Methylprednisolone Acetate

Generic Name: Methylprednisolone Acetate
Brand Name: -
Dosage Form: Injection 40mg/1ml
Pharmacological Category: Anti-inflammatory Agent
Therapeutic Category: Corticosteroids
Pregnancy Category: Category C

Pharmacology

Methylprednisolone is a potent anti-inflammatory steroid with greater anti-inflammatory potency than prednisolone and even less tendency than prednisolone to induce sodium and water retention.
Methylprednisolone sodium succinate has the same metabolic and anti-inflammatory actions as methylprednisolone. When given parenterally and in equimolar quantities, the two compounds are equivalent in biologic activity. The relative potency of methylprednisolone and hydrocortisone sodium succinate, as indicated by depression of eosinophil count, following intravenous administration, is at least four to one. This is in good agreement with the relative oral potency of methylprednisolone and hydrocortisone.

Pharmacokinetics:

Absorption
Absorption from IM injection of methylprednisolone sodium succinate is rapid.
Systemic absorption of methylprednisolone acetate occurs slowly following intra-articular, intrabursal, intrasynovial, intradermal, or soft tissue injection; Absorption from intra-articular injection sites is usually very slow and continues for about 7 days.

Onset
Following IM administration (80–120 mg) in patients with severe poison ivy, relief onset within 8–12 hours.
Following oral administration in patients with asthma, effects may not be evident for several hours.

Duration
The duration of anti-inflammatory activity of methylprednisolone approximately equals the duration of HPA-axis suppression, about 1.25–1.5 days for a single 40-mg oral dose.

Distribution
Most glucocorticoids are removed rapidly from the blood and distributed to muscles, liver, skin, intestines, and kidneys.
Glucocorticoids appear in breast milk and the placenta.

Metabolism
Metabolized in most tissues, but mainly in the liver, to inactive compounds.

Half-life
Approximately 2.5–3.5 hours following oral administration of methylprednisolone or IV or IM administration of methylprednisolone sodium succinate.

Indications:

1. Endocrine Disorders
Primary or secondary adrenocortical insufficiency (hydrocortisone or cortisone is the drug of choice; synthetic analogs may be used in conjunction with mineralocorticoids where applicable; in infancy,
mineralocorticoid supplementation is of particular importance)
Acute adrenocortical insufficiency (hydrocortisone or cortisone is the drug of choice; mineralocorticoid supplementation may be necessary, particularly when synthetic analogs are used)
Preoperatively and in the event of serious trauma or illness, in patients with known adrenal insufficiency or when adrenocortical reserve is doubtful
Shock unresponsive to conventional therapy if adrenocortical insufficiency exists or is suspected
Congenital adrenal hyperplasia
Hypercalcemia associated with cancer
Nonsuppurative thyroiditis
2. Rheumatic Disorders
As adjunctive therapy for short-term administration (to tide the patient over an acute episode or exacerbation) in:
Post-traumatic osteoarthritis Acute gouty arthritis
Synovitis of osteoarthritis Psoriatic arthritis
Rheumatoid arthritis, including juvenile rheumatoid arthritis (selected cases may require low-dose maintenance therapy) Ankylosing spondylitis
Epicondylitis Acute and subacute bursitis
Acute nonspecific tenosynovitis
3. Collagen Diseases
During an exacerbation or as maintenance therapy in selected cases of:
Systemic lupus erythematosus
Systemic dermatomyositis (polymyositis)
Acute rheumatic carditis
4. Dermatologic Diseases
Pemphigus Severe seborrheic dermatitis
Severe erythema multiforme (Stevens-Johnson syndrome) Severe psoriasis
Exfoliative dermatitis Mycosis fungoides
Bullous dermatitis herpetiformis
5. Allergic States
Control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment in:
Bronchial asthma Seasonal or perennial allergic rhinitis
Contact dermatitis Drug hypersensitivity reactions
Atopic dermatitis Urticarial transfusion reactions
Serum sickness Acute noninfectious laryngeal edema (epinephrine is the drug of first choice)
6. Ophthalmic Diseases
Severe acute and chronic allergic and inflammatory processes involving the eye, such as:
Herpes zoster ophthalmicus Sympathetic ophthalmia
Iritis, iridocyclitis Anterior segment inflammation
Chorioretinitis Allergic conjunctivitis
Diffuse posterior uveitis and choroiditis Allergic corneal marginal ulcers
Optic neuritis Keratitis
7. Gastrointestinal Diseases
To tide the patient over a critical period of the disease in:
Ulcerative colitis (systemic therapy)
Regional enteritis (systemic therapy)
8. Respiratory Diseases
Symptomatic sarcoidosis Loeffler’s syndrome not manageable by other means
Berylliosis Aspiration pneumonitis
Fulminating or disseminated pulmonary tuberculosis when used concurrentlywith appropriate anti-tuberculous chemotherapy
9. Hematologic Disorders
Acquired (autoimmune) hemolytic anemia
Idiopathic thrombocytopenic purpura in adults (IV only; IM administration is contraindicated)
Secondary thrombocytopenia in adults
Erythroblastopenia (RBC anemia)
Congenital (erythroid) hypoplastic anemia
10. Neoplastic Diseases
For palliative management of:
Leukemias and lymphomas in adults
Acute leukemia of childhood
11. Edematous States
To induce diuresis or remission of proteinuria in the nephrotic syndrome, without uremia, of the idiopathic type or that due to lupus erythematosus
12. Nervous System
Acute exacerbations of multiple sclerosis
13. Miscellaneous
Tuberculous meningitis with subarachnoid block or impending block when used concurrently with appropriate antituberculous chemotherapy
Trichinosis with neurologic or myocardial involvement

Contraindications:

The use of Methylprednisolone Sodium Succinate for Injection, USP is contraindicated in premature infants because the 1 g multiple dose vial when reconstituted will contain benzyl alcohol. Benzyl alcohol has been reported to be associated with a fatal “Gasping Syndrome” in premature infants. Methylprednisolone Sodium Succinate for Injection, USP is also contraindicated in systemic fungal infections and patients with known hypersensitivity to the product and its constituents.

Precautions:

Drug-induced secondary adrenocortical insufficiency may be minimized by gradual reduction of dosage. This type of relative insufficiency may persist for months after discontinuation of therapy; therefore, in any situation of stress occurring during that period, hormone therapy should be reinstituted. Since mineralocorticoid secretion may be impaired, salt and/or a mineralocorticoid should be administered concurrently.
There is an enhanced effect of corticosteroids on patients with hypothyroidism and in those with cirrhosis.
Corticosteroids should be used cautiously in patients with ocular herpes simplex because of possible corneal perforation.
The lowest possible dose of corticosteroid should be used to control the condition under treatment, and when reduction in dosage is possible, the reduction should be gradual.
Psychic derangements may appear when corticosteroids are used, ranging from euphoria, insomnia, mood swings, personality changes, and severe depression, to frank psychotic manifestations. Also, existing emotional instability or psychotic tendencies may be aggravated by corticosteroids.
Steroids should be used with caution in nonspecific ulcerative colitis, if there is a probability of impending perforation, abscess or other pyogenic infection; diverticulitis; fresh intestinal anastomoses; active or latent peptic ulcer; renal insufficiency; hypertension; osteoporosis; and myasthenia gravis.
Growth and development of infants and children on prolonged corticosteroid therapy should be carefully observed.
Although controlled clinical trials have shown corticosteroids to be effective in speeding the resolution of acute exacerbations of multiple sclerosis, they do not show that corticosteroids affect the ultimate outcome or natural history of the disease. The studies do show that relatively high doses of corticosteroids are necessary to demonstrate a significant effect
Since complications of treatment with glucocorticoids are dependent on the size of the dose and the duration of treatment, a risk/benefit decision must be made in each individual case as to dose and duration of treatment and as to whether daily or intermittent therapy should be used.
Convulsions have been reported with concurrent use of methylprednisolone and cyclosporin. Since concurrent use of these agents results in a mutual inhibition of metabolism, it is possible that adverse events associated with the individual use of either drug may be more apt to occur.
Aspirin should be used cautiously in conjunction with corticosteroids in patients suffering from hypoprothrombinemia

Drug Interactions:

The pharmacokinetic interactions are potentially clinically important. Mutual inhibition of metabolism occurs with concurrent use of cyclosporin and methylprednisolone; therefore, it is possible that adverse events associated with the individual use of either drug may be more apt to occur. Convulsions have been reported with concurrent use of methylprednisolone and cyclosporin. Drugs that induce hepatic enzymes such as phenobarbital, phenytoin and rifampin may increase the clearance of methylprednisolone and may require increases in methylprednisolone dose to achieve the desired response. Drugs such as troleandomycin and ketoconazole may inhibit the metabolism of methylprednisolone and thus decrease its clearance. Therefore, the dose of methylprednisolone should be titrated to avoid steroid toxicity.
Methylprednisolone may increase the clearance of chronic high dose aspirin. This could lead to decreased salicylate serum levels or increase the risk of salicylate toxicity when methylprednisolone is withdrawn. Aspirin should be used cautiously in conjunction with corticosteroids in patients suffering from hypoprothrombinemia.
The effect of methylprednisolone on oral anticoagulants is variable. There are reports of enhanced as well as diminished effects of anticoagulant when given concurrently with corticosteroids. Therefore, coagulation indices should be monitored to maintain the desired anticoagulant effect.

Side Effects:

Fluid and Electrolyte Distrubances
Sodium retention Potassium loss
Fluid retention Hypokalemic alkalosis
Congestive heart failure in susceptible patients Hypertension

Musculoskeletal
Muscle weakness Aseptic necrosis of femoral and humeral heads
Steroid myopathy Pathologic fracture of long bones
Loss of muscle mass Osteoporosis
Severe arthralgia
Vertebral compression fractures

Gastrointestinal
Peptic ulcer with possible perforation and hemorrhage Abdominal distention
Pancreatitis Ulcerative esophagitis

Dermatologic
Impaired wound healing Facial erythema
Thin fragile skin Increased sweating
Petechiae and ecchymoses May suppress reactions to skin tests

Neurological
Increased intracranial pressure with papilledema (Pseudo-tumor cerebri) usually after treatment Vertigo
Convulsions Headache

Endocrine
Development of Cushingoid state
Suppression of growth in children
Secondary adrenocortical and pituitary unresponsiveness, particularly in times of stress, as in trauma, surgery or illness
Menstrual irregularities
Decreased carbohydrate tolerance
Manifestations of latent diabetes mellitus
Increased requirements for insulin or oral hypoglycemic agents in diabetics
Ophthalmic
Posterior subcapsular cataracts Glaucoma
Increased intraocular pressure Exophthalmos

Metabolic
Negative nitrogen balance due to protein catabolism
The following additional adverse reactions are related to parenteral corticosteroid therapy:
Hyperpigmentation or hypopigmentation
Subcutaneous and cutaneous atrophy
Sterile abscess
Anaphylactic reaction with or without circulatory collapse, cardiac arrest, bronchospasm
Urticaria
Nausea and vomiting
Cardiac arrhythmias; hypotension or hypertension

Storage:

• Store below 30 C°
• Protect from light and freezing

Packing:

• Injection 40mg/1ml: Box of 1 ampoule

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Image: 
Brand Name: 

-

Dosage Form: 

Injection 40mg/1ml

Pharmacological Category: 

Anti-inflammatory Agent

Therapeutic Category: 

Corticosteroids

Pregnancy Category: 

Category C

Methylprednisolone is a potent anti-inflammatory steroid with greater anti-inflammatory potency than prednisolone and even less tendency than prednisolone to induce sodium and water retention.
Methylprednisolone sodium succinate has the same metabolic and anti-inflammatory actions as methylprednisolone. When given parenterally and in equimolar quantities, the two compounds are equivalent in biologic activity. The relative potency of methylprednisolone and hydrocortisone sodium succinate, as indicated by depression of eosinophil count, following intravenous administration, is at least four to one. This is in good agreement with the relative oral potency of methylprednisolone and hydrocortisone.

Pharmacokinetics: 

Absorption
Absorption from IM injection of methylprednisolone sodium succinate is rapid.
Systemic absorption of methylprednisolone acetate occurs slowly following intra-articular, intrabursal, intrasynovial, intradermal, or soft tissue injection; Absorption from intra-articular injection sites is usually very slow and continues for about 7 days.

Onset
Following IM administration (80–120 mg) in patients with severe poison ivy, relief onset within 8–12 hours.
Following oral administration in patients with asthma, effects may not be evident for several hours.

Duration
The duration of anti-inflammatory activity of methylprednisolone approximately equals the duration of HPA-axis suppression, about 1.25–1.5 days for a single 40-mg oral dose.

Distribution
Most glucocorticoids are removed rapidly from the blood and distributed to muscles, liver, skin, intestines, and kidneys.
Glucocorticoids appear in breast milk and the placenta.

Metabolism
Metabolized in most tissues, but mainly in the liver, to inactive compounds.

Half-life
Approximately 2.5–3.5 hours following oral administration of methylprednisolone or IV or IM administration of methylprednisolone sodium succinate.

Indications: 

1. Endocrine Disorders
Primary or secondary adrenocortical insufficiency (hydrocortisone or cortisone is the drug of choice; synthetic analogs may be used in conjunction with mineralocorticoids where applicable; in infancy,
mineralocorticoid supplementation is of particular importance)
Acute adrenocortical insufficiency (hydrocortisone or cortisone is the drug of choice; mineralocorticoid supplementation may be necessary, particularly when synthetic analogs are used)
Preoperatively and in the event of serious trauma or illness, in patients with known adrenal insufficiency or when adrenocortical reserve is doubtful
Shock unresponsive to conventional therapy if adrenocortical insufficiency exists or is suspected
Congenital adrenal hyperplasia
Hypercalcemia associated with cancer
Nonsuppurative thyroiditis
2. Rheumatic Disorders
As adjunctive therapy for short-term administration (to tide the patient over an acute episode or exacerbation) in:
Post-traumatic osteoarthritis Acute gouty arthritis
Synovitis of osteoarthritis Psoriatic arthritis
Rheumatoid arthritis, including juvenile rheumatoid arthritis (selected cases may require low-dose maintenance therapy) Ankylosing spondylitis
Epicondylitis Acute and subacute bursitis
Acute nonspecific tenosynovitis
3. Collagen Diseases
During an exacerbation or as maintenance therapy in selected cases of:
Systemic lupus erythematosus
Systemic dermatomyositis (polymyositis)
Acute rheumatic carditis
4. Dermatologic Diseases
Pemphigus Severe seborrheic dermatitis
Severe erythema multiforme (Stevens-Johnson syndrome) Severe psoriasis
Exfoliative dermatitis Mycosis fungoides
Bullous dermatitis herpetiformis
5. Allergic States
Control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment in:
Bronchial asthma Seasonal or perennial allergic rhinitis
Contact dermatitis Drug hypersensitivity reactions
Atopic dermatitis Urticarial transfusion reactions
Serum sickness Acute noninfectious laryngeal edema (epinephrine is the drug of first choice)
6. Ophthalmic Diseases
Severe acute and chronic allergic and inflammatory processes involving the eye, such as:
Herpes zoster ophthalmicus Sympathetic ophthalmia
Iritis, iridocyclitis Anterior segment inflammation
Chorioretinitis Allergic conjunctivitis
Diffuse posterior uveitis and choroiditis Allergic corneal marginal ulcers
Optic neuritis Keratitis
7. Gastrointestinal Diseases
To tide the patient over a critical period of the disease in:
Ulcerative colitis (systemic therapy)
Regional enteritis (systemic therapy)
8. Respiratory Diseases
Symptomatic sarcoidosis Loeffler’s syndrome not manageable by other means
Berylliosis Aspiration pneumonitis
Fulminating or disseminated pulmonary tuberculosis when used concurrentlywith appropriate anti-tuberculous chemotherapy
9. Hematologic Disorders
Acquired (autoimmune) hemolytic anemia
Idiopathic thrombocytopenic purpura in adults (IV only; IM administration is contraindicated)
Secondary thrombocytopenia in adults
Erythroblastopenia (RBC anemia)
Congenital (erythroid) hypoplastic anemia
10. Neoplastic Diseases
For palliative management of:
Leukemias and lymphomas in adults
Acute leukemia of childhood
11. Edematous States
To induce diuresis or remission of proteinuria in the nephrotic syndrome, without uremia, of the idiopathic type or that due to lupus erythematosus
12. Nervous System
Acute exacerbations of multiple sclerosis
13. Miscellaneous
Tuberculous meningitis with subarachnoid block or impending block when used concurrently with appropriate antituberculous chemotherapy
Trichinosis with neurologic or myocardial involvement

Contraindications: 

The use of Methylprednisolone Sodium Succinate for Injection, USP is contraindicated in premature infants because the 1 g multiple dose vial when reconstituted will contain benzyl alcohol. Benzyl alcohol has been reported to be associated with a fatal “Gasping Syndrome” in premature infants. Methylprednisolone Sodium Succinate for Injection, USP is also contraindicated in systemic fungal infections and patients with known hypersensitivity to the product and its constituents.

