Get rid of diprospan. Diprospan injections for the musculoskeletal system

Content

For the treatment of arthritis, muscle heaviness, joint pain, doctors use Diprospan - the instructions for its use contain information that the medicine can be used in various fields of medicine. It eliminates inflammation of the tendons, is used in ophthalmology and for the treatment of skin diseases. The drug solution is intended for parenteral administration.

Diprospan injections

According to the generally accepted classification, Diprospan belongs to glucocorticoid drugs for parenteral administration. This is a unique preparation containing substances of prolonged and rapid action. Injections with a suspension of Diprospan help to quickly cope with pathologies, but additionally and in parallel provide a long-term therapeutic effect.

Composition

Diprospan is available only in the form of a solution, there are no other types of medicine. Its composition and description:

pharmachologic effect

The drug is a glucocorticosteroid agent that inhibits the release of interleukins and gamma interferons from macrophages and lymphocytes. Due to this, the medicine has anti-allergic, anti-shock, anti-inflammatory effects. Diprospan has a desensitizing, antitoxic, immunosuppressive effect. The mechanism of work is the release of beta-lipotropin by the pituitary gland without reducing the level of beta-endorphin.

The drug increases the excitability of the central nervous system, lowers the number of lymphocytes and eosinophils, increases the number of red blood cells, stimulating the production of erythropoietins. In the body, the active substances of the composition interact with receptors, forming a complex that can penetrate the cell nucleus and stimulate RNA synthesis. This acid is responsible for the production of the protein lipocortin, which inhibits the phospholipase enzyme, inhibits the synthesis of arachidonic acid (a precursor of inflammatory processes).

The active components of the composition are involved in protein, carbohydrate, water-electrolyte and lipid metabolism. Betamethasone disodium phosphate dissolves easily, is quickly absorbed into tissues, and gives an instant effect. Betamethasone dipropionate is more slowly absorbed. The combination of components helps to achieve a general or local effect quickly, but for a long time. The solution is administered intravenously, intramuscularly, intraarticularly, periarticularly, intradermally.

Indications for use

Doctors often prescribe Diprospan - instructions for use of the drug include information about the following indications:

burn, cardiogenic, surgical, traumatic, toxic, blood transfusion, anaphylactic shock;
acute and severe forms drug allergy, anaphylactoid reactions;
swelling of the brain against the background of a tumor or surgery, radiation therapy, head trauma;
severe form bronchial asthma, asthmatic status;
systemic lupus erythematosus, rheumatoid arthritis;
acute adrenal insufficiency;
coma of the liver;
poisoning with caustic fluids.

For joints

Diprospan suspension for injection, according to the instructions, is widely used in the treatment of joints:

inflammatory diseases of the musculoskeletal system (synovitis, tenosynovitis, bursitis);
pain syndromes in arthritis knee joint;
rheumatoid arthritis;
gout, pain in psoriasis;
osteocondritis of the spine;
hygroma;
humeroscapular periarthritis;
pain in the spine, thoracic region, neck, after trauma;
spinal hernia.

Diprospan in ophthalmology

After eye surgery, Diprospan is used to relieve inflammation and pain. According to the instructions, it can also be used for the treatment of Graves' ophthalmopathy and chalazion. The latter disease is a benign formation on the eyelids, resulting from chronic proliferative inflammation of the meibomian gland. When used in ophthalmology, the drug is administered subconjunctivally.

For skin diseases

The drug can also be used in the treatment of skin diseases, including allergic manifestations on the skin. Indications for the use of the drug include:

contact dermatitis;
arthropathic psoriasis;
keloid scars;
lichen planus;
common pemphigus;
alopecia areata (baldness);
diffuse neurodermatitis and eczema.

How to inject Diprospan

Blockade with Diprospan is used for severe pain in the knee joint and for humeroscapular periarthritis. Other diseases require an individual approach. The method of application of the solution, dosage and course depend on the severity of the disease. This can be a slow intravenous jet or drip at a dose of 4-8 mg at a time, up to 20 mg if necessary, and a maintenance dose of 2-4 mg.

Intramuscularly, the solution is injected deeply. Children 1-5 years old are prescribed 2 mg, 6-12 years old - 4 mg. To prevent hyaline-membranous disease of newborns, the solution is administered intramuscularly in an amount of 8 mg for 48-72 hours, injections continue every day. Intraarticular and periarticular doses are administered:

very large pelvic joints - 4-8 mg;
large knee, ankle, shoulder joints - 4 mg;
medium joints (elbow, carpal) - 2-4 mg;
small interphalangeal, sternoclavicular, metacarpophalangeal - 1-2 mg.

Intradermal or intrawound administration for treatment inflammatory diseases skin has a dose of 0.2 ml/square cm, but not more than 4 mg/week. As a local infiltration for bursitis, 1-2 mg is administered (up to 8 mg in acute form), for tendinitis - 2 mg, for periarticular inflammation - 2-4 mg, the injection is repeated every 1-2 weeks. Subconjunctival injection of 2 mg solution.

Most diseases when injected do not require the parallel use of local anesthetics; if necessary, the local anesthetic drug Lidocaine is allowed. First, Diprospan is drawn into the syringe, then the anesthetic Lidocaine. With periarticular blockades, the drug is injected directly at the tendon. Symptoms of heel spurs are eliminated after a single local injection of 0.5 ml, with alopecia areata, 1 ml is injected into the muscle once a week with a course of 3-5 injections. After the detection of edema on the background of rhinoplasty, Diprospan injections are made into the nose.

How long does it take to take effect

According to the instructions, the medication begins to act 10 minutes after administration. This ability of the drug helps to provide first aid for anaphylactic shock. The action lasts up to 72 hours, after the injection is repeated. The average time of the effect of the drug lasts a day, sometimes less. The time depends on the characteristics of the patient's body.

How often can you inject Diprospan

In the same joint, the medication is injected once every 2-3 months, but not more often. Doctors recommend using the drug in different joints at intervals of 1-2 weeks. After the end of therapy with a glucocorticosteroid drug, the dose is reduced gradually. It is impossible to allow a sharp withdrawal of the drug, this threatens with unpleasant consequences.

special instructions

When studying the instructions for using the medication, it is useful to pay attention to the point of special instructions, which contains information:

you can not inject the drug into unstable joints;
before and after steroid therapy, blood control is carried out;
it is impossible to combine Diprospan injections with the use of anesthetics in one ampoule, the mixture is prepared in a syringe;
does not affect hormonal background;
therapy of active tuberculosis, intercurrent infections and sepsis requires combination with antibiotic therapy;
children who are in contact with patients with measles and chicken pox receive specific immunoglobulins during the treatment period.

Diprospan during pregnancy

Instructions for use Diprospan contains information that during pregnancy and breastfeeding the drug can be used, but after a careful balance of benefits and risks and if the expected effect for the mother exceeds the negative reactions for the fetus. For the prevention of certain diseases in newborns, intramuscular injections are administered 2-3 days before birth.

