Methylprednisolone

A to Z Drug Facts

Methylprednisolone

  Action
  Indications
  Contraindications
  Route/Dosage
  Interactions
  Lab Test Interferences
  Adverse Reactions
  Precautions
Patient Care Considerations
  Administration/Storage
  Assessment/Interventions
  Patient/Family Education


(METH-ill-pred-NIH-suh-lone)
Medrol,  Depo-Medrol, Medrol Veriderm
Methylpredinisolone Sodium Succinate
A-Methapred, Solu-Medrol
Methylprednisolone Acetate
Adlone, depMedalone 40, depMedalone 80, Depoject, Depo-Medrol, Depopred-40, D-Med 80, Duralone-40, Duralone-80, Medralone-40, Medralone-80, Medrol Acetate Topical, M-Prednisol-40, M-Prednisol-80, Rep-Pred 40, Rep-Pred 80
Class: Corticosteroid

 Action Depresses formation, release and activity of endogenous mediators of inflammation including prostaglandins, kinins, histamine, liposomal enzymes and complement system. Modifies body's immune response.

 Indications Replacement therapy in primary or secondary adrenal cortex insufficiency; djunctive therapy for short-term administration in rheumatic disorders; exacerbation or maintenance therapy in collagen diseases; treatment of dermatologic diseases; ontrol of allergic states or allergic and inflammatory ophthalmic processes; anagement of respiratory diseases; treatment of hematologic disorders; palliative management of neo-plastic diseases; management of cerebral edema associated with primary or metastatic brain tumor, craniotomy or head injury; induction of diuresis in edematous states (from nephrotic syndrome); management of critical exacerbations of GI diseases; management of acute exacerbations of multiple sclerosis; treatment of tuberculous meningitis; management of trichinosis with neurologic or myocardial involvement. Intra-articular or soft tissue administration: Adjunctive therapy for short-term administration in synovitis of osteoarthritis, rheumatoid arthritis, bursitis, acute gouty arthritis, epicondylitis, acute nonspecific tenosynovitis and posttraumatic osteoarthritis. Intralesional administration: Management of keloids; treatment of localized hypertrophic, infiltrated, inflammatory lesions of lichen planus, psoriatic plaques, granuloma annulare, lichen simplex chronicus; treatment of discoid lupus erythematosus, necrobiosis lipoidica diabeticorum, alopecia areata and cystic tumors of aponeurosis or tendon. Topical administration: Treatment of inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses. Unlabeled use(s): Reduction of mortality in severe alcoholic hepatitis; prevention of respiratory distress syndrome; treatment of septic shock; improvement of neurologic function in acute spinal cord injury.

 Contraindications Systemic fungal infections; idiopathic thrombocytopenic purpura (IM administration); administration of live virus vaccines; topical monotherapy in primary bacterial infections; topical use on face, groin or axilla; use in premature infants (sodium succinate salt).

 Route/Dosage

METHYLPREDNISOLONE

ADULTS: PO 4–48 mg/day.

METHYLPREDNISOLONE SODIUM SUCCINATE

ADULTS: IV/IM 10–40 mg administered over 1 to several min. In severe condition, 30 mg/kg infused over 30 min; may repeat q 4–6 hr for 48–72 hr. INFANTS & CHILDREN: IV/IM Not less than 0.5 mg/kg/24 hr.

METHYLPREDNISOLONE ACETATE

ADULTS: IM 40–120 mg q wk for 1–4 wk. Intra-articular/intralesional 4–80 mg into joints or lesions. Topical Apply sparingly to affected areas 2–4 times daily.

 Interactions

Anticholinesterases: May antagonize anticholinesterase effects in myasthenia gravis. Barbiturates: May decrease pharmacologic effect of methylprednisolone. Hydantoins, rifampin: May increase clearance and decrease efficacy of methylprednisolone. Ketoconazole: May decrease clearance of methylprednisolone. Macrolide antibiotics: Significantly decreases methylprednisolone clearance; may need to decrease dose. Salicylates: May reduce serum levels and efficacy of salicylates.

