so that the agent does not get into other tissues. The initial dose is 2 mm, but for dermatological ailments, a milliliter is enough. The action begins a few hours after administration.

It must be introduced into the joint according to certain rules. Usually, anesthetics are not required when using betamethasone, but if necessary, you can inject the drug in combination with lidocaine. To do this, first we draw diprospan into the syringe, then an analgesic and shake.

The concentration is determined by the size of the joint. So, in a large joint (knee, ankle, shoulder) is injected from one to two milliliters, in the middle (elbow and carpal) - from half a milliliter to one, in small ones - from a quarter of a milliliter to a half. An injection is given every two or three months, the interval between injections into different joints should be a week or two. In rheumatoid arthritis, injections are combined with treatment with glucocorticosteroids.

Blockades are carried out with tendinitis and bursitis. In this case, the drug is injected into the tissues surrounding the joints or near the tendon. The dosage also depends on the size of the joints.

For skin diseases, betamethasone is administered intradermally. To make such an injection, prick the skin around the perimeter evenly. The average dose of betamethasone in this case is about 2 milliliters per square centimeter of skin. For skin ailments, an injection once a week is enough, the course is from three to five procedures.

With ophthalmic ailments and eye operations, betamethasone is injected into the lower eyelid. After rhinoplasty (if edema has appeared), the injection is made directly into the nose. It only takes one time.

It is important to know! When injecting betamethasone into the knee joint, it is important not to hit the tendon. This drug can make them brittle and cause them to break.

Contraindications

Betamethasone has both contraindications and side effects. First of all, you can not use it for a long time and with individual intolerance. Absolute contraindications include all kinds of mycoses, since this remedy contributes to their spread. It cannot be injected into the joint cavity if there are infectious processes in it. So, tuberculosis under the action of betamethasone can begin to progress. You can not prick it into infected surfaces. In unstable joints and if they are damaged, injections are also prohibited.

Also, therapy with this remedy during vaccination (especially against smallpox) is not prescribed. It is not recommended after serious operations, especially on the gastrointestinal tract (there is a risk of scarring). Yes, and with ulcerative diseases of the intestine and stomach, betamethasone is prescribed with caution. Relative contraindications include thyroid dysfunction, as well as diabetes mellitus, herpetic eye damage, cardiovascular insufficiency, and increased blood clotting. During pregnancy, diprospan is also not recommended. If it was prescribed to a nursing mother, lactation should be temporarily interrupted.

It also has many side effects. The peculiarity is that side effects develop with prolonged use. It can disrupt the functioning of the kidneys, provoke spasms of blood vessels, increase blood pressure and cause fluid retention in the body. It also has other side effects:

• mood changes;
• loss of coordination;
• hallucinations and delusions;
• Increased intraocular pressure;
• Cataract;
• visual disturbances;
• Weakness of the heart muscle;
• bradycardia;
• Thrombosis;
• pressure increase;
• Myocardial rupture after a heart attack;
• Weight Gain:
• Disorders of carbohydrate and protein metabolism;
• growth retardation in children;
• Menstrual irregularities;
• muscle reduction;
• fragility of the bones;
• thinning of the skin;
• Stretch marks;
• rashes;
• Slow wound healing;
• Inflammation of the pancreas;
• The occurrence of ulcers and gastritis;
• Extremely rarely, anaphylactic shock and angioedema occur.

Diprospan is an excellent remedy for many diseases, but do not forget that it only treats the symptoms. In order to get rid of the disease forever, you need treatment, and not getting rid of the symptoms. During treatment, you must strictly follow the scheme proposed by the doctor, and not engage in amateur activities.

privivkainfo.ru

Diprospan for allergies - instructions

Diprospan is an injectable drug used in most cases in the treatment of pathologies of the musculoskeletal system. But this medicine also has another pharmacological action - anti-allergic, so Diprospan can be prescribed to eliminate certain types of allergies.

The medication must be used according to the scheme, taking into account all the nuances of its introduction. Otherwise, treatment with Diprospan can cause quite serious complications.

Trade name and active ingredient.

The trade name of the drug is Diprospan. The main active ingredient is betamethasone (Betamethasone).

Description

The drug is produced in Belgium. The registered office of Schering-Plough Labo NV, Indushtrypark 30. The international name used everywhere is betamethasone.

