Dex-Forte Dosage

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Dosage of Dex-Forte in details

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Tablet: General Population: According to the nature and severity of pain, the recommended dosage is generally 12.5 mg every 4-6 hrs or 25 mg every 8 hrs. The total daily dose should not exceed 75 mg. Undesirable effects may be minimized by using the lowest effective dose for the shortest duration necessary to control symptoms.

Dex-Forte tablets are not intended for long-term use and the treatment must be limited to the symptomatic period.

Concomitant administration with food delays the absorption rate of the drug, thus in case of acute pain, it is recommended that administration is at least 30 min before meals.

Elderly: In elderly patients it is recommended to start the therapy at the lower end of the dosage range (50 mg total daily dose). The dosage may be increased to that recommended for the general population only after good general tolerance has been ascertained.

Hepatic Dysfunction: Patients with mild to moderate hepatic dysfunction should start therapy at reduced doses (50 mg total daily dose) and be closely monitored. Dex-Forte tablets should not be used in patients with severe hepatic dysfunction.

Renal Dysfunction: The initial dosage should be reduced to 50 mg total daily dose in patients with mildly impaired renal function. Dex-Forte tablets should not be used in patients with moderate to severe renal dysfunction.

Injection: Adults: The recommended dose is 50 mg every 8-12 hrs. If necessary, the administration can be repeated 6 hrs apart. The total daily dose should not exceed 150 mg.

Dex-Forte solution for injection or concentrate for solution for infusion is intended for short-term use and the treatment must be limited to the acute symptomatic period (not >2 days). Patients should be switched to an oral analgesic treatment when possible.

Undesirable effects may be minimized by using the lowest effective dose for the shortest duration necessary to control symptoms.

In case of moderate to severe postoperative pain, Dex-Forte solution for injection or concentrate for solution for infusion can be used in combination with opioid analgesics, if indicated, at the same recommended doses in adults.

Elderly: No dosage adjustment is generally necessary in elderly patients. However, because of the physiological decline in renal function in elderly patients a lower dose is recommended in case of mild renal function impairment: 50 mg total daily dose.

Liver Disease: The dosage should be reduced to 50 mg total daily dose in patients with mild to moderate (Child-Pugh score 5-9) hepatic impairment and hepatic function should be closely monitored. Dex-Forte solution for injection or concentrate for solution for infusion should not be used in patients with severe hepatic dysfunction (Child-Pugh score 10-15).

Renal Dysfunction: The dosage should be reduced to 50 mg total daily dose in patients with mildly impaired renal function (CrCl 50-80 mL/min). Dex-Forte solution for injection or concentrate for solution for infusion should not be used in patients with moderate to severe renal dysfunction (CrCl <50 mL/min).

Administration: Injection: Dex-Forte solution for injection or concentrate for solution for infusion can be administered either by IM or IV route:

Intramuscular Use: The content of 1 ampoule (2 mL) of Dex-Forte solution for injection or concentrate for solution for infusion should be administered by slow injection deep into the muscle.

Intravenous Use:

Intravenous Infusion: The diluted solution, should be administered as a slow IV infusion, lasting 10-30 min. The solution must be always protected from natural daylight.

Intravenous Bolus: If necessary, the content of 1 ampoule (2 mL) of Dex-Forte solution for injection or concentrate for solution for infusion can be administered in a slow IV bolus over no less than 15 sec.

Instructions on Handling: When Dex-Forte is administered IM or as IV bolus, the solution should be injected after its removal from the colored ampoule. For administration as IV infusion, the solution should be diluted aseptically and protected from natural daylight.

Dex-Forte interactions

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The following interactions apply to NSAIDs in general: Inadvisable Combinations: Other NSAIDs, Including High Doses of Salicylates (≥3 g/day): Administration of several NSAIDs together may increase the risk of gastrointestinal ulcers and bleeding, via a synergistic effect.

Anticoagulants: NSAIDs may enhance the effects of anticoagulants eg, warfarin, due to the high plasma protein-binding of Dex-Forte and the inhibition of platelet function and damage to the gastroduodenal mucosa. If the combination cannot be avoided, close clinical observation and monitoring of laboratory values should be carried out.

Heparins: Increased risk of hemorrhage (due to the inhibition of platelet function and damage to the gastroduodenal mucosa). If the combination cannot be avoided, close clinical observation and monitoring of laboratory values should be carried out.

Corticosteroids: There is an increased risk of gastrointestinal ulceration or bleeding.

Lithium (Described with Several NSAIDs): NSAIDs increase blood lithium levels, which may reach toxic values (decreased renal excretion of lithium). This parameter therefore requires monitoring during the initiation, adjustment and withdrawal of treatment with Dex-Forte.

Methotrexate Used at High Doses of ≥15 mg/week: Increased hematological toxicity of methotrexate via a decrease in its renal clearance by anti-inflammatory agents in general.

