. . "Dexamethasone Sodium Phosphate (Injection)" . "Dexamethasone\nSodium Phosphate Injection, 4 mg/mL-For\nintravenous, intramuscular, intra-articular, intralesional and soft\ntissue injection. Dexamethasone\nSodium Phosphate Injection, 10 mg/mL-For\nintravenous and intramuscular injection only. Dexamethasone\nSodium Phosphate Injection can be given directly from the vial or it can\nbe added to Sodium Chloride Injection or Dextrose Injection and\nadministered by intravenous drip. Solutions used for\nintravenous administration or further dilution of this product should be\npreservative-free when used in the neonate, especially the premature\ninfant. When it is mixed\nwith an infusion solution, sterile precautions should be observed. Since\ninfusion solutions generally do not contain preservatives, mixtures\nshould be used within 24 hours. DOSAGE REQUIREMENTS ARE VARIABLE AND MUST\nBE INDIVIDUALIZED ON THE BASIS OF THE DISEASE AND THE RESPONSE OF\nTHE PATIENT.
INTRAVENOUS AND\nINTRAMUSCULAR INJECTION: The initial\ndosage of Dexamethasone Sodium Phosphate Injection varies from\n0.5 to 9 mg a day depending on the disease being treated. In\nless severe diseases doses lower than 0.5 mg may suffice, while in severe diseases doses higher than 9 mg may be required. The initial\ndosage should be maintained or adjusted until the patient's\nresponse is satisfactory. If a satisfactory clinical response\ndoes not occur after a reasonable period of time, discontinue\nDexamethasone Sodium Phosphate Injection and transfer the\npatient to other therapy. After a\nfavorable initial response, the proper maintenance dosage should\nbe determined by decreasing the initial dosage in small amounts\nto the lowest dosage that maintains an adequate clinical\nresponse. Patients\nshould be observed closely for signs that might require dosage\nadjustment, including changes in clinical status resulting from\nremissions or exacerbations of the disease, individual drug\nresponsiveness and the effect of stress (e.g., surgery,\ninfection, trauma). During stress it may be necessary to\nincrease dosage temporarily. If the drug\nis to be stopped after more than a few days of treatment, it\nusually should be withdrawn gradually. When the\nintravenous route of administration is used, dosage usually\nshould be the same as the oral dosage. In certain overwhelming,\nacute, life-threatening situations, however, administration in\ndosages exceeding the usual dosages may be justified and may be\nin multiples of the oral dosages. The slower rate of absorption\nby intramuscular administration should be\nrecognized.
Shock: There is a tendency in current medical practice to use\nhigh (pharmacologic) doses of corticosteroids for the\ntreatment of unresponsive shock. The following dosages\nof Dexamethasone Sodium Phosphate Injection have been\nsuggested by various authors: Administration of high dose corticosteroid therapy\nshould be continued only until the patient's condition\nhas stabilized and usually not longer than 48 to 72\nhours. Although adverse reactions associated with high dose, short term corticosteroid therapy are uncommon, peptic\nulceration may occur.
Cerebral\nEdema: Dexamethasone Sodium Phosphate Injection is generally\nadministered initially in a dosage of 10 mg\nintravenously followed by four mg every six hours\nintramuscularly until the symptoms of cerebral edema\nsubside. Response is usually noted within 12 to 24 hours\nand dosage may be reduced after two to four days and\ngradually discontinued over a period of five to seven\ndays. For palliative management of patients with\nrecurrent or inoperable brain tumors, maintenance\ntherapy with two mg two or three times a day may be\neffective.
Acute\nAllergic Disorders: In\nacute, self-limited allergic disorders or acute\nexacerbations of chronic allergic disorders the following dosage schedule combining parenteral and oral\ntherapy is suggested: Dexamethasone Sodium Phosphate Injection, 4 mg/mL -First day, 1\nor 2 mL (4 or 8 mg) intramuscularly. Dexamethasone tablets, 0.75 mg - Second and third days,\n4 tablets in two divided doses each day; fourth day 2 tablets\nin two divided doses; fifth\nand sixth days, 1 tablet each day;seventh day,\nno treatment; eighth\nday, follow-up visit. This schedule is designed to ensure adequate therapy\nduring acute episodes, while minimizing the risk of\noverdosage in chronic cases.
