Glucocorticoid therapy today: effectiveness and safety

Diprospan is a glucocorticosteroid that is prescribed to patients in the older age category. It is prescribed for children in exceptional cases and under the strict supervision of a specialist. The drug is available with a doctor's prescription. The product is available in the form of a solution intended for intramuscular administration.

Prescribed for the treatment of pathologies and disorders in which GCS therapy helps achieve an adequate clinical effect. Refers to hormonal drugs. It is recommended to use the medication according to the instructions without exceeding the specified dosage. If it is not possible to purchase this remedy, then the specialist will prescribe analogues of Diprospan in ointment, tablets or injections.

pharmachologic effect

Manufacturer: MSD PHARMACEUTICALS, Russia
Release form: solution for injection

Active ingredient: betamethasone

Diprospan is a fast-acting glucocorticosteroid that contains betamethasone. It has anti-inflammatory, antiallergic and immunosuppressive properties. It has a pronounced effect on different types of metabolism. The drug is metabolized in the liver and excreted by the kidneys. Therefore, patients with disorders of these organs should use the drug with caution.

What are the differences between drugs based on sodium hyaluronate and synthetic ones?

Means for restoring synovial fluid have appeared relatively recently, and hyaluronic acid, or sodium hyaluronate, its sodium salt, was chosen as the first active ingredient for replacement. It is a natural polysaccharide, a natural component of the connective tissues of the human body. There is especially a lot of hyaluronic acid in synovial fluid.

Sodium hyaluronate molecules have high hydrophilic properties - each of them attracts up to a thousand water molecules. Once inside the joint space, they restore the visco-elastic and shock-absorbing properties of the fluid.

Somewhat later, orthopedic traumatologists had access to synthetic polymer preparations, for example Noltrex, which in many respects surpassed those based on sodium hyaluronate. Noltrex is characterized by absolute biological compatibility with human tissues, therefore it does not cause allergic reactions or rejection.

The drug fills the joint space, enlarges it and normalizes the biomechanics of the joint by restoring synovial fluid. The interval for administering injections of the synthetic agent is increased due to its prolonged action - from 9 months to two years.

To treat arthrosis of the knee joint, one to four Noltrex injections per course is sufficient.

Indications for use of Diprospan

Diprospan is prescribed to patients for various disorders and pathologies:

• musculoskeletal system and soft tissues;
• for allergic pathologies;
• for dermatological pathologies and systemic connective tissue diseases;
• hemoblastoses;
• with primary and secondary insufficiency of the adrenal cortex;
• pathologies and conditions that require the use of systemic glucocorticosteroids for treatment.

Attention! The drug has a significant list of contraindications and side effects, so you should carefully read this information before starting the course. It is also necessary to remember the fact that it is prohibited to combine Diprospan with alcohol.

Diprospan - instructions for use

According to the instructions for use, Diprospan is intended for intramuscular, intraarticular, periarticular, antrabursal, intradermal, interstitial and intralesional administration. The injection method is selected by a specialist depending on the diagnosis and the condition of the patient’s body. The dosage regimen is also set individually.

The initial dosage is 1–2 ml. Repeated injections are given as needed. If no improvement is observed after the completed course, then another therapy is prescribed. For long-term treatment, it is recommended to gradually reduce the dose and discontinue it. After this, the patient should be under the supervision of a specialist.

Diprospan

Shake before use.

The dosage regimen is set individually, depending on the indications, severity of the disease and the patient’s clinical response to treatment.

Dosage

The dose should be minimal and the period of use should be as short as possible.

The initial dose should be adjusted to obtain a satisfactory clinical effect. If a satisfactory clinical effect is not observed within a certain period of time, treatment should be discontinued by progressive dose reduction and other appropriate therapy should be instituted.

If the response is favorable, the appropriate dose to be followed should be determined, gradually reducing the initial dose at acceptable intervals until the minimum dose with an appropriate clinical response is achieved.

Mode of application

Diprospan suspension is not intended for intravenous or subcutaneous administration.