Diprospan is available only in the form of a suspension - a viscous solution, colorless or slightly yellowish. After shaking, the liquid becomes homogeneous and acquires a white color.

The suspension consists of two active ingredients - betamethasone dipropionite and betamethasone sodium phosphate.

In addition to the main components in the preparation are auxiliary:

1. Anhydrous dibasic sodium phosphate;
2. Trilon B;
3. Water for injections;
4. Polysorbate 80;
5. benzyl alcohol;
6. Carboxymethylcellulose sodium salt;
7. Polyethylene glycol 4000;
8. Nipazol;
9. Nipagin.

The suspension is packaged in glass ampoules with a dosage of 1 ml. There may be one or five ampoules in a plastic package.

pharmacological group.

Diprospan belongs to the group of glucocorticosteroid drugs, which are hormonal drugs.

pharmachologic effect

Betamethasone, which is the active ingredient of Diprospan, belongs to a highly active class of glucocorticosteroids. Due to betamethasone, the drug has a pronounced anti-inflammatory, immunosuppressive and anti-allergic effect.

After entering the blood, the synthetic hormone binds to albumin proteins, after which it is quickly transferred to all cells of the body.

The effectiveness of Diprospan in the treatment of allergic reactions is explained by the ability of betemethasone to suppress the production of aggressive enzymes that cause an inflammatory reaction of the mucous membranes and skin.

The chemical structure of Diprospan is similar to the structure of adrenal hormones, so the drug begins to actively participate in all types of metabolism in the body - carbohydrate, protein, fat, water-salt.

At the same time, all natural reactions are accelerated, which is not always beneficial for the body - prolonged use of glucocorticosteroids causes unwanted side changes.

The high therapeutic effect of the use of Diprospan is explained by the fact that its two active components act in different ways:

1. Betamethasone in the form of sodium phosphate after injection quickly dissolves and spreads throughout the body. Thanks to this, the therapeutic effect occurs literally within 20-60 minutes. This form of the hormone lingers in the body for no more than a day.
2. Betamethasone dipropionate is a microcrystalline fraction, which, after entering the body, is converted into a kind of depot. From this depot, betamethasone comes out gradually, at a small dose for 20-25 days.

The dual mechanism of Diprospan's work allows you to achieve two goals in the treatment of allergies.

Under the influence of the drug, the acute symptoms of an allergic reaction are almost instantly stopped, and then a remission occurs, lasting for at least three weeks.

The components of the drug are completely metabolized in the liver and excreted by the kidneys.

Indications for use

Diprospan must be prescribed by a doctor. In some diseases, glucocorticosteroids are only additional medicines.

The drug is prescribed to patients with:

• Pathologies of the musculoskeletal system and soft tissue diseases, including bursitis, rheumatoid arthritis, osteoarthritis, sciatica, fasciitis, spondyloarthritis, torticollis, lumbago, foot disease.
• Allergic diseases. Most often, Diprospan is prescribed to those who have a history of bronchial asthma, allergic bronchitis, pollinosis, seasonal or year-round rhinitis. The drug is considered a first aid for drug allergies, serum sickness, with an acutely developing reaction to insect bites.
• Dermatological diseases - nummular eczema, neurodermatitis, atonic and contact dermatitis, urticaria, photodermatitis, psoriasis, lichen planus. Often, Diprospan is part of the complex therapy of alopecia areata, cystic acne, herpetic dermatitis and a number of other pathologies affecting the skin.
• Hemoblastoses. Diprospan is included in the scheme of palliative therapy for leukemia and lymphomas.
• Secondary and primary insufficiency of the adrenal cortex.

Diprospan is also used in the treatment of a number of diseases requiring systemic exposure to corticosteroids (glucocorticosteroids). These are ulcerative colitis, adrenogenital syndrome, malabsorption, nephrotic syndrome, regional ileitis.

Instructions for use

Diprospan is an injectable drug. It is allowed to administer it intramuscularly, into the joint or near it, less often intrabursal, intradermal and interstitial injections are prescribed.

The drug should be administered only by specialists who have the appropriate certificate.

Diprospan should be injected into the joint and tissues by a doctor. It is imperative to follow all the rules of asepsis, the dosing regimen is set for each patient individually.

