Celeston

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2023-12-15 07:39

Celeston: instructions for use and reviews

1. Release form and composition
2. Pharmacological properties
3. Indications for use
4. Contraindications
5. Method of application and dosage
6. Side effects
7. Overdose
8. Special instructions
9. Application during pregnancy and lactation
10. Use in childhood
11. In case of impaired renal function
12. For violations of liver function
13. Use in the elderly
14. Drug interactions
15. Analogs
16. Terms and conditions of storage
17. Terms of dispensing from pharmacies
18. Reviews
19. Price in pharmacies

Latin name: Celestone

ATX code: H02AB01

Active ingredient: betamethasone (betamethasone)

Manufacturer: Schering-Plow Labo N. V. (Belgium), Schering-Plow (USA)

Description and photo update: 2018-26-10

Celeston is a drug with anti-inflammatory, anti-allergic, antipruritic action.

Release form and composition

Dosage form of release of Celeston:

tablets (10 pcs. in blisters, 3 blisters in a cardboard box);
solution for injection (in ampoules of 1 ml, in a cardboard box of 1 or 10 ampoules).

The active substance is betamethasone:

1 tablet - 0.5 mg;
1 ml of solution - 4 mg (in the form of sodium phosphate).

Pharmacological properties

Pharmacodynamics

Betamethasone is a synthetic glucocorticoid drug for systemic use. It has a pronounced anti-inflammatory, anti-allergic and anti-rheumatic effect.

Interacts with specific receptors in the cell cytoplasm. The complex formed as a result of the interaction penetrates into the cell nucleus, binding with DNA (deoxyribonucleic acid) and stimulating the synthesis of mRNA (matrix ribonucleic acid), which induces the formation of proteins, including lipocortin, that mediate cellular effects.

Celeston affects all phases of inflammation. The anti-inflammatory effect is due to various factors. One of the leading ones is the inhibition of phospholipase A2, followed by inhibition of the formation of pro-inflammatory mediators - PG (prostaglandins) and leukotrienes. In addition, stabilization of cell membranes, prevention of the release of lysosomal enzymes and a decrease in their concentration in the focus of inflammation, inhibition of the migration of neutrophils and macrophages to the focus of inflammation and their phagocytic activity, improvement of microcirculation, decrease in vascular permeability, and decrease in fluid exudation are observed.

The antiallergic effect is provided by a decrease in the synthesis and secretion of allergy mediators, inhibition of the release of histamine and other biologically active substances from sensitized mast cells and basophils, a decrease in the number of circulating basophils, suppression of the proliferation of connective and lymphoid tissue, a decrease in the number of T- and B-lymphocytes, mast cells, inhibition of antibody production, a decrease in the sensitivity of effector cells to allergy mediators, a change in the body's immune response.

The immunosuppressive effect of Celeston is associated with the suppression of the activity of T- and B-lymphocytes, and is also due to inhibition of the release of cytokines from macrophages and leukocytes.

The anti-toxic and anti-shock effect is provided by an increase in blood pressure (due to an increase in the number of circulating catecholamines, restoration of the sensitivity of adrenergic receptors to catecholamines), activation of liver enzymes that are involved in the metabolism of endo- and xenobiotics.

During a long course, the drug suppresses the function of the hypothalamus-pituitary-adrenal system.

Celeston affects all types of exchange. Retains Na ⁺ and water, increases Ca ⁺ excretion, stimulates K ⁺ excretion.

Other effects of the drug:

stimulating gluconeogenesis in the liver, increasing blood glucose levels (possibly developing glucosuria);
acceleration of protein catabolism, especially in muscle tissue;
increasing lipolysis in the tissues of the limbs, stimulating the accumulation of fat mainly in the area of the shoulder girdle, neck, face (moon face).

Pharmacokinetics

Betamethasone is rapidly absorbed into the blood, the detection period in the blood after oral administration is 20 minutes.

The time to reach the maximum concentration in blood plasma is 60 minutes after injection and 2 hours after oral administration.

