Do not use the drug in patients with equipoise for horses acute and subacute myocardial infarction, since the use of glucocorticosteroids, they may lead to the spread of necrosis focus, slowing the formation of scar tissue and, as a consequence, – to rupture of the heart muscle.
The drug should be used in patients with eye disease caused by the herpes simplex virus, because it can lead to corneal perforation.
Corticosteroids should be used with caution in nonspecific ulcerative colitis, if there is a perforation of the threat, abscess or other purulent infection, as well as diverticulitis, in the presence of fresh intestinal anastomoses with active or latent peptic ulcer, renal insufficiency, hypertension, osteoporosis, myasthenia gravis.
This formulation contains benzyl alcohol. It was found that benzyl alcohol can cause “suffocation syndrome” fatal in premature infants. The drug is not recommended for use in neonates.
Pregnancy and breast-feeding
In a number of animal studies have shown that administration of high doses of corticosteroids females can lead to deformities in the fetus. However, in a number of clinical studies have shown that the use of corticosteroids during pregnancy apparently does not cause birth defects. In one retrospective study found an increased incidence of babies born with low birth weight in mothers who received corticosteroids.Since studies in pregnant women do not exclude the possible harm corticosteroids, use of these drugs in pregnancy, nursing mothers or women of childbearing age requires an assessment of the likely positive effect of the drug compared to the potential risk to the mother, fetus or embryo. Be used during pregnancy only if absolutely indicated.
Can easily penetrate through the placenta. Although babies born to mothers who have received substantial doses of corticosteroids during pregnancy, adrenal insufficiency is rare, these children should be carefully examined in order to identify possible symptoms of adrenal hypofunction. Effect of corticosteroids on the course and outcome of birth is unknown. Stand in breast milk, so if necessary, the appointment of equipoise for horsesduring lactation breastfeeding should be discontinued.
Dosage and administration
Can be administered as a w / w or w / o Injection, or in / in infusion, but in emergencies preferably start treatment in / injection. Babies should be administered a lower dose (but not less than 0.5 mg / kg / day), but when choosing the dose primarily take into account the severity of the condition and the patient’s response to therapy, and not the age and body weight. As an additional therapy for life-threatening conditions of 30 mg / kg body weight / in for at least 30 min. The introduction of this dose can be repeated every 4-6 hours for a maximum of 48 hours. Pulse therapy in the treatment of diseases for which effective corticosteroid therapy in exacerbations of the disease and / or ineffectiveness of standard therapy.
Preparation of solutions
Preparations for parenteral administration as much as possible should be checked visually for color changes or the appearance of the particles.
- Dvuhemkostny vial of equipoise for horses
- Click on plastic activator to the solvent fracture in his lower capacity.
- To gently swing the vial until the lyophilizate is dissolved.
- Remove the plastic disc, covering the center of the plug.
- Treat the surface of the stopper corresponding antiseptic.
- Puncture needle cork center so that was visible tip of the needle. Turn the vial and syringe Collect the required amount of solution.
- Aseptically enter the solvent into the vial of lyophilisate.
- Only use a special solvent.
- Preparation of solutions for intravenous infusion
- Prepare a solution as described above. The drug can also be administered in the form of diluted solutions obtained by mixing a starting drug solution with aqueous 5% dextrose, saline, 5% dextrose in 0.45% or 0.9% sodium chloride solution. Prepared solutions are physically and chemically stable for 48 hours.
Side effects NOTE: The following side effects are typical for all GCS with parenteral use. Inclusion in this list does not mean that these effects are specific to this drug. The violation of water-electrolyte balance: Sodium retention, congestive heart failure in patients with the appropriate disposition, fluid retention, potassium loss, hypokalemic alkalosis. Cardiovascular: hypotension or hypertension; cardiac arrhythmias; in patients with acute and subacute myocardial infarction -dissemination necrosis, slowing the formation of scar tissue, which can lead to rupture of the heart muscle. There are reports of heart rhythm disturbances and / or the development of circulatory collapse and / or cardiac arrest about after a rapid on / in the high doses of methylprednisolone (0.5 g, introduced in less than 10 minutes). During and after the on / in the high-dose equipoise for horses methylprednisolone have also been reported cases of bradycardia, but they are not necessarily dependent on the speed or duration of infusion. Musculoskeletal: steroid myopathy, muscle weakness, osteoporosis, pathologic fractures, compression fractures of the vertebrae, aseptic necrosis of the epiphysis of long bones , tendon rupture, particularly the Achilles tendon.Acute myopathy most often develops in the application of high doses of corticosteroids in patients with impaired neuromuscular transmission (eg, myasthenia gravis), or in patients while receiving treatment by peripheral muscle relaxants (eg, pancuronium bromide) .