Systemic application

When used systemically, in most cases, treatment begins with the administration of 1-2 ml of the drug and is repeated if necessary. Dosage and frequency of administration depend on the severity of the patient's condition and response to treatment. The drug is injected deep intramuscularly into the buttock:

• In severe conditions (systemic lupus erythematosus and status asthmaticus) that require emergency measures, the initial dose of the drug may be 2 ml.
• For various dermatological diseases, as a rule, 1 ml of the drug administered intramuscularly is sufficient; administration of the drug can be repeated, depending on the response to treatment.
• For diseases of the respiratory system, symptom relief is achieved within a few hours after injection of the drug Diprospan. For bronchial asthma, hay fever, allergic bronchitis and allergic rhinitis, a significant improvement in the condition is achieved after administration of 1-2 ml of the drug.
• For acute and chronic bursitis, the dose for intramuscular administration is 1-2 ml of the drug. If necessary, carry out several repeated injections.

Local application

The simultaneous use of a local anesthetic is necessary only in rare cases (the injection is practically painless). If simultaneous administration of an anesthetic is desired, Diprospan can be mixed (in a syringe rather than in a vial) with a 1% or 2% solution of lidocaine hydrochloride or procaine hydrochloride or similar local anesthetics using paraben-free dosage forms. It is not allowed to use anesthetics containing methylparaben, propylparaben, phenol and other similar substances. When using an anesthetic in combination with the drug Diprospan, first draw the required dose of the drug into a syringe from the bottle, then draw the required amount of local anesthetic into the same syringe and shake the syringe for a short period of time.

For acute bursitis (subdeltoid, subscapular, ulnar and anterior patella), injection of 1-2 ml of Diprospan into the synovial bursa relieves pain and completely restores mobility in a few hours.

Treatment of chronic bursitis is carried out with smaller doses of the drug after relief of acute symptoms of the disease.

In acute tenosynovitis, tendinitis and peritendinitis, one injection of the drug Diprospan can alleviate the patient’s condition; in chronic cases, repeated administration of the drug may be required depending on the patient’s condition.

For rheumatoid arthritis and osteoarthritis, intra-articular administration of the drug in a dose of 0.5-2 ml can reduce pain, tenderness and joint stiffness within 2-4 hours after administration. The duration of the therapeutic effect of the drug varies significantly and can be 4 or more weeks. Intra-articular administration of the drug Diprospan is well tolerated by the joint and periarticular tissues.

Recommended doses of the drug when administered into large joints (for example, knee, hip) are 1-2 ml; in the middle (for example, elbow) – 0.5-1 ml; in small ones (for example, carpal) - 0.25-0.5 ml.

In the case of dermatological diseases, intradermal injection of the drug directly into the lesion is effective. The response of some lesions that are not directly treated may be due to a small systemic effect of the drug. Inject 0.2 ml/cm2 of the drug Diprospan into the skin (not under the skin) using a tuberculin syringe and a 26 G needle. The total amount of the drug injected into the injection site should not exceed 1 ml.

Leg diseases sensitive to corticosteroids. You can overcome bursitis under the callus with two consecutive injections of 0.25 ml each. Conditions such as bunion toe (bending contracture of the big toe), bunion varus (inward deviation of the fifth toe), and acute gouty arthritis can provide relief very quickly. For most injections in the foot, a tuberculin syringe with a 25 G needle 1.9 cm long is suitable.

Recommended doses of the drug Diprospan (with intervals between injections of approximately 1 week): for bursitis under the callus - 0.25-0.5 ml; for heel spurs – 0.5 ml; for stiffness of the big toe – 0.5 ml; for varus toes – 0.5 ml; for synovial cyst – 0.25-0.5 ml; for Morton's metatarsalgia - 0.25-0.5 ml; for tenosynovitis – 0.5 ml; for inflammation of the cuboid bone - 0.5 ml; for acute gouty arthritis – 0.5-1 ml.

Diprospan's analogs

Analogs of Diprospan presented on pharmacy counters in ampoules for allergies and other pathologies are high-quality substitutes for medications. Before purchasing, it is recommended to consult with a specialist who can correctly adjust the course of therapy and dosage. All products are prescription and differ in age restrictions, significant lists of contraindications and side effects.