Precautions: 

Drug-induced secondary adrenocortical insufficiency may be minimized by gradual reduction of dosage. This type of relative insufficiency may persist for months after discontinuation of therapy; therefore, in any situation of stress occurring during that period, hormone therapy should be reinstituted. Since mineralocorticoid secretion may be impaired, salt and/or a mineralocorticoid should be administered concurrently.
There is an enhanced effect of corticosteroids on patients with hypothyroidism and in those with cirrhosis.
Corticosteroids should be used cautiously in patients with ocular herpes simplex because of possible corneal perforation.
The lowest possible dose of corticosteroid should be used to control the condition under treatment, and when reduction in dosage is possible, the reduction should be gradual.
Psychic derangements may appear when corticosteroids are used, ranging from euphoria, insomnia, mood swings, personality changes, and severe depression, to frank psychotic manifestations. Also, existing emotional instability or psychotic tendencies may be aggravated by corticosteroids.
Steroids should be used with caution in nonspecific ulcerative colitis, if there is a probability of impending perforation, abscess or other pyogenic infection; diverticulitis; fresh intestinal anastomoses; active or latent peptic ulcer; renal insufficiency; hypertension; osteoporosis; and myasthenia gravis.
Growth and development of infants and children on prolonged corticosteroid therapy should be carefully observed.
Although controlled clinical trials have shown corticosteroids to be effective in speeding the resolution of acute exacerbations of multiple sclerosis, they do not show that corticosteroids affect the ultimate outcome or natural history of the disease. The studies do show that relatively high doses of corticosteroids are necessary to demonstrate a significant effect
Since complications of treatment with glucocorticoids are dependent on the size of the dose and the duration of treatment, a risk/benefit decision must be made in each individual case as to dose and duration of treatment and as to whether daily or intermittent therapy should be used.
Convulsions have been reported with concurrent use of methylprednisolone and cyclosporin. Since concurrent use of these agents results in a mutual inhibition of metabolism, it is possible that adverse events associated with the individual use of either drug may be more apt to occur.
Aspirin should be used cautiously in conjunction with corticosteroids in patients suffering from hypoprothrombinemia

Drug Interactions: 

The pharmacokinetic interactions are potentially clinically important. Mutual inhibition of metabolism occurs with concurrent use of cyclosporin and methylprednisolone; therefore, it is possible that adverse events associated with the individual use of either drug may be more apt to occur. Convulsions have been reported with concurrent use of methylprednisolone and cyclosporin. Drugs that induce hepatic enzymes such as phenobarbital, phenytoin and rifampin may increase the clearance of methylprednisolone and may require increases in methylprednisolone dose to achieve the desired response. Drugs such as troleandomycin and ketoconazole may inhibit the metabolism of methylprednisolone and thus decrease its clearance. Therefore, the dose of methylprednisolone should be titrated to avoid steroid toxicity.
Methylprednisolone may increase the clearance of chronic high dose aspirin. This could lead to decreased salicylate serum levels or increase the risk of salicylate toxicity when methylprednisolone is withdrawn. Aspirin should be used cautiously in conjunction with corticosteroids in patients suffering from hypoprothrombinemia.
The effect of methylprednisolone on oral anticoagulants is variable. There are reports of enhanced as well as diminished effects of anticoagulant when given concurrently with corticosteroids. Therefore, coagulation indices should be monitored to maintain the desired anticoagulant effect.

Side Effects: 

Fluid and Electrolyte Distrubances
Sodium retention Potassium loss
Fluid retention Hypokalemic alkalosis
Congestive heart failure in susceptible patients Hypertension

Musculoskeletal
Muscle weakness Aseptic necrosis of femoral and humeral heads
Steroid myopathy Pathologic fracture of long bones
Loss of muscle mass Osteoporosis
Severe arthralgia
Vertebral compression fractures

Gastrointestinal
Peptic ulcer with possible perforation and hemorrhage Abdominal distention
Pancreatitis Ulcerative esophagitis

Dermatologic
Impaired wound healing Facial erythema
Thin fragile skin Increased sweating
Petechiae and ecchymoses May suppress reactions to skin tests

Neurological
Increased intracranial pressure with papilledema (Pseudo-tumor cerebri) usually after treatment Vertigo
Convulsions Headache

Endocrine
Development of Cushingoid state
Suppression of growth in children
Secondary adrenocortical and pituitary unresponsiveness, particularly in times of stress, as in trauma, surgery or illness
Menstrual irregularities
Decreased carbohydrate tolerance
Manifestations of latent diabetes mellitus
Increased requirements for insulin or oral hypoglycemic agents in diabetics
Ophthalmic
Posterior subcapsular cataracts Glaucoma
Increased intraocular pressure Exophthalmos

Metabolic
Negative nitrogen balance due to protein catabolism
The following additional adverse reactions are related to parenteral corticosteroid therapy:
Hyperpigmentation or hypopigmentation
Subcutaneous and cutaneous atrophy
Sterile abscess
Anaphylactic reaction with or without circulatory collapse, cardiac arrest, bronchospasm
Urticaria
Nausea and vomiting
Cardiac arrhythmias; hypotension or hypertension

Storage: 

• Store below 30 C°
• Protect from light and freezing

Packing: 

• Injection 40mg/1ml: Box of 1 ampoule

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) ) [field_contraindications] => Array ( [0] => Array ( [value] => The use of Methylprednisolone Sodium Succinate for Injection, USP is contraindicated in premature infants because the 1 g multiple dose vial when reconstituted will contain benzyl alcohol. Benzyl alcohol has been reported to be associated with a fatal “Gasping Syndrome” in premature infants. Methylprednisolone Sodium Succinate for Injection, USP is also contraindicated in systemic fungal infections and patients with known hypersensitivity to the product and its constituents. [format] => 1 [safe] =>

The use of Methylprednisolone Sodium Succinate for Injection, USP is contraindicated in premature infants because the 1 g multiple dose vial when reconstituted will contain benzyl alcohol. Benzyl alcohol has been reported to be associated with a fatal “Gasping Syndrome” in premature infants. Methylprednisolone Sodium Succinate for Injection, USP is also contraindicated in systemic fungal infections and patients with known hypersensitivity to the product and its constituents.

[view] =>

The use of Methylprednisolone Sodium Succinate for Injection, USP is contraindicated in premature infants because the 1 g multiple dose vial when reconstituted will contain benzyl alcohol. Benzyl alcohol has been reported to be associated with a fatal “Gasping Syndrome” in premature infants. Methylprednisolone Sodium Succinate for Injection, USP is also contraindicated in systemic fungal infections and patients with known hypersensitivity to the product and its constituents.

) ) [field_dosage_form] => Array ( [0] => Array ( [value] => Injection 40mg/1ml [format] => 1 [safe] =>

Injection 40mg/1ml

[view] =>

Injection 40mg/1ml

) ) [field_drug_interactions] => Array ( [0] => Array ( [value] => The pharmacokinetic interactions are potentially clinically important. Mutual inhibition of metabolism occurs with concurrent use of cyclosporin and methylprednisolone; therefore, it is possible that adverse events associated with the individual use of either drug may be more apt to occur. Convulsions have been reported with concurrent use of methylprednisolone and cyclosporin. Drugs that induce hepatic enzymes such as phenobarbital, phenytoin and rifampin may increase the clearance of methylprednisolone and may require increases in methylprednisolone dose to achieve the desired response. Drugs such as troleandomycin and ketoconazole may inhibit the metabolism of methylprednisolone and thus decrease its clearance. Therefore, the dose of methylprednisolone should be titrated to avoid steroid toxicity. Methylprednisolone may increase the clearance of chronic high dose aspirin. This could lead to decreased salicylate serum levels or increase the risk of salicylate toxicity when methylprednisolone is withdrawn. Aspirin should be used cautiously in conjunction with corticosteroids in patients suffering from hypoprothrombinemia. The effect of methylprednisolone on oral anticoagulants is variable. There are reports of enhanced as well as diminished effects of anticoagulant when given concurrently with corticosteroids. Therefore, coagulation indices should be monitored to maintain the desired anticoagulant effect. [format] => 1 [safe] =>

The pharmacokinetic interactions are potentially clinically important. Mutual inhibition of metabolism occurs with concurrent use of cyclosporin and methylprednisolone; therefore, it is possible that adverse events associated with the individual use of either drug may be more apt to occur. Convulsions have been reported with concurrent use of methylprednisolone and cyclosporin. Drugs that induce hepatic enzymes such as phenobarbital, phenytoin and rifampin may increase the clearance of methylprednisolone and may require increases in methylprednisolone dose to achieve the desired response. Drugs such as troleandomycin and ketoconazole may inhibit the metabolism of methylprednisolone and thus decrease its clearance. Therefore, the dose of methylprednisolone should be titrated to avoid steroid toxicity.
Methylprednisolone may increase the clearance of chronic high dose aspirin. This could lead to decreased salicylate serum levels or increase the risk of salicylate toxicity when methylprednisolone is withdrawn. Aspirin should be used cautiously in conjunction with corticosteroids in patients suffering from hypoprothrombinemia.
The effect of methylprednisolone on oral anticoagulants is variable. There are reports of enhanced as well as diminished effects of anticoagulant when given concurrently with corticosteroids. Therefore, coagulation indices should be monitored to maintain the desired anticoagulant effect.

[view] =>

The pharmacokinetic interactions are potentially clinically important. Mutual inhibition of metabolism occurs with concurrent use of cyclosporin and methylprednisolone; therefore, it is possible that adverse events associated with the individual use of either drug may be more apt to occur. Convulsions have been reported with concurrent use of methylprednisolone and cyclosporin. Drugs that induce hepatic enzymes such as phenobarbital, phenytoin and rifampin may increase the clearance of methylprednisolone and may require increases in methylprednisolone dose to achieve the desired response. Drugs such as troleandomycin and ketoconazole may inhibit the metabolism of methylprednisolone and thus decrease its clearance. Therefore, the dose of methylprednisolone should be titrated to avoid steroid toxicity.
Methylprednisolone may increase the clearance of chronic high dose aspirin. This could lead to decreased salicylate serum levels or increase the risk of salicylate toxicity when methylprednisolone is withdrawn. Aspirin should be used cautiously in conjunction with corticosteroids in patients suffering from hypoprothrombinemia.
The effect of methylprednisolone on oral anticoagulants is variable. There are reports of enhanced as well as diminished effects of anticoagulant when given concurrently with corticosteroids. Therefore, coagulation indices should be monitored to maintain the desired anticoagulant effect.

) ) [field_indications] => Array ( [0] => Array ( [value] => 1. Endocrine Disorders Primary or secondary adrenocortical insufficiency (hydrocortisone or cortisone is the drug of choice; synthetic analogs may be used in conjunction with mineralocorticoids where applicable; in infancy, mineralocorticoid supplementation is of particular importance) Acute adrenocortical insufficiency (hydrocortisone or cortisone is the drug of choice; mineralocorticoid supplementation may be necessary, particularly when synthetic analogs are used) Preoperatively and in the event of serious trauma or illness, in patients with known adrenal insufficiency or when adrenocortical reserve is doubtful Shock unresponsive to conventional therapy if adrenocortical insufficiency exists or is suspected Congenital adrenal hyperplasia Hypercalcemia associated with cancer Nonsuppurative thyroiditis 2. Rheumatic Disorders As adjunctive therapy for short-term administration (to tide the patient over an acute episode or exacerbation) in: Post-traumatic osteoarthritis Acute gouty arthritis Synovitis of osteoarthritis Psoriatic arthritis Rheumatoid arthritis, including juvenile rheumatoid arthritis (selected cases may require low-dose maintenance therapy) Ankylosing spondylitis Epicondylitis Acute and subacute bursitis Acute nonspecific tenosynovitis 3. Collagen Diseases During an exacerbation or as maintenance therapy in selected cases of: Systemic lupus erythematosus Systemic dermatomyositis (polymyositis) Acute rheumatic carditis 4. Dermatologic Diseases Pemphigus Severe seborrheic dermatitis Severe erythema multiforme (Stevens-Johnson syndrome) Severe psoriasis Exfoliative dermatitis Mycosis fungoides Bullous dermatitis herpetiformis 5. Allergic States Control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment in: Bronchial asthma Seasonal or perennial allergic rhinitis Contact dermatitis Drug hypersensitivity reactions Atopic dermatitis Urticarial transfusion reactions Serum sickness Acute noninfectious laryngeal edema (epinephrine is the drug of first choice) 6. Ophthalmic Diseases Severe acute and chronic allergic and inflammatory processes involving the eye, such as: Herpes zoster ophthalmicus Sympathetic ophthalmia Iritis, iridocyclitis Anterior segment inflammation Chorioretinitis Allergic conjunctivitis Diffuse posterior uveitis and choroiditis Allergic corneal marginal ulcers Optic neuritis Keratitis 7. Gastrointestinal Diseases To tide the patient over a critical period of the disease in: Ulcerative colitis (systemic therapy) Regional enteritis (systemic therapy) 8. Respiratory Diseases Symptomatic sarcoidosis Loeffler’s syndrome not manageable by other means Berylliosis Aspiration pneumonitis Fulminating or disseminated pulmonary tuberculosis when used concurrentlywith appropriate anti-tuberculous chemotherapy 9. Hematologic Disorders Acquired (autoimmune) hemolytic anemia Idiopathic thrombocytopenic purpura in adults (IV only; IM administration is contraindicated) Secondary thrombocytopenia in adults Erythroblastopenia (RBC anemia) Congenital (erythroid) hypoplastic anemia 10. Neoplastic Diseases For palliative management of: Leukemias and lymphomas in adults Acute leukemia of childhood 11. Edematous States To induce diuresis or remission of proteinuria in the nephrotic syndrome, without uremia, of the idiopathic type or that due to lupus erythematosus 12. Nervous System Acute exacerbations of multiple sclerosis 13. Miscellaneous Tuberculous meningitis with subarachnoid block or impending block when used concurrently with appropriate antituberculous chemotherapy Trichinosis with neurologic or myocardial involvement [format] => 1 [safe] =>

