What is CELESTONE CHRONODOSE and what is it used for?
• CELESTONE CHRONODOSE is packaged in 1 milliliter ampoules containing a colorless clear solution containing no foreign matter, white grain.
• CELESTONE CHRONODOSE is a germ-free (sterile), aqueous suspension containing betamethasone disodium phosphate and betamethasone acetate as the active ingredient. These substances belong to a class of drugs called corticosteroids.
• CELESTONE CHRONODOSE is a combination of two derivatives of betamethasone, an effective remedy against inflammation, rheumatism and allergy. Applied through injection.
CELESTONE CHRONODOSE (systemic) corticosteroid applied to the whole body
acute (starts suddenly with severe symptoms and shows short course) that respond to treatment
it is also used in chronic (long-standing, loutine), severe or moderate-weight diseases. In particular, it is used in patients who cannot use corticosteroids by mouth. The recommended ways of application are:
• intramuscular injection into allergic conditions, some skin diseases and rheumatic diseases that respond to corticosteroid therapy, including soft tissue inflammation (bursitis)
• tendon inflammations (tenosinovitis) that accompany bursitis, such as bursitis and inflammation of the tendon sheath, are injected directly into the soft tissue, which is sick in inflammatory diseases of the muscles such as fibrosis and myositis
• Injection into or around the joint in rheumatoid arthritis and osteoarthritis
• injection into diseased area in some skin diseases
• regional (local) injection in certain inflammatory diseases seen in the foot
What are the Side Effects?
As with all medications, there may be side effects in people who are sensitive to the substances contained in CELESTONE CHRONODOSE.
Corticosteroids applied to soft tissue or into the patient area may cause local effects as well as (systemic) effects that concern the entire body.
Side effects are closely related to dose and duration of treatment.
To reduce side effects, it is preferable to lower the dose of CELESTONE CHRONODOSE instead of discontinuing treatment.
Systemic side effects seen in people taking CELESTONE CHRONODOSE are similar to those seen when using other corticosteroids.
If you notice any of the following, tell your doctor immediately or contact the emergency department of the hospital closest to you.
• Tongue, lip and percentage
• blindness: The result of applications to the diseased area around the face and head can be seen as rare.
• headache, nausea, vomiting and dizziness
These are all serious side effects. Urgent medical intervention may be required. Serious side effects are very rare.
Tell your doctor about any of the following:
• Increase or decrease in pigments that give color to the skin (hyperpigmentation), (hypopigmentation),
• thinning of skin and subcutaneous tissues (atrophy),
• Fever after injection (in-joint applications),
• Joint disease due to the loss of pain and sense of position in the joint (Charcot type joint disease)
These side effects are side effects seen at the injection site and are rare.
If you have any disorders related to these organs and tissues, tell your doctor.
How to use CELESTONE CHRONODOSE?
CELESTONE CHRONODOSE should be administered by a medical staff under physician or physician control.
In order to prevent regional tissue thinning (atrophy), corticosteroid administration into the muscle should be done deeply into a large muscle.
The dose of CELESTONE CHRONODOSE varies from patient to patient based on the type, weight and response of the disease. Your doctor will maintain or adjust the initial dose until a positive response is received and will reduce the dose at certain intervals to find the lowest dose that maintains an adequate clinical efficacy after adequate response is received. If the effect is not seen within the time period in which the response should be received, CELESTONE will discontinue treatment and try other treatment methods.
Facing stresses unrelated to your current illness may require an increase in the CELESTONE CHRONODOSE dose. In such a case, inform your doctor.
Application for diffuse (systemic) effect:
Use in the elderly:
In most cases where systemic therapy is concerned, treatment is started with 1 ml of intramuscular injection and repeated once a week. In the case of the required cases, the dose may be administered more frequently. In milder cases, your doctor may give you a lower dose.
In severe cases, such as an episode of persistent asthma (status astmaticus) or dysemine lupus erythematosus, treatment may begin with 2 mL. Your doctor will maintain the initial dose until you get an adequate response or will make a dose adjustment. If there is not enough response within a certain period of time, your doctor will discontinue CELESTONE CHRONODOSE treatment and switch to other appropriate treatment methods.
In premature (premature) babies, in the prevention of respiratory distress syndrome, if labor needs to be started before the 32nd week of pregnancy, or due to a birth-related disorder, the, if premature (premature) delivery is mentioned before the 32nd week of pregnancy, at least 24 hours before the time of birth is expected, it is necessary to apply 2 mL (12 mg) of CELESTONE CHRONODOSE intramuscularly. A second 2 mL dose is administered 24 hours after the birth occurs.
Regional (local) application:
If regional application is to be carried out, it may be rarely necessary to use a local anesthetic drug in addition to CELESTONE CHRONODOSE.