List of Diprospan analogues and substitutes with prices

Attention! The cost of analogues of Diprospan in injection ampoules, tablets and cream depends on many factors that are recommended to be taken into account before purchasing. The price is adjusted depending on the packaging, release form, manufacturer, and quantity of the active ingredient. Most substitutes differ in composition and list of indications.

Glucocorticoid therapy today: effectiveness and safety

In what cases is glucocorticoid therapy used? What types of hormone therapy are used?

The history of the use of glucocorticosteroids (GCS) in clinical practice goes back a little more than half a century, although the “antirheumatic substance X” has been known since the 20s of the twentieth century. A detailed study of the clinical significance of adrenal hormones, begun by Edward Calvin Kendall and Tadeus Reichstein, was continued only after Philip Hench in the late 40s drew attention to the improvement of rheumatoid arthritis in jaundice and pregnancy. In 1950, all three were awarded the Nobel Prize for "...discoveries concerning the hormones of the adrenal cortex, their structure and biological effects."

Currently, GCS includes both natural hormones of the adrenal cortex with a predominantly glucocorticoid function - cortisone and hydrocortisone (cortisol), and their synthesized analogues - prednisone, prednisolone, methylprednisolone, etc., including halogenated (fluorinated) derivatives - triamcinolone, dexamethasone, betamethasone etc. A wide range of physiological and pharmacological effects of glucocorticoids (adaptogenic, anti-inflammatory, analgesic and antipyretic, nonspecific membrane-stabilizing and anti-edematous, antiallergic and immunosuppressive, hematological, hemodynamic and anti-shock, antitoxic, antiemetic, etc.) makes these drugs almost universal medicines , and today it is difficult to find a pathological condition in which they would not be indicated at one or another stage of development. Among the indications, first of all, we can highlight the so-called rheumatic diseases, kidney diseases, blood diseases, allergic diseases, transplantations, urgent conditions.

Depending on the purpose, there are three options for GCS therapy; Moreover, any of them can be either urgent or planned.

• Replacement therapy carried out for adrenal insufficiency should imitate both the basal secretion of the adrenal glands and its circadian rhythm, and its increase under stress; in this case, the doses used are close to the daily secretion of the hormone. Here it is preferable to use a natural hormone - hydrocortisone (solu cortef), which has glucocorticoid and certain mineralocorticoid activity, in a dose of 20-25 to 30-37.5 mg per day. If there is a slight loss of mineralocorticoid function (small loss of salt), it alone is sufficient. In case of severe salt loss or when using equivalent doses of prednisolone (from 5 to 7.5 mg), which may be more effective, a corticosteroid with pronounced mineral and some glucocorticosteroid activity is added - fludrocortisone (Cortineff, Cortef). In practice, those minimum doses are used that ensure good health and performance, normal levels of blood pressure and blood electrolytes. During stress, the dose of hydrocortisone can reach 250-300 mg per day. To simulate the rhythm of secretion, 2/3 doses are prescribed at 8 o’clock and 1/3 at 4 pm.
• Blocking (suppressive) therapy uses an effect that is most often considered as a side effect - blockade of the hypothalamic-pituitary-adrenal cortex (HPA) axis. Thus, in the treatment of adrenogenital syndrome, externally administered corticosteroids, in addition to their replacement function, also perform a blocking function in relation to the hypersecretion of ACTH and androgens. GCS also suppress the secretion of TSH, which, along with a decrease in the level of thyroid binding globulin and inhibition of the conversion of T4 to T3, reduces thyroid activity and is used in the treatment of thyrotoxic crises. The HPA axis is most actively suppressed by natural corticosteroids or drugs with a long tissue half-life (fluorinated hormones - dexamethasone, betamethasone); in this case, both physiological and higher (pharmacodynamic) doses are used.
• Most indications for pharmacodynamic therapy are based on one feature of GCS - a unique combination of anti-inflammatory and immunosuppressive effects. This combination underlies the traditional idea that so-called rheumatic diseases, where inflammation is a consequence of an immunopathological process, serve as almost an absolute indication for its implementation.