1. Endocrine Disorders
Primary or secondary adrenocortical insufficiency (hydrocortisone or cortisone is the drug of choice; synthetic analogs may be used in conjunction with mineralocorticoids where applicable; in infancy,
mineralocorticoid supplementation is of particular importance)
Acute adrenocortical insufficiency (hydrocortisone or cortisone is the drug of choice; mineralocorticoid supplementation may be necessary, particularly when synthetic analogs are used)
Preoperatively and in the event of serious trauma or illness, in patients with known adrenal insufficiency or when adrenocortical reserve is doubtful
Shock unresponsive to conventional therapy if adrenocortical insufficiency exists or is suspected
Congenital adrenal hyperplasia
Hypercalcemia associated with cancer
Nonsuppurative thyroiditis
2. Rheumatic Disorders
As adjunctive therapy for short-term administration (to tide the patient over an acute episode or exacerbation) in:
Post-traumatic osteoarthritis Acute gouty arthritis
Synovitis of osteoarthritis Psoriatic arthritis
Rheumatoid arthritis, including juvenile rheumatoid arthritis (selected cases may require low-dose maintenance therapy) Ankylosing spondylitis
Epicondylitis Acute and subacute bursitis
Acute nonspecific tenosynovitis
3. Collagen Diseases
During an exacerbation or as maintenance therapy in selected cases of:
Systemic lupus erythematosus
Systemic dermatomyositis (polymyositis)
Acute rheumatic carditis
4. Dermatologic Diseases
Pemphigus Severe seborrheic dermatitis
Severe erythema multiforme (Stevens-Johnson syndrome) Severe psoriasis
Exfoliative dermatitis Mycosis fungoides
Bullous dermatitis herpetiformis
5. Allergic States
Control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment in:
Bronchial asthma Seasonal or perennial allergic rhinitis
Contact dermatitis Drug hypersensitivity reactions
Atopic dermatitis Urticarial transfusion reactions
Serum sickness Acute noninfectious laryngeal edema (epinephrine is the drug of first choice)
6. Ophthalmic Diseases
Severe acute and chronic allergic and inflammatory processes involving the eye, such as:
Herpes zoster ophthalmicus Sympathetic ophthalmia
Iritis, iridocyclitis Anterior segment inflammation
Chorioretinitis Allergic conjunctivitis
Diffuse posterior uveitis and choroiditis Allergic corneal marginal ulcers
Optic neuritis Keratitis
7. Gastrointestinal Diseases
To tide the patient over a critical period of the disease in:
Ulcerative colitis (systemic therapy)
Regional enteritis (systemic therapy)
8. Respiratory Diseases
Symptomatic sarcoidosis Loeffler’s syndrome not manageable by other means
Berylliosis Aspiration pneumonitis
Fulminating or disseminated pulmonary tuberculosis when used concurrentlywith appropriate anti-tuberculous chemotherapy
9. Hematologic Disorders
Acquired (autoimmune) hemolytic anemia
Idiopathic thrombocytopenic purpura in adults (IV only; IM administration is contraindicated)
Secondary thrombocytopenia in adults
Erythroblastopenia (RBC anemia)
Congenital (erythroid) hypoplastic anemia
10. Neoplastic Diseases
For palliative management of:
Leukemias and lymphomas in adults
Acute leukemia of childhood
11. Edematous States
To induce diuresis or remission of proteinuria in the nephrotic syndrome, without uremia, of the idiopathic type or that due to lupus erythematosus
12. Nervous System
Acute exacerbations of multiple sclerosis
13. Miscellaneous
Tuberculous meningitis with subarachnoid block or impending block when used concurrently with appropriate antituberculous chemotherapy
Trichinosis with neurologic or myocardial involvement

[view] =>

1. Endocrine Disorders
Primary or secondary adrenocortical insufficiency (hydrocortisone or cortisone is the drug of choice; synthetic analogs may be used in conjunction with mineralocorticoids where applicable; in infancy,
mineralocorticoid supplementation is of particular importance)
Acute adrenocortical insufficiency (hydrocortisone or cortisone is the drug of choice; mineralocorticoid supplementation may be necessary, particularly when synthetic analogs are used)
Preoperatively and in the event of serious trauma or illness, in patients with known adrenal insufficiency or when adrenocortical reserve is doubtful
Shock unresponsive to conventional therapy if adrenocortical insufficiency exists or is suspected
Congenital adrenal hyperplasia
Hypercalcemia associated with cancer
Nonsuppurative thyroiditis
2. Rheumatic Disorders
As adjunctive therapy for short-term administration (to tide the patient over an acute episode or exacerbation) in:
Post-traumatic osteoarthritis Acute gouty arthritis
Synovitis of osteoarthritis Psoriatic arthritis
Rheumatoid arthritis, including juvenile rheumatoid arthritis (selected cases may require low-dose maintenance therapy) Ankylosing spondylitis
Epicondylitis Acute and subacute bursitis
Acute nonspecific tenosynovitis
3. Collagen Diseases
During an exacerbation or as maintenance therapy in selected cases of:
Systemic lupus erythematosus
Systemic dermatomyositis (polymyositis)
Acute rheumatic carditis
4. Dermatologic Diseases
Pemphigus Severe seborrheic dermatitis
Severe erythema multiforme (Stevens-Johnson syndrome) Severe psoriasis
Exfoliative dermatitis Mycosis fungoides
Bullous dermatitis herpetiformis
5. Allergic States
Control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment in:
Bronchial asthma Seasonal or perennial allergic rhinitis
Contact dermatitis Drug hypersensitivity reactions
Atopic dermatitis Urticarial transfusion reactions
Serum sickness Acute noninfectious laryngeal edema (epinephrine is the drug of first choice)
6. Ophthalmic Diseases
Severe acute and chronic allergic and inflammatory processes involving the eye, such as:
Herpes zoster ophthalmicus Sympathetic ophthalmia
Iritis, iridocyclitis Anterior segment inflammation
Chorioretinitis Allergic conjunctivitis
Diffuse posterior uveitis and choroiditis Allergic corneal marginal ulcers
Optic neuritis Keratitis
7. Gastrointestinal Diseases
To tide the patient over a critical period of the disease in:
Ulcerative colitis (systemic therapy)
Regional enteritis (systemic therapy)
8. Respiratory Diseases
Symptomatic sarcoidosis Loeffler’s syndrome not manageable by other means
Berylliosis Aspiration pneumonitis
Fulminating or disseminated pulmonary tuberculosis when used concurrentlywith appropriate anti-tuberculous chemotherapy
9. Hematologic Disorders
Acquired (autoimmune) hemolytic anemia
Idiopathic thrombocytopenic purpura in adults (IV only; IM administration is contraindicated)
Secondary thrombocytopenia in adults
Erythroblastopenia (RBC anemia)
Congenital (erythroid) hypoplastic anemia
10. Neoplastic Diseases
For palliative management of:
Leukemias and lymphomas in adults
Acute leukemia of childhood
11. Edematous States
To induce diuresis or remission of proteinuria in the nephrotic syndrome, without uremia, of the idiopathic type or that due to lupus erythematosus
12. Nervous System
Acute exacerbations of multiple sclerosis
13. Miscellaneous
Tuberculous meningitis with subarachnoid block or impending block when used concurrently with appropriate antituberculous chemotherapy
Trichinosis with neurologic or myocardial involvement

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• Injection 40mg/1ml: Box of 1 ampoule

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Absorption
Absorption from IM injection of methylprednisolone sodium succinate is rapid.
Systemic absorption of methylprednisolone acetate occurs slowly following intra-articular, intrabursal, intrasynovial, intradermal, or soft tissue injection; Absorption from intra-articular injection sites is usually very slow and continues for about 7 days.


Onset
Following IM administration (80–120 mg) in patients with severe poison ivy, relief onset within 8–12 hours.
Following oral administration in patients with asthma, effects may not be evident for several hours.


Duration
The duration of anti-inflammatory activity of methylprednisolone approximately equals the duration of HPA-axis suppression, about 1.25–1.5 days for a single 40-mg oral dose.


Distribution
Most glucocorticoids are removed rapidly from the blood and distributed to muscles, liver, skin, intestines, and kidneys.
Glucocorticoids appear in breast milk and the placenta.


Metabolism
Metabolized in most tissues, but mainly in the liver, to inactive compounds.


Half-life
Approximately 2.5–3.5 hours following oral administration of methylprednisolone or IV or IM administration of methylprednisolone sodium succinate.

[format] => 1 [safe] =>

Absorption
Absorption from IM injection of methylprednisolone sodium succinate is rapid.
Systemic absorption of methylprednisolone acetate occurs slowly following intra-articular, intrabursal, intrasynovial, intradermal, or soft tissue injection; Absorption from intra-articular injection sites is usually very slow and continues for about 7 days.

Onset
Following IM administration (80–120 mg) in patients with severe poison ivy, relief onset within 8–12 hours.
Following oral administration in patients with asthma, effects may not be evident for several hours.

Duration
The duration of anti-inflammatory activity of methylprednisolone approximately equals the duration of HPA-axis suppression, about 1.25–1.5 days for a single 40-mg oral dose.

Distribution
Most glucocorticoids are removed rapidly from the blood and distributed to muscles, liver, skin, intestines, and kidneys.
Glucocorticoids appear in breast milk and the placenta.

Metabolism
Metabolized in most tissues, but mainly in the liver, to inactive compounds.

Half-life
Approximately 2.5–3.5 hours following oral administration of methylprednisolone or IV or IM administration of methylprednisolone sodium succinate.

[view] =>

Absorption
Absorption from IM injection of methylprednisolone sodium succinate is rapid.
Systemic absorption of methylprednisolone acetate occurs slowly following intra-articular, intrabursal, intrasynovial, intradermal, or soft tissue injection; Absorption from intra-articular injection sites is usually very slow and continues for about 7 days.

Onset
Following IM administration (80–120 mg) in patients with severe poison ivy, relief onset within 8–12 hours.
Following oral administration in patients with asthma, effects may not be evident for several hours.

Duration
The duration of anti-inflammatory activity of methylprednisolone approximately equals the duration of HPA-axis suppression, about 1.25–1.5 days for a single 40-mg oral dose.

Distribution
Most glucocorticoids are removed rapidly from the blood and distributed to muscles, liver, skin, intestines, and kidneys.
Glucocorticoids appear in breast milk and the placenta.

Metabolism
Metabolized in most tissues, but mainly in the liver, to inactive compounds.

Half-life
Approximately 2.5–3.5 hours following oral administration of methylprednisolone or IV or IM administration of methylprednisolone sodium succinate.

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Anti-inflammatory Agent

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Anti-inflammatory Agent

) ) [field_precautions] => Array ( [0] => Array ( [value] => Drug-induced secondary adrenocortical insufficiency may be minimized by gradual reduction of dosage. This type of relative insufficiency may persist for months after discontinuation of therapy; therefore, in any situation of stress occurring during that period, hormone therapy should be reinstituted. Since mineralocorticoid secretion may be impaired, salt and/or a mineralocorticoid should be administered concurrently. There is an enhanced effect of corticosteroids on patients with hypothyroidism and in those with cirrhosis. Corticosteroids should be used cautiously in patients with ocular herpes simplex because of possible corneal perforation. The lowest possible dose of corticosteroid should be used to control the condition under treatment, and when reduction in dosage is possible, the reduction should be gradual. Psychic derangements may appear when corticosteroids are used, ranging from euphoria, insomnia, mood swings, personality changes, and severe depression, to frank psychotic manifestations. Also, existing emotional instability or psychotic tendencies may be aggravated by corticosteroids. Steroids should be used with caution in nonspecific ulcerative colitis, if there is a probability of impending perforation, abscess or other pyogenic infection; diverticulitis; fresh intestinal anastomoses; active or latent peptic ulcer; renal insufficiency; hypertension; osteoporosis; and myasthenia gravis. Growth and development of infants and children on prolonged corticosteroid therapy should be carefully observed. Although controlled clinical trials have shown corticosteroids to be effective in speeding the resolution of acute exacerbations of multiple sclerosis, they do not show that corticosteroids affect the ultimate outcome or natural history of the disease. The studies do show that relatively high doses of corticosteroids are necessary to demonstrate a significant effect Since complications of treatment with glucocorticoids are dependent on the size of the dose and the duration of treatment, a risk/benefit decision must be made in each individual case as to dose and duration of treatment and as to whether daily or intermittent therapy should be used. Convulsions have been reported with concurrent use of methylprednisolone and cyclosporin. Since concurrent use of these agents results in a mutual inhibition of metabolism, it is possible that adverse events associated with the individual use of either drug may be more apt to occur. Aspirin should be used cautiously in conjunction with corticosteroids in patients suffering from hypoprothrombinemia [format] => 1 [safe] =>

Drug-induced secondary adrenocortical insufficiency may be minimized by gradual reduction of dosage. This type of relative insufficiency may persist for months after discontinuation of therapy; therefore, in any situation of stress occurring during that period, hormone therapy should be reinstituted. Since mineralocorticoid secretion may be impaired, salt and/or a mineralocorticoid should be administered concurrently.
There is an enhanced effect of corticosteroids on patients with hypothyroidism and in those with cirrhosis.
Corticosteroids should be used cautiously in patients with ocular herpes simplex because of possible corneal perforation.
The lowest possible dose of corticosteroid should be used to control the condition under treatment, and when reduction in dosage is possible, the reduction should be gradual.
Psychic derangements may appear when corticosteroids are used, ranging from euphoria, insomnia, mood swings, personality changes, and severe depression, to frank psychotic manifestations. Also, existing emotional instability or psychotic tendencies may be aggravated by corticosteroids.
Steroids should be used with caution in nonspecific ulcerative colitis, if there is a probability of impending perforation, abscess or other pyogenic infection; diverticulitis; fresh intestinal anastomoses; active or latent peptic ulcer; renal insufficiency; hypertension; osteoporosis; and myasthenia gravis.
Growth and development of infants and children on prolonged corticosteroid therapy should be carefully observed.
Although controlled clinical trials have shown corticosteroids to be effective in speeding the resolution of acute exacerbations of multiple sclerosis, they do not show that corticosteroids affect the ultimate outcome or natural history of the disease. The studies do show that relatively high doses of corticosteroids are necessary to demonstrate a significant effect
Since complications of treatment with glucocorticoids are dependent on the size of the dose and the duration of treatment, a risk/benefit decision must be made in each individual case as to dose and duration of treatment and as to whether daily or intermittent therapy should be used.
Convulsions have been reported with concurrent use of methylprednisolone and cyclosporin. Since concurrent use of these agents results in a mutual inhibition of metabolism, it is possible that adverse events associated with the individual use of either drug may be more apt to occur.
Aspirin should be used cautiously in conjunction with corticosteroids in patients suffering from hypoprothrombinemia

[view] =>

Drug-induced secondary adrenocortical insufficiency may be minimized by gradual reduction of dosage. This type of relative insufficiency may persist for months after discontinuation of therapy; therefore, in any situation of stress occurring during that period, hormone therapy should be reinstituted. Since mineralocorticoid secretion may be impaired, salt and/or a mineralocorticoid should be administered concurrently.
There is an enhanced effect of corticosteroids on patients with hypothyroidism and in those with cirrhosis.
Corticosteroids should be used cautiously in patients with ocular herpes simplex because of possible corneal perforation.
The lowest possible dose of corticosteroid should be used to control the condition under treatment, and when reduction in dosage is possible, the reduction should be gradual.
Psychic derangements may appear when corticosteroids are used, ranging from euphoria, insomnia, mood swings, personality changes, and severe depression, to frank psychotic manifestations. Also, existing emotional instability or psychotic tendencies may be aggravated by corticosteroids.
Steroids should be used with caution in nonspecific ulcerative colitis, if there is a probability of impending perforation, abscess or other pyogenic infection; diverticulitis; fresh intestinal anastomoses; active or latent peptic ulcer; renal insufficiency; hypertension; osteoporosis; and myasthenia gravis.
Growth and development of infants and children on prolonged corticosteroid therapy should be carefully observed.
Although controlled clinical trials have shown corticosteroids to be effective in speeding the resolution of acute exacerbations of multiple sclerosis, they do not show that corticosteroids affect the ultimate outcome or natural history of the disease. The studies do show that relatively high doses of corticosteroids are necessary to demonstrate a significant effect
Since complications of treatment with glucocorticoids are dependent on the size of the dose and the duration of treatment, a risk/benefit decision must be made in each individual case as to dose and duration of treatment and as to whether daily or intermittent therapy should be used.
Convulsions have been reported with concurrent use of methylprednisolone and cyclosporin. Since concurrent use of these agents results in a mutual inhibition of metabolism, it is possible that adverse events associated with the individual use of either drug may be more apt to occur.
Aspirin should be used cautiously in conjunction with corticosteroids in patients suffering from hypoprothrombinemia

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Category C

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Category C

) ) [field_references] => Array ( [0] => Array ( [value] => [format] => [safe] => [view] => ) ) [field_side_effects] => Array ( [0] => Array ( [value] => Fluid and Electrolyte Distrubances Sodium retention Potassium loss Fluid retention Hypokalemic alkalosis Congestive heart failure in susceptible patients Hypertension Musculoskeletal Muscle weakness Aseptic necrosis of femoral and humeral heads Steroid myopathy Pathologic fracture of long bones Loss of muscle mass Osteoporosis Severe arthralgia Vertebral compression fractures Gastrointestinal Peptic ulcer with possible perforation and hemorrhage Abdominal distention Pancreatitis Ulcerative esophagitis Dermatologic Impaired wound healing Facial erythema Thin fragile skin Increased sweating Petechiae and ecchymoses May suppress reactions to skin tests Neurological Increased intracranial pressure with papilledema (Pseudo-tumor cerebri) usually after treatment Vertigo Convulsions Headache Endocrine Development of Cushingoid state Suppression of growth in children Secondary adrenocortical and pituitary unresponsiveness, particularly in times of stress, as in trauma, surgery or illness Menstrual irregularities Decreased carbohydrate tolerance Manifestations of latent diabetes mellitus Increased requirements for insulin or oral hypoglycemic agents in diabetics Ophthalmic Posterior subcapsular cataracts Glaucoma Increased intraocular pressure Exophthalmos Metabolic Negative nitrogen balance due to protein catabolism The following additional adverse reactions are related to parenteral corticosteroid therapy: Hyperpigmentation or hypopigmentation Subcutaneous and cutaneous atrophy Sterile abscess Anaphylactic reaction with or without circulatory collapse, cardiac arrest, bronchospasm Urticaria Nausea and vomiting Cardiac arrhythmias; hypotension or hypertension [format] => 1 [safe] =>