When conducting intramuscular administration of the drug, a single dose usually does not exceed two milliliters. It is necessary to re-introduce the drug after assessing all changes.

After Diprospan helps to cope with the elimination of severe symptoms of diseases, a maintenance dose is selected. To do this, the dose of the suspension is reduced over several weeks, observing the patient's well-being.

Contraindications

Hypersensitivity to betamethasone or to additional components of the drug is considered an absolute contraindication to the appointment of Diprospan.

Subcutaneous and intravenous injections are strictly prohibited. If the drug is planned to be injected into the joint, then infectious arthritis and an unstable joint are contraindications.

Diprospan cannot be injected into infected tissues, into the intervertebral space; treatment with them is prohibited for systemic mycoses.

Carefully.

If long-term treatment with glucocorticosteroids is planned, then it is necessary to find out if the patient has a history of diseases that can become relative contraindications:

• severe hypertension;
• Purulent and viral infections;
• Diabetes;
• Cushing's syndrome;
• Stomach ulcer;
• Glaucoma;
• Tuberculosis;
• mental illness;
• thromboembolic syndrome.

Intramuscularly, the drug is not administered with thrombocytopenic purpura.

Temporary contraindications are the resulting foci of psoriasis or necrosis at the intended injection site, treatment with anticoagulant drugs.

Overdose

In most cases, the introduction of high doses of Diprospan suspension for several days does not lead to a deterioration in the patient's well-being and complications.

An overdose may develop if GCS is used to treat patients with diabetes mellitus, with an ulcerative lesion of the gastrointestinal tract in the acute stage.

Drugs such as Digitalis, potassium-removing diuretics, and indirect anticoagulants can also enhance the glucocorticosteroid effect.

Overdose symptoms:

1. Nausea and vomiting;
2. sleep disorders;
3. Excitation;
4. Euphoria;
5. Depression.

If an overdose is detected, Diprospan is canceled gradually, therapy is prescribed to maintain vital functions.

It is necessary to correct the water and electrolyte balance, if necessary, antacids, phenothiazines are prescribed.

How often to prick Diprospan

The frequency of administration of Diprospan, and its dosage depends on the type of disease:

• With rheumatoid arthritis, the drug is placed in the joint once every two to three months. The interval between setting in different joints should be at least one week.
• In the treatment of alopecia, Diprospan is placed into the muscle once a week, the course of treatment is up to 5 injections.
• With eczema, the drug is prescribed only in case of its severe course. The number of injections is selected by the doctor, taking into account changes in the skin.

Diprospan for allergies is used in different ways:

• For the relief of acute manifestations of asthma, bronchitis, conditions after insect bites or drug allergies, a single administration of the drug at a dose of 1-2 ml is prescribed. Further treatment is carried out with other medicines.
• In the treatment of pollinosis, rhinitis, a treatment regimen is chosen in which Diprospan is administered every day, 1-2 ml, for 5 to 10 days.

It is strictly forbidden to increase the frequency of administration of a suspension of glucocorticosteroid without the permission of a doctor - synthetic hormones have quite pronounced side reactions and failure to follow the scheme of their administration leads to complications.

How harmful is the drug

With the correct selection of the dose and a short course of treatment, adverse reactions almost never develop.

Most often, unwanted changes in the body occur with prolonged use and they are associated with the fact that betamethasone inhibits the function of the pituitary gland.

Possible side effects:

At the injection site of Diprospan, the occurrence of foci of hyper or hypopigmentation, atrophy of subcutaneous fat and skin, abscesses are not excluded.

With intra-articular injections of the drug, the likelihood of developing sepsis increases, damage to the tendons, nerves, cartilage, and hemorrhages into the joint cavity are not excluded.

Frequent injections can cause microcrystalline arthritis.

Interaction with other drugs

When prescribing Diprospan for a long period, it is necessary to consider what other drugs the patient is taking:

• Azathioprine, when used simultaneously with corticosteroids, increases the risk of developing cataracts and myopathy.
• Ibuprofen, anabolic steroids, delagil increase the likelihood of developing all side effects from Diprospan.
• The combination of Isoniazid and Diprospan leads to a decrease in concentration, the appearance of mental abnormalities is not excluded.
• Medicines with an antiepileptic effect reduce the concentration of betamethasone.
• Simultaneous treatment with Diprospan and non-steroidal anti-inflammatory drugs increases the risk of ulcerative lesions of the digestive tract.
• Estrogens (which include contraceptives) enhance the therapeutic effect of betamethasone.
• Antidepressants, when used simultaneously with a synthetic hormone, can cause increased intraocular pressure.
• Simultaneous treatment with Diprospan and antibiotics reduces the risk of developing allergies from taking antibiotic therapy.

