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Section 1 (Name of Medicinal Product): Removed 'Dexamethasone'
Section 2 (Qualitative and Quantitative composition): Added 'For excipients see 6.1'
Section 3 (Pharmaceutical form): Added description
Section 4.1 (Therapeutic indications): Amended endocrine disorders to just endocrine exaphthalamos., removed 'angioneurotic oedema', removed 'cardiovascular disorders', added idiopathic thrombocytopaenic pupura and reticulomphoproliferative disorders, indicated 'rectal only' for ulcerative colitis, added regional enteritis and certain forms of hepatitis. Removed sarcoidosis. Removed Miliary tuberculosis. Addedd acute exacerbations of multiple sclerosis. Added chorioretinitis, iridocyclitis, temporal arteritis, orbital pseudotumour.Removed 'lupus nephritis', added 'nephrotic syndrome'. Additional respiratory disorders. Additional rheumatic disorders. Aditional skin disorders. Added oncological disorders. Added 'Other' disorders.
Section 4.2 (Posology): Added dosing infomation in 'Raised Intracranial pressure'.
Section 4.3 (Contraindications): Added 'Infection with tropical worms'. Removed 'live vaccines, viral infections, uncontrolled psychotic status, glaucoma, osteoporosis, diabetes mellitus, hypertension (CHF), TB, Severe renal disease, Haemorrhage, gastroduodenal ulcer (replaced with stomach ulcer or duodenal ulcer.
Section 4.4 (Warnings and Precautions): Updated incformation on live vaccines (contraindicated). Added information on activation of latent disease. Added 'complication of fat embolism'. Added 'left-ventricular free-wall rupture after recent MI'. Added 'Anaphylactoid and hypersensitivity reactions'. Added decrease ot withdrawal of therapy may reveal underlying disease.
Section 4.5 (Interactions): Added info on cytochrome P450 3A4 metabolism, ketoconazole, ephedrine, incometacin (false-negative in supression tests), antibiotics, anticholinetserases, colestyramine, estrogens, aminoglutethimide, GI topicals, antacids, charcoal. Added antitubercular drugs, ciclosporin, thalidomide. Removed antacids. Added Praziquantel andoral anticoagulants. Added insulin, sulonylureas, metformin, isoniazid
Section 4.6 (Pregnancy): Added info on lack of reproductive studies therefore 'lowest effective dose needed' should be used', 'placental trnasfer is considerable', information on breast-feeding (removed advice not to breast-feed). Added 'Evidence of harmful effects on pregnancy in animals'.
Section 4.8 (Undesirable effects): Added muscle weakness, aseptic necrosis of femoral & humoral heads, los of muslce mass, perforation of the bowwl, thinning scalp hair, decreased resistance to infection, secondary adrenocortical and pituitary unresponsiveness, abnormal fat deposits, increased and decreased motility and number of spermatozoa. Removed Cardiovascular effects.
Section 5.1 (Pharmacodynamic properties): Added ATC code and pharmacotherapeutic group.
Section 5.2 (Pharmacokinetic properties): Added dexamethasone is bound to 'mainly albumins' (plasma proteins).Removed info about crossing the placenta and exretion into breast milk.
Section 5.3 (Preclinical safety data): Added info on toxicity (cleft palate, CNS and heart abnormalities in animal studies), inhibition in intrauterine growth (High dose). Added statement that no further safety info available.
Section 6.3 (Shelf life): Amended from 24months to 2 years.
Section 6.5 (Nature and contents of the container): Added 150 ml bottle. Removed closures apart from HDPE, EPE wadded, tamper evident , child resistant closure.
Section 6.6 (Instructions for use): Re-wording of exiting sentance.
Section 8 (MA number): Amended to PL 00427/0137 (Mutual recognition licence)
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