In contrast to planned therapy, the use of GCS in urgent situations is, as a rule, symptomatic, less often pathogenetic in nature and does not replace, but complements other treatment methods. As part of emergency therapy, GCS are used for acute adrenal insufficiency, thyrotoxic crisis, allergic diseases (serum sickness, anaphylactic shock, bronchial asthma, urticaria, Quincke's edema), liver diseases (hepatocellular failure), neurological diseases (tuberculous and bacterial meningitis, some forms of cerebral edema), various types of shock (except cardiogenic).

Due to the abundance of side effects, GCS therapy is aimed mainly at achieving maximum effect when prescribing minimal doses, the value of which is determined by the disease and does not depend on body weight and age; the dose is adjusted according to individual response. Two fundamentally different schemes for prescribing GCS have been adopted:

• starting with the lowest possible dose, increase it if the effect is insufficient to the optimal one; in this case, there is a danger of increasing the duration of treatment, loss of effectiveness and development of side effects;
• starting from the maximum daily doses, they are reduced after obtaining a clinical effect; in this case, a rapid effect is achieved, the duration of treatment and the total dose of GCS are reduced.

Depending on the daily dose (in terms of prednisolone) and the duration of use of GCS, it is customary to distinguish several types of therapy with different indications:

• in immediately life-threatening situations, intensive therapy is prescribed with ultra-high (up to 500-4000 mg intravenously) or medium/high (25-150 mg orally) doses (oral prednisolone dose is equivalent to approximately 1/6 intravenous) - such therapy can be carried out for several days and does not require gradual withdrawal;
• in case of severe exacerbations or in the chronic course of severe diseases (leukemia, some collagenoses, hemolytic anemia, thrombocytopenia), limited therapy is carried out, limited to weeks when using high doses orally (80–200 mg) and weeks or months when using medium doses (25–60 mg); the maximum doses prescribed at the beginning are gradually reduced as the condition improves, followed by a transition to maintenance doses;
• for a number of chronic diseases (bronchial asthma, rheumatoid arthritis), long-term therapy with low doses (up to 10 mg) is carried out, but doses less than 5 mg are most likely only replacement and provide a clinical effect only with atrophy of the adrenal cortex induced by long-term glucocorticoid therapy.

The result of GCS therapy depends not only on the dose, but also on the dosage regimen. The most promising are intermittent regimens of use, when the drug is not taken every day by increasing the daily dose. Intravenous pulse therapy with maximum doses seems to be the most effective, but it also turns out to be the most unsafe. The “mini-pulse” mode should be considered significantly safer, which, however, is inferior in effectiveness to pulse therapy. Prescribing a moderate/high dose, divided into several doses, is equally effective; but in terms of safety, this mode is inferior to “mini-pulse”. Next in effectiveness are the alternating regimen (every other day, double the daily dose followed by a gradual decrease) and the regimen of a daily single dose of moderate/high dose; the first of them is safer and according to this criterion is closer to a “mini-pulse”. The safest therapy is low doses, which, however, provides only a maintenance effect. For all daily regimens, GCS should be administered in the early morning hours (between 6 and 8 a.m.); if a one-time dose is not possible due to the size of the dose, 2/3 of the dose is prescribed at 8 o’clock and 1/3 in the afternoon (around noon). With any dosage regimen, once the planned effect is achieved, the dose is gradually reduced to a maintenance dose or the drug is discontinued altogether.

An important problem in GCS therapy is the choice of drug. The pharmacokinetic and pharmacodynamic properties of GCS, including their side effects, vary significantly among individual drugs (Table 1, Table 2). Taking the severity of the various effects of hydrocortisone as one, it is possible to obtain quantitative characteristics of the activity of individual drugs. When comparing GCS, the anti-inflammatory effect of these drugs is most often analyzed, according to which the equivalent oral dose is calculated, decreasing as the anti-inflammatory activity increases. Its increase, parallel to the increase in the duration of action of individual corticosteroids, is accompanied by a decrease in mineralocorticoid activity, which can generally be neglected in methylprednisolone (solu-medrol) and fluorinated compounds.