In childhood

Diprospan intramuscularly or intravenously for children can be used only according to absolute indications and after a thorough examination by a doctor. According to the instructions, during therapy, the child should be constantly monitored by a doctor, because during the period of growth, glucocorticosteroids can adversely affect the function of the pituitary gland and the adrenal cortex, which leads to a slowdown in development.

drug interaction

The combination of Diprospan with other drugs may not always be safe. How drugs affect each other is indicated in the instructions for use:

reduces the effectiveness of insulin, oral hypoglycemic drugs, indirect anticoagulants, weakens the effect of diuretics, vaccines with viruses;
Rifampin, barbiturates, Phenytoin weaken the effect of GCS, hormonal contraceptives - increase;
ethanol and non-steroidal anti-inflammatory drugs lead to erosions, bleeding and ulcers of the gastrointestinal tract;
estrogens, oral contraceptives increase the risk of developing hirsutism, acne;
diuretics lead to hypokalemia, cardiac digitalis glycosides - to arrhythmia, Ritodrine can cause pulmonary edema in pregnant women.

Alcohol compatibility

According to the instructions, ethanol in combination with glucocorticosteroids can cause erosive and ulcerative lesions. gastrointestinal tract and bleeding. In parallel, glucocorticoids increase tolerance to ethyl alcohol and reduce its toxic effect without changing the concentration in the blood. This effect gives a chance to use Diprospan for the treatment of ethyl alcohol poisoning.

Side effects of Diprospan

Against the background of the use of Diprospan injections, various side effects appear, the frequency and severity of which depend on the dose and compliance with the circadian rhythm:

"steroid" diabetes mellitus;
suppression of adrenal function, Itsenko-Cushing's syndrome;
increased pressure, striae, myasthenia gravis;
nausea, pancreatitis, vomiting, esophagitis, gastrointestinal perforation;
flatulence, hiccups, decreased or increased appetite;
arrhythmia, bradycardia, cardiac arrest, heart failure, foci of thrombosis;
increased intracranial pressure, insomnia, convulsions;
increased excretion of potassium, weakness;
osteoporosis, pathological bone fractures;
nephritis;
allergic reactions, exacerbation of infections;
burning, numbness of tissues, pain at the injection site, glaucoma;
flushing of the face, nosebleeds.

Overdose

Overdose symptoms are nausea, sleep disturbance, euphoria, agitation or depression. When using high doses, manifestations of systemic osteoporosis, fluid retention in the body, and increased pressure are possible. The treatment is the gradual withdrawal of the drug, supporting the body by correcting the electrolyte balance, taking antacids, phenothiazines, lithium preparations. According to the instructions, with the development of Itsenko-Cushing's syndrome, Aminoglutethimide is taken.

Contraindications

For parenteral administration of the solution, a contraindication is hypersensitivity to the components of the composition. For intra-articular injections, prohibitions on use are:

arthroplasty, pathological bleeding of the joint;
intra-articular infections, fractures;
history of periarticular infections;
periarticular osteoporosis, osteoarthritis without synovitis, bone destruction;
deformity, pathological joint mobility, ankylosis, narrowing of the joint space, aseptic necrosis of the forming epiphyses.

Terms of sale and storage

The drug is dispensed by prescription, stored in a dry place at a temperature of 2-25 degrees for three years.

Analogues

A direct analogue of the drug is a suspension for injection Flosteron with the same active ingredients and action. Indirect substitutes for the drug can be drugs with a similar therapeutic effect, but with other substances of the composition:

Diprospan price

You can buy Diprospan through Internet sites or pharmacies at prices that depend on the level of the trade margin and the number of ampoules in the package. The approximate cost for one ampoule of the drug in Moscow and St. Petersburg pharmacies will be:

Video

Diprospan is a locally acting glucocorticoid drug. With its help, treatment of inflamed joints, blockade of nerve roots (with infringement) is carried out. Often, an injection is also prescribed to prevent pain during the destruction of the joint (before the operation to replace it). When is Diprospan prescribed, does it have side effects and how quickly does it start to work?

The benefits and harms of Diprospan

An injection of Diprospan is prescribed for a local blockade of inflammation, relieving painful symptoms, or if the spine has shifted (meaning the discs) and the nerve root has been infringed. Such treatment is not the main therapy and is used solely to deactivate the pain syndrome, relieve and prevent inflammation.

The injection can be administered subcutaneously, intramuscularly, into the area of \u200b\u200bthe joint itself, but not intravenously.

It should be borne in mind that despite its positive properties, it has a large number of possible side effects. Among them:

hypernatremia;
increase in blood pressure to a critical level;
flatulence, prolonged hiccups (neurological disorder in the functioning of the gastrointestinal tract);
increased sweating;
convulsions;
strengthening of aseptic abscesses;
exacerbation of adrenal insufficiency;
failure in work endocrine system(including the synthesis of sex hormones).

A single blockade of Diprospan, as a rule, is not accompanied by side effects. But its long-term use with a frequency of 2-4 weeks causes a high risk of their occurrence. Often, taking Diprospan is also accompanied by an increase in body weight due to the accumulation of organic fluids and subcutaneous fat. When prescribing an injection, the doctor must warn about all this. The blockade of Diprospan is also carried out only at his discretion.

It should not be considered dangerous in any way. All of these side effects are eliminated on their own after stopping the use of the drug. Full recovery takes up to 4-6 months, depending on the number of ampoules administered for the entire period of therapy. There is no habituation effect, however, in the future, the sensitivity of the part of the skin where the inflamed joint is located may decrease. This is also a temporary phenomenon.

Diprospan injection in the knee joint

The introduction of Diprospan into the knee joint is prescribed for periodic inflammation of the connective tissue, which is accompanied by severe pain. The recommended dose is 1 milliliter (ampoule) with a frequency of 2-4 weeks (re-appointment is performed in compliance with the symptoms).

The introduction is performed either into the joint itself or into the periarticular part, depending on the location of the inflammation and the painful point. Pain after an injection of Diprospan is significantly reduced after 20-30 minutes (depending on the variation of betamethasone used).

Diprospan is valid for several weeks.

Its main action is the blockade of the receptor function, with the help of which substances are released that stimulate the appearance of inflammation. At the same time, the sensitivity of nerve endings decreases. Blockade with Diprospan can be performed in conjunction with lidocaine, but with a break between injections of at least a few days. Treatment of the knee joint with this method can take from 2 to 12 weeks. Further use of Diprospan is not recommended - analogues are prescribed instead.

Diprospan injection in the shoulder joint

The blockade of the shoulder joint by Diprospan can be performed in several stages. The standard injection dose is 1-1.5 milliliters (depending on another blockade).

The use of the drug is prescribed even before the onset of signs of arthritis, that is, when it is possible to prevent inflammation.

