Dexamethasone is administered intravenously or intramuscularly in emergency cases and if it is not possible to administer it orally.

Endocrine disorders:

• replacement therapy of the primary and secondary (hypophyseal) insufficiency of the adrenal glands (excluding acute insufficiency of the adrenal glands upon which hydrocortisone or cortisone are the most reasonable considering their more pronounced hormonal effect);
• acute insufficiency of the adrenal glands (hydrocortisone or cortisone are the drugs of choice, and concomitant administration with mineralocorticoids, especially, in case of administration of the synthetic analogues may be required);
• before surgery and in case of serious injuries or diseases in patients with established adrenal insufficiency or in case of unspecified adrenocortical reserve;
• shock resistant to the conventional therapy, in case of existing or suspecting insufficiency of the adrenal glands;
• congenital insufficiency of the adrenal glands;
• non-purulent inflammation of the thyroid gland and severe forms of the radiation thyroiditis.

Rheumatologic disorders

(as the supportive therapy during the period when the background therapy had no effect, i.e., in patients with unsatisfactory analgesic and anti-inflammatory effect of NSAIDs):

• rheumatoid arthritis, including juvenile rheumatoid arthritis and extra-articular manifestations of the rheumatoid arthritis (rheumatoid lung disease, changes in the heart and eyes, cutaneous vasculitis);
• synovitis in case of osteoarthrosis, post-traumatic osteoarthrosis; epicondylitis, acute non-specific tendosynovitis; acute gouty arthritis; psoriatic arthritis; ankylosing spondylitis; systemic diseases of the connective tissue; vasculitis.

Skin disorders:

• pemphigus, severe erythema multiform (Stevens-Johnson syndrome); exfoliative dermatitis; bullous dermatitis herpetiformis; severe forms of exudative erythema; erythema nodosum; severe forms of seborrheic dermatitis; severe forms of psoriasis; urticaria resistant to the standard treatment; mycosis fungoides; dermatomyositis.

Allergic disorders:

(resistant to the conventional treatment):

•  bronchial asthma; contact dermatitis; atopic dermatitis; serum disease; chronic or seasonal allergic rhinitis; drug allergy; urticaria following blood transfusion.

Eye disorders:

• inflammatory diseases of the eyes (acute central chorioiditis, optic neuritis); allergic diseases (conjunctivitis, uveitis, scleritits, keratitis, iritis); systemic immune diseases (sarcoidosis, temporal arteritis); proliferative changes in the orbital cavity (endocrinous ophthalmopathy, pseudotumour); immunosuppressive therapy following keratoplasty.

Solution can be administered systemically or locally (administration under conjunctive and retrobulbar or parabulbar administration).

Gastrointestinal disorders:

in order to treat emergency condition in case of:

• ulcerative colitis (severe development), Crohn's disease (severe development); chronic autoimmune hepatitis; rejection reaction following liver transplantation.

Respiratory system disorders:

• symptomatic sarcoidosis (symptomatic treatment); acute toxic bronchiolitis; chronic bronchitis and asthma (in case of exacerbation); focal or disseminated pulmonary tuberculosis (along with the appropriate antituberculous therapy); berylliosis (granulomatous inflammation); radiation or aspiration pneumonitis.

Haematological disorders:

• acquired or congenital chronic aplastic anaemia; autoimmune hemolytic anaemia; secondary thrombocytopenia in adults; erythroblastopenia; acute lymphoblastic leukaemia (induction therapy); − idiopathic thrombocytopenic purpura in adults (only intravenous administration − intramuscular administration is contraindicated).

Renal disorders:

• immunosuppressive therapy in case of kidney transplantation; diuresis stimulation or reduction of the proteinuria in case of idiopathic nephrotic syndrome (without uraemia) and renal impairment in case of systemic lupus erythematosus.

Malignant oncological diseases:

• palliative treatment of leukemia and lymphoma in adults; acute leukemia in children, hypercalcemia in case of the malignant diseases.

Cerebral oedema:

• cerebral oedema due to the primary or metastatic tumour of the brain, craniotomy and craniocerebral injuries.

Shock:

• shock resistant to the standard treatment; shock in patients with insufficiency of the adrenal glands; anaphylactic shock (intravenously following adrenalin administration), before surgery in order to prevent shock if insufficiency of the adrenal glands is suspected or established.

Other indications:

• tuberculous meningitis with subarachnoid blockade (along with the appropriate antituberculous therapy); trichinellosis with neurological symptoms or myocardial trichinellosis; cystic tumour of aponeurosis or tendon (ganglion).

Indications for intra-articular administration or administration into the soft tissues:

• rheumatoid arthritis (severe inflammation of the separate joint); ankylosing spondylitis (when inflamed joints are resistant to the conventional treatment); psoriatic arthritis (oligoarticular form and tendovaginitis); monoarthritis (following evacuation of the synovial fluid), joint osteoarthritis (only in case of synovitis and exudation); extra-articular rheumatism (epicondylitis, tendovaginitis, bursitis); acute and gouty arthritis.

Local administration (administration into the site of lesion):

•  keloid lesions; hypertrophic, inflammatory, and infiltrated lesions in case of lichen, psoriasis, granuloma annulare, sclerogenous folliculitis, discoid lupus, and cutaneous sarcoidosis; discoid lupus erythematosus, Urbach-Oppeheim disease, localized alopecia.