Fluid and Electrolyte Distrubances
Sodium retention Potassium loss
Fluid retention Hypokalemic alkalosis
Congestive heart failure in susceptible patients Hypertension

Musculoskeletal
Muscle weakness Aseptic necrosis of femoral and humeral heads
Steroid myopathy Pathologic fracture of long bones
Loss of muscle mass Osteoporosis
Severe arthralgia
Vertebral compression fractures

Gastrointestinal
Peptic ulcer with possible perforation and hemorrhage Abdominal distention
Pancreatitis Ulcerative esophagitis

Dermatologic
Impaired wound healing Facial erythema
Thin fragile skin Increased sweating
Petechiae and ecchymoses May suppress reactions to skin tests

Neurological
Increased intracranial pressure with papilledema (Pseudo-tumor cerebri) usually after treatment Vertigo
Convulsions Headache

Endocrine
Development of Cushingoid state
Suppression of growth in children
Secondary adrenocortical and pituitary unresponsiveness, particularly in times of stress, as in trauma, surgery or illness
Menstrual irregularities
Decreased carbohydrate tolerance
Manifestations of latent diabetes mellitus
Increased requirements for insulin or oral hypoglycemic agents in diabetics
Ophthalmic
Posterior subcapsular cataracts Glaucoma
Increased intraocular pressure Exophthalmos

Metabolic
Negative nitrogen balance due to protein catabolism
The following additional adverse reactions are related to parenteral corticosteroid therapy:
Hyperpigmentation or hypopigmentation
Subcutaneous and cutaneous atrophy
Sterile abscess
Anaphylactic reaction with or without circulatory collapse, cardiac arrest, bronchospasm
Urticaria
Nausea and vomiting
Cardiac arrhythmias; hypotension or hypertension

[view] =>

Fluid and Electrolyte Distrubances
Sodium retention Potassium loss
Fluid retention Hypokalemic alkalosis
Congestive heart failure in susceptible patients Hypertension

Musculoskeletal
Muscle weakness Aseptic necrosis of femoral and humeral heads
Steroid myopathy Pathologic fracture of long bones
Loss of muscle mass Osteoporosis
Severe arthralgia
Vertebral compression fractures

Gastrointestinal
Peptic ulcer with possible perforation and hemorrhage Abdominal distention
Pancreatitis Ulcerative esophagitis

Dermatologic
Impaired wound healing Facial erythema
Thin fragile skin Increased sweating
Petechiae and ecchymoses May suppress reactions to skin tests

Neurological
Increased intracranial pressure with papilledema (Pseudo-tumor cerebri) usually after treatment Vertigo
Convulsions Headache

Endocrine
Development of Cushingoid state
Suppression of growth in children
Secondary adrenocortical and pituitary unresponsiveness, particularly in times of stress, as in trauma, surgery or illness
Menstrual irregularities
Decreased carbohydrate tolerance
Manifestations of latent diabetes mellitus
Increased requirements for insulin or oral hypoglycemic agents in diabetics
Ophthalmic
Posterior subcapsular cataracts Glaucoma
Increased intraocular pressure Exophthalmos

Metabolic
Negative nitrogen balance due to protein catabolism
The following additional adverse reactions are related to parenteral corticosteroid therapy:
Hyperpigmentation or hypopigmentation
Subcutaneous and cutaneous atrophy
Sterile abscess
Anaphylactic reaction with or without circulatory collapse, cardiac arrest, bronchospasm
Urticaria
Nausea and vomiting
Cardiac arrhythmias; hypotension or hypertension

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• Protect from light and freezing

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• Store below 30 C°
• Protect from light and freezing

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Corticosteroids

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Corticosteroids

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Corticosteroids

) [#title] => [#description] => [#children] =>

Corticosteroids

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Corticosteroids

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Therapeutic Category: 

Corticosteroids

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Category C

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Category C

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Category C

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Category C

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Pregnancy Category: 

Category C

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Methylprednisolone is a potent anti-inflammatory steroid with greater anti-inflammatory potency than prednisolone and even less tendency than prednisolone to induce sodium and water retention.
Methylprednisolone sodium succinate has the same metabolic and anti-inflammatory actions as methylprednisolone. When given parenterally and in equimolar quantities, the two compounds are equivalent in biologic activity. The relative potency of methylprednisolone and hydrocortisone sodium succinate, as indicated by depression of eosinophil count, following intravenous administration, is at least four to one. This is in good agreement with the relative oral potency of methylprednisolone and hydrocortisone.

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Absorption
Absorption from IM injection of methylprednisolone sodium succinate is rapid.
Systemic absorption of methylprednisolone acetate occurs slowly following intra-articular, intrabursal, intrasynovial, intradermal, or soft tissue injection; Absorption from intra-articular injection sites is usually very slow and continues for about 7 days.


Onset
Following IM administration (80–120 mg) in patients with severe poison ivy, relief onset within 8–12 hours.
Following oral administration in patients with asthma, effects may not be evident for several hours.


Duration
The duration of anti-inflammatory activity of methylprednisolone approximately equals the duration of HPA-axis suppression, about 1.25–1.5 days for a single 40-mg oral dose.


Distribution
Most glucocorticoids are removed rapidly from the blood and distributed to muscles, liver, skin, intestines, and kidneys.
Glucocorticoids appear in breast milk and the placenta.


Metabolism
Metabolized in most tissues, but mainly in the liver, to inactive compounds.


Half-life
Approximately 2.5–3.5 hours following oral administration of methylprednisolone or IV or IM administration of methylprednisolone sodium succinate.

[format] => 1 [safe] =>

Absorption
Absorption from IM injection of methylprednisolone sodium succinate is rapid.
Systemic absorption of methylprednisolone acetate occurs slowly following intra-articular, intrabursal, intrasynovial, intradermal, or soft tissue injection; Absorption from intra-articular injection sites is usually very slow and continues for about 7 days.

Onset
Following IM administration (80–120 mg) in patients with severe poison ivy, relief onset within 8–12 hours.
Following oral administration in patients with asthma, effects may not be evident for several hours.

Duration
The duration of anti-inflammatory activity of methylprednisolone approximately equals the duration of HPA-axis suppression, about 1.25–1.5 days for a single 40-mg oral dose.

Distribution
Most glucocorticoids are removed rapidly from the blood and distributed to muscles, liver, skin, intestines, and kidneys.
Glucocorticoids appear in breast milk and the placenta.

Metabolism
Metabolized in most tissues, but mainly in the liver, to inactive compounds.

Half-life
Approximately 2.5–3.5 hours following oral administration of methylprednisolone or IV or IM administration of methylprednisolone sodium succinate.

[#delta] => 0 ) [#title] => [#description] => [#theme_used] => 1 [#printed] => 1 [#type] => [#value] => [#prefix] => [#suffix] => [#children] =>

Absorption
Absorption from IM injection of methylprednisolone sodium succinate is rapid.
Systemic absorption of methylprednisolone acetate occurs slowly following intra-articular, intrabursal, intrasynovial, intradermal, or soft tissue injection; Absorption from intra-articular injection sites is usually very slow and continues for about 7 days.

Onset
Following IM administration (80–120 mg) in patients with severe poison ivy, relief onset within 8–12 hours.
Following oral administration in patients with asthma, effects may not be evident for several hours.

Duration
The duration of anti-inflammatory activity of methylprednisolone approximately equals the duration of HPA-axis suppression, about 1.25–1.5 days for a single 40-mg oral dose.

Distribution
Most glucocorticoids are removed rapidly from the blood and distributed to muscles, liver, skin, intestines, and kidneys.
Glucocorticoids appear in breast milk and the placenta.

Metabolism
Metabolized in most tissues, but mainly in the liver, to inactive compounds.

Half-life
Approximately 2.5–3.5 hours following oral administration of methylprednisolone or IV or IM administration of methylprednisolone sodium succinate.

) [#title] => [#description] => [#children] =>

Absorption
Absorption from IM injection of methylprednisolone sodium succinate is rapid.
Systemic absorption of methylprednisolone acetate occurs slowly following intra-articular, intrabursal, intrasynovial, intradermal, or soft tissue injection; Absorption from intra-articular injection sites is usually very slow and continues for about 7 days.

Onset
Following IM administration (80–120 mg) in patients with severe poison ivy, relief onset within 8–12 hours.
Following oral administration in patients with asthma, effects may not be evident for several hours.

Duration
The duration of anti-inflammatory activity of methylprednisolone approximately equals the duration of HPA-axis suppression, about 1.25–1.5 days for a single 40-mg oral dose.

Distribution
Most glucocorticoids are removed rapidly from the blood and distributed to muscles, liver, skin, intestines, and kidneys.
Glucocorticoids appear in breast milk and the placenta.

Metabolism
Metabolized in most tissues, but mainly in the liver, to inactive compounds.

Half-life
Approximately 2.5–3.5 hours following oral administration of methylprednisolone or IV or IM administration of methylprednisolone sodium succinate.

[#printed] => 1 ) [#single] => 1 [#attributes] => Array ( ) [#required] => [#parents] => Array ( ) [#tree] => [#context] => full [#page] => 1 [#field_name] => field_pharmacokinetics [#title] => Pharmacokinetics [#access] => 1 [#label_display] => above [#teaser] => [#node] => stdClass Object *RECURSION* [#type] => content_field [#children] =>

Absorption
Absorption from IM injection of methylprednisolone sodium succinate is rapid.
Systemic absorption of methylprednisolone acetate occurs slowly following intra-articular, intrabursal, intrasynovial, intradermal, or soft tissue injection; Absorption from intra-articular injection sites is usually very slow and continues for about 7 days.

Onset
Following IM administration (80–120 mg) in patients with severe poison ivy, relief onset within 8–12 hours.
Following oral administration in patients with asthma, effects may not be evident for several hours.

Duration
The duration of anti-inflammatory activity of methylprednisolone approximately equals the duration of HPA-axis suppression, about 1.25–1.5 days for a single 40-mg oral dose.

Distribution
Most glucocorticoids are removed rapidly from the blood and distributed to muscles, liver, skin, intestines, and kidneys.
Glucocorticoids appear in breast milk and the placenta.

Metabolism
Metabolized in most tissues, but mainly in the liver, to inactive compounds.

Half-life
Approximately 2.5–3.5 hours following oral administration of methylprednisolone or IV or IM administration of methylprednisolone sodium succinate.

[#printed] => 1 ) [#title] => [#description] => [#children] =>
Pharmacokinetics: 

Absorption
Absorption from IM injection of methylprednisolone sodium succinate is rapid.
Systemic absorption of methylprednisolone acetate occurs slowly following intra-articular, intrabursal, intrasynovial, intradermal, or soft tissue injection; Absorption from intra-articular injection sites is usually very slow and continues for about 7 days.

Onset
Following IM administration (80–120 mg) in patients with severe poison ivy, relief onset within 8–12 hours.
Following oral administration in patients with asthma, effects may not be evident for several hours.

Duration
The duration of anti-inflammatory activity of methylprednisolone approximately equals the duration of HPA-axis suppression, about 1.25–1.5 days for a single 40-mg oral dose.

Distribution
Most glucocorticoids are removed rapidly from the blood and distributed to muscles, liver, skin, intestines, and kidneys.
Glucocorticoids appear in breast milk and the placenta.

Metabolism
Metabolized in most tissues, but mainly in the liver, to inactive compounds.

Half-life
Approximately 2.5–3.5 hours following oral administration of methylprednisolone or IV or IM administration of methylprednisolone sodium succinate.

[#printed] => 1 ) [field_indications] => Array ( [#type_name] => product [#context] => full [#field_name] => field_indications [#post_render] => Array ( [0] => content_field_wrapper_post_render ) [#weight] => 5 [field] => Array ( [#description] => [items] => Array ( [0] => Array ( [#formatter] => default [#node] => stdClass Object *RECURSION* [#type_name] => product [#field_name] => field_indications [#weight] => 0 [#theme] => text_formatter_default [#item] => Array ( [value] => 1. Endocrine Disorders Primary or secondary adrenocortical insufficiency (hydrocortisone or cortisone is the drug of choice; synthetic analogs may be used in conjunction with mineralocorticoids where applicable; in infancy, mineralocorticoid supplementation is of particular importance) Acute adrenocortical insufficiency (hydrocortisone or cortisone is the drug of choice; mineralocorticoid supplementation may be necessary, particularly when synthetic analogs are used) Preoperatively and in the event of serious trauma or illness, in patients with known adrenal insufficiency or when adrenocortical reserve is doubtful Shock unresponsive to conventional therapy if adrenocortical insufficiency exists or is suspected Congenital adrenal hyperplasia Hypercalcemia associated with cancer Nonsuppurative thyroiditis 2. Rheumatic Disorders As adjunctive therapy for short-term administration (to tide the patient over an acute episode or exacerbation) in: Post-traumatic osteoarthritis Acute gouty arthritis Synovitis of osteoarthritis Psoriatic arthritis Rheumatoid arthritis, including juvenile rheumatoid arthritis (selected cases may require low-dose maintenance therapy) Ankylosing spondylitis Epicondylitis Acute and subacute bursitis Acute nonspecific tenosynovitis 3. Collagen Diseases During an exacerbation or as maintenance therapy in selected cases of: Systemic lupus erythematosus Systemic dermatomyositis (polymyositis) Acute rheumatic carditis 4. Dermatologic Diseases Pemphigus Severe seborrheic dermatitis Severe erythema multiforme (Stevens-Johnson syndrome) Severe psoriasis Exfoliative dermatitis Mycosis fungoides Bullous dermatitis herpetiformis 5. Allergic States Control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment in: Bronchial asthma Seasonal or perennial allergic rhinitis Contact dermatitis Drug hypersensitivity reactions Atopic dermatitis Urticarial transfusion reactions Serum sickness Acute noninfectious laryngeal edema (epinephrine is the drug of first choice) 6. Ophthalmic Diseases Severe acute and chronic allergic and inflammatory processes involving the eye, such as: Herpes zoster ophthalmicus Sympathetic ophthalmia Iritis, iridocyclitis Anterior segment inflammation Chorioretinitis Allergic conjunctivitis Diffuse posterior uveitis and choroiditis Allergic corneal marginal ulcers Optic neuritis Keratitis 7. Gastrointestinal Diseases To tide the patient over a critical period of the disease in: Ulcerative colitis (systemic therapy) Regional enteritis (systemic therapy) 8. Respiratory Diseases Symptomatic sarcoidosis Loeffler’s syndrome not manageable by other means Berylliosis Aspiration pneumonitis Fulminating or disseminated pulmonary tuberculosis when used concurrentlywith appropriate anti-tuberculous chemotherapy 9. Hematologic Disorders Acquired (autoimmune) hemolytic anemia Idiopathic thrombocytopenic purpura in adults (IV only; IM administration is contraindicated) Secondary thrombocytopenia in adults Erythroblastopenia (RBC anemia) Congenital (erythroid) hypoplastic anemia 10. Neoplastic Diseases For palliative management of: Leukemias and lymphomas in adults Acute leukemia of childhood 11. Edematous States To induce diuresis or remission of proteinuria in the nephrotic syndrome, without uremia, of the idiopathic type or that due to lupus erythematosus 12. Nervous System Acute exacerbations of multiple sclerosis 13. Miscellaneous Tuberculous meningitis with subarachnoid block or impending block when used concurrently with appropriate antituberculous chemotherapy Trichinosis with neurologic or myocardial involvement [format] => 1 [safe] =>