Intra-articular,\nIntralesional and Soft Tissue Injection: Intra-articular, intralesional and soft tissue injections are\ngenerally employed when the affected joints or areas are limited\nto one or two sites. Dosage and frequency of injection varies\ndepending on the condition and the site of injection. The usual\ndose is from 0.2 to 6 mg. The frequency usually ranges from once\nevery three to five days to once every two to three weeks.\nFrequent intra-articular injection may result in damage to joint\ntissues. Some of the usual single doses are: Dexamethasone Sodium Phosphate Injection is particularly\nrecommended for use in conjunction with one of the less soluble,\nlonger-acting steroids for intra-articular and soft tissue\ninjection. Parenteral drug products should be\ninspected visually for particulate matter and discoloration\nprior to administration, whenever the solution and container\npermit." . "Dexamethasone sodium phosphate, a synthetic adrenocortical steroid, is a white or\nslightly yellow crystalline powder. It is freely soluble in water and is\nexceedingly hygroscopic. The molecular weight is 516.41. It is\ndesignated chemically as\n9-fluoro-11\uFFFD\uFFFD,17-dihydroxy-16\uFFFD\uFFFD-methyl-21-(phosphonooxy)pregna-1,4-diene-3,\n20-dione disodium salt. The molecular\nformula is: CHFNaOP\nand the structural formula is: Dexamethasone\nSodium Phosphate Injection is a sterile solution of dexamethasone sodium\nphosphate for intravenous and intramuscular use. The 4 mg/mL strength\nmay also be used for intra-articular, intralesional and soft tissue\nadministration. Each mL of\nDexamethasone Sodium Phosphate Injection 4 mg/mL contains dexamethasone\nsodium phosphate, equivalent to 4 mg dexamethasone phosphate or 3.33 mg\ndexamethasone. Inactive ingredients per mL: 1 mg sodium sulfite\nanhydrous, 19.4 mg sodium citrate anhydrous and 10.42 mg (0.01 mL)\nbenzyl alcohol (preservative) in Water for Injection. Each mL of\nDexamethasone Sodium Phosphate Injection 10 mg/mL contains dexamethasone\nsodium phosphate, equivalent to 10 mg dexamethasone phosphate or 8.33 mg\ndexamethasone. Inactive ingredients per mL: 1.5 mg sodium sulfite\nanhydrous, 16.5 mg sodium citrate anhydrous and 10.42 mg (0.01 mL)\nbenzyl alcohol (preservative) in Water for Injection. The pH of both\nconcentrations is 7.0-8.5; sodium hydroxide and/or citric acid used, if\nneeded, for pH adjustment. Sealed under nitrogen." . "Dexamethasone\nsodium phosphate injection has a rapid onset but short duration of\naction when compared with less soluble preparations. Because of this, it\nis suitable for the treatment of acute disorders responsive to\nadrenocortical steroid therapy. Naturally occurring\nglucocorticoids (hydrocortisone and cortisone), which also have\nsalt-retaining properties, are used as replacement therapy in\nadrenocortical deficiency states. Their synthetic analogs, including\ndexamethasone, are primarily used for their potent anti-inflammatory\neffects in disorders of many organ systems. Glucocorticoids\ncause profound and varied metabolic effects. In addition, they modify\nthe body's immune responses to diverse stimuli. At equipotent\nanti-inflammatory doses, dexamethasone almost completely lacks the\nsodium-retaining property of hydrocortisone and closely related\nderivatives of hydrocortisone." . . "Systemic fungal\ninfections (see WARNINGS\nregarding amphotericin B). Hypersensitivity to\nany component of this product, including sulfites ." . "Dexamethasone\nSodium Phosphate Injection, USP is available in the following package: 10 mg/mL 1 mL DOSETTE vials\npackaged in 25s (NDC 0641-0367-25)