Diprospan, when it enters the area of the shoulder joint, not only blocks the sensitivity of the nerve roots, but also prevents the synthesis of sodium. This is important for those patients in whom inflammation occurs against the background of salt accumulation and connective tissue mineralization. A second injection into the shoulder joint is performed no earlier than 2 weeks later (if necessary).

It is allowed to use Diprospan for the treatment of rheumatoid arthritis, combined with joint displacement. In this case, the treatment takes exactly as much time as is necessary for the regeneration of the connective tissue and the restoration of mobility.

It is allowed to use Diprospan for the treatment of inflammatory damage to soft tissues and ligamentous apparatus (in case of rupture of the articular bag). If after the first ampoule the patient notes an improvement in well-being, then in the future the dose can be reduced to 0.25 milliliters for a single blockade (at the discretion of the doctor). As a prophylactic, the use of Diprospan is prohibited.

The use of Diprospan for arthrosis

In case of arthrosis, the blockade with Diprospan implies the periarticular administration of the drug at the rate of 0.2-0.3 milliliters of the active substance per square centimeter of the skin area where the pain is localized. The introduction is carried out by microinjections. The ampoule after opening, regardless of the amount of the drug used, is disposed of. The dose for each joint is regulated only by the site of the lesion and the visual manifestation of inflammation.

The use of Diprospan is allowed for arthrosis no more than 1 time in 5 days. The injection is performed exclusively by a doctor, since subcutaneous injection is done only with arthrosis of the joints of the palms or feet.

Blockade with Diprospan is less effective than with lidocaine, but the advantage of the former is the prevention of further development of inflammation. This simplifies the treatment of the joint, reduces its response to infectious and viral damage. The dose of Diprospan is increased only if there are signs of a rupture of the joint bag or mineralization of the connecting movable part. In the future, treatment flows into the surgical stage, that is, an operation is performed.

It is allowed to use injections for osteoarthritis of the spine. At one time, no more than two ampoules can be administered locally (without distribution to several disks).

The maximum therapeutic effect occurs after 2-4 hours. It should be taken into account that the curvature of the connective tissue will not prevent this, but it will significantly relieve pain and improve mobility. But if mineralization has already occurred, then Diprospan will not eliminate it. In the treatment of arthrosis of the spine, it is recommended to use Diprospan no more than 6 times. Then a break of 3 months is made and, if necessary, a second course is prescribed.

What happens after an injection?

The introduction of Diprospan into the joint area is accompanied by anti-allergic, anti-inflammatory and immunomodulatory functions.

Already after a single application, the activity of the pituitary gland, the synthesis of hormones of the histamine group (they provoke allergies) are slightly suppressed. If the drug is injected into the spine, into the disc junction, then the regeneration of the connective tissue is stimulated. Combining such treatment with the traditional therapy of a vertebrologist, a significant improvement in the patient's well-being can be achieved.

Two components are used as the active substance of Diprospan - betamethasone sodium phosphate and betamethasone dipropionate.

The first in a small dose is used as a catalyst and stimulates the fastest possible action of the drug.

The introduction of the second component contributes to a long-term effect that lasts from 5 to 10 days (or even more). The latter also directly depends on the dose used and the location of the inflamed joint. For example, in the region of the spine, Diprospan blockade is effective for 7-9 days (with intra-articular use).

Is it possible that the blockade with Diprospan will not work?

This happens only when the nerve roots are wrapped in purulent masses, through which there is no anesthetic effect on the joint. Here, the pain, in principle, occurs against the background of mechanical compression of the nerve endings. Even with the maximum dose, there will be no improvement in well-being in this situation.

Contraindications

Diprospan is not prescribed for:

violation of metabolic processes in the body;
high risk of developing acute heart failure;
skin infection at the site of the planned injection;
diagnosed immunodeficiency;
diabetes, Itsenko-Cushing's disease;
osteoporosis;
viral diseases of the endocrine system (including prostatitis);
arterial hypertension.

The minimum age for the use of Diprospan is 12 years with a maximum dosage of 1 ampoule, including in the spine. Deviation from the indicated dose is allowed only in cases where the probable benefit of therapy outweighs the potential danger.

The introduction of betamethasone derivatives during pregnancy or lactation is not recommended. This substance is not able to cross the placenta, however, it affects the activity of the endocrine system. In certain cases, the introduction of the drug can provoke self-abortion of the fetus, so treatment is allowed only with a likely threat to the life of the mother. Diprospan is introduced at the same time into the joint (intra-articular).

Holiday conditions

Regardless of the variant of the use of the drug, it is released exclusively by prescription. The introduction is performed only by a doctor. The maximum possible delivery is no more than 10 ampoules per hand, regardless of the prescribed single dose. For more, you must provide a new prescription with a doctor's prescription.

Diprospan is a highly active drug from the group of glucocorticosteroids. a wide range actions.

It is used to treat inflammatory and degenerative-dystrophic diseases of the musculoskeletal system, as well as other diseases requiring hormone therapy.

It is a whitish or yellowish suspension containing 2.63 mg of betamethasone sodium phosphate (equivalent to 2 mg of betamethasone) and 6.43 mg of betamethasone dipropionate (equivalent to 5 mg of betamethasone).

Pharmacokinetics means

Contains two active forms of betamethasone salt. Betamethasone disodium phosphate causes a rapid onset of the therapeutic effect.

Betamethasone dipropionate is activated slowly, prolonging the time of effective action of the drug.

Who needs these injections?

Indications for the use of Diprospan in diseases of the musculoskeletal system:

Allergic conditions:

allergic rhinitis;
allergic bronchitis;
bronchial asthma;
drug allergy;
anaphylactic shock.

Dermatological diseases:

dermatitis (contact, herpetic, atopic);
neurodermatitis;
psoriasis;
keloid scars.

Diseases internal organs:

acute hepatitis;
nephritis;
hepatic coma;
nephrotic syndrome;
acute adrenal insufficiency;
ulcerative colitis.

With intra-articular administration of the drug:

infectious processes in the joints;
ligament disorder, joint instability.

Regardless of the route of administration of the drug:

individual hypersensitivity to the components of the drug;
systemic fungal diseases (generalized candidiasis, actinomycosis);
in the presence of a bacterial or viral infection, tuberculosis, chickenpox, stomach and duodenal ulcers, glaucoma.

Mechanism of action

The anti-inflammatory properties of the drug are due to the ability of betamethasone salts to inhibit the formation of inflammatory mediators (prostaglandins, leukotrients) and inhibit the activity of enzymes that have a destructive effect on tissues.

The antiallergic effects of the drug are realized through a decrease in the formation of IgE-immunoglobulins, blocking the release of histamine by mast cells, and reducing the susceptibility of tissues to inflammatory mediators.

The anti-shock and antitoxic effect of the drug is associated with the stimulation of compensatory reactions of the body, including the activation of the cardiovascular system and the antitoxic function of the liver.