Binds to plasma proteins. Easily penetrates the histohematogenous barriers, including the placental. Partly excreted in breast milk.

After taking a single dose, the elimination half-life ranges from 180-220 minutes to 300 minutes or more. In liver diseases, betamethasone clearance is slower.

Biotransformation occurs mainly in the liver with the formation of inactive metabolites. Excreted by the kidneys.

Indications for use

pemphigus;
disseminated lupus erythematosus;
scleroderma;
acute rheumatic heart disease;
dermatomyositis;
thyroiditis;
bullous dermatitis herpetiformis;
polymorphic erythema (Stevens-Johnson syndrome);
allergic eczema;
exfoliative dermatitis;
hives;
psoriasis;
allergic conjunctivitis and rhinitis;
fungal mycosis;
bronchial asthma;
serum sickness;
allergic reactions to medications;
adrenocortical insufficiency;
congenital adrenal hyperplasia;
tumor hypercalcemia;
psoriatic, rheumatoid and gouty arthritis;
thrombocytopenia;
ankylosing spondylitis, bursitis, tendosynovitis, synovitis;
acute rheumatic fever;
keratitis;
Leffler's syndrome;
allergic corneal ulcers;
Herpes zoster;
iritis, iridocyclitis;
beryllium disease;
chorioretinitis;
optic neuritis and retrobulbar neuritis;
symptomatic sarcoidosis;
emphysema and pulmonary fibrosis;
autoimmune hemolytic anemia;
erythroblastopenia;
transfusion reactions;
erythroid hypoplastic anemia;
leukemia and lymphomas in adults, acute leukemia in children (palliative care);
tuberculous meningitis;
nonspecific ulcerative colitis;
Bell's palsy.
Additionally (injection solution):
shock;
tetanus;
swelling of the brain;
respiratory distress syndrome in premature babies (prenatal prophylaxis);
rejection reactions of the renal allograft (prevention).

Contraindications

For short-term use for health reasons, Celeston is contraindicated to use only if there is an individual intolerance to its components.

Additional absolute contraindications:

myasthenia gravis;
diabetes mellitus, including impaired glucose tolerance;
vaccination period;
hepatic / renal failure;
systemic mycoses;
herpes diseases, including chickenpox, as well as measles (currently / recently transferred, including recent contact with the patient);
strongyloidiasis (established / suspected),
tuberculosis (in active form in the absence of specific treatment, latent);
immunodeficiency conditions, including AIDS or HIV infection;
acute psychosis;
diseases of the gastrointestinal tract, including diverticulitis, gastritis, esophagitis, peptic ulcer, exacerbation of gastric ulcer and duodenal ulcer, recently created intestinal anastomosis;
diseases of the cardiovascular system, including arterial hypertension, congestive heart failure, recent myocardial infarction;
preeclampsia, eclampsia, symptoms of placental lesions during pregnancy;
period of breastfeeding.

Relative (Celeston should be used under medical supervision):

diabetes;
herpes simplex of the cornea;
conditions accompanied by a risk of thrombosis (Celeston is prescribed in combination with anticoagulants);
systemic lupus erythematosus (associated with an increased risk of developing aseptic necrosis);
osteoporosis;
abscesses, purulent infections, tuberculosis (Celeston can only be prescribed in combination with appropriate antibiotic therapy);
old age (associated with an increased risk of osteoporosis, arterial hypertension, especially in postmenopausal women);
pregnancy.

It is necessary to take into account the enhancement of the action of Celeston in liver cirrhosis, hypothyroidism, the likelihood of relative adrenal insufficiency (within several months after discontinuation of the drug, especially with a long course).

Instructions for the use of Celeston: method and dosage

The dosage regimen of Celeston is determined by the disease, its severity and the patient's response to the therapy.

Pills

Recommended daily dose range:

adults: 0.25-8 mg;
children: 0.017-0.25 mg / kg.

