.png&w=384&q=75)
Indications:
1. Rheumatoid arthritis
2. Collagen diseases
3. Inflammatory & allergic disorders
4. Anaphylactic shock
5. Cerebral oedema
6. Nausea & vomiting with chemotherapy
7. Acute adrenocortical insufficiency
8. Urticaria
9. Eczema
10. Skin diseases
11. Hyperplasia & hyperpyrexia
12. Gout
Sonexa contains Dexamethasone which is a synthetically prepared glucocorticosteroid. Its main clinical
applications are as a steroidal anti-inflammatory agent. It acts on the Hypothalamic-pituitary-adrenal (HPA) at
specific receptors on the plasma membrane. On other tissues it diffuses across cell membranes and complex
with specific cytoplasmic receptors, which enter the cell nucleus and stimulate protein synthesis. It has
anti-allergic anti-toxic, anti-shock, anti-pyretic and immunosuppressive properties. After 20 mg intravenous
administration, peak plasma level is reached within 5 minutes. The mean plasma half life of Dexamethasone is
(3.6+0.9) hours. It binds to plasma protiens, mainly albumin. Dexamethasone metabolism in the liver is slow
and rather limited. Over 60% of the administered dose are excreted in the urine within 24 hours.
Dexamethasone has only minimum mineralocorticoid activity, which makes it suitable for use in patients with
cardiac failure or hypertension. Because of the long biological half-life (36-54 hours) Dexamethasone is
especially suitable in conditions when continuous glucocorticoid action is desired.
Sonexa 6 Tablet: The initial dosage of Dexamethasone varies from 0.75 to 9 mg per day. In general,
corticosteroids dosage depends on the severity of the condition and the response of the patient.
Sonexa 6 Injection: Dexamethasone Sodium Phosphate can be given parenterally at doses of 0.5-20 mg daily
either as a single (slow) intravenous or intramascular injection or by intravenous infusion.
Large intravenous doses should be administered slowly to reduce the risk of cardiovascular collapse. The total
daily intake of Dexamethasone, even in acute conditions should not exceed 80 mg except in certain very
special circumstances.
Cerebral oedema: 10 mg initially by intravenous injection, then 4 mg by intramascular injection every 6 hours is
required for 2-10 days.
Shock: By intravenous or intramascular injection or infusion 2-6 mg/Kg, repeated if necessary after 2-6 hours.
The dose in children varies from 0.03 to 0.09 mg per Kg body weight twice a day for adrenal suppression and
between 0.01 mg per Kg body weight once a day for other indications. An alternate-day regimen reduces the
risk of growth retardation.
Dexamethasone exhibits interaction with phenytoin and phenobarbitone, ephedrine, rifampicin, magnesium
trisilicate, salicylate, potassium depleting diuretics (such as thiazide or frusemide), cardiac glycosides, NSAIDs,
anticoagulants, antidiabetics, antihypertensives, barbiturates, carbamazepine, primidone, antimuscarinic
agents.
Contraindications:
Ocular herpes simplex is an example of absolute contraindication to corticosteroid therapy relative
contraindications are:
Gastro-intestinal ulcer, acute or chronic infections, osteoporosis, pregnancy, diabetes mellitus, renal
insufficiency, hypertension, history of psychotic illness, immediate before prophylactic immunization and finally
hypersensitivity to Dexamethasone.
Precautions:
Dexamethasone should be used with caution in the presence of congestive heart failure or hypertension, in
patients with diabetes mellitus, epilepsy, glaucoma, infectious disease, chronic renal failure and uremia and in
elderly persons.
Hypersensitivity including anaphylaxis and allergic skin reactions have been reported. The incidence of
predictable undesirable effects of glucocorticoids correlates with the dosage timing of administration and
duration of treatment. Patients on prolonged Dexamethasone therapy are at risk of collapse and possibly death
if their daily dose is not increased at times of severe physical stress e.g injury, surgery or infections The
somatic manifestations include growth retardation in children, osteoporosis and aseptic disturbances and
myopathy. Other cushing like features, characteristic of glucocorticoid excess includes truncal obesity,
moon-face, oedema, delayed wound healing, glaucoma and various psychiatric syndromes. These are all
generally reversible with discontinuation of Dexamethasone treatment.
Use in pregnancy: Safety for use during pregnancy has not been established. Infants born of mothers who have
received substantial doses of corticosteroids during pregnancy should be carefully observed for signs of
hyperthyroidism.
Use in lactation: Corticosteroid appears in breast milk and may suppress growth, interfere with endogenous
corticosteroid production or cause other untoward effects, so patient should stop nursing if drug is prescribed.
Store below 300 C. Keep in dry place & protect from light. Keep out of reach of children.
Sonexa 6 Tablet: Each film coated tablet contains Dexamethasone USP 6 mg.
Sonexa 6 Injection: Each 1 ml ampoule contains Dexamethasone Sodium Phosphate USP equivalent to
Dexamethasone 6 mg.