Storage: Protect from light: Keep covered in\ncarton until time of use. Store at 20\uFFFD\uFFFD-25\uFFFD\uFFFDC (68\uFFFD\uFFFD-77\uFFFD\uFFFDF),\nexcursions permitted to 15\uFFFD\uFFFD-30\uFFFD\uFFFDC (59\uFFFD\uFFFD-86\uFFFD\uFFFDF) [see USP\nControlled Room Temperature]. Avoid freezing. Do not use if\nsolution is hazy or has a precipitate. Do not\nautoclave." . . . . . . . . "General: This\nproduct, like many other steroid formulations, is sensitive to\nheat. Therefore, it should not be autoclaved when it is\ndesirable to sterilize the exterior of the vial. Following\nprolonged therapy, withdrawal of corticosteroids may result in\nsymptoms of the corticosteroid withdrawal syndrome including fever, myalgia, arthralgia and malaise. This may occur in\npatients even without evidence of adrenal insufficiency. There is an\nenhanced effect of corticosteroids in patients with\nhypothyroidism and in those with cirrhosis. Corticosteroids should be used cautiously in patients with\nocular herpes simplex for fear of corneal perforation. The lowest\npossible dose of corticosteroid should be used to control the\ncondition under treatment, and when reduction in dosage is\npossible, the reduction must be gradual. Psychic\nderangements may appear when corticosteroids are used, ranging\nfrom euphoria, insomnia, mood swings, personality changes and\nsevere depression to frank psychotic manifestations. Also,\nexisting emotional instability or psychotic tendencies may be\naggravated by corticosteroids. Aspirin\nshould be used cautiously in conjunction with corticosteroids in\nhypoprothrombinemia. Steroids\nshould be used with caution in nonspecific ulcerative colitis,\nif there is a probability of impending perforation, abscess, or\nother pyogenic infection, also in diverticulitis, fresh\nintestinal anastomoses, active or latent peptic ulcer, renal\ninsufficiency, hypertension, osteoporosis and myasthenia gravis.\nSigns of peritoneal irritation following gastrointestinal\nperforation in patients receiving large doses of corticosteroids\nmay be minimal or absent. Fat embolism has been reported as a\npossible complication of hypercortisonism. When large\ndoses are given, some authorities advise that antacids be administered between meals to help prevent peptic ulcer. Growth and\ndevelopment of infants and children on prolonged corticosteroid\ntherapy should be carefully followed. Steroids\nmay increase or decrease motility and number of spermatozoa in\nsome patients. Phenytoin,\nphenobarbital, ephedrine and rifampin may enhance the metabolic\nclearance of corticosteroids resulting in decreased blood levels\nand lessened physiologic activity, thus requiring adjustment in\ncorticosteroid dosage. These interactions may interfere with\ndexamethasone suppression tests which should be interpreted with\ncaution during administration of these drugs. False\nnegative results in the dexamethasone suppression test (DST) in\npatients being treated with indomethacin have been reported.\nThus, results of the DST should be interpreted with caution in\nthese patients. The\nprothrombin time should be checked frequently in patients who\nare receiving corticosteroids and coumarin anticoagulants at the\nsame time because of reports that corticosteroids have altered\nthe response to these anticoagulants. Studies have shown that\nthe usual effect produced by adding corticosteroids is\ninhibition of response to coumarins, although there have been\nsome conflicting reports of potentiation not substantiated by\nstudies. When\ncorticosteroids are administered concomitantly with\npotassium-depleting diuretics, patients should be observed\nclosely for development of hypokalemia. Intra-articular injection of a corticosteroid may produce\nsystemic as well as local effects. Appropriate\nexamination of any joint fluid present is necessary to exclude a\nseptic process. A marked\nincrease in pain accompanied by local swelling, further\nrestriction of joint motion, fever and malaise is suggestive of\nseptic arthritis. If this complication occurs and the diagnosis\nof sepsis is confirmed, appropriate antimicrobial therapy should\nbe instituted. Injection\nof a steroid into an infected site is to be avoided. Corticosteroids should not be injected into unstable joints. Patients\nshould be impressed strongly with the importance of not\noverusing joints in which symptomatic benefit has been obtained\nas long as the inflammatory process remains active. Frequent\nintra-articular injection may result in damage to joint tissues. The slower\nrate of absorption by intramuscular administration should be\nrecognized.