After improvement, the initial dose is gradually reduced to the minimum maintenance dose, which provides the desired clinical effect. In chronic diseases during the period of spontaneous remission, therapy should be discontinued. Dose increases may be required due to stressful situations.

Features of the use of Celeston (initial / maintenance dose):

dermatological diseases: 2.5-4.5 mg / as needed;
acute rheumatic fever: 6-8 mg / as needed;
rheumatoid arthritis and other rheumatic diseases: 1–2.5 mg / 0.5–1.5 mg;
status asthmaticus: 3.5–4.5 mg / as needed;
bursitis: 1–2.5 mg / as needed;
bronchial asthma: from 3.5 mg / as needed:
inflammatory eye diseases: 2.5–4.5 mg / as needed;
adrenogenital syndrome: 1–1.5 mg / as needed;
systemic lupus erythematosus: 3 times a day, 1–1.5 mg / as needed (usually 1.5–3 mg daily);
hay fever (pollen allergy): 1.5–2.5 mg / as needed;
fibrosis and emphysema of the lungs: 2–3.5 mg / 1–2.5 mg.

With gouty arthritis, after the symptoms of exacerbation disappear, Celeston should be continued for several days.

The maintenance daily dose can be applied once in the early morning. It is not recommended to take Celeston every other day.

Injection solution

Method of administration of Celeston: intramuscularly, intravenously, into the lesion focus, into the joint cavity, and also into soft tissues. The drug can be administered by intravenous drip with isotonic sodium chloride solution or dextrose solution.

The initial adult daily dose is up to 8 mg. Depending on the condition, the drug can be prescribed in higher or lower doses. Before receiving a clinical response, it is necessary to adjust the initial dose.

The average starting dose for children is 0.02–0.125 mg / kg per day.

After achieving positive results of treatment, the patient should be gradually transferred to the minimum maintenance dose. Under stress, it may be necessary to increase the dose.

Improvement in cerebral edema can occur within a few hours after the introduction of 0.5–1 ml of Celeston (2–4 mg of betamethasone). Patients in a coma are usually given 2–4 mg 4 times a day.

In order to prevent a kidney transplant rejection reaction, 60 mg of betamethasone is injected intravenously during the first 24 hours. Taking into account the individual characteristics of the patient, minor changes in the dosage regimen are possible.

For the prevention of transfusion reactions immediately before blood transfusion, it is necessary to inject 1–2 mg of Celeston intravenously. The drug should not be mixed with blood transfused. With repeated blood transfusions, the solution can be injected repeatedly in the same doses, in total, within 24 hours, the dose of Celeston can reach 4 single doses.

Recommended dosing regimen for soft tissue diseases and musculoskeletal lesions:

small joints: 0.8–2 mg;
large joints (hip joint): 2–4 mg;
calluses, tendon sheaths: 0.4-1 mg;
bursa synovial: 2-3 mg;
ganglia: 1-2 mg;
soft tissues: 2–6 mg.

If it is impossible to avoid premature birth before the 32nd week of pregnancy due to obstetric complications and when labor is stimulated, intramuscular administration of 4-6 mg of betamethasone every 12 hours is recommended for 24-48 hours before the intended delivery. It is necessary that therapy has been started at least 24 hours (preferably 48–72 hours) before delivery. This will allow sufficient time to achieve a clinical result. If there is a decrease in the lecithin / sphingomyelin ratio in the amniotic fluid, Celeston's solution can be used prophylactically.

The average dose for subconjunctival administration is 0.5 ml.

After prolonged use, the dose of Celeston should be reduced gradually.

Side effects

The severity of adverse reactions and the frequency of their occurrence depend on the size of the dose used and the duration of therapy. High doses or long-term use of Celeston can lead to the development of pronounced manifestations of mineral and glucocorticoid effects, which are considered as side effects.