The immunosuppressive effect of diprospan is associated with its ability to inhibit the activity of lymphoid cells, inhibit their proliferative activity and maturation, including through the mechanisms of suppression of the secretion of pro-inflammatory interleukins involved in immune reactions.

Instructions for use

The drug is available as a suspension for injection in glass ampoules of 1 ml, packed in plastic contour cells. Produced in cardboard packs in two packages - 1 and 5 ampoules.

The drug is used once or in a short course.

At acute diseases joints, as a rule, a one-time administration of the drug is sufficient; in chronic forms, the injections are repeated.

From 0.25 to 0.5 ml of the drug is injected into small joints, from 0.5 to 2 ml into medium joints, and 1-2 ml into large ones. For intramuscular injections(the drug is injected into the gluteal muscle) is 1-2 ml.

Overdose and additional instructions

Even high doses of the drug do not pose a threat to life, but can cause various side effects (see below), especially when taking the drug against the background diabetes, gastric ulcer, glaucoma.

If the patient's condition worsens, it is necessary to control the level of sodium and potassium in the blood and urine.

Side effect

The appearance of adverse events is due to the dose and duration of the drug. Reducing the dose, as a rule, leads to a decrease in the severity of these reactions.

Diprospan injections can cause:

special instructions

The drug is not intended for intravenous and subcutaneous administration. Abrupt discontinuation of the drug may increase adrenal insufficiency.

Intramuscular injections must be administered deeply to prevent local tissue atrophy. With intra-articular administration, it is necessary to exclude the presence of a septic process with the help of laboratory studies of the synovial fluid. In the presence of an intra-articular infection, the drug is not prescribed.

Alcohol enhances the side effects of the drug, during treatment with the drug it is necessary to completely exclude the use of any alcoholic beverages.

In case of impaired liver or kidney function, the drug is prescribed with caution.

Due to the presence of data on the teratogenicity of betamethasone dipropionate in animals, the drug is not prescribed during pregnancy. When using the drug during lactation, it is necessary to completely abandon breastfeeding.

For children, the drug is prescribed in exceptional cases and only with absolute indications.

Interaction with other drugs

Ephedrine, rifampicin, phenobarbital, phenytoin increase the metabolism of Diprospan and reduce its therapeutic activity.

When Diprospan is used simultaneously with diuretics, the risk of hypoglycemia increases, with cardiac glycosides - the risk of developing arrhythmias, with non-steroidal anti-inflammatory drugs and salicylates - the frequency of development and intensity of erosive and ulcerative lesions of the gastrointestinal tract increases.

The opinion of professional doctors

In their reviews, doctors who use Diprospan injections to treat joints note the particular effectiveness of the drug, but at the same time a large number of contraindications.

The voice of the people

Patient Admission Tips:

the drug should be used only under the supervision of a physician;
the main thing is not to overdo it;
use for severe pain only as directed by a doctor.

Pros and cons from practical experience

The advantages of the drug:

gives a quick and lasting effect;
relieves pain well;
optimal combination of price and quality.

Disadvantages of the drug:

many side effects;
can not be used often and for a long time;
even local intra-articular administration often results in systemic action.

The cost of injections

The price of Diprospan depends on the volume of the package:

glass ampoule 1 ml, 1 pc. - 200 rubles;
glass ampoule 1 ml, 5 pcs. - 820 rubles;
syringe 1 ml, 1 pc. - 220 rubles.

The drug is stored in a dry place at a temperature. Medicine is released only according to the recipe.

Pharmaceutical equivalents

Diprospan's analogues are:

Flosterone (KRKA, Slovenia) - 1 ml, 7 mg/ml, 5 ampoules per pack.
Betaspan (Lekhim, Ukraine) - 1 ml, 4 mg / ml, 1 ampoules per pack.
Betaspan Depot (Farmak, Ukraine) - 1 ml, 7 mg / ml, 1 ampoules per pack.
Lorakort (Exir Pharmaceutical Co., Iran) - 1 ml, 4 mg / ml, 10 ampoules per pack.
Celeston (Schering-Plau Labo N.V., Belgium) - 1 ml, 4 mg / ml, 1 ampoules per pack.

Injections for arthritis: treatment of inflammation of the joints with injections

To learn more…

Arthritis is a common joint disease. With this disease, inflammatory processes occur in the area of \u200b\u200bthe connection of the bones. The skin in this area swells and turns red. As a rule, rheumatoid arthritis affects one joint, but sometimes infection of the joints can occur.

Like any other disease, arthritis has 2 stages:

acute;
chronic.

In the acute form of the disease, sharp manifestations are observed. In the treatment of pathologists, chondroprotectors are used, due to which a quick result is achieved, and if the therapy is timely, then there will be no relapse.

The chronic stage develops against the background of an acute form of pathology due to untimely and illiterate treatment of rheumatoid arthritis.

This form of the disease is characterized by severe symptoms, complicated treatment and the appearance of relapses.

Treatment

Therapy of arthritis, both acute and chronic, should be comprehensive in terms of means and methods of treatment. The most effective way are medications produced in the form of compresses, gels, vitamins, ointments, injections of tablets and sprays.

These drugs:

eliminate inflammation;
anesthetize;
have a non-steroidal effect;
affect bone mineralization;
have an anti-gout effect;
have a homeopathic effect.

But injections for arthritis are considered the most effective, since their action extends to the entire body.

Injection Treatment: Benefits

Injections for arthritis, for example, blockade of the knee joint, are introduced into the body in the form of injections and ampoules. They can be entered in three ways:

intra-articular;
intravenously;
intramuscularly.

The intra-articular method is used in rare cases to eliminate severe pain in the case of an advanced form of the disease.

A very effective remedy for rheumatoid arthritis is Arthryl injections, however, only a doctor should share the injection, and injections from ampoules can be administered without assistance.

Corticosteroids

Often, chondroprotectors and corticosteroid hormones are prescribed to get rid of joint inflammation in rheumatoid arthritis. Basically, the treatment of the disease is carried out with the help of corticosteroid injections:

Celeston;
Hydrocortisone;
Kenalog;
Flosteron.

These drugs quickly eliminate pain and inflammation, so they are often prescribed by doctors.

But corticosteroids will not eliminate the causes of joint damage, therefore, they do not prevent the progression of the disease and do not protect against relapses.

Moreover, corticosteroid hormones should not be used in cirrhosis of the liver, heart failure, hypertension, nephrosis, nephritis and angina pectoris.

And in case of an overdose, various complications can occur: exacerbation of infectious diseases, changes in internal organs, internal bleeding, shock.

Chondroprotectors: Hyaluronate

Treatment of rheumatoid arthritis of the elbow, shoulder or knee joints should be specific. Thus, the most effective remedy is Hyaluronate in the form of injections. The composition of this drug contains such active substances as:

synvisc;
hyalgan;
euflex;
orthovisc;
suparts.