1. Endocrine Disorders
Primary or secondary adrenocortical insufficiency (hydrocortisone or cortisone is the drug of choice; synthetic analogs may be used in conjunction with mineralocorticoids where applicable; in infancy,
mineralocorticoid supplementation is of particular importance)
Acute adrenocortical insufficiency (hydrocortisone or cortisone is the drug of choice; mineralocorticoid supplementation may be necessary, particularly when synthetic analogs are used)
Preoperatively and in the event of serious trauma or illness, in patients with known adrenal insufficiency or when adrenocortical reserve is doubtful
Shock unresponsive to conventional therapy if adrenocortical insufficiency exists or is suspected
Congenital adrenal hyperplasia
Hypercalcemia associated with cancer
Nonsuppurative thyroiditis
2. Rheumatic Disorders
As adjunctive therapy for short-term administration (to tide the patient over an acute episode or exacerbation) in:
Post-traumatic osteoarthritis Acute gouty arthritis
Synovitis of osteoarthritis Psoriatic arthritis
Rheumatoid arthritis, including juvenile rheumatoid arthritis (selected cases may require low-dose maintenance therapy) Ankylosing spondylitis
Epicondylitis Acute and subacute bursitis
Acute nonspecific tenosynovitis
3. Collagen Diseases
During an exacerbation or as maintenance therapy in selected cases of:
Systemic lupus erythematosus
Systemic dermatomyositis (polymyositis)
Acute rheumatic carditis
4. Dermatologic Diseases
Pemphigus Severe seborrheic dermatitis
Severe erythema multiforme (Stevens-Johnson syndrome) Severe psoriasis
Exfoliative dermatitis Mycosis fungoides
Bullous dermatitis herpetiformis
5. Allergic States
Control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment in:
Bronchial asthma Seasonal or perennial allergic rhinitis
Contact dermatitis Drug hypersensitivity reactions
Atopic dermatitis Urticarial transfusion reactions
Serum sickness Acute noninfectious laryngeal edema (epinephrine is the drug of first choice)
6. Ophthalmic Diseases
Severe acute and chronic allergic and inflammatory processes involving the eye, such as:
Herpes zoster ophthalmicus Sympathetic ophthalmia
Iritis, iridocyclitis Anterior segment inflammation
Chorioretinitis Allergic conjunctivitis
Diffuse posterior uveitis and choroiditis Allergic corneal marginal ulcers
Optic neuritis Keratitis
7. Gastrointestinal Diseases
To tide the patient over a critical period of the disease in:
Ulcerative colitis (systemic therapy)
Regional enteritis (systemic therapy)
8. Respiratory Diseases
Symptomatic sarcoidosis Loeffler’s syndrome not manageable by other means
Berylliosis Aspiration pneumonitis
Fulminating or disseminated pulmonary tuberculosis when used concurrentlywith appropriate anti-tuberculous chemotherapy
9. Hematologic Disorders
Acquired (autoimmune) hemolytic anemia
Idiopathic thrombocytopenic purpura in adults (IV only; IM administration is contraindicated)
Secondary thrombocytopenia in adults
Erythroblastopenia (RBC anemia)
Congenital (erythroid) hypoplastic anemia
10. Neoplastic Diseases
For palliative management of:
Leukemias and lymphomas in adults
Acute leukemia of childhood
11. Edematous States
To induce diuresis or remission of proteinuria in the nephrotic syndrome, without uremia, of the idiopathic type or that due to lupus erythematosus
12. Nervous System
Acute exacerbations of multiple sclerosis
13. Miscellaneous
Tuberculous meningitis with subarachnoid block or impending block when used concurrently with appropriate antituberculous chemotherapy
Trichinosis with neurologic or myocardial involvement

[#delta] => 0 ) [#title] => [#description] => [#theme_used] => 1 [#printed] => 1 [#type] => [#value] => [#prefix] => [#suffix] => [#children] =>

1. Endocrine Disorders
Primary or secondary adrenocortical insufficiency (hydrocortisone or cortisone is the drug of choice; synthetic analogs may be used in conjunction with mineralocorticoids where applicable; in infancy,
mineralocorticoid supplementation is of particular importance)
Acute adrenocortical insufficiency (hydrocortisone or cortisone is the drug of choice; mineralocorticoid supplementation may be necessary, particularly when synthetic analogs are used)
Preoperatively and in the event of serious trauma or illness, in patients with known adrenal insufficiency or when adrenocortical reserve is doubtful
Shock unresponsive to conventional therapy if adrenocortical insufficiency exists or is suspected
Congenital adrenal hyperplasia
Hypercalcemia associated with cancer
Nonsuppurative thyroiditis
2. Rheumatic Disorders
As adjunctive therapy for short-term administration (to tide the patient over an acute episode or exacerbation) in:
Post-traumatic osteoarthritis Acute gouty arthritis
Synovitis of osteoarthritis Psoriatic arthritis
Rheumatoid arthritis, including juvenile rheumatoid arthritis (selected cases may require low-dose maintenance therapy) Ankylosing spondylitis
Epicondylitis Acute and subacute bursitis
Acute nonspecific tenosynovitis
3. Collagen Diseases
During an exacerbation or as maintenance therapy in selected cases of:
Systemic lupus erythematosus
Systemic dermatomyositis (polymyositis)
Acute rheumatic carditis
4. Dermatologic Diseases
Pemphigus Severe seborrheic dermatitis
Severe erythema multiforme (Stevens-Johnson syndrome) Severe psoriasis
Exfoliative dermatitis Mycosis fungoides
Bullous dermatitis herpetiformis
5. Allergic States
Control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment in:
Bronchial asthma Seasonal or perennial allergic rhinitis
Contact dermatitis Drug hypersensitivity reactions
Atopic dermatitis Urticarial transfusion reactions
Serum sickness Acute noninfectious laryngeal edema (epinephrine is the drug of first choice)
6. Ophthalmic Diseases
Severe acute and chronic allergic and inflammatory processes involving the eye, such as:
Herpes zoster ophthalmicus Sympathetic ophthalmia
Iritis, iridocyclitis Anterior segment inflammation
Chorioretinitis Allergic conjunctivitis
Diffuse posterior uveitis and choroiditis Allergic corneal marginal ulcers
Optic neuritis Keratitis
7. Gastrointestinal Diseases
To tide the patient over a critical period of the disease in:
Ulcerative colitis (systemic therapy)
Regional enteritis (systemic therapy)
8. Respiratory Diseases
Symptomatic sarcoidosis Loeffler’s syndrome not manageable by other means
Berylliosis Aspiration pneumonitis
Fulminating or disseminated pulmonary tuberculosis when used concurrentlywith appropriate anti-tuberculous chemotherapy
9. Hematologic Disorders
Acquired (autoimmune) hemolytic anemia
Idiopathic thrombocytopenic purpura in adults (IV only; IM administration is contraindicated)
Secondary thrombocytopenia in adults
Erythroblastopenia (RBC anemia)
Congenital (erythroid) hypoplastic anemia
10. Neoplastic Diseases
For palliative management of:
Leukemias and lymphomas in adults
Acute leukemia of childhood
11. Edematous States
To induce diuresis or remission of proteinuria in the nephrotic syndrome, without uremia, of the idiopathic type or that due to lupus erythematosus
12. Nervous System
Acute exacerbations of multiple sclerosis
13. Miscellaneous
Tuberculous meningitis with subarachnoid block or impending block when used concurrently with appropriate antituberculous chemotherapy
Trichinosis with neurologic or myocardial involvement

) [#title] => [#description] => [#children] =>

1. Endocrine Disorders
Primary or secondary adrenocortical insufficiency (hydrocortisone or cortisone is the drug of choice; synthetic analogs may be used in conjunction with mineralocorticoids where applicable; in infancy,
mineralocorticoid supplementation is of particular importance)
Acute adrenocortical insufficiency (hydrocortisone or cortisone is the drug of choice; mineralocorticoid supplementation may be necessary, particularly when synthetic analogs are used)
Preoperatively and in the event of serious trauma or illness, in patients with known adrenal insufficiency or when adrenocortical reserve is doubtful
Shock unresponsive to conventional therapy if adrenocortical insufficiency exists or is suspected
Congenital adrenal hyperplasia
Hypercalcemia associated with cancer
Nonsuppurative thyroiditis
2. Rheumatic Disorders
As adjunctive therapy for short-term administration (to tide the patient over an acute episode or exacerbation) in:
Post-traumatic osteoarthritis Acute gouty arthritis
Synovitis of osteoarthritis Psoriatic arthritis
Rheumatoid arthritis, including juvenile rheumatoid arthritis (selected cases may require low-dose maintenance therapy) Ankylosing spondylitis
Epicondylitis Acute and subacute bursitis
Acute nonspecific tenosynovitis
3. Collagen Diseases
During an exacerbation or as maintenance therapy in selected cases of:
Systemic lupus erythematosus
Systemic dermatomyositis (polymyositis)
Acute rheumatic carditis
4. Dermatologic Diseases
Pemphigus Severe seborrheic dermatitis
Severe erythema multiforme (Stevens-Johnson syndrome) Severe psoriasis
Exfoliative dermatitis Mycosis fungoides
Bullous dermatitis herpetiformis
5. Allergic States
Control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment in:
Bronchial asthma Seasonal or perennial allergic rhinitis
Contact dermatitis Drug hypersensitivity reactions
Atopic dermatitis Urticarial transfusion reactions
Serum sickness Acute noninfectious laryngeal edema (epinephrine is the drug of first choice)
6. Ophthalmic Diseases
Severe acute and chronic allergic and inflammatory processes involving the eye, such as:
Herpes zoster ophthalmicus Sympathetic ophthalmia
Iritis, iridocyclitis Anterior segment inflammation
Chorioretinitis Allergic conjunctivitis
Diffuse posterior uveitis and choroiditis Allergic corneal marginal ulcers
Optic neuritis Keratitis
7. Gastrointestinal Diseases
To tide the patient over a critical period of the disease in:
Ulcerative colitis (systemic therapy)
Regional enteritis (systemic therapy)
8. Respiratory Diseases
Symptomatic sarcoidosis Loeffler’s syndrome not manageable by other means
Berylliosis Aspiration pneumonitis
Fulminating or disseminated pulmonary tuberculosis when used concurrentlywith appropriate anti-tuberculous chemotherapy
9. Hematologic Disorders
Acquired (autoimmune) hemolytic anemia
Idiopathic thrombocytopenic purpura in adults (IV only; IM administration is contraindicated)
Secondary thrombocytopenia in adults
Erythroblastopenia (RBC anemia)
Congenital (erythroid) hypoplastic anemia
10. Neoplastic Diseases
For palliative management of:
Leukemias and lymphomas in adults
Acute leukemia of childhood
11. Edematous States
To induce diuresis or remission of proteinuria in the nephrotic syndrome, without uremia, of the idiopathic type or that due to lupus erythematosus
12. Nervous System
Acute exacerbations of multiple sclerosis
13. Miscellaneous
Tuberculous meningitis with subarachnoid block or impending block when used concurrently with appropriate antituberculous chemotherapy
Trichinosis with neurologic or myocardial involvement

[#printed] => 1 ) [#single] => 1 [#attributes] => Array ( ) [#required] => [#parents] => Array ( ) [#tree] => [#context] => full [#page] => 1 [#field_name] => field_indications [#title] => Indications [#access] => 1 [#label_display] => above [#teaser] => [#node] => stdClass Object *RECURSION* [#type] => content_field [#children] =>

1. Endocrine Disorders
Primary or secondary adrenocortical insufficiency (hydrocortisone or cortisone is the drug of choice; synthetic analogs may be used in conjunction with mineralocorticoids where applicable; in infancy,
mineralocorticoid supplementation is of particular importance)
Acute adrenocortical insufficiency (hydrocortisone or cortisone is the drug of choice; mineralocorticoid supplementation may be necessary, particularly when synthetic analogs are used)
Preoperatively and in the event of serious trauma or illness, in patients with known adrenal insufficiency or when adrenocortical reserve is doubtful
Shock unresponsive to conventional therapy if adrenocortical insufficiency exists or is suspected
Congenital adrenal hyperplasia
Hypercalcemia associated with cancer
Nonsuppurative thyroiditis
2. Rheumatic Disorders
As adjunctive therapy for short-term administration (to tide the patient over an acute episode or exacerbation) in:
Post-traumatic osteoarthritis Acute gouty arthritis
Synovitis of osteoarthritis Psoriatic arthritis
Rheumatoid arthritis, including juvenile rheumatoid arthritis (selected cases may require low-dose maintenance therapy) Ankylosing spondylitis
Epicondylitis Acute and subacute bursitis
Acute nonspecific tenosynovitis
3. Collagen Diseases
During an exacerbation or as maintenance therapy in selected cases of:
Systemic lupus erythematosus
Systemic dermatomyositis (polymyositis)
Acute rheumatic carditis
4. Dermatologic Diseases
Pemphigus Severe seborrheic dermatitis
Severe erythema multiforme (Stevens-Johnson syndrome) Severe psoriasis
Exfoliative dermatitis Mycosis fungoides
Bullous dermatitis herpetiformis
5. Allergic States
Control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment in:
Bronchial asthma Seasonal or perennial allergic rhinitis
Contact dermatitis Drug hypersensitivity reactions
Atopic dermatitis Urticarial transfusion reactions
Serum sickness Acute noninfectious laryngeal edema (epinephrine is the drug of first choice)
6. Ophthalmic Diseases
Severe acute and chronic allergic and inflammatory processes involving the eye, such as:
Herpes zoster ophthalmicus Sympathetic ophthalmia
Iritis, iridocyclitis Anterior segment inflammation
Chorioretinitis Allergic conjunctivitis
Diffuse posterior uveitis and choroiditis Allergic corneal marginal ulcers
Optic neuritis Keratitis
7. Gastrointestinal Diseases
To tide the patient over a critical period of the disease in:
Ulcerative colitis (systemic therapy)
Regional enteritis (systemic therapy)
8. Respiratory Diseases
Symptomatic sarcoidosis Loeffler’s syndrome not manageable by other means
Berylliosis Aspiration pneumonitis
Fulminating or disseminated pulmonary tuberculosis when used concurrentlywith appropriate anti-tuberculous chemotherapy
9. Hematologic Disorders
Acquired (autoimmune) hemolytic anemia
Idiopathic thrombocytopenic purpura in adults (IV only; IM administration is contraindicated)
Secondary thrombocytopenia in adults
Erythroblastopenia (RBC anemia)
Congenital (erythroid) hypoplastic anemia
10. Neoplastic Diseases
For palliative management of:
Leukemias and lymphomas in adults
Acute leukemia of childhood
11. Edematous States
To induce diuresis or remission of proteinuria in the nephrotic syndrome, without uremia, of the idiopathic type or that due to lupus erythematosus
12. Nervous System
Acute exacerbations of multiple sclerosis
13. Miscellaneous
Tuberculous meningitis with subarachnoid block or impending block when used concurrently with appropriate antituberculous chemotherapy
Trichinosis with neurologic or myocardial involvement

[#printed] => 1 ) [#title] => [#description] => [#children] =>
Indications: 

1. Endocrine Disorders
Primary or secondary adrenocortical insufficiency (hydrocortisone or cortisone is the drug of choice; synthetic analogs may be used in conjunction with mineralocorticoids where applicable; in infancy,
mineralocorticoid supplementation is of particular importance)
Acute adrenocortical insufficiency (hydrocortisone or cortisone is the drug of choice; mineralocorticoid supplementation may be necessary, particularly when synthetic analogs are used)
Preoperatively and in the event of serious trauma or illness, in patients with known adrenal insufficiency or when adrenocortical reserve is doubtful
Shock unresponsive to conventional therapy if adrenocortical insufficiency exists or is suspected
Congenital adrenal hyperplasia
Hypercalcemia associated with cancer
Nonsuppurative thyroiditis
2. Rheumatic Disorders
As adjunctive therapy for short-term administration (to tide the patient over an acute episode or exacerbation) in:
Post-traumatic osteoarthritis Acute gouty arthritis
Synovitis of osteoarthritis Psoriatic arthritis
Rheumatoid arthritis, including juvenile rheumatoid arthritis (selected cases may require low-dose maintenance therapy) Ankylosing spondylitis
Epicondylitis Acute and subacute bursitis
Acute nonspecific tenosynovitis
3. Collagen Diseases
During an exacerbation or as maintenance therapy in selected cases of:
Systemic lupus erythematosus
Systemic dermatomyositis (polymyositis)
Acute rheumatic carditis
4. Dermatologic Diseases
Pemphigus Severe seborrheic dermatitis
Severe erythema multiforme (Stevens-Johnson syndrome) Severe psoriasis
Exfoliative dermatitis Mycosis fungoides
Bullous dermatitis herpetiformis
5. Allergic States
Control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment in:
Bronchial asthma Seasonal or perennial allergic rhinitis
Contact dermatitis Drug hypersensitivity reactions
Atopic dermatitis Urticarial transfusion reactions
Serum sickness Acute noninfectious laryngeal edema (epinephrine is the drug of first choice)
6. Ophthalmic Diseases
Severe acute and chronic allergic and inflammatory processes involving the eye, such as:
Herpes zoster ophthalmicus Sympathetic ophthalmia
Iritis, iridocyclitis Anterior segment inflammation
Chorioretinitis Allergic conjunctivitis
Diffuse posterior uveitis and choroiditis Allergic corneal marginal ulcers
Optic neuritis Keratitis
7. Gastrointestinal Diseases
To tide the patient over a critical period of the disease in:
Ulcerative colitis (systemic therapy)
Regional enteritis (systemic therapy)
8. Respiratory Diseases
Symptomatic sarcoidosis Loeffler’s syndrome not manageable by other means
Berylliosis Aspiration pneumonitis
Fulminating or disseminated pulmonary tuberculosis when used concurrentlywith appropriate anti-tuberculous chemotherapy
9. Hematologic Disorders
Acquired (autoimmune) hemolytic anemia
Idiopathic thrombocytopenic purpura in adults (IV only; IM administration is contraindicated)
Secondary thrombocytopenia in adults
Erythroblastopenia (RBC anemia)
Congenital (erythroid) hypoplastic anemia
10. Neoplastic Diseases
For palliative management of:
Leukemias and lymphomas in adults
Acute leukemia of childhood
11. Edematous States
To induce diuresis or remission of proteinuria in the nephrotic syndrome, without uremia, of the idiopathic type or that due to lupus erythematosus
12. Nervous System
Acute exacerbations of multiple sclerosis
13. Miscellaneous
Tuberculous meningitis with subarachnoid block or impending block when used concurrently with appropriate antituberculous chemotherapy
Trichinosis with neurologic or myocardial involvement

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The use of Methylprednisolone Sodium Succinate for Injection, USP is contraindicated in premature infants because the 1 g multiple dose vial when reconstituted will contain benzyl alcohol. Benzyl alcohol has been reported to be associated with a fatal “Gasping Syndrome” in premature infants. Methylprednisolone Sodium Succinate for Injection, USP is also contraindicated in systemic fungal infections and patients with known hypersensitivity to the product and its constituents.