Hydantoins and Sulphonamides: The toxic effects of these substances may be increased.

Combinations Requiring Precautions: Diuretics, Angiotensin-converting Enzyme (ACE) Inhibitors and Angiotensin II Receptor Antagonists: Dex-Forte may reduce the effect of diuretics and other antihypertensive drugs. In some patients with compromised renal function (eg, dehydrated or elderly patients with compromised renal function), the co-administration of agents that inhibit cyclooxygenase and ACE inhibitors or angiotensin II receptor antagonists may result in further deterioration of renal function, which is usually reversible. In case of combined prescription of Dex-Forte and a diuretic, it is essential to ensure that the patient is adequately hydrated and to monitor renal function at the start of the treatment.

Methotrexate Used at Low Doses <15 mg/week: Increased hematological toxicity of methotrexate via a decrease in its renal clearance by anti-inflammatory agents in general. Weekly monitoring of blood count during the 1st weeks of the combination. Increased surveillance in the presence of even mildly impaired renal function, as well as in the elderly.

Pentoxyfylline: Increased risk of bleeding. Intensify clinical monitoring and check bleeding time more often.

Zidovudine: Risk of increased red cell line toxicity via action on reticulocytes, with severe anemia occurring 1 week after the NSAID is started. Check complete blood count and reticulocyte count 1-2 weeks after starting treatment with the NSAID.

Sulfonylureas: NSAIDs can increase the hypoglycemic effect of sulfonylureas by displacement from plasma protein-binding sites.

Combinations Needing to be Taken Into Account: Beta-blockers: Treatment with an NSAID may decrease their antihypertensive effect via inhibition of prostaglandin synthesis.

Cyclosporin and Tacrolimus: Nephrotoxicity may be enhanced by NSAIDs via renal prostaglandin mediated effects. During combination therapy, renal function has to be measured.

Thrombolytics: Increased risk of bleeding.

Anti-platelet Agents and Selective Serotonin Reuptake Inhibitors (SSRIs): Increased risk of gastrointestinal bleeding.

Probenecid: Plasma concentrations of Dex-Forte may be increased; this interaction can be due to an inhibitory mechanism at the site of renal tubular secretion and of glucuronoconjugation and requires adjustment of the dose of Dex-Forte.

Cardiac Glycosides: NSAIDs may increase plasma glycoside concentration.

Mifepristone: Because of a theoretical risk that prostaglandin synthetase inhibitors may alter the efficacy of mifepristone, NSAIDs should not be used for 8-12 days after mifepristone administration.

Quinolone Antibiotics: Animal data indicate that high doses of quinolones in combination with NSAIDs can increase the risk of developing convulsions.

Incompatibilities: Injection: Dex-Forte solution for injection or concentrate for solution for infusion must not be mixed in a small volume (eg, in a syringe) with solutions of dopamine, promethazine, pentazocine, pethidine or hydroxyzine, as this will result in a precipitation of the solution.

The diluted solutions for infusion obtained as stated in Instructions for Use and Handling under Cautions for Usage, must not be mixed with promethazine or pentazocine.

Dex-Forte must not be mixed with other medicinal products except those mentioned in Instructions for Use and Handling under Cautions for Usage.


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Reviews

The results of a survey conducted on ndrugs.com for Dex-Forte are given in detail below. The results of the survey conducted are based on the impressions and views of the website users and consumers taking Dex-Forte. We implore you to kindly base your medical condition or therapeutic choices on the result or test conducted by a physician or licensed medical practitioners.

User reports

8 consumers reported frequency of use

How frequently do I need to take Dex-Forte?
It was reported by ndrugs.com website users that Dex-Forte should ideally be taken Twice in a day as the most common frequency of the Dex-Forte. You should you adhere strictly to the instructions and guidelines provided by your doctor on how frequently this Dex-Forte should be taken. Get another patient's view on how frequent the capsule should be used by clicking here.
Users%
Twice in a day4
50.0%
Once in a day2
25.0%
3 times in a day1
12.5%
4 times in a day1
12.5%


29 consumers reported doses

What doses of Dex-Forte drug you have used?
The drug can be in various doses. Most anti-diabetic, anti-hypertensive drugs, pain killers, or antibiotics are in different low and high doses and prescribed by the doctors depending on the severity and demand of the condition suffered by the patient. In our reports, ndrugs.com website users used these doses of Dex-Forte drug in following percentages. Very few drugs come in a fixed dose or a single dose. Common conditions, like fever, have almost the same doses, e.g., [acetaminophen, 500mg] of drug used by the patient, even though it is available in various doses.
Users%
11-50mg22
75.9%
51-100mg3
10.3%
6-10mg2
6.9%
1-5mg1
3.4%
201-500mg1
3.4%


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Information checked by Dr. Sachin Kumar, MD Pharmacology

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