The action of the drug is aimed at increasing the viscosity of the synovial substance, resuming the motor functions of the joints, reducing pain. This medicine is injected by a doctor into the lesion.

Chondroprotectors, in particular Hyaluronate, cannot be used by people who are allergic to the constituent substances of the product, joint diseases, skin irritation.

In case of an overdose, the symptoms of rheumatoid arthritis may be intense: pain, swelling.

Treatment for rheumatoid arthritis: Abatacept

In the future, the prevention of joint inflammation will become more effective due to the use of innovative developments in the treatment of the disease. So, doctors of the European Community have developed Abatacepta. The new drug is used for subcutaneous administration as an auxiliary element in the prevention of the disease.

The commission approved the production of a modern drug for arthritis. New chondroprotectors have a completely different mechanism for the treatment of necrosis at different stages of the disease.

Scientists claim that the innovative development slows down lymphocytic activity. All chondroprotectors and other joint therapy agents are combined into groups of inhibitors that suppress the progression of the tumor process.

Abatacept treatment is unique in terms of application methods and therapy factors. Injections can be done subcutaneously or intravenously, which suits different patients.

Soon Abatacept will become an alternative anti-TNF drug, so it can be introduced into the main treatment of rheumatoid arthritis of varying severity. Moreover, doctors will be able to choose which chondroprotectors are most suitable for the patient.

Abatacept has already proven effective in the treatment of joint inflammation. The injections are well combined with other drugs, including Methotrexate. Comprehensive treatment with Abatacept is necessary for those people who are allergic to certain types of anti-inflammatory drugs.

In addition, the agent can be administered subcutaneously, but in some cases it is administered intravenously, due to the good effect of the drug on the area of inflammation. It is not difficult to make a hypodermic injection, therefore, to make such an injection, it is not necessary to resort to medical help.

In the course of studies in which patients diagnosed with stage 3 rheumatoid arthritis were observed, treatment with Abatacept showed high results. In the process of testing the drug, the effect of the drug on the symptoms of arthritis was analyzed.

The systematic use of Abatacepta significantly reduces the appearance of the main symptoms of the disease and slows down the destructive processes of articular tissues. Therefore, in the near future, in the treatment of inflamed and deformed joints, not only chondroprotectors, but also new drug presented by ORENCIA.

Relieves pain and swelling in the joints with arthritis and arthrosis
Restores joints and tissues, effective for osteochondrosis

To learn more…

Injections for the joints: an overview of drugs and injection methods of treatment

Joint injections are an integral part of the treatment of many diseases of the musculoskeletal system. Most often they are prescribed for deforming osteoarthritis (OA), injuries and chronic inflammatory diseases of the joints. Several groups of drugs are used to perform injections. The choice of the drug, the method of its administration and the treatment regimen is carried out by the attending physician.

We will figure out which injections for joint diseases a specialist can prescribe for you in different situations. Let's find out how this or that medicine works, what are the advantages of each method of administration.

Who needs joint injections and why?

Drug blockades are usually used to quickly relieve pain, which can be caused by bruises, injuries, dislocations, sprains, meniscus ruptures, and acute inflammation in the knee area. Such injections are made for post-traumatic pain in the knee joint. The introduction of local anesthetics can alleviate the suffering of the patient, but does not have a therapeutic effect. After the injection, the patient is examined and a course of treatment is prescribed.

Names of widely used injections from acute pain in the joints: Novocaine, Trimecaine, Lidocaine.

Planned local injection therapy (LIT) is prescribed only after the examination of the patient. Doctors select drugs and a treatment regimen in consultation with the patient. Procedures are performed on an outpatient basis, less often in a hospital setting.

Diseases requiring LIT:

deforming osteoarthritis;
periarthritis;
rheumatoid arthritis;
bursitis;
tendinitis;
synovitis;
gout;
post-traumatic degenerative changes in the joints.

In addition to drugs, carbon dioxide (CO2), platelet-rich plasma (PRP), cellular or tissue engineering products can also be injected into the joint cavities. These tools are used for chronic diseases joints, which are accompanied by the destruction of cartilage.

With purulent synovitis, bursitis and arthritis, patients remove excess synovial fluid, wash the joint cavity and inject antibiotics there. The names of popular antibacterial injections for joints: Tseporin, Ampicillin, Gentamicin.

Types of injections

In orthopedics and traumatology, several methods of administering drugs are used. Doctors give preference to each of them in a given situation. With sprain or inflammation of the ligaments, periarticular injections of corticosteroids with local anesthetics are more often prescribed, with severe deforming osteoarthritis, intra-articular injection of hyaluronic acid.

Methods of injection administration of drugs in orthopedics and traumatology:

intramuscular. It is used when it is necessary to stop a pronounced pain syndrome. Intramuscularly, patients are injected with non-steroidal anti-inflammatory drugs (Artrozan, Movalis, Dynastat, Amelotex). In chronic osteoarthritis, chondroprotectors can be injected into the muscles of patients. Hyaluronic acid and corticosteroids are not administered by this method;
periarticular. Medicines are injected into the periarticular tissues. Periarticular blockade is needed for severe pain in the joint caused by trauma or inflammation. The introduction of corticosteroids and local anesthetics is effective when only the periarticular tissues are affected, but not the joint itself;
intraarticular. Used for severe joint diseases. Drugs are injected into the synovial cavity that have an anti-inflammatory, regenerating or restorative effect. For injections, corticosteroids, chondroprotectors or hyaluronic acid are usually used. Sometimes several drugs are used for treatment.

With deforming osteoarthritis, intra-articular administration of drugs is most effective. It allows you to create the maximum concentration of the drug in the foci of pathology. The effect of such therapy is higher than that of taking pills and intramuscular injections.

Groups of drugs for injection

For the treatment of joints of different localization, the same drugs are used. According to the direction of action, they can be divided into anti-inflammatory, analgesic, antibacterial and regenerating agents. Let's find out how different groups of drugs work.

Many people are interested in the names of injections for the knee joint. For injuries and diseases of the knee, patients are injected with the same drugs as with damage to the joints of any other localization.

Table 1. Injectables used in orthopedics and traumatology

Group	Representatives	Mechanism of action and purpose of application
Corticosteroids	Hydrocortisone Kenalog-40 Flosteron	They have a powerful anti-inflammatory and analgesic effect. They are prescribed for arthrosis, chronic arthritis, non-infectious synovitis and periarthritis to stop the inflammatory process.
Chondroprotectors	Alflutop Chondrolon Noltrex	Protect intra-articular cartilage from rapid destruction, inhibit the development of deforming OA. In scientific circles, there is still debate about whether chondroprotectors can restore destroyed cartilage.
Hyaluronic acid	Synocrom Fermatron	Normalize the composition of the synovial fluid, making it more viscous and dense. Protect intra-articular cartilage from trauma, promote their regeneration
Local anesthetics	Lidocaine Bupivacaine Trimecain	Quickly stop the pain syndrome, are used for some injuries
NSAIDs	Dynastat Artrozan	Relieve pain and reduce inflammation. Prescribe these drugs in the form of tablets or intramuscular injections
Antibiotics	Gentamicin Ampicillin	They have an antibacterial effect. When administered intraarticularly, the synovial cavity is cleansed of pathogenic bacteria.