[#delta] => 0 ) [#title] => [#description] => [#theme_used] => 1 [#printed] => 1 [#type] => [#value] => [#prefix] => [#suffix] => [#children] =>

The use of Methylprednisolone Sodium Succinate for Injection, USP is contraindicated in premature infants because the 1 g multiple dose vial when reconstituted will contain benzyl alcohol. Benzyl alcohol has been reported to be associated with a fatal “Gasping Syndrome” in premature infants. Methylprednisolone Sodium Succinate for Injection, USP is also contraindicated in systemic fungal infections and patients with known hypersensitivity to the product and its constituents.

) [#title] => [#description] => [#children] =>

The use of Methylprednisolone Sodium Succinate for Injection, USP is contraindicated in premature infants because the 1 g multiple dose vial when reconstituted will contain benzyl alcohol. Benzyl alcohol has been reported to be associated with a fatal “Gasping Syndrome” in premature infants. Methylprednisolone Sodium Succinate for Injection, USP is also contraindicated in systemic fungal infections and patients with known hypersensitivity to the product and its constituents.

[#printed] => 1 ) [#single] => 1 [#attributes] => Array ( ) [#required] => [#parents] => Array ( ) [#tree] => [#context] => full [#page] => 1 [#field_name] => field_contraindications [#title] => Contraindications [#access] => 1 [#label_display] => above [#teaser] => [#node] => stdClass Object *RECURSION* [#type] => content_field [#children] =>

The use of Methylprednisolone Sodium Succinate for Injection, USP is contraindicated in premature infants because the 1 g multiple dose vial when reconstituted will contain benzyl alcohol. Benzyl alcohol has been reported to be associated with a fatal “Gasping Syndrome” in premature infants. Methylprednisolone Sodium Succinate for Injection, USP is also contraindicated in systemic fungal infections and patients with known hypersensitivity to the product and its constituents.

[#printed] => 1 ) [#title] => [#description] => [#children] =>
Contraindications: 

The use of Methylprednisolone Sodium Succinate for Injection, USP is contraindicated in premature infants because the 1 g multiple dose vial when reconstituted will contain benzyl alcohol. Benzyl alcohol has been reported to be associated with a fatal “Gasping Syndrome” in premature infants. Methylprednisolone Sodium Succinate for Injection, USP is also contraindicated in systemic fungal infections and patients with known hypersensitivity to the product and its constituents.

[#printed] => 1 ) [field_precautions] => Array ( [#type_name] => product [#context] => full [#field_name] => field_precautions [#post_render] => Array ( [0] => content_field_wrapper_post_render ) [#weight] => 8 [field] => Array ( [#description] => [items] => Array ( [0] => Array ( [#formatter] => default [#node] => stdClass Object *RECURSION* [#type_name] => product [#field_name] => field_precautions [#weight] => 0 [#theme] => text_formatter_default [#item] => Array ( [value] => Drug-induced secondary adrenocortical insufficiency may be minimized by gradual reduction of dosage. This type of relative insufficiency may persist for months after discontinuation of therapy; therefore, in any situation of stress occurring during that period, hormone therapy should be reinstituted. Since mineralocorticoid secretion may be impaired, salt and/or a mineralocorticoid should be administered concurrently. There is an enhanced effect of corticosteroids on patients with hypothyroidism and in those with cirrhosis. Corticosteroids should be used cautiously in patients with ocular herpes simplex because of possible corneal perforation. The lowest possible dose of corticosteroid should be used to control the condition under treatment, and when reduction in dosage is possible, the reduction should be gradual. Psychic derangements may appear when corticosteroids are used, ranging from euphoria, insomnia, mood swings, personality changes, and severe depression, to frank psychotic manifestations. Also, existing emotional instability or psychotic tendencies may be aggravated by corticosteroids. Steroids should be used with caution in nonspecific ulcerative colitis, if there is a probability of impending perforation, abscess or other pyogenic infection; diverticulitis; fresh intestinal anastomoses; active or latent peptic ulcer; renal insufficiency; hypertension; osteoporosis; and myasthenia gravis. Growth and development of infants and children on prolonged corticosteroid therapy should be carefully observed. Although controlled clinical trials have shown corticosteroids to be effective in speeding the resolution of acute exacerbations of multiple sclerosis, they do not show that corticosteroids affect the ultimate outcome or natural history of the disease. The studies do show that relatively high doses of corticosteroids are necessary to demonstrate a significant effect Since complications of treatment with glucocorticoids are dependent on the size of the dose and the duration of treatment, a risk/benefit decision must be made in each individual case as to dose and duration of treatment and as to whether daily or intermittent therapy should be used. Convulsions have been reported with concurrent use of methylprednisolone and cyclosporin. Since concurrent use of these agents results in a mutual inhibition of metabolism, it is possible that adverse events associated with the individual use of either drug may be more apt to occur. Aspirin should be used cautiously in conjunction with corticosteroids in patients suffering from hypoprothrombinemia [format] => 1 [safe] =>

Drug-induced secondary adrenocortical insufficiency may be minimized by gradual reduction of dosage. This type of relative insufficiency may persist for months after discontinuation of therapy; therefore, in any situation of stress occurring during that period, hormone therapy should be reinstituted. Since mineralocorticoid secretion may be impaired, salt and/or a mineralocorticoid should be administered concurrently.
There is an enhanced effect of corticosteroids on patients with hypothyroidism and in those with cirrhosis.
Corticosteroids should be used cautiously in patients with ocular herpes simplex because of possible corneal perforation.
The lowest possible dose of corticosteroid should be used to control the condition under treatment, and when reduction in dosage is possible, the reduction should be gradual.
Psychic derangements may appear when corticosteroids are used, ranging from euphoria, insomnia, mood swings, personality changes, and severe depression, to frank psychotic manifestations. Also, existing emotional instability or psychotic tendencies may be aggravated by corticosteroids.
Steroids should be used with caution in nonspecific ulcerative colitis, if there is a probability of impending perforation, abscess or other pyogenic infection; diverticulitis; fresh intestinal anastomoses; active or latent peptic ulcer; renal insufficiency; hypertension; osteoporosis; and myasthenia gravis.
Growth and development of infants and children on prolonged corticosteroid therapy should be carefully observed.
Although controlled clinical trials have shown corticosteroids to be effective in speeding the resolution of acute exacerbations of multiple sclerosis, they do not show that corticosteroids affect the ultimate outcome or natural history of the disease. The studies do show that relatively high doses of corticosteroids are necessary to demonstrate a significant effect
Since complications of treatment with glucocorticoids are dependent on the size of the dose and the duration of treatment, a risk/benefit decision must be made in each individual case as to dose and duration of treatment and as to whether daily or intermittent therapy should be used.
Convulsions have been reported with concurrent use of methylprednisolone and cyclosporin. Since concurrent use of these agents results in a mutual inhibition of metabolism, it is possible that adverse events associated with the individual use of either drug may be more apt to occur.
Aspirin should be used cautiously in conjunction with corticosteroids in patients suffering from hypoprothrombinemia

[#delta] => 0 ) [#title] => [#description] => [#theme_used] => 1 [#printed] => 1 [#type] => [#value] => [#prefix] => [#suffix] => [#children] =>

Drug-induced secondary adrenocortical insufficiency may be minimized by gradual reduction of dosage. This type of relative insufficiency may persist for months after discontinuation of therapy; therefore, in any situation of stress occurring during that period, hormone therapy should be reinstituted. Since mineralocorticoid secretion may be impaired, salt and/or a mineralocorticoid should be administered concurrently.
There is an enhanced effect of corticosteroids on patients with hypothyroidism and in those with cirrhosis.
Corticosteroids should be used cautiously in patients with ocular herpes simplex because of possible corneal perforation.
The lowest possible dose of corticosteroid should be used to control the condition under treatment, and when reduction in dosage is possible, the reduction should be gradual.
Psychic derangements may appear when corticosteroids are used, ranging from euphoria, insomnia, mood swings, personality changes, and severe depression, to frank psychotic manifestations. Also, existing emotional instability or psychotic tendencies may be aggravated by corticosteroids.
Steroids should be used with caution in nonspecific ulcerative colitis, if there is a probability of impending perforation, abscess or other pyogenic infection; diverticulitis; fresh intestinal anastomoses; active or latent peptic ulcer; renal insufficiency; hypertension; osteoporosis; and myasthenia gravis.
Growth and development of infants and children on prolonged corticosteroid therapy should be carefully observed.
Although controlled clinical trials have shown corticosteroids to be effective in speeding the resolution of acute exacerbations of multiple sclerosis, they do not show that corticosteroids affect the ultimate outcome or natural history of the disease. The studies do show that relatively high doses of corticosteroids are necessary to demonstrate a significant effect
Since complications of treatment with glucocorticoids are dependent on the size of the dose and the duration of treatment, a risk/benefit decision must be made in each individual case as to dose and duration of treatment and as to whether daily or intermittent therapy should be used.
Convulsions have been reported with concurrent use of methylprednisolone and cyclosporin. Since concurrent use of these agents results in a mutual inhibition of metabolism, it is possible that adverse events associated with the individual use of either drug may be more apt to occur.
Aspirin should be used cautiously in conjunction with corticosteroids in patients suffering from hypoprothrombinemia

) [#title] => [#description] => [#children] =>

Drug-induced secondary adrenocortical insufficiency may be minimized by gradual reduction of dosage. This type of relative insufficiency may persist for months after discontinuation of therapy; therefore, in any situation of stress occurring during that period, hormone therapy should be reinstituted. Since mineralocorticoid secretion may be impaired, salt and/or a mineralocorticoid should be administered concurrently.
There is an enhanced effect of corticosteroids on patients with hypothyroidism and in those with cirrhosis.
Corticosteroids should be used cautiously in patients with ocular herpes simplex because of possible corneal perforation.
The lowest possible dose of corticosteroid should be used to control the condition under treatment, and when reduction in dosage is possible, the reduction should be gradual.
Psychic derangements may appear when corticosteroids are used, ranging from euphoria, insomnia, mood swings, personality changes, and severe depression, to frank psychotic manifestations. Also, existing emotional instability or psychotic tendencies may be aggravated by corticosteroids.
Steroids should be used with caution in nonspecific ulcerative colitis, if there is a probability of impending perforation, abscess or other pyogenic infection; diverticulitis; fresh intestinal anastomoses; active or latent peptic ulcer; renal insufficiency; hypertension; osteoporosis; and myasthenia gravis.
Growth and development of infants and children on prolonged corticosteroid therapy should be carefully observed.
Although controlled clinical trials have shown corticosteroids to be effective in speeding the resolution of acute exacerbations of multiple sclerosis, they do not show that corticosteroids affect the ultimate outcome or natural history of the disease. The studies do show that relatively high doses of corticosteroids are necessary to demonstrate a significant effect
Since complications of treatment with glucocorticoids are dependent on the size of the dose and the duration of treatment, a risk/benefit decision must be made in each individual case as to dose and duration of treatment and as to whether daily or intermittent therapy should be used.
Convulsions have been reported with concurrent use of methylprednisolone and cyclosporin. Since concurrent use of these agents results in a mutual inhibition of metabolism, it is possible that adverse events associated with the individual use of either drug may be more apt to occur.
Aspirin should be used cautiously in conjunction with corticosteroids in patients suffering from hypoprothrombinemia

[#printed] => 1 ) [#single] => 1 [#attributes] => Array ( ) [#required] => [#parents] => Array ( ) [#tree] => [#context] => full [#page] => 1 [#field_name] => field_precautions [#title] => Precautions [#access] => 1 [#label_display] => above [#teaser] => [#node] => stdClass Object *RECURSION* [#type] => content_field [#children] =>

Drug-induced secondary adrenocortical insufficiency may be minimized by gradual reduction of dosage. This type of relative insufficiency may persist for months after discontinuation of therapy; therefore, in any situation of stress occurring during that period, hormone therapy should be reinstituted. Since mineralocorticoid secretion may be impaired, salt and/or a mineralocorticoid should be administered concurrently.
There is an enhanced effect of corticosteroids on patients with hypothyroidism and in those with cirrhosis.
Corticosteroids should be used cautiously in patients with ocular herpes simplex because of possible corneal perforation.
The lowest possible dose of corticosteroid should be used to control the condition under treatment, and when reduction in dosage is possible, the reduction should be gradual.
Psychic derangements may appear when corticosteroids are used, ranging from euphoria, insomnia, mood swings, personality changes, and severe depression, to frank psychotic manifestations. Also, existing emotional instability or psychotic tendencies may be aggravated by corticosteroids.
Steroids should be used with caution in nonspecific ulcerative colitis, if there is a probability of impending perforation, abscess or other pyogenic infection; diverticulitis; fresh intestinal anastomoses; active or latent peptic ulcer; renal insufficiency; hypertension; osteoporosis; and myasthenia gravis.
Growth and development of infants and children on prolonged corticosteroid therapy should be carefully observed.
Although controlled clinical trials have shown corticosteroids to be effective in speeding the resolution of acute exacerbations of multiple sclerosis, they do not show that corticosteroids affect the ultimate outcome or natural history of the disease. The studies do show that relatively high doses of corticosteroids are necessary to demonstrate a significant effect
Since complications of treatment with glucocorticoids are dependent on the size of the dose and the duration of treatment, a risk/benefit decision must be made in each individual case as to dose and duration of treatment and as to whether daily or intermittent therapy should be used.
Convulsions have been reported with concurrent use of methylprednisolone and cyclosporin. Since concurrent use of these agents results in a mutual inhibition of metabolism, it is possible that adverse events associated with the individual use of either drug may be more apt to occur.
Aspirin should be used cautiously in conjunction with corticosteroids in patients suffering from hypoprothrombinemia

[#printed] => 1 ) [#title] => [#description] => [#children] =>
Precautions: 

