Baycadron

Baycadron

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Questions & Answers

Side Effects & Adverse Reactions

In patients on corticosteroid therapy subjected to unusual stress, increased dosage of rapidly acting corticosteroids before, during, and after the stressful situation is indicated.

Drug-induced secondary adrenocortical insufficiency may result from too rapid withdrawal of corticosteroids and may be minimized by gradual reduction of dosage. This type of relative insufficiency may persist for months after discontinuation of therapy; therefore, in any situation of stress occurring during that period, hormone therapy should be reinstituted. If the patient is receiving steroids already, dosage may have to be increased. Since mineralocorticoid secretion may be impaired, salt and/or a mineralocorticoid should be administered concurrently.

Corticosteroids may mask some signs of infection, and new infections may appear during their use. There may be decreased resistance and inability to localize infection when corticosteroids are used. Moreover, corticosteroids may affect the nitroblue-tetrazolium test for bacterial infection and produce false-negative results.

In cerebral malaria, a double-blind trial has shown that the use of corticosteroids is associated with prolongation of coma and a higher incidence of pneumonia and gastrointestinal bleeding.

Corticosteroids may activate latent amebiasis. Therefore, it is recommended that latent or active amebiasis be ruled out before initiating corticosteroid therapy in any patient who has spent time in the tropics or any patient with unexplained diarrhea.

Prolonged use of corticosteroids may produce posterior subcapsular cataracts, glaucoma with possible damage to the optic nerves, and may enhance the establishment of secondary ocular infections due to fungi or viruses.

Usage in Pregnancy

Since adequate human reproduction studies have not been done with corticosteroids, use of these drugs in pregnancy or in women of childbearing potential requires that the anticipated benefits be weighed against the possible hazards to the mother and embryo or fetus. Infants born of mothers who have received substantial doses of corticosteroids during pregnancy should be carefully observed for signs of hypoadrenalism.

Corticosteroids appear in breast milk and could suppress growth, interfere with endogenous corticosteroid production, or cause other unwanted effects. Mothers taking pharmacologic doses of corticosteroids should be advised not to nurse.

Average and large doses of hydrocortisone or cortisone can cause elevation of blood pressure, salt and water retention, and increased excretion of potassium. These effects are less likely to occur with the synthetic derivatives except when used in large doses. Dietary salt restriction and potassium supplementation may be necessary. All corticosteroids increase calcium excretion.

Administration of live virus vaccines, including smallpox, is contraindicated in individuals receiving immunosuppressive doses of corticosteroids. If inactivated viral or bacterial vaccines are administered to individuals receiving immunosuppressive doses of corticosteroids, the expected serum antibody response may not be obtained. However, immunization procedures may be undertaken in patients who are receiving corticosteroids as replacement therapy, e.g., for Addison's disease.

Persons who are on drugs which suppress the immune system are more susceptible to infections than healthy individuals. Chickenpox and measles, for example, can have more serious or even fatal course in non-immune children or adults on corticosteroids. In such children or adults who have not had these diseases, particular care should be taken to avoid exposure. How the dose, route and duration of corticosteroid administration affects the risk of developing a disseminated infection is not known. The contribution of the underlying disease and/or prior corticosteroid treatment to the risk is also not known. If exposed to chickenpox, prophylaxis with varicella zoster immune globulin (VZIG) may be indicated. If exposed to measles, prophylaxis with pooled intramuscular immunoglobulin (IG) may be indicated. (See the respective package inserts for complete VZIG and IG prescribing information.) If chickenpox develops, treatment with antiviral agents may be considered.

The use of Baycadron™ Elixir in active tuberculosis should be restricted to those cases of fulminating or disseminated tuberculosis in which the corticosteroid is used for the management of the disease in conjunction with an appropriate antituberculous regimen.

If corticosteroids are indicated in patients with latent tuberculosis or tuberculin reactivity, close observation is necessary as reactivation of the disease may occur. During prolonged corticosteroid therapy, these patients should receive chemoprophylaxis.

Literature reports suggest an apparent association between use of corticosteroids and left ventricular free wall rupture after a recent myocardial infarction; therefore, therapy with corticosteroids should be used with great caution in these patients.

Legal Issues

There is currently no legal information available for this drug.

FDA Safety Alerts

There are currently no FDA safety alerts available for this drug.

Manufacturer Warnings

There is currently no manufacturer warning information available for this drug.

FDA Labeling Changes

There are currently no FDA labeling changes available for this drug.