Basic principles of corticosteroid therapy

For the treatment of joint diseases, mainly long-acting corticosteroids are used (Diprospan, Flosteron, Kenalog-40). These drugs are enough to be administered 1 time in 7-12 days. The duration of the course of therapy depends on the severity of the disease and the response to treatment. Doctors prescribe 1-5 injections of hormones to patients.

Steroid anti-inflammatory injections for joints well stop pain and relieve inflammation. Their action is best manifested after the first procedure. In the future, the effect of each injection seems to be less pronounced for a person. If you do not feel better after the first injection, tell your doctor. Most likely, he will decide that there is no point in continuing treatment.

Corticosteroids are only suitable for the symptomatic treatment of chronic arthritis and arthrosis. They do not restore the structure of cartilage, but only temporarily relieve pain and inflammation. With prolonged use, steroids disrupt the metabolic processes in cartilage, which accelerates their destruction.

Treatment with different types of chondroprotectors

For injections into the joints with arthrosis, injectable forms of chondroprotectors (Noltrex, Chondrolon, Alflutop) are very often used. They are injected into the synovial cavity with an interval of 6-10 days. The course of treatment usually consists of 5-6 procedures. Sometimes, along with injections, patients are also prescribed tablets or intramuscular injections.

Tableted chondroprotectors:

Structum;
Artra;
Glucosamine;
Hondrolon;
Piascledin;
Mukosat.

Names of chondroprotectors for intramuscular injections for joints:

Rumalon;
Alflutop;
Don;
Artradol.

In clinical studies, scientists have found that combination treatment different types chondroprotectors allows you to achieve more pronounced results than monotherapy. For example, oral administration of the drug along with its intra-articular administration is very effective. different forms chondroprotectors potentiate (that is, enhance) the action of each other.

Simultaneous treatment with chondroprotectors and hyaluronic acid allows you to stop the pain syndrome and improve the functional state of the joint.

Hyaluronic acid preparations for injections into the joints

Hyaluronic acid is the main and most important component of synovial fluid. With degenerative-destructive diseases of the joints, its amount decreases, which accelerates the destruction of cartilage. Replenishment of hyaluronic acid deficiency slows down the progression of arthrosis and significantly improves the patient's condition.

Names of drugs for injections in the knee and TBS for arthrosis of the joints:

Viskosil;
Ostenil;
Suplazin;
Hyaluron;
Synvisc;
Hyastat;
Synokrom.

Hyaluronic acid preparations are injected only into the synovial cavity. Medicines are usually injected with an interval of 5-7 days. The course of treatment consists of 3-5 injections, and the effect of its passage is enough for 8-10 months. The introduction of hyaluronic acid is recommended to be repeated 1-2 times a year.

Hyaluronic acid is almost instantly destroyed in inflamed joints. Therefore, it makes no sense to introduce it to persons with acute arthritis and purulent synovitis. The drug is only suitable for the treatment of chronic degenerative-destructive diseases of the joints and non-purulent inflammatory processes in the periarticular tissues.

Hyaluronic acid preparations are also called synovial fluid implants. If you come across this term somewhere, don't get lost. Know that the introduction of hyaluronic acid has nothing to do with arthroplasty, that is, surgical replacement of the joint.

Gas injections or carboxytherapy

Carboxytherapy is an alternative treatment that is used to combat certain joint diseases. The essence of the technique is the intra-articular injection of carbon dioxide. The procedure is performed using a special device. Manipulation can be repeated with a frequency of 3 times a week to 1 time per month.

After administration, a person has slight pain, swelling, redness of the skin in the joint area. Soon all these unpleasant symptoms disappear. Carbon dioxide is completely eliminated from the body after 5-20 minutes, but the therapeutic effect lasts up to 20 days. Carboxytherapy stimulates blood flow to the joints and should technically promote cartilage repair. But it is impossible to cure arthrosis or arthritis with its help. The technique is used only as an auxiliary method of treatment.

Carboxytherapy is not a method traditional medicine and therefore must be handled with extreme caution. Before deciding on the procedure, be sure to consult with an orthopedist.

PRP method

Other names for such injections from joint diseases are plasmoplasty, plasmolifting. The essence of the technique lies in the intra-articular injection of a person's own platelet-rich plasma (PRP). To obtain it, 150 ml of blood is taken from a patient from a vein and centrifuged, obtaining a concentrate containing about 1,000,000 platelets per 1 μl.

PRP is administered in an amount of 5 ml every 2-3 days. The standard course of treatment consists of 3 procedures. Platelet-rich plasma contains a large number of growth factors and chondroprotective agents. It stimulates the restoration of cartilage, slows down the development of arthrosis. Plasmolifting is especially effective in young patients with stages I-II of deforming OA.

PRP is a cell engineering method. In addition to platelet-rich plasma, stromavascular adipose tissue and biomedical cell products can also be injected into the joint cavities. The latter are artificially made from human cartilage cells.

Technique for performing periarticular and intraarticular injections

Physicians do periarticular and intraarticular injections in a specially equipped treatment room. The patient removes the clothes that interfere with him and assumes the most comfortable position. The doctor washes his hands, puts on gloves, treats the person's skin with an alcohol solution and prepares the drug for administration. For injections, syringes with a volume of 2 or 5 ml are most often used. Some experts prefer small "insulin" needles.

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Immediately before the injection, the doctor once again treats the patient's skin. If necessary, he will numb the injection site with a local anesthetic solution with or without adrenaline. Only then does the doctor administer the drug. A specialist who is well versed in the techniques of intra-articular and peri-articular injections has the right to perform the procedure.

If there is a need to remove excess intra-articular fluid before administering the drug, a separate 20 ml syringe is used for this. It is strictly forbidden to draw medicine into it after performing aspiration.

Possible injection complications

Although injections are performed in compliance with all the rules of asepsis and antisepsis, in some cases, infectious complications may develop after them. The reason may be the introduction of pathogenic microorganisms during manipulation. Undesirable effects most often occur in people with a weakened immune system and immunodeficiency states.

In the first hours after intra-articular or periarticular administration of corticosteroid drugs, 5-15% of patients develop the so-called post-injection crystalline synovitis. It is characterized by increased pain and the appearance of signs of inflammation of the joint. Unpleasant sensations persist for 2-3 days and disappear without any consequences.