Possible systemic effects:

cardiovascular system and blood (hemostasis, hematopoiesis): ECG changes characteristic of hypokalemia, arterial hypertension, chronic heart failure (in predisposed patients), hypercoagulability, myocardial dystrophy, thrombosis;
nervous system and sensory organs: hallucinations, delirium (in the form of confusion, agitation, anxiety), euphoria, disorientation, manic / depressive episode, paranoia or depression, increased intracranial pressure with edema of the optic nerve head (pseudotumor of the cerebellum), vertigo, sleep disturbance, headache, dizziness, sudden loss of vision (with parenteral administration in the area of the turbinates, neck, head, scalp), the formation of posterior subcapsular cataract, glaucoma, increased intraocular pressure with possible damage to the optic nerve, the development of secondary viral / fungal eye infections, steroid exophthalmos;
digestive system: pancreatitis, hiccups, erosive esophagitis, decreased / increased appetite, nausea, vomiting, erosive and ulcerative lesions of the gastrointestinal tract;
endocrine system: Itsenko-Cushing's syndrome, manifestation of latent diabetes mellitus or steroid diabetes mellitus, hirsutism, suppression of adrenal cortex function, decreased glucose tolerance, growth retardation in children;
musculoskeletal system: decreased muscle mass, tendon rupture, steroid myopathy, muscle weakness, osteoporosis (including aseptic necrosis of the femoral head, spontaneous bone fractures);
metabolism: hypokalemia, sodium and water retention, negative nitrogen balance due to protein catabolism, weight gain;
allergic reactions: anaphylactic shock, swelling of the face, hives, skin rash, shortness of breath or stridor;
skin: increased sweating, delayed wound healing, striae, steroid acne, thinning of the skin, hypo- or hyperpigmentation, ecchymosis and petechiae;
others: activation of infectious diseases and decreased immunity, violation of the regularity of menstruation, withdrawal syndrome (lethargy, anorexia, nausea, abdominal pain, pain in muscles or joints, back, general weakness, etc.).

Adverse reactions associated with the method of administration of Celeston:

intra-articular administration: increased joint pain;
intravenous administration: flushing of the face, arrhythmia, convulsions;
parenteral administration (local reactions): numbness, burning, pain, scarring at the injection site, infection and paresthesia at the injection site, atrophy of the skin and subcutaneous tissue (with intramuscular injection).

Overdose

The main symptoms of an overdose: agitation, euphoria, nausea, sleep disorders, vomiting. With prolonged use in high doses - osteoporosis, fluid retention in the body, secondary adrenal insufficiency, increased blood pressure and other signs of hypercortisolism, including Itsenko-Cushing syndrome.

Therapy: against the background of the gradual withdrawal of Celeston, correction of the electrolyte balance, maintenance of vital functions, phenothiazines, lithium preparations, antacids are shown; with Itsenko-Cushing syndrome, aminoglutethimide is prescribed.

special instructions

Mental disorders during therapy are more likely in patients with chronic diseases predisposing to the appearance of these disorders, and when using high doses. The development of these symptoms is possible in the period from several days to 2 weeks from the start of therapy.

You should not drink alcoholic beverages while using Celeston.

When conducting a long course, it is necessary to carefully monitor the dynamics of the development and growth of children. An ophthalmological examination should be carried out periodically (to detect cataracts, glaucoma, etc.). For systemic use, EEG control (electroencephalogram) is recommended. In addition, it is necessary to regularly monitor the function of the hypothalamic-pituitary-adrenal system, glucose in blood and urine (especially in patients with diabetes mellitus), occult blood in feces, electrolytes in serum.

During therapy, immunization and vaccination should be avoided.

It is necessary to strictly adhere to all the norms and requirements of asepsis.

To prevent local tissue atrophy, injections should be made deep into large muscle masses.

With the introduction of Celeston intra-articularly, into soft tissues and lesions, the development of local and systemic effects of glucocorticosteroids is possible.

It is necessary to avoid injection into the infected joint, in order to exclude the septic process, the study of intra-articular fluid is shown.

Corticosteroids should not be injected into unstable joints, directly into the tendon, the area of inflammation, and the intervertebral space. In osteoarthritis, repeated injections into the joints can increase their destruction.