Drug-induced secondary adrenocortical insufficiency may be minimized by gradual reduction of dosage. This type of relative insufficiency may persist for months after discontinuation of therapy; therefore, in any situation of stress occurring during that period, hormone therapy should be reinstituted. Since mineralocorticoid secretion may be impaired, salt and/or a mineralocorticoid should be administered concurrently.
There is an enhanced effect of corticosteroids on patients with hypothyroidism and in those with cirrhosis.
Corticosteroids should be used cautiously in patients with ocular herpes simplex because of possible corneal perforation.
The lowest possible dose of corticosteroid should be used to control the condition under treatment, and when reduction in dosage is possible, the reduction should be gradual.
Psychic derangements may appear when corticosteroids are used, ranging from euphoria, insomnia, mood swings, personality changes, and severe depression, to frank psychotic manifestations. Also, existing emotional instability or psychotic tendencies may be aggravated by corticosteroids.
Steroids should be used with caution in nonspecific ulcerative colitis, if there is a probability of impending perforation, abscess or other pyogenic infection; diverticulitis; fresh intestinal anastomoses; active or latent peptic ulcer; renal insufficiency; hypertension; osteoporosis; and myasthenia gravis.
Growth and development of infants and children on prolonged corticosteroid therapy should be carefully observed.
Although controlled clinical trials have shown corticosteroids to be effective in speeding the resolution of acute exacerbations of multiple sclerosis, they do not show that corticosteroids affect the ultimate outcome or natural history of the disease. The studies do show that relatively high doses of corticosteroids are necessary to demonstrate a significant effect
Since complications of treatment with glucocorticoids are dependent on the size of the dose and the duration of treatment, a risk/benefit decision must be made in each individual case as to dose and duration of treatment and as to whether daily or intermittent therapy should be used.
Convulsions have been reported with concurrent use of methylprednisolone and cyclosporin. Since concurrent use of these agents results in a mutual inhibition of metabolism, it is possible that adverse events associated with the individual use of either drug may be more apt to occur.
Aspirin should be used cautiously in conjunction with corticosteroids in patients suffering from hypoprothrombinemia

[#printed] => 1 ) [field_drug_interactions] => Array ( [#type_name] => product [#context] => full [#field_name] => field_drug_interactions [#post_render] => Array ( [0] => content_field_wrapper_post_render ) [#weight] => 9 [field] => Array ( [#description] => [items] => Array ( [0] => Array ( [#formatter] => default [#node] => stdClass Object *RECURSION* [#type_name] => product [#field_name] => field_drug_interactions [#weight] => 0 [#theme] => text_formatter_default [#item] => Array ( [value] => The pharmacokinetic interactions are potentially clinically important. Mutual inhibition of metabolism occurs with concurrent use of cyclosporin and methylprednisolone; therefore, it is possible that adverse events associated with the individual use of either drug may be more apt to occur. Convulsions have been reported with concurrent use of methylprednisolone and cyclosporin. Drugs that induce hepatic enzymes such as phenobarbital, phenytoin and rifampin may increase the clearance of methylprednisolone and may require increases in methylprednisolone dose to achieve the desired response. Drugs such as troleandomycin and ketoconazole may inhibit the metabolism of methylprednisolone and thus decrease its clearance. Therefore, the dose of methylprednisolone should be titrated to avoid steroid toxicity. Methylprednisolone may increase the clearance of chronic high dose aspirin. This could lead to decreased salicylate serum levels or increase the risk of salicylate toxicity when methylprednisolone is withdrawn. Aspirin should be used cautiously in conjunction with corticosteroids in patients suffering from hypoprothrombinemia. The effect of methylprednisolone on oral anticoagulants is variable. There are reports of enhanced as well as diminished effects of anticoagulant when given concurrently with corticosteroids. Therefore, coagulation indices should be monitored to maintain the desired anticoagulant effect. [format] => 1 [safe] =>

The pharmacokinetic interactions are potentially clinically important. Mutual inhibition of metabolism occurs with concurrent use of cyclosporin and methylprednisolone; therefore, it is possible that adverse events associated with the individual use of either drug may be more apt to occur. Convulsions have been reported with concurrent use of methylprednisolone and cyclosporin. Drugs that induce hepatic enzymes such as phenobarbital, phenytoin and rifampin may increase the clearance of methylprednisolone and may require increases in methylprednisolone dose to achieve the desired response. Drugs such as troleandomycin and ketoconazole may inhibit the metabolism of methylprednisolone and thus decrease its clearance. Therefore, the dose of methylprednisolone should be titrated to avoid steroid toxicity.
Methylprednisolone may increase the clearance of chronic high dose aspirin. This could lead to decreased salicylate serum levels or increase the risk of salicylate toxicity when methylprednisolone is withdrawn. Aspirin should be used cautiously in conjunction with corticosteroids in patients suffering from hypoprothrombinemia.
The effect of methylprednisolone on oral anticoagulants is variable. There are reports of enhanced as well as diminished effects of anticoagulant when given concurrently with corticosteroids. Therefore, coagulation indices should be monitored to maintain the desired anticoagulant effect.

[#delta] => 0 ) [#title] => [#description] => [#theme_used] => 1 [#printed] => 1 [#type] => [#value] => [#prefix] => [#suffix] => [#children] =>

The pharmacokinetic interactions are potentially clinically important. Mutual inhibition of metabolism occurs with concurrent use of cyclosporin and methylprednisolone; therefore, it is possible that adverse events associated with the individual use of either drug may be more apt to occur. Convulsions have been reported with concurrent use of methylprednisolone and cyclosporin. Drugs that induce hepatic enzymes such as phenobarbital, phenytoin and rifampin may increase the clearance of methylprednisolone and may require increases in methylprednisolone dose to achieve the desired response. Drugs such as troleandomycin and ketoconazole may inhibit the metabolism of methylprednisolone and thus decrease its clearance. Therefore, the dose of methylprednisolone should be titrated to avoid steroid toxicity.
Methylprednisolone may increase the clearance of chronic high dose aspirin. This could lead to decreased salicylate serum levels or increase the risk of salicylate toxicity when methylprednisolone is withdrawn. Aspirin should be used cautiously in conjunction with corticosteroids in patients suffering from hypoprothrombinemia.
The effect of methylprednisolone on oral anticoagulants is variable. There are reports of enhanced as well as diminished effects of anticoagulant when given concurrently with corticosteroids. Therefore, coagulation indices should be monitored to maintain the desired anticoagulant effect.

) [#title] => [#description] => [#children] =>

The pharmacokinetic interactions are potentially clinically important. Mutual inhibition of metabolism occurs with concurrent use of cyclosporin and methylprednisolone; therefore, it is possible that adverse events associated with the individual use of either drug may be more apt to occur. Convulsions have been reported with concurrent use of methylprednisolone and cyclosporin. Drugs that induce hepatic enzymes such as phenobarbital, phenytoin and rifampin may increase the clearance of methylprednisolone and may require increases in methylprednisolone dose to achieve the desired response. Drugs such as troleandomycin and ketoconazole may inhibit the metabolism of methylprednisolone and thus decrease its clearance. Therefore, the dose of methylprednisolone should be titrated to avoid steroid toxicity.
Methylprednisolone may increase the clearance of chronic high dose aspirin. This could lead to decreased salicylate serum levels or increase the risk of salicylate toxicity when methylprednisolone is withdrawn. Aspirin should be used cautiously in conjunction with corticosteroids in patients suffering from hypoprothrombinemia.
The effect of methylprednisolone on oral anticoagulants is variable. There are reports of enhanced as well as diminished effects of anticoagulant when given concurrently with corticosteroids. Therefore, coagulation indices should be monitored to maintain the desired anticoagulant effect.

[#printed] => 1 ) [#single] => 1 [#attributes] => Array ( ) [#required] => [#parents] => Array ( ) [#tree] => [#context] => full [#page] => 1 [#field_name] => field_drug_interactions [#title] => Drug Interactions [#access] => 1 [#label_display] => above [#teaser] => [#node] => stdClass Object *RECURSION* [#type] => content_field [#children] =>

The pharmacokinetic interactions are potentially clinically important. Mutual inhibition of metabolism occurs with concurrent use of cyclosporin and methylprednisolone; therefore, it is possible that adverse events associated with the individual use of either drug may be more apt to occur. Convulsions have been reported with concurrent use of methylprednisolone and cyclosporin. Drugs that induce hepatic enzymes such as phenobarbital, phenytoin and rifampin may increase the clearance of methylprednisolone and may require increases in methylprednisolone dose to achieve the desired response. Drugs such as troleandomycin and ketoconazole may inhibit the metabolism of methylprednisolone and thus decrease its clearance. Therefore, the dose of methylprednisolone should be titrated to avoid steroid toxicity.
Methylprednisolone may increase the clearance of chronic high dose aspirin. This could lead to decreased salicylate serum levels or increase the risk of salicylate toxicity when methylprednisolone is withdrawn. Aspirin should be used cautiously in conjunction with corticosteroids in patients suffering from hypoprothrombinemia.
The effect of methylprednisolone on oral anticoagulants is variable. There are reports of enhanced as well as diminished effects of anticoagulant when given concurrently with corticosteroids. Therefore, coagulation indices should be monitored to maintain the desired anticoagulant effect.

[#printed] => 1 ) [#title] => [#description] => [#children] =>
Drug Interactions: 

The pharmacokinetic interactions are potentially clinically important. Mutual inhibition of metabolism occurs with concurrent use of cyclosporin and methylprednisolone; therefore, it is possible that adverse events associated with the individual use of either drug may be more apt to occur. Convulsions have been reported with concurrent use of methylprednisolone and cyclosporin. Drugs that induce hepatic enzymes such as phenobarbital, phenytoin and rifampin may increase the clearance of methylprednisolone and may require increases in methylprednisolone dose to achieve the desired response. Drugs such as troleandomycin and ketoconazole may inhibit the metabolism of methylprednisolone and thus decrease its clearance. Therefore, the dose of methylprednisolone should be titrated to avoid steroid toxicity.
Methylprednisolone may increase the clearance of chronic high dose aspirin. This could lead to decreased salicylate serum levels or increase the risk of salicylate toxicity when methylprednisolone is withdrawn. Aspirin should be used cautiously in conjunction with corticosteroids in patients suffering from hypoprothrombinemia.
The effect of methylprednisolone on oral anticoagulants is variable. There are reports of enhanced as well as diminished effects of anticoagulant when given concurrently with corticosteroids. Therefore, coagulation indices should be monitored to maintain the desired anticoagulant effect.

[#printed] => 1 ) [field_side_effects] => Array ( [#type_name] => product [#context] => full [#field_name] => field_side_effects [#post_render] => Array ( [0] => content_field_wrapper_post_render ) [#weight] => 10 [field] => Array ( [#description] => [items] => Array ( [0] => Array ( [#formatter] => default [#node] => stdClass Object *RECURSION* [#type_name] => product [#field_name] => field_side_effects [#weight] => 0 [#theme] => text_formatter_default [#item] => Array ( [value] => Fluid and Electrolyte Distrubances Sodium retention Potassium loss Fluid retention Hypokalemic alkalosis Congestive heart failure in susceptible patients Hypertension Musculoskeletal Muscle weakness Aseptic necrosis of femoral and humeral heads Steroid myopathy Pathologic fracture of long bones Loss of muscle mass Osteoporosis Severe arthralgia Vertebral compression fractures Gastrointestinal Peptic ulcer with possible perforation and hemorrhage Abdominal distention Pancreatitis Ulcerative esophagitis Dermatologic Impaired wound healing Facial erythema Thin fragile skin Increased sweating Petechiae and ecchymoses May suppress reactions to skin tests Neurological Increased intracranial pressure with papilledema (Pseudo-tumor cerebri) usually after treatment Vertigo Convulsions Headache Endocrine Development of Cushingoid state Suppression of growth in children Secondary adrenocortical and pituitary unresponsiveness, particularly in times of stress, as in trauma, surgery or illness Menstrual irregularities Decreased carbohydrate tolerance Manifestations of latent diabetes mellitus Increased requirements for insulin or oral hypoglycemic agents in diabetics Ophthalmic Posterior subcapsular cataracts Glaucoma Increased intraocular pressure Exophthalmos Metabolic Negative nitrogen balance due to protein catabolism The following additional adverse reactions are related to parenteral corticosteroid therapy: Hyperpigmentation or hypopigmentation Subcutaneous and cutaneous atrophy Sterile abscess Anaphylactic reaction with or without circulatory collapse, cardiac arrest, bronchospasm Urticaria Nausea and vomiting Cardiac arrhythmias; hypotension or hypertension [format] => 1 [safe] =>

Fluid and Electrolyte Distrubances
Sodium retention Potassium loss
Fluid retention Hypokalemic alkalosis
Congestive heart failure in susceptible patients Hypertension

Musculoskeletal
Muscle weakness Aseptic necrosis of femoral and humeral heads
Steroid myopathy Pathologic fracture of long bones
Loss of muscle mass Osteoporosis
Severe arthralgia
Vertebral compression fractures

Gastrointestinal
Peptic ulcer with possible perforation and hemorrhage Abdominal distention
Pancreatitis Ulcerative esophagitis

Dermatologic
Impaired wound healing Facial erythema
Thin fragile skin Increased sweating
Petechiae and ecchymoses May suppress reactions to skin tests

Neurological
Increased intracranial pressure with papilledema (Pseudo-tumor cerebri) usually after treatment Vertigo
Convulsions Headache

Endocrine
Development of Cushingoid state
Suppression of growth in children
Secondary adrenocortical and pituitary unresponsiveness, particularly in times of stress, as in trauma, surgery or illness
Menstrual irregularities
Decreased carbohydrate tolerance
Manifestations of latent diabetes mellitus
Increased requirements for insulin or oral hypoglycemic agents in diabetics
Ophthalmic
Posterior subcapsular cataracts Glaucoma
Increased intraocular pressure Exophthalmos

Metabolic
Negative nitrogen balance due to protein catabolism
The following additional adverse reactions are related to parenteral corticosteroid therapy:
Hyperpigmentation or hypopigmentation
Subcutaneous and cutaneous atrophy
Sterile abscess
Anaphylactic reaction with or without circulatory collapse, cardiac arrest, bronchospasm
Urticaria
Nausea and vomiting
Cardiac arrhythmias; hypotension or hypertension

[#delta] => 0 ) [#title] => [#description] => [#theme_used] => 1 [#printed] => 1 [#type] => [#value] => [#prefix] => [#suffix] => [#children] =>

Fluid and Electrolyte Distrubances
Sodium retention Potassium loss
Fluid retention Hypokalemic alkalosis
Congestive heart failure in susceptible patients Hypertension

Musculoskeletal
Muscle weakness Aseptic necrosis of femoral and humeral heads
Steroid myopathy Pathologic fracture of long bones
Loss of muscle mass Osteoporosis
Severe arthralgia
Vertebral compression fractures

Gastrointestinal
Peptic ulcer with possible perforation and hemorrhage Abdominal distention
Pancreatitis Ulcerative esophagitis

Dermatologic
Impaired wound healing Facial erythema
Thin fragile skin Increased sweating
Petechiae and ecchymoses May suppress reactions to skin tests

Neurological
Increased intracranial pressure with papilledema (Pseudo-tumor cerebri) usually after treatment Vertigo
Convulsions Headache

Endocrine
Development of Cushingoid state
Suppression of growth in children
Secondary adrenocortical and pituitary unresponsiveness, particularly in times of stress, as in trauma, surgery or illness
Menstrual irregularities
Decreased carbohydrate tolerance
Manifestations of latent diabetes mellitus
Increased requirements for insulin or oral hypoglycemic agents in diabetics
Ophthalmic
Posterior subcapsular cataracts Glaucoma
Increased intraocular pressure Exophthalmos

Metabolic
Negative nitrogen balance due to protein catabolism
The following additional adverse reactions are related to parenteral corticosteroid therapy:
Hyperpigmentation or hypopigmentation
Subcutaneous and cutaneous atrophy
Sterile abscess
Anaphylactic reaction with or without circulatory collapse, cardiac arrest, bronchospasm
Urticaria
Nausea and vomiting
Cardiac arrhythmias; hypotension or hypertension

) [#title] => [#description] => [#children] =>

Fluid and Electrolyte Distrubances
Sodium retention Potassium loss
Fluid retention Hypokalemic alkalosis
Congestive heart failure in susceptible patients Hypertension

Musculoskeletal
Muscle weakness Aseptic necrosis of femoral and humeral heads
Steroid myopathy Pathologic fracture of long bones
Loss of muscle mass Osteoporosis
Severe arthralgia
Vertebral compression fractures

Gastrointestinal
Peptic ulcer with possible perforation and hemorrhage Abdominal distention
Pancreatitis Ulcerative esophagitis