Special instructions for use

Diprospan suspension is not intended for intravenous or subcutaneous administration. Injection into a vein and under the skin leads to a host of complications, some of which may require immediate resuscitation.

When prescribing and staging Diprospan, the following recommendations should be observed:

• Parenteral administration of a corticosteroid can cause anaphylactoid reactions. Therefore, the patient should find out the entire allergic history and observe all precautions at the time of the injection.
• With a tendency to psychosis and emotional instability, the development of mental disorders is possible.
• Patients treated with corticosteroids are not vaccinated against smallpox. Also, against the background of hormone treatment, immunization with any drugs is temporarily prohibited due to the fact that this can cause a low immune response and neurological disorders.
• In the treatment of corticosteroids, it should be borne in mind that these drugs smooth out the signs of infections and reduce the body's resistance.
• When the drug is injected into the joint, infectious arthritis should be excluded, since against the background of this disease, the corticosteroid can cause destruction of the joint tissue.
• When the drug is injected into the joint, the patient needs to reduce the load on the affected area.
• An ophthalmological examination is necessary for those patients who are treated with Diprospan for more than 6 months.
• If, during the treatment of GCS, blood pressure rises, signs of fluid retention are noted, then the patient is recommended a certain diet therapy with a decrease in the amount of salt.
• Rapid withdrawal of a corticosteroid after long-term treatment may cause secondary adrenal insufficiency. Careful adherence to the cancellation scheme helps to avoid this.
• With long-term treatment, it is advisable to replace parenteral administration with oral forms of glucocorticosteroids.

Diprospan and alcohol

Glucocorticosteroids are those drugs that increase the body's tolerance to ethyl alcohol. This reduces the toxic effect of alcohol, but its concentration remains the same.

This property of the drug is used in the treatment of patients with acute ethyl alcohol poisoning.

Children and during pregnancy

Is it possible to use the drug for administration to children, during pregnancy and lactation.

Studies of the safety of Diprospan on the body of a pregnant woman have not been conducted, in connection with this, the decision to prescribe GCS during the period of bearing a child should be made only taking into account the possible negative impact on the fetus.

The corticosteroid crosses the placenta, so newborns of those mothers who received corticosteroids should be monitored for a long time. This helps to identify early violations.

During lactation, GCS should be prescribed only when breastfeeding is discontinued. If pregnancy occurred when a woman was taking Diprospan, then it should be canceled gradually.

Long-term treatment with Diprospan in children can cause a delay in sexual development and growth of the child. As such, they must be constantly monitored.

During the period of treatment with corticosteroids, it is necessary to ensure that children do not come into contact with patients with chickenpox and measles.

Also at this time, vaccination is prohibited - glucocorticosteroids do not allow antibodies to form, so the vaccine is ineffective.

drug analogues.

The absolute analogue of Diprospan is the drug Flosteron.

Conditions of storage and dispensing in pharmacies.

The drug should be sold in pharmacies only on presentation of a prescription from a doctor. It is necessary to store ampoules where the temperature is not higher than 25 degrees.

The cost of one ampoule of Diprospan starts from 177 to 240 rubles.

The composition of the drug injections includes betamethasone dipropionate , equivalent to pure betamethasone in the amount of 2 mg and 5 mg.

Additional components are: sodium edetate, methyl parahydroxybenzoate, injection water, sodium phosphate, benzyl alcohol, nipagin, sodium chloride, polysorbate 80, nipazole, sodium carboxymethylcellulose, polyethylene glycol 4000, propyl parahydroxybenzoate and trilon B.

Release form

Suspension for injection in ampoules or disposable syringes.

pharmachologic effect

Glucocorticosteroid . The active component is . The mechanism of action is based on the inhibition of the release processes interleukins 1 and 2, gamma from macrophages and lymphocytes. The drug has anti-allergic, anti-shock, anti-inflammatory, immunosuppressive, anti-toxic and desensitizing effects. Diprospan does not affect the rate of circulating beta-endorphin, but inhibits the release of beta-lipotropin and ACTH from.