The ratio of therapeutic and side effects suggests that currently the drug of choice for long-term and lifelong therapy is methylprednisolone (solu-medrol). Currently, solu-medrol is widely used in the treatment of autoimmune diseases, in transplantation and intensive care. The variety of release forms allows the drug to be used in all age categories in optimal dosages.

The second most effective drug remains in most cases prednisolone. In many urgent situations, fluorinated compounds have certain advantages: dexamethasone (Dexazone, Dexona) and betamethasone (Celeston, Diprospan). However, in the case of emergency therapy, in which the anti-inflammatory effect does not play a leading role, a comparative assessment of the effectiveness and safety of various drugs is very difficult for at least two reasons:

• The effectiveness and safety of different drugs can only be compared on the basis of their equivalent doses. Meanwhile, if there are relative activity characteristics for various side effects of individual GCS, of all the therapeutic effects only the anti-inflammatory effect is compared, according to which the equivalent dose is calculated;
• There is no clear data on the ratio of doses for oral and parenteral use of specific drugs, even when it comes to the anti-inflammatory effect, not to mention other therapeutic or side properties.

In connection with the above difficulties, a conventional equivalent unit (CUE) was proposed, which is taken to be the minimum effective dose. It has been shown that the maximum daily effective doses of fluorinated corticosteroids (dexamethasone and betamethasone), expressed in UEE, are five times less than those of non-halogenated drugs. This ensures not only higher efficiency and safety of this group of drugs prescribed in certain situations, but also their pharmacoeconomic advantages.

No matter how carefully the choice of drug, dosage regimen and type of therapy is made, it is not possible to completely prevent the development of certain side effects when using GCS. The nature of adverse reactions may depend on a number of reasons (Table 3).

The likelihood and severity of suppression of the HPA axis with the development of first functional failure and later atrophy of the adrenal cortex are determined by the dose and duration of therapy. Discontinuation of glucocorticoid therapy is almost always associated with the risk of developing acute adrenal insufficiency.

A common side effect of GCS is infectious complications, which in this case occur atypically, which is associated with the anti-inflammatory, analgesic and antipyretic activity of these drugs. This makes timely diagnosis difficult and requires a number of preventive measures. Due to the tendency to generalization, protracted course, tissue decay and resistance to specific therapy, these complications become especially dangerous. Equally insidious are “steroid ulcers”, characterized by an asymptomatic course and a tendency to bleeding and perforation. Meanwhile, gastric discomfort, nausea, and other dyspeptic complaints while taking GCS are often not associated with damage to the mucous membrane. Exogenous Cushing's syndrome as a complication of GCS therapy does not always occur, however, individual disorders of metabolism, hormonal regulation and the activity of certain systems develop in almost all cases of glucocorticoid therapy.

It is with regret that we note that the statement of E.M. Tareev, who called GCS therapy difficult, complex and dangerous, is still true. As Tareev wrote, such therapy is much easier to start than to stop. However, a responsible approach to treatment can significantly improve its safety. This is achieved through strict consideration of contraindications (among which there are no absolute ones) and side effects of GCS (assessment of the “expected effect/estimated risk” ratio), as well as conducting “cover therapy” in risk groups (antibacterial drugs for chronic foci of infection, dose adjustment of hypoglycemic drugs or switching to insulin for diabetes, etc.). A special place in the long-term use of GCS is occupied by metabolic therapy, which is carried out in order to prevent and correct disturbances of electrolyte metabolism and catabolic processes primarily in the myocardium (dystrophy) and bone tissue (osteoporosis). However, the most reliable way to ensure the safety of GCS therapy remains compliance with the basic principle of clinical pharmacology and pharmacotherapy—prescribing treatment according to strict indications.

V. V. Gorodetsky, Candidate of Medical Sciences A. V. Topolyansky, Candidate of Medical Sciences

Note!