Dermatologic
Impaired wound healing Facial erythema
Thin fragile skin Increased sweating
Petechiae and ecchymoses May suppress reactions to skin tests

Neurological
Increased intracranial pressure with papilledema (Pseudo-tumor cerebri) usually after treatment Vertigo
Convulsions Headache

Endocrine
Development of Cushingoid state
Suppression of growth in children
Secondary adrenocortical and pituitary unresponsiveness, particularly in times of stress, as in trauma, surgery or illness
Menstrual irregularities
Decreased carbohydrate tolerance
Manifestations of latent diabetes mellitus
Increased requirements for insulin or oral hypoglycemic agents in diabetics
Ophthalmic
Posterior subcapsular cataracts Glaucoma
Increased intraocular pressure Exophthalmos

Metabolic
Negative nitrogen balance due to protein catabolism
The following additional adverse reactions are related to parenteral corticosteroid therapy:
Hyperpigmentation or hypopigmentation
Subcutaneous and cutaneous atrophy
Sterile abscess
Anaphylactic reaction with or without circulatory collapse, cardiac arrest, bronchospasm
Urticaria
Nausea and vomiting
Cardiac arrhythmias; hypotension or hypertension

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Fluid and Electrolyte Distrubances
Sodium retention Potassium loss
Fluid retention Hypokalemic alkalosis
Congestive heart failure in susceptible patients Hypertension

Musculoskeletal
Muscle weakness Aseptic necrosis of femoral and humeral heads
Steroid myopathy Pathologic fracture of long bones
Loss of muscle mass Osteoporosis
Severe arthralgia
Vertebral compression fractures

Gastrointestinal
Peptic ulcer with possible perforation and hemorrhage Abdominal distention
Pancreatitis Ulcerative esophagitis

Dermatologic
Impaired wound healing Facial erythema
Thin fragile skin Increased sweating
Petechiae and ecchymoses May suppress reactions to skin tests

Neurological
Increased intracranial pressure with papilledema (Pseudo-tumor cerebri) usually after treatment Vertigo
Convulsions Headache

Endocrine
Development of Cushingoid state
Suppression of growth in children
Secondary adrenocortical and pituitary unresponsiveness, particularly in times of stress, as in trauma, surgery or illness
Menstrual irregularities
Decreased carbohydrate tolerance
Manifestations of latent diabetes mellitus
Increased requirements for insulin or oral hypoglycemic agents in diabetics
Ophthalmic
Posterior subcapsular cataracts Glaucoma
Increased intraocular pressure Exophthalmos

Metabolic
Negative nitrogen balance due to protein catabolism
The following additional adverse reactions are related to parenteral corticosteroid therapy:
Hyperpigmentation or hypopigmentation
Subcutaneous and cutaneous atrophy
Sterile abscess
Anaphylactic reaction with or without circulatory collapse, cardiac arrest, bronchospasm
Urticaria
Nausea and vomiting
Cardiac arrhythmias; hypotension or hypertension

[#printed] => 1 ) [#title] => [#description] => [#children] =>
Side Effects: 

Fluid and Electrolyte Distrubances
Sodium retention Potassium loss
Fluid retention Hypokalemic alkalosis
Congestive heart failure in susceptible patients Hypertension

Musculoskeletal
Muscle weakness Aseptic necrosis of femoral and humeral heads
Steroid myopathy Pathologic fracture of long bones
Loss of muscle mass Osteoporosis
Severe arthralgia
Vertebral compression fractures

Gastrointestinal
Peptic ulcer with possible perforation and hemorrhage Abdominal distention
Pancreatitis Ulcerative esophagitis

Dermatologic
Impaired wound healing Facial erythema
Thin fragile skin Increased sweating
Petechiae and ecchymoses May suppress reactions to skin tests

Neurological
Increased intracranial pressure with papilledema (Pseudo-tumor cerebri) usually after treatment Vertigo
Convulsions Headache

Endocrine
Development of Cushingoid state
Suppression of growth in children
Secondary adrenocortical and pituitary unresponsiveness, particularly in times of stress, as in trauma, surgery or illness
Menstrual irregularities
Decreased carbohydrate tolerance
Manifestations of latent diabetes mellitus
Increased requirements for insulin or oral hypoglycemic agents in diabetics
Ophthalmic
Posterior subcapsular cataracts Glaucoma
Increased intraocular pressure Exophthalmos

Metabolic
Negative nitrogen balance due to protein catabolism
The following additional adverse reactions are related to parenteral corticosteroid therapy:
Hyperpigmentation or hypopigmentation
Subcutaneous and cutaneous atrophy
Sterile abscess
Anaphylactic reaction with or without circulatory collapse, cardiac arrest, bronchospasm
Urticaria
Nausea and vomiting
Cardiac arrhythmias; hypotension or hypertension

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• Store below 30 C°
• Protect from light and freezing

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• Store below 30 C°
• Protect from light and freezing

) [#title] => [#description] => [#children] =>

• Store below 30 C°
• Protect from light and freezing

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• Store below 30 C°
• Protect from light and freezing

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Storage: 

• Store below 30 C°
• Protect from light and freezing

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• Injection 40mg/1ml: Box of 1 ampoule

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• Injection 40mg/1ml: Box of 1 ampoule

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• Injection 40mg/1ml: Box of 1 ampoule

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Packing: 

• Injection 40mg/1ml: Box of 1 ampoule

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Image: 
Brand Name: 

-

Dosage Form: 

Injection 40mg/1ml

Pharmacological Category: 

Anti-inflammatory Agent

Therapeutic Category: 

Corticosteroids

Pregnancy Category: 

Category C

Methylprednisolone is a potent anti-inflammatory steroid with greater anti-inflammatory potency than prednisolone and even less tendency than prednisolone to induce sodium and water retention.
Methylprednisolone sodium succinate has the same metabolic and anti-inflammatory actions as methylprednisolone. When given parenterally and in equimolar quantities, the two compounds are equivalent in biologic activity. The relative potency of methylprednisolone and hydrocortisone sodium succinate, as indicated by depression of eosinophil count, following intravenous administration, is at least four to one. This is in good agreement with the relative oral potency of methylprednisolone and hydrocortisone.

Pharmacokinetics: 

Absorption
Absorption from IM injection of methylprednisolone sodium succinate is rapid.
Systemic absorption of methylprednisolone acetate occurs slowly following intra-articular, intrabursal, intrasynovial, intradermal, or soft tissue injection; Absorption from intra-articular injection sites is usually very slow and continues for about 7 days.

Onset
Following IM administration (80–120 mg) in patients with severe poison ivy, relief onset within 8–12 hours.
Following oral administration in patients with asthma, effects may not be evident for several hours.

Duration
The duration of anti-inflammatory activity of methylprednisolone approximately equals the duration of HPA-axis suppression, about 1.25–1.5 days for a single 40-mg oral dose.

Distribution
Most glucocorticoids are removed rapidly from the blood and distributed to muscles, liver, skin, intestines, and kidneys.
Glucocorticoids appear in breast milk and the placenta.

Metabolism
Metabolized in most tissues, but mainly in the liver, to inactive compounds.

Half-life
Approximately 2.5–3.5 hours following oral administration of methylprednisolone or IV or IM administration of methylprednisolone sodium succinate.

Indications: 

1. Endocrine Disorders
Primary or secondary adrenocortical insufficiency (hydrocortisone or cortisone is the drug of choice; synthetic analogs may be used in conjunction with mineralocorticoids where applicable; in infancy,
mineralocorticoid supplementation is of particular importance)
Acute adrenocortical insufficiency (hydrocortisone or cortisone is the drug of choice; mineralocorticoid supplementation may be necessary, particularly when synthetic analogs are used)
Preoperatively and in the event of serious trauma or illness, in patients with known adrenal insufficiency or when adrenocortical reserve is doubtful
Shock unresponsive to conventional therapy if adrenocortical insufficiency exists or is suspected
Congenital adrenal hyperplasia
Hypercalcemia associated with cancer
Nonsuppurative thyroiditis
2. Rheumatic Disorders
As adjunctive therapy for short-term administration (to tide the patient over an acute episode or exacerbation) in:
Post-traumatic osteoarthritis Acute gouty arthritis
Synovitis of osteoarthritis Psoriatic arthritis
Rheumatoid arthritis, including juvenile rheumatoid arthritis (selected cases may require low-dose maintenance therapy) Ankylosing spondylitis
Epicondylitis Acute and subacute bursitis
Acute nonspecific tenosynovitis
3. Collagen Diseases
During an exacerbation or as maintenance therapy in selected cases of:
Systemic lupus erythematosus
Systemic dermatomyositis (polymyositis)
Acute rheumatic carditis
4. Dermatologic Diseases
Pemphigus Severe seborrheic dermatitis
Severe erythema multiforme (Stevens-Johnson syndrome) Severe psoriasis
Exfoliative dermatitis Mycosis fungoides
Bullous dermatitis herpetiformis
5. Allergic States
Control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment in:
Bronchial asthma Seasonal or perennial allergic rhinitis
Contact dermatitis Drug hypersensitivity reactions
Atopic dermatitis Urticarial transfusion reactions
Serum sickness Acute noninfectious laryngeal edema (epinephrine is the drug of first choice)
6. Ophthalmic Diseases
Severe acute and chronic allergic and inflammatory processes involving the eye, such as:
Herpes zoster ophthalmicus Sympathetic ophthalmia
Iritis, iridocyclitis Anterior segment inflammation
Chorioretinitis Allergic conjunctivitis
Diffuse posterior uveitis and choroiditis Allergic corneal marginal ulcers
Optic neuritis Keratitis
7. Gastrointestinal Diseases
To tide the patient over a critical period of the disease in:
Ulcerative colitis (systemic therapy)
Regional enteritis (systemic therapy)
8. Respiratory Diseases
Symptomatic sarcoidosis Loeffler’s syndrome not manageable by other means
Berylliosis Aspiration pneumonitis
Fulminating or disseminated pulmonary tuberculosis when used concurrentlywith appropriate anti-tuberculous chemotherapy
9. Hematologic Disorders
Acquired (autoimmune) hemolytic anemia
Idiopathic thrombocytopenic purpura in adults (IV only; IM administration is contraindicated)
Secondary thrombocytopenia in adults
Erythroblastopenia (RBC anemia)
Congenital (erythroid) hypoplastic anemia
10. Neoplastic Diseases
For palliative management of:
Leukemias and lymphomas in adults
Acute leukemia of childhood
11. Edematous States
To induce diuresis or remission of proteinuria in the nephrotic syndrome, without uremia, of the idiopathic type or that due to lupus erythematosus
12. Nervous System
Acute exacerbations of multiple sclerosis
13. Miscellaneous
Tuberculous meningitis with subarachnoid block or impending block when used concurrently with appropriate antituberculous chemotherapy
Trichinosis with neurologic or myocardial involvement

Contraindications: 

The use of Methylprednisolone Sodium Succinate for Injection, USP is contraindicated in premature infants because the 1 g multiple dose vial when reconstituted will contain benzyl alcohol. Benzyl alcohol has been reported to be associated with a fatal “Gasping Syndrome” in premature infants. Methylprednisolone Sodium Succinate for Injection, USP is also contraindicated in systemic fungal infections and patients with known hypersensitivity to the product and its constituents.

Precautions: 

Drug-induced secondary adrenocortical insufficiency may be minimized by gradual reduction of dosage. This type of relative insufficiency may persist for months after discontinuation of therapy; therefore, in any situation of stress occurring during that period, hormone therapy should be reinstituted. Since mineralocorticoid secretion may be impaired, salt and/or a mineralocorticoid should be administered concurrently.
There is an enhanced effect of corticosteroids on patients with hypothyroidism and in those with cirrhosis.
Corticosteroids should be used cautiously in patients with ocular herpes simplex because of possible corneal perforation.
The lowest possible dose of corticosteroid should be used to control the condition under treatment, and when reduction in dosage is possible, the reduction should be gradual.
Psychic derangements may appear when corticosteroids are used, ranging from euphoria, insomnia, mood swings, personality changes, and severe depression, to frank psychotic manifestations. Also, existing emotional instability or psychotic tendencies may be aggravated by corticosteroids.
Steroids should be used with caution in nonspecific ulcerative colitis, if there is a probability of impending perforation, abscess or other pyogenic infection; diverticulitis; fresh intestinal anastomoses; active or latent peptic ulcer; renal insufficiency; hypertension; osteoporosis; and myasthenia gravis.
Growth and development of infants and children on prolonged corticosteroid therapy should be carefully observed.
Although controlled clinical trials have shown corticosteroids to be effective in speeding the resolution of acute exacerbations of multiple sclerosis, they do not show that corticosteroids affect the ultimate outcome or natural history of the disease. The studies do show that relatively high doses of corticosteroids are necessary to demonstrate a significant effect
Since complications of treatment with glucocorticoids are dependent on the size of the dose and the duration of treatment, a risk/benefit decision must be made in each individual case as to dose and duration of treatment and as to whether daily or intermittent therapy should be used.
Convulsions have been reported with concurrent use of methylprednisolone and cyclosporin. Since concurrent use of these agents results in a mutual inhibition of metabolism, it is possible that adverse events associated with the individual use of either drug may be more apt to occur.
Aspirin should be used cautiously in conjunction with corticosteroids in patients suffering from hypoprothrombinemia

Drug Interactions: 

The pharmacokinetic interactions are potentially clinically important. Mutual inhibition of metabolism occurs with concurrent use of cyclosporin and methylprednisolone; therefore, it is possible that adverse events associated with the individual use of either drug may be more apt to occur. Convulsions have been reported with concurrent use of methylprednisolone and cyclosporin. Drugs that induce hepatic enzymes such as phenobarbital, phenytoin and rifampin may increase the clearance of methylprednisolone and may require increases in methylprednisolone dose to achieve the desired response. Drugs such as troleandomycin and ketoconazole may inhibit the metabolism of methylprednisolone and thus decrease its clearance. Therefore, the dose of methylprednisolone should be titrated to avoid steroid toxicity.
Methylprednisolone may increase the clearance of chronic high dose aspirin. This could lead to decreased salicylate serum levels or increase the risk of salicylate toxicity when methylprednisolone is withdrawn. Aspirin should be used cautiously in conjunction with corticosteroids in patients suffering from hypoprothrombinemia.
The effect of methylprednisolone on oral anticoagulants is variable. There are reports of enhanced as well as diminished effects of anticoagulant when given concurrently with corticosteroids. Therefore, coagulation indices should be monitored to maintain the desired anticoagulant effect.

Side Effects: 

Fluid and Electrolyte Distrubances
Sodium retention Potassium loss
Fluid retention Hypokalemic alkalosis
Congestive heart failure in susceptible patients Hypertension

Musculoskeletal
Muscle weakness Aseptic necrosis of femoral and humeral heads
Steroid myopathy Pathologic fracture of long bones
Loss of muscle mass Osteoporosis
Severe arthralgia
Vertebral compression fractures

Gastrointestinal
Peptic ulcer with possible perforation and hemorrhage Abdominal distention
Pancreatitis Ulcerative esophagitis

Dermatologic
Impaired wound healing Facial erythema
Thin fragile skin Increased sweating
Petechiae and ecchymoses May suppress reactions to skin tests

Neurological
Increased intracranial pressure with papilledema (Pseudo-tumor cerebri) usually after treatment Vertigo
Convulsions Headache

Endocrine
Development of Cushingoid state
Suppression of growth in children
Secondary adrenocortical and pituitary unresponsiveness, particularly in times of stress, as in trauma, surgery or illness
Menstrual irregularities
Decreased carbohydrate tolerance
Manifestations of latent diabetes mellitus
Increased requirements for insulin or oral hypoglycemic agents in diabetics
Ophthalmic
Posterior subcapsular cataracts Glaucoma
Increased intraocular pressure Exophthalmos

Metabolic
Negative nitrogen balance due to protein catabolism
The following additional adverse reactions are related to parenteral corticosteroid therapy:
Hyperpigmentation or hypopigmentation
Subcutaneous and cutaneous atrophy
Sterile abscess
Anaphylactic reaction with or without circulatory collapse, cardiac arrest, bronchospasm
Urticaria
Nausea and vomiting
Cardiac arrhythmias; hypotension or hypertension

Storage: 

• Store below 30 C°
• Protect from light and freezing

Packing: 

• Injection 40mg/1ml: Box of 1 ampoule

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