Information for\nPatients: Persons who\nare on immunosuppressant doses of corticosteroids should be\nwarned to avoid exposure to chickenpox or measles. Patients\nshould also be advised that if they are exposed, medical advice\nshould be sought without delay." . "Reports of acute\ntoxicity and/or death following overdosage of glucocorticoids are rare.\nIn the event of overdosage, no specific antidote is available; treatment\nis supportive and symptomatic. The oral\nLDof dexamethasone in female mice was 6.5 g/kg. The\nintravenous LDof dexamethasone sodium phosphate in female\nmice was 794 mg/kg." . "Dexamethasone Sodium Phosphate" . "Dexamethasone Sodium Phosphate (Injection)" . "Fluid and\nElectrolyte Disturbances: Sodium\nretention Fluid\nretention Congestive\nheart failure in susceptible patients Potassium\nloss Hypokalemic\nalkalosis Hypertension
Musculoskeletal: Muscle\nweakness Steroid\nmyopathy Loss of\nmuscle mass Osteoporosis Vertebral\ncompression fractures Aseptic\nnecrosis of femoral and humeral heads Pathologic\nfracture of long bones Tendon\nrupture
Gastrointestinal: Peptic\nulcer with possible subsequent perforation and hemorrhage Perforation\nof the small and large bowel, particularly in patients with\ninflammatory bowel disease Pancreatitis Abdominal\ndistention Ulcerative\nesophagitis
Dermatologic: Impaired\nwound healing Thin,\nfragile skin Petechiae\nand ecchymoses Erythema Increased\nsweating May\nsuppress reactions to skin tests Burning or\ntingling, especially in the perineal area (after IV injection) Other\ncutaneous reactions, such as allergic dermatitis, urticaria,\nangioneurotic edema
Neurologic: Convulsions Increased\nintracranial pressure with papilledema (pseudotumor cerebri)\nusually after treatment Vertigo Headache Psychic\ndisturbances
Endocrine: Menstrual\nirregularities Development\nof cushingoid state Suppression\nof growth in children Secondary\nadrenocortical and pituitary unresponsiveness, particularly in\ntimes of stress, as in trauma, surgery or illness Decreased carbohydrate tolerance Manifestations of latent diabetes mellitus Increased\nrequirements for insulin or oral hypoglycemic agents in\ndiabetics Hirsutism
Ophthalmic: Posterior\nsubcapsular cataracts Increased\nintraocular pressure Glaucoma Exophthalmos
Metabolic: Negative\nnitrogen balance due to protein catabolism
Cardiovascular: Myocardial\nrupture following recent myocardial infarction
Other: Anaphylactoid or hypersensitivity reactions Thromboembolism Weight gain Increased\nappetite Nausea Malaise Hiccups The\nfollowing additional\nadverse reactions are related to parenteral corticosteroid\ntherapy: Rare\ninstances of blindness associated with intralesional therapy\naround the face and head Hyperpigmentation or hypopigmentation Subcutaneous and cutaneous atrophy Sterile\nabscess Postinjection flare (following intra-articular use) Charcot-like arthropathy" . "Because rare\ninstances of anaphylactoid reactions have occurred in patients receiving\nparenteral corticosteroid therapy, appropriate precautionary measures\nshould be taken prior to administration, especially when the patient has\na history of allergy to any drug. Anaphylactoid and hypersensitivity\nreactions have been reported for Dexamethasone Sodium Phosphate\nInjection (see ADVERSE\nREACTIONS). Dexamethasone\nSodium Phosphate Injection contains sodium sulfite, a sulfite that may\ncause allergic-type reactions including anaphylactic symptoms and\nlife-threatening or less severe asthmatic episodes in certain\nsusceptible people. The overall prevalence of sulfite sensitivity in the\ngeneral population is unknown and probably low. Sulfite sensitivity is\nseen more frequently in asthmatic than in nonasthmatic people. Corticosteroids may\nexacerbate systemic fungal infections and, therefore, should not be used\nin the presence of such infections unless they are needed to control\ndrug reactions due to amphotericin B. Moreover, there have been cases\nreported in which concomitant use of amphotericin B and hydrocortisone\nwas followedby cardiac enlargement and congestive failure. In patients on\ncorticosteroid therapy subjected to unusual stress, increased dosage of\nrapidly acting corticosteroids before, during and after the stressful\nsituation is indicated. Drug-induced\nsecondary adrenocortical insufficiency may result from too rapid\nwithdrawal of corticosteroids and may be minimized by gradual reduction\nof dosage. This type of relative insufficiency may persist for months\nafter discontinuation of therapy; therefore, in any situation of stress\noccurring during that period, hormone therapy should be reinstituted. If\nthe