• Currently, GCS includes both natural hormones of the adrenal cortex with a predominantly glucocorticoid function, and their synthesized analogues, including halogenated (fluorinated) derivatives.
• Depending on the purpose, there are three options for GCS therapy: replacement, blocking and pharmacodynamic; Moreover, any of them can be either urgent or planned.
• Due to the abundance of side effects, GCS therapy is aimed at achieving maximum effect with minimal doses, the magnitude of which is determined by the disease and does not depend on body weight and age; Dose adjustment is carried out in accordance with individual response.
• The result of GCS therapy depends not only on the dose, but also on the dosage regimen. The most promising are intermittent regimens of use, when the drug is not taken every day by increasing the daily dose.
• No matter how carefully the choice of drug, dosage regimen and type of therapy is made, it is not possible to completely prevent the development of certain side effects when using GCS.

Diprospan or Kenalog

Manufacturer: KRKA, Italy
Release form: injection solution, tablets

Active ingredient: triamcinolone

Kenalog is a prescription analogue of Diprospan in injections for arthritis, allergies and other pathologies of the body. Refers to glucocorticosteroids and hormonal agents, which suppress the function of leukocytes and tissue macrophages. Can be prescribed to children, but only under the clear guidance of a specialist. In high doses, it increases the excitability of brain tissue and lowers the threshold of convulsive readiness. It has anti-inflammatory, anti-allergic, anti-exudative properties. Kenalog is prescribed to patients for the following disorders and pathologies:

• bronchial asthma, chronic bronchitis, pamphigoid, psoriasis, dermatitis;
• chronic inflammatory pathologies of joint tissue;
• eczema, neurodermatitis, various dermatitis;
• allergic and inflammatory pathologies of the skin of non-microbial etiology.

Diprospan or Flosteron

Manufacturer: KRKA, Slovenia
Release form: injection solution

Active ingredient: betamethasone disodium phosphate + betamethasone dipropionate

Flosteron is a foreign prescription analogue of Diprospan, which is a fast-acting glucocorticosteroid with a similar composition. It has anti-inflammatory, antiallergic, desensitizing, antishock, antitoxic and immunosuppressive effects. The drug is able to increase the excitability of the central nervous system, reduce the production of lymphocytes and eosinophils, and increase red blood cells.

Diprospan substitute Flosteron takes part in protein, lipid, carbohydrate, water and electrolyte metabolism. The product is intended for local and systemic treatment. Helps get rid of joint pathologies, skin pathologies, and allergic diseases.

Review of some liquid prostheses based on sodium hyaluronate

1. Gialgan Phidias

One of the most affordable products with a very low molecular weight, which is an aqueous solution of hyaluronic acid. The fluid is quickly distributed in the joint capsule, but is also quickly absorbed into the ligaments and adjacent muscles. A local reaction is possible within 24 hours after administration.

Some liquid hyaluronic acid-based prostheses lead to swelling and redness of the skin

2. Duralan

A product with a low molecular weight is recommended for use during remission - to maintain joints. In large ones, a dosage of 3 ml is administered, in small ones - 1 ml, in courses with an interval of six months.

3. Fermatron

The drug is indicated for moderate forms of osteoarthritis and is available in sealed glass syringes with a volume of 2 ml. The medicine is not patented, so its pharmacokinetics have not been studied enough. There are virtually no clinical indications regarding interactions with other medications. The drug, however, is approved for use during pregnancy and lactation, although many doctors prohibit its administration during pregnancy, as well as in patients under 18 years of age.

The maximum period of action of Fermatron is up to 6 months

4. Adantom

Produced by a Japanese pharmaceutical company in syringes, it contains 25 milligrams of the active substance - sodium hyaluron. Before administration, the viscoelastic agent is warmed and injected using a 22G needle.

5. Sinokrom

A special feature of this medication is a specialized lock on the disposable syringe, which prevents accidental opening of the container. The product is administered in a course of six injections every one week. Manufacturer: Austrian pharmaceutical company.

6. Ostenil

This Swiss development is also based on hyaluronic acid. The drug must be stored in a cool, dry place, and before administration, make sure the syringe is tight. Hyaluronate and mannitol in the product protect joints from free radicals, which somewhat prolongs the duration of the medication. The course involves at least 3-5 injections. After each of them, a burning sensation is possible, which is eliminated with ice.

