FAQ

Key Clinical Uses

1. Treatment of Chronic Rheumatoid Arthritis (RA)
   • Dexamethasone palmitate is indicated for alleviating joint inflammation, pain, and stiffness in patients with RA.
   • It is often administered via intra-articular injection directly into affected joints to provide localized anti-inflammatory effects, reducing systemic exposure and side effects.
2. Management of Other Inflammatory Joint Diseases
   • The drug is used for conditions such as osteoarthritis, ankylosing spondylitis, and psoriatic arthritis, where inflammation and joint damage are prominent.
3. Sustained-Release Anti-Inflammatory Therapy
   • As a prodrug of dexamethasone, it is hydrolyzed in the body to release the active metabolite, allowing for prolonged therapeutic action.
   • Its lipophilic nature enhances tissue penetration, enabling targeted delivery to inflammatory sites.

Mechanism of Action

• Anti-inflammatory Effects: Binds to glucocorticoid receptors in immune cells, inhibiting the production of pro-inflammatory cytokines (e.g., TNF-α, IL-1) and reducing edema, erythema, and pain.
• Immunosuppression: Suppresses immune responses by inhibiting lymphocyte proliferation and antibody production, making it useful in autoimmune diseases.

Administration Considerations

• Routes: Typically administered via intra-articular injection or, less commonly, intravenous (IV) injection.
  • IV use requires slow administration to minimize vascular irritation and adverse reactions.
• Dosing: Frequency and dosage depend on the severity of the condition and patient response. For RA, injections may be repeated every 2–4 weeks.

Contraindications and Precautions

• Contraindications:
  • Hypersensitivity to dexamethasone or corticosteroids.
  • Systemic fungal infections, untreated active infections, or ocular conditions like glaucoma or cataracts.
• Precautions:
  • Long-term use may lead to adrenal suppression, osteoporosis, hyperglycemia, and increased susceptibility to infections.
  • Close monitoring is required in patients with diabetes, hypertension, or peptic ulcer disease.

Adverse Effects

• Common: Local pain, swelling, or joint stiffness post-injection.
• Systemic: Fluid retention, hypertension, mood changes, and increased risk of infections with prolonged use.

Formulations and Availability

• Marketed under brand names such as Ledermix® (as a dental paste) or in injectable forms for joint therapy.
• Dosage strengths vary (e.g., 4 mg/mL for injection).