Dexsol

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How does it work?

This medicine contains the active ingredient dexamethasone, which is a type of medicine known as a corticosteroid. Corticosteroids are hormones produced naturally by the adrenal glands which have many important functions on every organ system. Corticosteroids affect the strength of heart muscle and its response to natural chemicals affecting heart rate. They affect the water and salt balance in the body and also enable the body to cope with stress. Stress includes changes in temperature, pain, fear, anxiety and illness and can be hazardous if the body is not equiped to cope, due to low levels of corticosteroids. Corticosteroids allow us to respond to stress by increasing the rate and force of the heartbeat, increasing blood supply to essential tissues (muscle, heart, brain), increasing the body's supply of energy by raising blood sugar and by several other effects on body systems. Dexamethasone is a synthetic corticosteroid and is used to control symptoms caused by low levels of corticosteroids in the body. This can be due to many reasons, including Addison's disease or surgical removal of the adrenal gland(s). Low blood levels of corticosteroids must be treated with replacement therapy to allow the body to function normally. Dexamethasone is also used to decrease inflammation. It works by acting within cells to prevent the release of certain chemicals that are important in the immune system. These chemicals are normally involved in producing immune and allergic responses, resulting in inflammation. By decreasing the release of these chemicals in a particular area, inflammation is reduced. This can help control a wide number of disease states, characterised by excessive inflammation. They include severe allergic reactions, inflammation of the lungs in asthma and inflammation of the joints in arthritis. Dexamethasone also decreases the numbers of white blood cells circulating in the blood. This is useful for the treatment of certain types of leukaemia, where there is an abnormally large production of certain white blood cells. Dexamethasone can be used in much higher doses than the levels of corticosteroids produced naturally by the body, and as such, the usual actions of corticosteroids become exaggerated and can be observed as side effects of this medicine. A further use of dexamethasone is by hospital specialists to test for the underlying cause of Cushing's syndrome.

What is it used for?

- A form of cancer of the bone marrow (myeloma)
- Certain types of tuberculosis (fulminating or disseminated) along with anti-tuberculosis therapy
- Complication following a heart attack involving fever, chest pain, inflammation of the lungs (pneumonitis) and inflammation of the membrane which surrounds the heart (pericarditis)
- Decreased numbers of red blood cells in the bloodstream caused by an increase in their breakdown (haemolytic anaemia)
- Fluid retention and swelling in the brain (cerebral oedema) due to a brain tumour
- Inflammatory disorders e.g. asthma, arthritis, severe allergic reactions, Crohn's disease, systemic lupus erythematosus
- Insufficient production of natural steroid hormones by the adrenal glands (adrenal insufficiency)
- Leukaemia
- Life threatening allergic reaction (anaphylactic reaction)
- More serious allergic reaction causing swelling of the eyes, lips or tongue
- Tests to determine the underlying cause of Cushing's syndrome

Warning!

- Corticosteroid medicines taken by mouth should be taken in the morning to mimic the natural production of corticosteroids by the body. They should be taken after food.
- If you are taking a corticosteroid for longer than three weeks you will usually be given a steroid card with your medicine. The card contains details of your prescriber, type of steroid, dose taken and the duration of treatment. It's purpose is to act as reminder that your medicine should not be stopped suddenly, and to provide information of your treatment in case of an accident. You should carry it with you at all times and show it to anyone who treats you (eg doctor, nurse, pharmacist, dentist).
- If you are taking this medicine long-term, your doctor may need to temporarily increase your dose if you experience any any additional illness, trauma or surgery during treatment. Discuss this with your doctor.
- If you have never had chickenpox you should avoid close personal contact with people who have chickenpox or shingles (herpes zoster). If you are exposed you should your doctor urgently, as these diseases can be life-threatening in people who are taking long-term steroids and whose immune system is suppressed.
- You should not stop taking this medicine suddenly, particularly if you have been taking it for longer than 3 weeks. This is because long-term use of the medicine suppresses the natural production of corticosteroids by the adrenal glands. This means that the body becomes temporarily reliant on the medicine. When it is time to stop treatment the dose should be tapered down gradually, to allow the adrenal glands to start producing adequate amounts of natural steroids again. Follow the instructions given by your doctor or pharmacist.
- This medicine may increase your susceptibility to infections and also mask the symptoms of these infections. Consult your doctor if you get an infection during treatment.
- This medicine may reduce the secretion of steroid hormones in the body normally responsible for fluid and salt balance. A replacement steroid (mineralocorticoid) and/or salt should be taken with this medicine.
- Individuals should avoid close personal contact with people with measles. If exposed, seek urgent medical attention as this disease can be life-threatening in people whose immune system is suppressed.
- Tests should be performed to exclude protozoal infection of the intestine (amoebiasis) and roundworm infection (strongyloidiasis) before starting treatment.

Use with caution in

- Abnormal muscle weakness
- Adolescents
- Children
- Decreased kidney function
- Diabetes
- Elderly people
- Epilepsy
- Family history of diabetes
- Family history of glaucoma
- Glaucoma
- Heart failure
- Herpes simplex virus infection of the eye
- High blood pressure
- History of allergies
- History of or current mental disorder
- History of steroid induced mental disturbances
- Hypothyroidism
- Inflammation of small sac-like structures which sometimes form in the walls of the intestine (diverticulitis)
- Inflammation of the bowel and back passage
- Liver cirrhosis
- Liver failure
- Migraine
- Osteoporosis
- People who have recently had a heart attack
- Peptic ulcer
- Post-menopausal women
- Previous muscle disease (myopathy) caused by steroids
- Recent surgical procedure involving the joining together of ends of the intestine after a section has been removed (intestinal anastomosis)
- Schizophrenia
- Severe malaria affecting the brain
- Tuberculosis

Not to be used in

- Fungal infection throughout the body (systemic fungal infection)
- Infection throughout the body (systemic infection) unless treated with specific anti-infectives
- Protozoal infection of the intestine
- Roundworm infection (strongyloidiasis)

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

- This medicine should be used with caution during pregnancy, and only if the expected benefit to the mother is greater than any possible risk to the foetus. Seek medical advice from your doctor.
- The safety of this medicine during breastfeeding has not been established. Seek medical advice from your doctor.

Label warnings

- Follow the printed instructions you have been given with this medication.
- Take this medication with or after food.

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