Hormonal or not? The drug is hormonal.

Pharmacodynamics and pharmacokinetics

The drug is able to inhibit the secretion of FSH and TSH. The drug Diprospan stimulates the production, increases the number erythrocytes , reduces the number of eosinophils and lymphocytes, increases the excitability of the central nervous system. When the active component interacts with specific, cytoplasmic receptors, a complex is formed that is able to penetrate into the cell, into its nucleus and stimulate the process of mRNA synthesis (it is this that induces the formation of lipocortin and other proteins that mediate cellular effects). Licortin inhibits the release process arachidonic acid , inhibits phospholipase A2, inhibits the process of synthesizing leukotrienes, and endoperoxides, which are actively involved in inflammatory processes, in the formation of an allergic response. Under the action of diprospan, the amount of protein in the blood plasma decreases due to globulins , but at the same time, the albumin / globulin ratio increases, the production of albumins in the tissues of the kidneys and liver increases, and protein catabolism in muscle tissues increases.

The effect of the drug Diprospan on lipid metabolism: redistribution of fat (fat deposits are localized mainly in the abdomen, face, shoulder girdle), increased synthesis triglycerides and higher fatty acids, the formation of hypercholesterolemia. The effect of the drug on carbohydrate metabolism: activation of phosphoenolpyruvate carboxylase, increased synthesis of aminotransferases (leads to activation of gluconeogenesis), increased absorption of carbohydrates from the digestive tract, increased activity of glucose-6-phosphatase (increases the flow of glucose into the blood from the liver).

The effect of the drug on water-electrolyte exchange : stimulation of the excretion of potassium ions, retention of water and sodium ions in the body, "washing out" of calcium ions from the skeletal system, reduced absorption of calcium ions from the digestive tract, increased excretion of calcium ions by the renal system. The anti-inflammatory effect is achieved by inhibiting the release of inflammatory mediators by eosinophils; by reducing the number mast cells (they produce hyaluronic acid), inducing the formation of lipocortin, by stabilizing organelle membranes (lysosomal organelles are of particular importance), stabilizing cell membranes, by reducing capillary permeability.

The anti-allergic effect is achieved by suppressing the secretion and synthesis of allergy mediators, inhibiting the process of antibody formation, by changing the body's immune response, reducing the sensitivity of effect cells to allergic mediators, by inhibiting the release of biologically active substances and histamine from mast cells, T-lymphocytes, B -lymphocytes.

In COPD, the drug Diprospan prevents and inhibits the development of swelling of the mucous membranes, slows down the course of inflammatory processes, slows down the deposition of circulating immune complexes in the mucous membranes of the bronchial tree, reduces the rate of eosinophilic infiltration of the submucosal layer in the epithelium of the bronchial tree. The drug inhibits the process of desquamation and erosion of the mucous membranes. By reducing production and inhibiting the production of mucus, its viscosity decreases. Antitoxic and antishock effects are achieved by increasing blood pressure by vasoconstriction, increasing the level of catecholamines circulating in the blood and restoring the sensitivity of adrenoreceptors to them. The effect is achieved by activating liver enzymes that are involved in xenobiotics and endobiotics, by reducing the permeability of vascular walls, and also due to membrane-protective action .

The immunosuppressive effect is provided by a decrease in the release rate of cytokines (interferon gamma, interleukin-1,2) from macrophages and lymphocytes. The drug inhibits the secretion and synthesis of ACTH, secondarily inhibits the process of synthesizing endogenous glucocorticosteroids. Under the action of the drug, the likelihood of scar formation decreases due to the inhibition of the rate of connective tissue reactions during inflammation. You can buy Diprospan in the form of suspensions and injections.

Indications for use Diprospan

What is Diprospan medicine for?

Indications for the use of Diprospan injections are as follows: the drug is prescribed for shock (toxic, cardiogenic, surgical, burn, traumatic), with anaphylactoid reactions , transfusion shock, allergic reactions, status asthmaticus, in severe cases, with cerebral edema (after radiation therapy, after surgical interventions), with acute adrenal insufficiency. Also indications for use are: systemic connective tissue pathology (, SLE), poisoning with caustic fluids (prevention of the formation of cicatricial constrictions and a decrease in the severity of inflammation), hepatic coma , acute hepatitis, thyrotoxic crisis . Blockades with Diprospan are often put.