Uses

1. Endocrine Disorders

Primary or secondary adrenocortical insufficiency (hydrocortisone or cortisone is the first choice; synthetic analogs may be used in conjunction with mineralocorticoids where applicable; in infancy mineralocorticoid supplementation is of particular importance).

 
Congenital adrenal hyperplasia
 
Nonsuppurative thyroiditis
 
Hypercalcemia associated with cancer
2. Rheumatic Disorders

As adjunctive therapy for short-term administration (to tide the patient over an acute episode or exacerbation) in:

 
Psoriatic arthritis
 
Rheumatoid arthritis, including juvenile rheumatoid arthritis (selected cases may require low-dose maintenance therapy)
 
Ankylosing spondylitis
 
Acute and subacute bursitis
 
Acute nonspecific tenosynovitis
 
Acute gouty arthritis
 
Post-traumatic osteoarthritis
 
Synovitis of osteoarthritis
 
Epicondylitis
3. Collagen Diseases

During an exacerbation or as maintenance therapy in selected cases of:

 
Systemic lupus erythematosus
 
Acute rheumatic carditis
4. Dermatologic Diseases

 
Pemphigus
 
Bullous dermatitis herpetiformis
 
Severe erythema multiforme (Stevens-Johnson syndrome)
 
Exfoliative dermatitis
 
Mycosis fungoides
 
Severe psoriasis
 
Severe seborrheic dermatitis
5. Allergic States

Control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment:

 
Seasonal or perennial allergic rhinitis
 
Bronchial asthma
 
Contact dermatitis
 
Atopic dermatitis
 
Serum sickness
 
Drug hypersensitivity reactions
6. Ophthalmic Diseases

Severe acute and chronic allergic and inflammatory processes involving the eye and its adnexa, such as:

 
Allergic conjunctivitis
 
Keratitis
 
Allergic corneal marginal ulcers
 
Herpes zoster ophthalmicus
 
Iritis and iridocyclitis
 
Chorioretinitis
 
Anterior segment inflammation
 
Diffuse posterior uveitis and choroiditis
 
Optic neuritis
 
Sympathetic ophthalmia
7. Respiratory Diseases
 
Symptomatic sarcoidosis
 
Loeffler's syndrome not manageable by other means
 
Berylliosis
 
Fulminating or disseminated pulmonary tuberculosis when used concurrently with appropriate antituberculous chemotherapy
 
Aspiration pneumonitis
8. Hematologic Disorders
 
Idiopathic thrombocytopenic purpura in adults
 
Secondary thrombocytopenia in adults
 
Acquired (autoimmune) hemolytic anemia
 
Erythroblastopenia (RBC anemia)
 
Congenital (erythroid) hypoplastic anemia
9. Neoplastic Diseases

For palliative management of:

 
Leukemia and lymphomas in adults
 
Acute leukemia of childhood
10. Edematous States

To induce a diuresis or remission of proteinuria in the nephrotic syndrome, without uremia, of the idiopathic type or that due to lupus erythematosus

11. Gastrointestinal Diseases

To tide the patient over a critical period of the disease in:

 
Ulcerative colitis
 
Regional enteritis
12. Miscellaneous
 
Tuberculous meningitis with subarachnoid block or impending block when used concurrently with appropriate antituberculous chemotherapy
 
Trichinosis with neurologic or myocardial involvement
13. Diagnostic testing of adrenocortical hyperfunction

History

There is currently no drug history available for this drug.

Other Information

Each 5 mL (teaspoonful) contains:
Dexamethasone, USP……….……….…………………………. 0.5 mg

Also contains:
Benzoic Acid, USP……………………………………………….. 0.1%
  (as preservative)
Alcohol……………………………………………………………. 5.1%

Inactive Ingredients: Artificial Raspberry Flavor; Citric Acid, USP; FD&C Red No. 40; Liquid Sugar; Propylene Glycol, USP and Purified Water, USP. It may also contain Sodium Citrate, USP.

Glucocorticoids are adrenocortical steroids, both naturally occurring and synthetic, which are readily absorbed from the gastrointestinal tract.

Dexamethasone, a synthetic adrenocortical steroid, is a white to practically white, odorless, crystalline powder. It is stable in air. It is practically insoluble in water. The molecular weight is 392.47. It is designated chemically as 9-fluoro-11β,17,21-trihydroxy-16α-methylpregna-1,4-diene-3,20-dione. The molecular formula is C22H29FO5 and the structural formula is:

Chemical Structure

Baycadron Manufacturers


  • Wockhardt Usa, Llc
    Baycadron (Dexamethasone) Elixir [Wockhardt Usa, Llc]

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