西藥品
用藥查詢
西藥品查詢
外觀圖示:
外觀圖示

外觀描述:
白色圓凸錠劑,8mm,單面刻痕

醫令代碼:
23124

商品名:
doRison 4MG(高劑量DEXAMETHASONE)

中文名:
得立生錠

學名:
Dexamethasone

劑型:
TAB

孕婦用藥分級:
C 級

健保碼:
AC196431G0

藥品許可證:
衛署藥製字第019643號

仿單下載:

用藥指導單張:

ATC7藥理類別:

結構式 :

(8S,9R,10S,11S,13S,14S,16R,17R)- 9-Fluoro-11,17-dihydroxy-17- (2-hydroxyacetyl)-10,13,16-trimethyl- 6,7,8,11,12,14,15,16- octahydrocyclopenta[a]phenanthren- 3-one


UpToDate:

藥理作用 :

1.本藥為合成長效型類固醇,作用廣泛,其可能之作用與所有內源性之腎上腺皮質酮(身體自行分泌的類固醇,如可體松-cortisol)相同。

2. 婦女用藥安全等級:D-在妊娠第一期使用。


適應症:
副腎皮質機能萎縮症、急性風濕性關節炎、支氣管性氣喘、膠原病、急性過敏病、皮膚病。

用法用量:

成人初劑量每次1顆,每天一次,以後可是病情酌增劑量至每次2顆。小孩初劑量每次半顆,每天一次。


副作用:
常見口乾舌燥,喝多尿多,長期或大量服用則可能出現腸胃不適、四肢浮腫等,若出現腸胃道症狀,需立即告知醫師。

藥物動力學:

Metabolism
Metabolized in the liver by CYP3A4.

Elimination
The t ½ 1.8 to 3.5 h.

Onset
Rapid (injection).

Duration
Short (injection).


交互作用:

Aminoglutethimide
May decrease dexamethasone-induced adrenal suppression.

Amphotericin B
Cardiac enlargement and CHF have been reported.

Anticholinesterases
May antagonize anticholinesterase effects in myasthenia gravis.

Anticoagulants, oral
May alter anticoagulant dose requirements.

Antidiabetic agents
Dexamethasone may increase blood glucose levels, necessitating antidiabetic agent dosage adjustments.

Aprepitant
Dexamethasone plasma levels may be elevated and the t ½ prolonged, increasing the pharmacologic effects and adverse reactions.

Cholestyramine, epinephrine
Dexamethasone plasma levels may be reduced, decreasing the efficacy.

Cyclosporine
Activity of both cyclosporine and dexamethasone may be increased. In addition, convulsions have been reported.

CYP3A4 substrates (eg, erythromycin, indinavir)
Plasma levels may be reduced by dexamethasone, decreasing efficacy.

Digoxin
Because of possible dexamethasone-induced hypokalemia, the risk of arrhythmias may be increased.

Hepatic enzyme inducers (eg, barbiturates, carbamazepine, phenytoin, rifampin)
Dexamethasone plasma levels may be reduced, decreasing the efficacy. In addition, seizure control with phenytoin may be altered.

Hepatic enzyme inhibitors (eg, azole antifungal agents [eg, ketoconazole], estrogens [including oral contraceptives], macrolide antibiotics [eg, erythromycin])
Dexamethasone plasma levels may be elevated, increasing the pharmacologic effects and adverse reactions. In addition, ketoconazole can inhibit adrenal corticosteroid synthesis, causing adrenal insufficiency during dexamethasone withdrawal.

NSAIDs, salicylates
Risk of GI adverse reactions may be increased. In addition, salicylate levels and efficacy may be reduced.

Potassium-depleting agents (eg, amphotericin B, loop and thiazide diuretics)
Risk of hypokalemia may be increased.

Thalidomide
Use with caution, toxic epidermal necrolysis has been reported with concurrent use of dexamethasone.


禁忌:
精神病、消化管潰瘍、抗生物質不能奏效之須要手術之感染性疾患。心臟血管障害、腎臟機能不全、糖尿病、閉塞性靜脈炎、骨粗鬆病、痙攣性疾患、結核。

注意事項:
1. 胃腸潰瘍病患使用時務需特別注意。
2. 因可能引起浮腫及血壓上升,腎臟疾患及高血壓患者應特別注意。
3. 糖尿病患者使用時有需增加Insulin藥量。
4. 服藥期間需充分補充蛋白質。

藥品保存方式:
藥品應置於攝氏 15 ~ 25 度乾燥處所;如發生變質或過期,不可再食用。

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