patient is receiving steroids already, dosage may have to be\nincreased. Since mineralocorticoid secretion may be impaired, salt\nand/or a mineralocorticoid should be administered concurrently. Corticosteroids may\nmask some signs of infection, and new infections may appear during their\nuse. There may be decreased resistance and inability to localize\ninfections when corticosteroids are used. Moreover, corticosteroids may\naffect the nitroblue-tetrazolium test for bacterial infection and\nproduce false-negative results. In cerebral\nmalaria, a double blind trial has shown that the use of corticosteroids\nis associated with prolongation of coma and a higher incidence of\npneumonia and gastrointestinal bleeding. Corticosteroids may\nactivate latent amebiasis. Therefore, it is recommended that latent or\nactive amebiasis be ruled out before initiating corticosteroid therapy\nin any patient who has spent time in the tropics or in any patient with\nunexplained diarrhea. Prolonged use of\ncorticosteroids may produce posterior subcapsular cataracts, glaucoma\nwith possible damage to the optic nerves and may enhance the\nestablishment of secondary ocular infections due to fungi or viruses. Average and large\ndoses of cortisone or hydrocortisone can cause elevation of blood\npressure, salt and water retention and increased excretion of potassium.\nThese effects are less likely to occur with the synthetic derivatives\nexcept when used in large doses. Dietary salt restriction and potassium\nsupplementation may be necessary. All corticosteroids increase calcium\nexcretion. Administration of\nlive virus vaccines, including smallpox, is contraindicated in\nindividuals receiving immunosuppressive doses of corticosteroids. If\ninactivated viral or bacterial vaccines are administered to individuals\nreceiving immunosuppressive doses of corticosteroids, the expected serum\nantibody response may not be obtained. However, immunization procedures\nmay be undertaken in patients who are receiving corticosteroids as\nreplacement therapy, e.g., for Addison's disease. Persons who are on\ndrugs which suppress the immune system are more susceptible to\ninfections than healthy individuals. Chickenpox and measles, for\nexample, can have a more serious or even fatal course in non-immune\nchildren or adults on corticosteroids. In such children or adults who\nhave not had these diseases, particularcare should be taken to avoid\nexposure. How the dose, route and duration of corticosteroid\nadministration affects the risk of developing a disseminated infection\nis unknown. The contribution of the underlying disease and/or prior\ncorticosteroid treatment to the risk is also not known. If exposed to\nchickenpox, prophylaxis with varicella zoster immune globulin (VZIG) may\nbe indicated. If exposed to measles, prophylaxis with pool intramuscular\nimmune globulin (IG) may be indicated. (See the respective package\ninserts for VZIG and IG for complete prescribing information.) If\nchickenpox develops, treatment with antiviral agents may be considered. The use of Dexamethasone Sodium Phosphate Injection in active tuberculosis should\nbe restricted to those cases of fulminating or disseminated tuberculosis in which the corticosteroid is used for the management of the disease in\nconjunction with an appropriate antituberculosis regimen. If corticosteroids\nare indicated in patients with latent tuberculosis or tuberculin\nreactivity, close observation is necessary as reactivation of the\ndisease may occur. During prolonged corticosteroid therapy, these\npatients should receive chemoprophylaxis. Literature reports\nsuggest an apparent association between use of corticosteroids and left\nventricular free wall rupture after a recent myocardial infarction;\ntherefore, therapy with corticosteroids should be used with great\ncaution in these patients.
Usage in Pregnancy: Since\nadequate human reproduction studies have not been done with\ncorticosteroids, use of these drugs in pregnancy or in women of\nchildbearing potential requires that the anticipated benefits be\nweighed against the possible hazards to the mother and embryo or\nfetus. Infants born of mothers who have received substantial\ndoses of corticosteroids during pregnancy should be carefully\nobserved for signs of hypoadrenalism. Corticosteroids appear in breast milk and could suppress\ngrowth, interfere with endogenous corticosteroid production or\ncause other unwanted effects. Mothers taking pharmacologic doses\nof corticosteroids should be advised not to nurse." . "A. By Intravenous\nor Intramuscular Injection When Oral Therapy is not Feasible::