When undertaking long-term corticosteroid therapy, the risks and potential benefits must be considered before switching from parenteral to oral administration.

Depending on the course of the disease (remission or exacerbation), the patient's response to therapy, negative changes in the patient's physical and emotional state (surgery, severe infection, trauma), it is possible to change the dosage regimen.

After the end of an intensive / long course of treatment for a year, constant monitoring of the patient's condition is required.

Celeston can mask the signs of an infectious disease, reduce the ability to localize the infection and reduce the body's resistance.

With a long course, posterior subcapsular cataract may develop (especially in children), glaucoma (with possible damage to the optic nerve), and the likelihood of developing a secondary viral or fungal eye infection increases.

When using Celeston for the purpose of immunosuppression, patients should avoid contact with patients with chickenpox and measles (especially important for children).

Long-term use of the drug can change the motility and the number of sperm in the ejaculate.

For the prevention of distress syndrome after childbirth, the drug is not prescribed.

Women who received Celeston during pregnancy should be monitored during / after childbirth, which is associated with the likelihood of developing adrenocortical insufficiency.

Application during pregnancy and lactation

According to the instructions, Celeston can be prescribed to pregnant women under medical supervision after assessing the ratio of the expected benefit with the possible risk. In case of eclampsia, preeclampsia and the presence of symptoms of placental lesions, the drug is contraindicated. Frequent, long-term use, as well as use in large doses is not recommended.

During lactation, the use of Celeston is contraindicated.

Pediatric use

In pediatric practice, Celeston is used according to indications, according to the dosage regimen.

In children, when conducting a long course of Celeston, it is necessary to take into account the likelihood of growth inhibition and endogenous production of corticosteroids.

With impaired renal function

Celeston is contraindicated in renal failure.

For violations of liver function

Celeston is contraindicated in liver failure.

Use in the elderly

In old age, therapy should be carried out under medical supervision.

Drug interactions

Possible interactions:

estrogens and oral contraceptives: increased therapeutic, toxic effects;
liver enzyme inducers: reduction of therapeutic, toxic effects;
alcohol and non-steroidal anti-inflammatory drugs: an increased risk of ulcerative erosive lesions or bleeding in the gastrointestinal tract;
digitalis glycosides, amphotericin B, diuretics (causing potassium deficiency), carbonic anhydrase inhibitors: increased likelihood of hypokalemia and arrhythmias;
ritodrin: an increase in the likelihood of pulmonary edema in pregnant women;
immunosuppressants: increased risk of infections and the development of lymphomas and other lymphoproliferative diseases;
drugs with a diuretic effect: weakening natriuretic and diuretic activity;
antidiabetic agents and insulin: weakening of hypoglycemic activity;
coumarin derivatives and indandione, heparin, streptokinase, urokinase: decrease in anticoagulant activity;
vaccines: inhibition of their activity (associated with a decrease in the production of antibodies);
salicylates, mexiletine: a decrease in their concentration in the blood;
paracetamol: an increase in its hepatotoxicity.

Analogs

The analogs of Celeston are: Akriderm, Beloderm Express, Beloderm, Diprospan, Celestoderm-V, Betaspan Depo, Flosteron, etc.

Terms and conditions of storage

Store in a place protected from light at a temperature of 2-30 ° C. Do not freeze. Keep out of the reach of children.

Shelf life: tablets - 3 years; injection solution - 4 years.

Terms of dispensing from pharmacies

Dispensed by prescription.

Reviews about Celeston

Reviews of Celeston are few, due to its absence in pharmacies, and do not allow obtaining reliable information about the effectiveness of the drug.

Price for Celeston in pharmacies

The price of Celeston is unknown. Approximate price for analogues: Akriderm - from 62 rubles, Beloderm Express - from 201 rubles, Beloderm - from 93 rubles, Diprospan - from 202 rubles, Celestoderm-V - from 133 rubles.

The use of analog drugs must be agreed with the attending physician!

Maria Kulkes Medical journalist About the author

Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".

Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!