In inflammation of the soft tissue (subdeltoid, subacromial and prepatellar bursitis), injection of 1 mL CELESTONE CHRONODOSE into the tissue, relieves pain and within a few hours, the limitation of movement in the joint is eliminated. In recurrent acute bursitis and chronic bursitis, injections into many tissues are usually required 1-2 weeks apart. Tendon inflammation (tendonitis), muscle inflammation (myositis), tendon sheath inflammation (tenosinovitis), tendon circumference inflammation (peritendonitis) and mLlik 1-2 weeks apart in inflammatory cases around the joint 3-4 regional injection, which is, usually enough. The injections are not made inside the tendon itself, but inside the inflamed tendon layers. In inflammatory cases around the joint, the drug is given to the painful area. In the treatment of cysts seen in ganglia of joint capsules, 0.5 mL CELESTONE CHRONODOSE is injected directly into the cyst.
In joint diseases called rheumatoid arthritis and osteoarthritis, after injection into the joint, pain reduction for 2-4 hours, tenderness and stiffness can be seen in the joint. The dose varies between 0.25-2 mL, depending on the size of the joint. Usually a dosage scheme is applied: 1-2 mL to very large joints, such as the hip, 1 mL to large joints, such as the knee, ankle and shoulder, 0.5-1 mL is enough for medium-sized joints such as the elbow and wrist, and 0.25-0.5 mL for small joints such as the finger and rib joints. The effect usually lasts 1-4 weeks.
If the injection in skin diseases is to be carried out into the diseased zone, the CELESTONE CHRONODOSE is ground into the skin (not below). The total amount of injection should not exceed 1 mL per week.
CELESTONE CHRONODOSE is also used in diseases that occur standing and respond to corticosteroid therapy. In the treatment of inflammation of the soft tissue (bursitis), which is seen under hard corn (heloma condition), two injections of 0.25 mL of urine produced a successful result. Pain in conditions such as hallux rigidus (disruption of the flexibility of the big toe), digiti quinti varus (the fifth toe is tilted inward), and joint parity in acute gout disease, is usually stopped immediately. In other foot-related diseases, 3-7 daily intervals of 0.25-0.5 mL CELESTONE CHRONODOSE injection is performed. In case of joint inflammation in acute gout disease, doses of 1.0 mL may be necessary.
CELESTONE CHRONODOSE
What to Do in case of Overdose?
if you have used more than you should use CELESTONE CHRONODOSE, talk to a doctor or pharmacist.
Since CELESTONE CHRONODOSE depot is an effective drug, do not exceed the dose to be determined by your doctor.
What Should I Do When I Forget to Use CELESTONE CHRONODOSE?
Do not take double doses to offset forgotten doses.
post Treatment For Those Using CELESTONE CHRONODOSE
When the medication is discontinued after long-term or high-dose corticosteroid therapy, your doctor will closely monitor you for about a year. When corticosteroid therapy is stopped suddenly, drug-induced secondary adrenal gland insufficiency may occur; if the dose is gradually reduced and treatment is stopped, this can be prevented. In treatment, the lowest effective dose should be determined. When it is necessary to reduce the dose, it should be done gradually.
Things to consider before using CELESTONE CHRONODOSE
CELESTONE CHRONODOSE Who Shouldn't Use?
• you have fungal infection (systemic)
• If you are hypersensitive (allergic) to betamethasone sodium phosphate, betamethasone acetate and other corticosteroids, which are active substances of CELESTONE CHRONODOSE’
• if you have pre-eclampsia and pregnancy hypertension referred to as eclampsia
• If you are pregnant and your doctor has told you that you have a placenta lesion, corticosteroids are not used in the hyaline membrane disease seen after birth in newborns.
CELESTONE CHRONODOSE should not be administered intramuscularly in those with a disease called idiopathic thrombocytopenic purpura.
What Should CELESTONE CHRONODOSE Users Pay Attention to?
If you have hypothyroidism or cirrhosis, you should tell your doctor about these diseases as the effect of the drug will be higher.
Corticosteroid-grade drugs such as CELESTONE CHRONODOSE should be used with caution in patients with eye herpes (Ocular Herpes Simplex).
Corticosteroids may aggravate existing emotional disorders or psychotic tendencies.
Care should be taken if corticosteroids are to be used in patients with hypoprotrombinemia, a type of blood clotting disorder, along with a medication containing acetyl salicylic acid (aspirin).
Inflammation of the ulcerated intestine with a risk of perforation (ulcerative colitis) and diseases of the stomach-intestine, referred to as diverticulitis, abscess or another purulent infection, newly undergone bowel surgery (intestinal anastomosis), etc, caution should be exercised when using corticosteroids in patients with active or inactive peptic ulcer, renal failure, high blood pressure, bone resorption (osteoporosis) or myasthenia gravis, a muscle disease.