1.\nEndocrine Disorders: Primary or secondary adrenocortical insufficiency (hydrocortisone or cortisone is the drug of choice;\nsynthetic analogs may be used in conjunction with\nmineralocorticoids where applicable; in infancy,\nmineralocorticoid supplementation is of particular\nimportance) Acute adrenocortical insufficiency (hydrocortisone or\ncortisone is the drug of choice; mineralocorticoid\nsupplementation may be necessary, particularly when\nsynthetic analogs are used) Preoperatively, and in the event of serious trauma or\nillness, in patients with known adrenal insufficiency or\nwhen adrenocortical reserve is doubtful Shock unresponsive to conventional therapy if\nadrenocortical insufficiency exists or is suspected Congenital adrenal hyperplasia Nonsuppurative thyroiditis Hypercalcemia associated with cancer
2.\nRheumatic Disorders: As\nadjunctive therapy for short-term administration (to\ntide the patient over an acute episode or exacerbation)\nin: Post-traumatic osteoarthritis Synovitis of osteoarthritis Rheumatoid arthritis, including juvenile rheumatoid\narthritis (selected cases may require low-dose\nmaintenance therapy) Acute and subacute bursitis Epicondylitis Acute nonspecific tenosynovitis Acute gouty arthritis Psoriatic arthritis Ankylosing spondylitis
3. Collagen\nDiseases: During an exacerbation or as maintenance therapy in\nselected cases of: Systemic lupus erythematosus Acute rheumatic carditis
4.\nDermatologic Diseases: Pemphigus Severe erythema multiforme (Stevens-Johnson syndrome) Exfoliative dermatitis Bullous dermatitis herpetiformis Severe seborrheic dermatitis Severe psoriasis Mycosis fungoides
5. Allergic\nStates: Control of severe or incapacitating allergic conditions\nintractable to adequate trials of conventional treatment\nin: Bronchial asthma Contact dermatitis Atopic dermatitis Serum sickness Seasonal or perennial allergic rhinitis Drug hypersensitivity reactions Urticarial transfusion reactions Acute noninfectious laryngeal edema (epinephrine is the drug of first choice)
6.\nOphthalmic Diseases: Severe acute and chronic allergic and inflammatory\nprocesses involving the eye, such as: Herpes zoster ophthalmicus Iritis, iridocyclitis Chorioretinitis Diffuse posterior uveitis and choroiditis Optic neuritis Sympathetic ophthalmia Anterior segment inflammation Allergic conjunctivitis Keratitis Allergic corneal marginal ulcers
7.\nGastrointestinal Diseases: To\ntide the patient over a critical period of the disease\nin: Ulcerative colitis (Systemic therapy) Regional enteritis (Systemic therapy)
8.\nRespiratory Diseases: Symptomatic sarcoidosis Berylliosis Fulminating or disseminated pulmonary tuberculosis when\nused concurrently with appropriate antituberculous\nchemotherapy Loeffler's syndrome not manageable by other means Aspiration pneumonitis
9.\nHematologic Disorders: Acquired (autoimmune) hemolytic anemia Idiopathic thrombocytopenic purpura in adults (IV only;\nIM administration is contraindicated) Secondary thrombocytopenia in adults Erythroblastopenia (RBC anemia) Congenital (erythroid) hypoplastic anemia
10.\nNeoplastic Diseases: For\npalliative management of: Leukemias and lymphomas in adults Acute leukemia of childhood
11.\nEdematous States: To\ninduce diuresis or remission of proteinuria in the\nnephrotic syndrome, without uremia, of the idiopathic\ntype, or that due to lupus erythematosus
12.\nMiscellaneous: Tuberculous meningitis with subarachnoid block or\nimpending block when used concurrently with appropriate\nantituberculous chemotherapy Trichinosis with neurologic or myocardial\ninvolvement
13.\nDiagnostic Testing Of Adrenocortical Hyperfunction:
14.\nCerebral Edema associated with primary or metastatic brain\ntumor, craniotomy or head injury. Use in cerebral edema is\nnot a substitute for careful neurosurgical evaluation and\ndefinitive management such as neurosurgery or other specific\ntherapy.:
B. By\nIntra-Articular or Soft Tissue Injection: As\nadjunctive therapy for short-term administration (to tide the\npatient over an acute episode or exacerbation) in: Synovitis\nof osteoarthritis Rheumatoid\narthritis Acute and\nsubacute bursitis Acute gouty\narthritis Epicondylitis Acute\nnonspecific tenosynovitis Post-traumatic osteoarthritis
C. By Intralesional\nInjection: Keloids Localized\nhypertrophic, infiltrated, inflammatory lesions of: lichen\nplanus, psoriatic plaques, granuloma annulare, and lichen\nsimplex chronicus (neurodermatitis) Discoid\nlupus erythematosus Necrobiosis\nlipoidica diabeticorum Alopecia\nareata May also be\nuseful in cystic tumors of an aponeurosis or tendon\n(ganglia)." . . . "Dexamethasone Sodium Phosphate" .