Frequent injections lead to excessive injury to the joints. And prolonged treatment with steroids contributes to the destruction of cartilage, weakening of ligaments and tendons. All this eventually causes "looseness" of the joint. Abuse of corticosteroids (as well as any other injectable drugs) is not worth it. It is necessary to carry out treatment rationally and without harm to the person.

Diprospan- This is a drug with which you can quickly relieve inflammation or prevent the growth of connective tissue. It effectively suppresses immunological and allergic reactions. It works even when others medicines powerless, but, being a glucocorticosteroid agent, Diprospan has serious side effects.

Side effects of Diprospan from the side of the central nervous system

Most often, after the appointment of Diprospan injections, side effects are manifested by the human central nervous system and sensory organs. With long-term use, this medicine may cause:

dizziness;
headache;
convulsions;
insomnia;
increase in intracranial pressure.

If you do not stop the course of treatment using Diprospan, some patients experience damage optic nerve. Very often, when using it, sharp jumps in mood are possible. For example, it can change from joyfully elevated to depressed, while being combined with increased irritability or anxiety. In rare cases, even acute psychoses develop, which are accompanied by a violation of the orientation of the patient and the appearance of hallucinations.

The consequences of the introduction of Diprospan in the head or neck area are an increase in intraocular pressure and the formation of cataracts. Because of this, a sudden loss of vision can even occur. And with prolonged use of this medication, the risk of developing viral, fungal and bacterial eye infections increases.

Side effects of Diprospan on the part of the cardiovascular system

Despite the obvious benefits, Diprospan can also harm the patient's cardiovascular system, since it contributes to the retention of water and sodium in the body, and also removes potassium and calcium, because this provokes a load on the human heart and leads to weakness of the heart muscle. As a result, a person may develop:

cardiovascular insufficiency;
vascular thrombosis;
increase in blood pressure.

With myocardial infarction, the harm of Diprospan is that the patient slowly forms a scar in the area of myocardial tissue necrosis, and this leads to myocardial rupture.

Side effects of Diprospan on the part of metabolism

According to the instructions, the side effects of Diprospan are also changes in all types of metabolism. Protein metabolism changes, as protein breakdown increases, and carbohydrate metabolism, due to the fact that the amount of glucose in the blood increases significantly and the process of its deposition accelerates. All this leads to the fact that fat accumulates and is deposited, mainly in the upper body.

All changes in metabolism affect the state of the endocrine system and the consequences of Diprospan injections can be:

development of Itsenko-Cushing's syndrome;
exacerbation of the course of diabetes;

Other side effects of Diprospan

In some cases, under the influence of Diprospan, muscle weakness occurs, and bone tissue loses calcium. This leads to muscle loss and increased bone fragility. After the use of this remedy, aseptic necrosis of the humerus and femur, as well as tendon ruptures, may occur. If Diprospan was used to treat children, then they may have premature complete closure of growth zones in the bones.

Often, intramuscular administration of this type of drug causes erosive and ulcerative lesions of even a healthy stomach, inflammation of the pancreas, thinning of the skin. At the injection site of Diprostan, areas of reduced or increased pigmentation, purulent abscesses may appear.

Most diseases occur with a strong pain syndrome and a pronounced inflammatory reaction. The primary goal of a specialist is to relieve pain and inflammation, improve the patient's condition.

Before the advent of modern NSAIDs, hormonal drugs from the pharmacological group of glucocorticoids did an excellent job with this task. These are substitutes for hormones produced in the human body by the adrenal glands. Diprospan belongs to this group of drugs. It has found wide application in various fields of medicine.

To use a hormonal agent or not is determined by the doctor in accordance with the symptoms and course of the disease. Together with high performance and a large range of action, Diprospan has many side effects. Pathogenesis, contraindications and rules for the use of Diprospan are indicated in the instructions.

Pharmacological characteristics

Diprospan contains 2 active ingredients - betamethasone dipropionate and betamethasone sodium phosphate. The first causes a prolonging effect, the second is responsible for the speed of its onset. The unexpressed effect on water-salt metabolism makes Diprospan less dangerous than mineralocorticoids. After using the latter, edema appears, blood pressure rises, the heart rhythm is disturbed, and osteoporosis develops.

medicinal product has the following effects:

anti-inflammatory- stops the inflammatory response. As a result, signs of inflammation are eliminated - hyperthermia of the affected area, swelling, soreness and redness of the skin in this area.
Antiallergic- eliminates the effects of allergies.
immunosuppressive- in high doses, it has a suppressive effect on the immune system.
Vasoconstrictor- reduces the diameter of blood vessels, reduces blood flow and vascular permeability. As a result, the amount of fluid released into the tissue during the inflammatory process decreases, and hypertension develops.
Antiproliferative- stops cell growth at the site of injury.
Antishock- increases the body's immunity to stressful situations, hyperthermia, a sudden drop in glucose and other conditions in which the production of hormones and blood cells increases.

Diprospan affects the metabolism of proteins, fats and carbohydrates in the body. The drug inhibits protein synthesis, leads to the breakdown of proteins in the skin, bones and muscles. Why is this condition dangerous? As a result of this process, the healing of the wound surface slows down, skin areas atrophy, muscle weakness and necrosis develops. The drug increases the breakdown of lipids in the tissues of the limbs, promotes the redistribution of fats and their deposition in the upper body. Diprospan stimulates the formation and accumulation of glucose in the liver, reduces its uptake by tissues, and increases blood glucose levels.

Composition and form of release of the drug

Glucocorticosteroids containing betamethasone are produced under various trade names and in various dosage forms. As a rule, these are medicines for external use - ointments, sprays with a sprayer, creams.

Tablets are not found in pharmacies. Under the name Diprospan, a suspension is made for parenteral administration, with the exception of intravenous and subcutaneous injections. According to the instructions for use, Diprospan injections are prescribed once or in a short course. The package contains 1 or 5 glass ampoules with a solution.

1 vial of Diprospan with a capacity of 1 ml contains 2 forms of betamethasone, corresponding to 5 and 2 mg of the active substance and several auxiliary substances. Outwardly, it is a transparent or light yellow viscous liquid with white particles without foreign inclusions. When shaking, a suspension is formed with smoothly settling small grains.

Excipients:

sodium dihydrogen phosphate– acidity regulator, stabilizer, water-saving component;
sodium chloride, benzyl alcohol, hydrochloric acid- solvents, detoxifying agents;
disodium edetate– for the formation of stable complexes;
polyoxyethylene sorbitan monooleate- stabilizer, emulsifier, maintains the required viscosity;
para-hydroxybenzoic acid methyl and propyl ester- antiseptics, preservatives;
carmellose sodium– loosening agent, disintegrator;
macrogol (polymer of ethylene glycol), sterile water- solvent, binder.

The action of Diprospan

The comprehensive effect of Diprospan is due to its ability to quickly pass through the cell membrane. The general effect on the body at the cell level is manifested by the formation of some and inhibition of the synthesis of other cellular proteins. Due to the presence of fluorine in the composition of betamethasone, an anti-inflammatory reaction occurs quickly.