Contraindications for Diprospan

Instructions for use Diprospan does not recommend prescribing the drug intraarticularly with pathological bleeding, with periarticular infections , with septic and infectious lesions of the joint, with a pronounced form of periarticular, with common infectious diseases, with intra-articular fracture of the bone, after arthroplasty , with severe bone destruction, with a "dry" joint, with no signs of synovitis, with joint instability after arthritis, with aseptic necrosis the epiphyses of the bones that form the joint.

In severe infectious diseases, the drug can be prescribed only with the simultaneous conduct of specific therapy. The drug is not used for diseases of the digestive tract:, peptic ulcer of the digestive system, esophagitis , intestinal anastomosis, peptic ulcer, ulcerative . Betamethasone is not prescribed in the post-vaccination period, with after the vaccine . The drug is contraindicated for use in , , with recently transferred, with decompensated form of CHF, with Itsenko-Cushing's disease , at , at nephrourolithiasis , severe pathology of the liver and kidneys, with obesity, myasthenia gravis, systemic osteoporosis, with hypoalbuminemia, with acute psychosis , (closed and open-angle forms), during pregnancy, during breastfeeding.

A contraindication to Diprospan is hypersensitivity to betamethasone .

Side effects of Diprospan

Side effects from the use of the drug Diprospan depend on the possibility of compliance with the circadian treatment regimen, dosage and duration of the drug. Endocrine system: manifestation of latent diabetes mellitus, "steroidal" diabetes mellitus, delayed sexual development in children, Itsenko-Cushing's syndrome (myasthenia gravis, amenorrhea, striae, hirsutism , obesity of the pituitary type, moon face, increased , hirsutism). Digestive tract: loss of appetite, "steroid" ulcer of the gastrointestinal system, vomiting, nausea, increased levels of enzymes in the liver system. The cardiovascular system: the formation of thrombosis, hypercoagulation , increased severity of CHF, bradycardia,. Nervous system: convulsions, headaches, cerebellar pseudotumor, delirium, vertigo, dizziness, insomnia, nervousness, increased levels, depression.

Description of the side effects of Diprospan on sense organs: posterior subcapsular, sudden loss of vision, trophic changes in the cornea, increased intraocular pressure. Metabolism: increased sweating, increased protein breakdown, negative nitrogen balance, weight gain, hypocalcemia, increased excretion of calcium ions from the body. Musculoskeletal system: osteoporosis, atrophy and loss of muscle mass, "steroid" myopathy , rupture of muscle tendons, slowing down the processes of ossification and growth of the skeletal system in children as a result of premature closure of the epiphyseal growth zones. Skin covers: tendency to develop candidiasis and pyoderma, steroid acne, pigmentation disorders, thinning of the skin, formation ecchymosis and petechiae, slowing wound healing. It is possible to form leukocyturia . With intravenous administration, convulsions, "tides" of blood flow to the face, arrhythmias are possible.

Diprospan injections, instructions for use

Dosing regimen betamethasone and the method of administration is selected depending on the nature and severity of the underlying disease.

According to the instructions for use of Diprospan, the infusion solution is diluted in a 0.9% sodium chloride solution or in a dextrose solution before administration. You can enter only freshly prepared solution. Diprospan injections are done deep intramuscularly at a dose of 4-8 mg in severe pathology.

Periarticular and intra-articular injections of the drug are carried out in very large joints at a dose of 4-8 mg. An injection into the joint directly allows you to achieve a more effective effect on the inflammatory process in it. Injections are also made in the knee, however, it is better to entrust such injections to doctors, as this is a complex process.

In case of skin diseases, the drug is injected into the wound or intradermally at a dose of 0.2 ml / square centimeter.

What is better Kenalog or Diprospan?

Both drugs belong to the same pharmaceutical group glucocorticosteroid drugs . However, based on research, Diprospan is considered more effective than Kenalog, while the price of the former is slightly higher.

Alcohol compatibility

It is better to stop taking alcohol, as its use increases the side effects of the drug.