Corticosteroids may mask the symptoms of an infection. Long-term corticosteroid treatments may cause some form of cataract (posterior subcapsular cataract) or increased intraocular pressure (glaucoma; depending on this condition, the eye nerve may become damaged); it can facilitate eye infections due to fungi and viruses.
Synthetic corticosteroid derivatives can cause high blood pressure at very high doses, salt and fluid retention in the body, or potassium loss.
It is inconvenient to give flower vaccinations to patients under corticosteroid therapy. Other immunosuppressive applications are also not suitable, especially for patients taking high doses of corticosteroids. Tell your doctor that you are using CELESTONE CHRONODOSE when you need to be vaccinated.
Its use in active tuberculosis is restricted except for its use in addition to an appropriate tuberculosis treatment in fast-spreading and widespread tuberculosis (verem disease). In patients with latent tuberculosis, the patient is kept under the control of the doctor when it is necessary to use corticosteroids, and in long-term treatment, preventive treatments from tuberculosis are also performed.
If long-term corticosteroid therapy is to be performed in infants and children, growth and development should be closely monitored.
Corticosteroids may alter sperm count and motility in male patients.
Even if it is rare, injection corticosteroid applications can have reactions similar to a severe allergic reaction, so you should consult your doctor, especially if you have a drug allergy in your past.
In long-term corticosteroid treatments, if injection-based administration is desired, your doctor will evaluate the risk/benefit. For this reason, you should not go to oral corticosteroids without consulting your doctor, by your own decision.
If these warnings apply to you, even at any time in the past, please consult your doctor.
Food and Beverage Consumption With CELESTONE CHRONODOSE
What are the foods and drinks that are inconvenient to be consumed with the specified medication? What should we eat or not eat?
Food and Beverage Consumption With CELESTONE CHRONODOSE
What are the foods and drinks that are inconvenient to be consumed with the specified medication? What should we eat or not eat?
Use in children
In long-term corticosteroid treatments, the growth and development of infants and children should be closely monitored. It can lead to growth delay.
Is it Used During Pregnancy (Pregnancy) Period?
Consult your doctor or pharmacist before using the medicine.
CELESTONE CHRONODOSE is a drug that should not be used in pregnant women except for medical necessity. Since the application of corticosteroids before the 32 ’th week of pregnancy is controversial, it should be used according to the decision of the doctor in women of childbearing age by performing risk/tar evaluation.
Babies of mothers who used high doses of corticosteroids during pregnancy should be evaluated for hypoadrenalism (insufficient work of the adrenal gland).
If you notice that you are pregnant during your treatment, consult your doctor immediately.
Can it be Used During Breastfeeding?
Consult your doctor or pharmacist before using the medicine.
Corticosteroids can be detected in breast milk. Therefore, if you are breastfeeding your baby, your doctor will evaluate the importance of the drug for you and ask you to stop treatment or breastfeeding.
Vehicle and machinery use
CELESTONE CHRONODOSE has no effect on driving vehicles and machinery.
What is CELESTONE CHRONODOSE Active Agent?
If you do not have an extreme sensitivity to the excipients contained in CELESTONE CHRONODOSE, no adverse effects due to these substances are expected.
Auxiliary substances:
Benzalkonium chloride: No warning is required due to the way of use (injection).
Is It Used With Other Drugs?
Medications called phenobarbital, rifampin, phenytoin, or ephedrine may reduce the effects of corticosteroids when used together. In patients taking estrogen hormone along with corticosteroids, an excessive corticosteroid effect may occur.
When corticosteroids are used together with diuretic drugs that cause potassium loss, potassium deficiency may occur in the body.
When used in conjunction with cardiac glycosides, also referred to digitally and used to treat heart failure, there is an increased risk of rhythm disturbance or digital intoxication due to potassium deficiency.
Corticosteroids increase the loss of potassium caused by a drug called amphotericin B. In patients receiving this and similar drug combination, serum electrolyte levels, especially potassium levels, should be closely monitored.
When corticosteroids are used in conjunction with the blood-thinning coumarin group drugs that reduce clotting, they can alter this effect enough to require a new dose adjustment (in the direction of increase or decrease).
When corticosteroids are used in combination with pain-relieving-inflammatory drugs (non-steroidal anti-inflammatory), the risk of developing or aggravating digestive tract ulcers increases.
Corticosteroids may reduce the amount of aspirin and similar drugs in the blood, called salicylates, so they can alter its effect.
If you have diabetes, you may need to re-adjust the dose of your sugar medicine. When taken together with corticosteroids, a decrease in the effect of the drug called somatotropin may occur.
If you are currently taking any prescription or over-the-counter medications or have recently used them, please tell your doctor or pharmacist about them.
Drug and laboratory test interactions
Corticosteroids may cause false negative results in a test called nitroblue tetrazolium, which is used in bacterial infections. If such a test is to be performed, tell your doctor that you are using CELESTONE CHRONODOSE.
To download CELESTONE CHRONODOSE prospectus as PDF file here
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