According to the instructions for use, the therapeutic effect of Diprospan is observed 10-20 minutes after administration.

According to the duration of action, all glucocorticosteroids are divided into 3 groups. Diprospan belongs to the 3rd group - glucocorticoids with a long (over 24 hours) effect. It stabilizes the patient's condition for up to 72 hours. The drug inhibits the function of the hypothalamus-pituitary-adrenal system. Why is this influence dangerous? With prolonged use, a withdrawal syndrome often occurs.

Pharmacokinetics of Diprospan:

Has good solubility.
Up to 62-64% binds to plasma proteins.
Betamethasone sodium phosphate is excreted from the body in a day, betamethasone dipropionate - after 10 days or more.
Metabolized in the liver.
Inactive metabolites are excreted by the kidneys, a small part - by bile.

How often to use the medicine - only the doctor determines. In most cases, the drug is used as an auxiliary in the basic therapy. What Diprospan treats is:

Musculoskeletal diseases - osteoarthritis, osteochondropathy. The drug is prescribed for arthritis, with arthrosis, with a heel spur;
Diseases of the connective tissue, feet, spine, epicondylitis of the elbow joint;
Rheumatoid arthritis, other systemic pathologies - scleroderma, lupus erythematosus, disseminated angiitis, Wagner's disease;
Diseases of the sciatic nerve, psoriasis, sciatica, lumbago;
Soft tissue diseases - inflammation of the joint bags, tendon tissues, muscles and ligaments;
Traumatic shock, post-traumatic arthritis. The latter is often observed in athletes. For joint pain, 5 injections per year are usually sufficient;
Allergic processes - hay, drug fever, allergic diseases of the eyes, ear or bronchi, insect bites, anaphylactic shock;
Diseases of the skin and lymphatic tissue, tumors, Crohn's disease and other intestinal pathologies;
Burn, cardiogenic, blood transfusion shock;
Violation of the function of the adrenal cortex, blood pathology, nephrotic syndrome.

The introduction of Diprospan into the joint cavity is not carried out during infectious processes.

How to administer Diprospan

According to experts, therapy with glucocorticosteroid drugs is not an easy process. How to properly put Diprospan and cancel it without disturbing the function of the adrenal cortex, only the doctor knows. To prevent the development of withdrawal syndrome, you should follow the recommendations for the duration of the course and the amount of medication. The body's response to injections is also observed. Having received the desired effect, the patient is transferred to maintenance therapy, slowly reducing the dosage. Carry out annual monitoring of the patient's condition.

To prevent infection during injections, it is necessary to strictly adhere to aseptic measures: sterilize instruments, clean hands and the injection site with disinfectants. How to administer Diprospan is decided on an individual basis.

There are the following methods of administration:

Intramuscular- injected deep into the area with a high content muscle tissue. How often intramuscular injections are given depends on the disease itself. For skin diseases, 1 ampoule is enough, for allergies, 2 ml of medication is needed to completely eliminate clinical symptoms. With bursitis, a whole course is needed (1 injection of Diprospan per week) with an initial dosage of 1 ml. With severe pain, immediately apply 2 ml of the drug, it is possible to repeat the manipulation after 2-4 weeks to consolidate the effect. The dosage of Diprospan for rheumatoid arthritis is 1, you can 2, ml of the solution intramuscularly.
intra-articular- 1 or 2 ampoules are injected into the cavity of the large joint, 0.5 or 1 ampule of the middle joint, 1/4 or 1/2 ampoules of the small joint. Within a couple of hours after the injection, the pain caused by arthritis or arthrosis disappears, the mobility of the bone joint resumes. The action continues for a month or more.
Periarticular in the space around the joint. Drug blockades are often carried out in this way. The drug is used along with a local anesthetic. Initially mixed in a syringe (Diprospan is taken first) and shaken vigorously. A puncture needle is used to puncture in the right place, based on the dosage - 0.2 ml of a glucocorticoid preparation per 1 sq. cm. Diprospan with lidocaine (or other anesthetic) works instantly, the desired effect (elimination of pain, swelling, redness of tissues, inactivity) lasts 3 days.
Intradermal, intralesional, or drug delivery into tissue- the introduction of a thin needle into the skin at a shallow depth. With skin lesions - directly to the pathological focus. Blockade with Diprospan for spinal hernia helps to effectively reduce the pain symptom and swelling. For back pain, intradermal injections are prescribed, based on 0.2 ml per 1 sq. cm, but not more than 1 ml / week.
intrabursally- the drug is injected shallowly into the synovial cavity, trying to avoid damage to blood vessels and nerves. In the treatment of bursitis of the shoulder joint, 1-2 ml of the solution is sufficient for the blockade, the result can be seen after 15 minutes. Pain and swelling disappear, discomfort and hyperemia disappear, after a couple of hours the mobility of the joint returns.

If there is no desired effect, they refuse Diprospan, slowly reducing the dosage, up to the complete withdrawal of the drug.

Children are not prescribed due to lack of clinical data.

An overdose of the drug does not pose a great danger to life. Manifested by insomnia, weakness, nausea, nervous excitement, depression. With long-term use of large amounts - adrenal insufficiency, hypertension, fluid retention, a decrease in bone density.

Side effect

The frequency of occurrence of adverse reactions and their severity are determined by the amount of the drug and the duration of its use. The consequences are reversible.

To side effects relate:

Hypertension, angioedema, anaphylactic shock;
Metabolic disorders - increased excretion of potassium, calcium, nitrogen, fluid retention, decreased acidity, growth of adipose tissue like a tumor. The level of sodium in the blood serum rises, weight increases;
Candidiasis, disorder menstrual cycle, decreased adrenal function, hyperhidrosis;
Dizziness, mood changes, insomnia, excitability;
Diseases of the gastrointestinal tract, increased risk of bleeding;
Skeletal muscle damage, decreased bone density, spasm, increased risk of fractures, improper wound healing;
Change in skin color, acne, stretch marks, atrophy, dermatitis, purulent tissue damage, hemorrhages in the skin or mucous membranes;
Cataract, glaucoma, displacement of the eyeball, visual impairment.

Diprospan is not recommended for pregnant and lactating women, people with liver and kidney failure, and the elderly. During therapy with Diprospan, vaccination is not carried out. After an intra-articular course of treatment, the joint is not overloaded. When using the drug for 6 months, an ophthalmologist's consultation is necessary.

Simultaneous medication with:

NSAIDs and alcohol - increases the risk of bleeding and ulcerative pathologies of the gastrointestinal tract;
Cardiac glycosides - disrupts the functions of the body as a whole;
Diuretics - removes potassium from the body;
Anticoagulants of indirect action - changes blood clotting;
Other glucocorticoids - leads to changes in the blood test.