7. Hyastat

One of the Russian developments, produced in a sterile disposable syringe with a capacity of 20 milligrams. Before administration, the patient is always given an x-ray of the joint, and general clinical blood and urine tests are taken to exclude inflammatory processes in the body. If the outcome is positive, the course of treatment is repeated after a year.

Giastat is administered in courses of 3-5 injections at intervals of several months.

8. Go On

Another product based on sodium hyaluronate, which demonstrates stable positive dynamics in the treatment of arthrosis and osteoarthritis. Used to replenish synovial fluid deficiency.

9. Synvisc

Biological analogue of hyaluronic acid with high molecular weight – 6,000,000 Daltons. For the treatment of arthrosis of the knee joint, 3 injections are recommended at intervals of a week. For diseases of the hip, shoulder or ankle joint, one injection is performed, and to achieve a better effect, a second one is performed 1-3 months later. The effect, according to clinical indications, is on average up to 26 weeks, with a maximum of 52 weeks in the treatment of knee osteoarthritis.

Synvisc – a drug with maximum molecular weight – lasts from 6 to 12 months

Diprospan or Dexamethasone

Manufacturer: KRKA, d.d., Novo Mesto
Release form: tablets, injection solution, eye drops

Active ingredient: dexamethasone

Dexamethasone is a cheaper prescription analogue of Diprospan injections, which contains the active ingredient of the same name. Refers to glucocorticosteroids, which suppresses the function of leukocytes and tissue macrophages. The product can suppress collagen formation. It is prescribed to patients taking into account their age category. The drug has anti-inflammatory, antiallergic, immunosuppressive and antiproliferative properties.

In comparison with the Diprospan analogue in tablets, Dexamethasone is prescribed for the following disorders and pathologies:

• shock of various origins;
• swelling of brain tissue;
• for asthma and severe allergic reactions;
• for anemia, thrombocytopenia, leukemia;
• in case of severe infectious pathologies and acute adrenal insufficiency;
• for joint pathologies.

It is better to use one of the presented drugs for allergies and for joints, when blocking the inflammatory process, but taking into account existing contraindications and the body’s reaction.

Contraindications

Diprospan should not be administered into an unstable joint if the ligamentous apparatus is damaged, the menisci or muscles are damaged, since this drug delays the maturation of the connective tissue that makes up the ligaments and tendons that hold the joint and causes dystrophy and degeneration of muscles and cartilage, and bone tissue loses calcium. This leads to muscle atrophy and increased bone fragility (osteoporosis and “steroid” myopathy), cartilage detachment and the development of arthrosis. After its use, aseptic necrosis of the humerus and femur, microcrystalline arthritis, and tendon ruptures may occur. If diprospan was used to treat children, then their growth and ossification processes may slow down (premature closure of the epiphyseal growth zones).

Administration of the drug into soft tissues, into the lesion and inside the joint can, with a pronounced local effect, simultaneously lead to a systemic effect:

• with 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, adjustment of hypoglycemic therapy may be required;
• when using diprospan, it should be taken into account that glucocorticosteroids can mask the signs of an infectious disease, as well as reduce the body’s resistance to infections;
• against the background of the use of glucocorticosteroids, changes in sperm motility and number are possible.

Diprospan or Betaspan

Manufacturer: Farmak, Ukraine
Release form: injection solution

Active ingredient: betamethasone dipropionate

Betaspan Depot has a similar composition and pharmacological properties. Also refers to glucocorticosteroids. It has anti-inflammatory, antiallergic, desensitizing, antishock, antitoxic and immunosuppressive properties. Diprospan's analog Betaspan also has a pronounced effect on various types of metabolism. It is prescribed to patients for pathologies and disorders that require the use of systemic corticosteroids.

Diprospan or Diprometa

Manufacturer: K.O.
Rompharm Company S.R.L., Romania Release form: solution for injection

Active ingredient: betamethasone

Diprometa is a prescription analogue of Diprospan, which also belongs to the GCS. It has anti-inflammatory, antiallergic and immunosuppressive properties. It has a pronounced effect on different types of metabolism. Use according to the instructions under the supervision of a specialist without exceeding the specified dosage. The drug is discontinued with a gradual dose reduction.