 Lab Test Interferences Drug may cause increased levels of urine glucose and serum cholesterol, decreased serum levels of potassium, T3 and T4, decreased uptake of thyroid I131, false-negative result in nitroblue-tetrazolium test for systemic bacterial infection and suppression of skin-test reactions.

 Adverse Reactions

CV: Thromboembolism or fat embolism; thrombophlebitis; necrotizing angiitis; cardiac arrhythmias or ECG changes; syncopal episodes; hypertension; yocardial rupture; fatal arrest; circulatory collapse; CHF. CNS: Convulsions; pseudotumor cerebri (increased intracranial pressure with papilledema); vertigo; headache; neuritis; paresthesias; psychosis. DERM: Impaired wound healing; thin, fragile skin; petechiae and ecchymoses; rythema; lupus erythematosus-like lesions; subcutaneous fat atrophy; striae; irsutism; acneiform eruptions; allergic dermatitis; urticaria; angioneurotic edema; perineal irritation; hyperpigmentation or hypopigmentation. Topical application: burning; itching; irritation; erythema; dryness; folliculitis; ypertrichosis; pruritus; perioral dermatitis; allergic contact dermatitis; tinging, cracking and tightening of skin; secondary infections; skin atrophy; triae; miliaria; telangiectasia. EENT: Posterior subcapsular cataracts; increased intraocular pressure; glaucoma; xophthalmos. GI: Pancreatitis; abdominal distention; ulcerative esophagitis; nausea; vomiting; ncreased appetite and weight gain; peptic ulcer with perforation and hemorrhage; owel perforation. GU: Increased or decreased motility and number of spermatozoa. HEMA: Leukocytosis. META: Sodium and fluid retention; hypokalemia; hypokalemic alkalosis; etabolic alkalosis; hypocalcemia. OTHER: Musculoskeletal effects (eg, weakness, myopathy, muscle mass loss, osteoporosis, spontaneous fractures); endocrine abnormalities (eg, menstrual irregularities, cushingoid state, growth suppression in children, sweating, decreased carbohydrate tolerance, hyperglycemia, glycosuria, increased insulin or sulfonylurea requirements in diabetic patients, hirsutism); anaphylactoid or hypersensitivity reactions; aggravation or masking of infections; fatigue; nsomnia. Intra-articular administration: Osteonecrosis; tendon rupture; infection; skin atrophy; postinjection flare; hypersensitivity; facial flushing. Topical application may produce adverse reactions seen with systemic use because of absorption.

 Precautions

Pregnancy: Pregnancy category undetermined (systemic use); Category C (topical use). Lactation: Excreted in breast milk. Children: May be more susceptible to adverse effects from topical use. Benzyl alcohol/gasping syndrome may occur with use of methylprednisolone sodium succinate. Elderly patients: May require lower doses. Adrenal suppression: Prolonged therapy may lead to hypothalamic-pituitary-adrenal suppression. Hepatitis: Drug may be harmful in chronic active hepatitis positive for hepatitis B surface antigen. Hypersensitivity: Reactions, including anaphylaxis, may occur rarely. Immunosuppression: Because drug causes immunosuppressed state, do not administer live virus vaccines during treatment. Infections: May mask signs of infection. May decrease host-defense mechanisms to prevent dissemination of infection. Ocular effects: Use drug systemically with caution in ocular herpes simplex because of risk of possible corneal perforation. Peptic ulcer: Drug may contribute to peptic ulceration, especially in large doses. Repository injections: Do not inject subcutaneously. Avoid injection into deltoid muscle and repeated intramuscular injection into same site. Stress: Increased dosage of rapidly acting corticosteroid may be needed before, during and after stressful situations. Tartrazine sensitivity: May contain tartrazine, which may cause allergic-type reactions in susceptible individuals.


PATIENT CARE CONSIDERATIONS


 Administration/Storage

 Assessment/Interventions

OVERDOSAGE: SIGNS & SYMPTOMS
  Cushingoid changes, moonface, central obesity, striae, hirsutism, acne, ecchymoses, hypertension, osteoporosis, myopathy, sexual dysfunction, diabetes mellitus, hyperlipidemia, peptic ulcer, increased susceptibility to infection, electrolyte and fluid imbalance

 Patient/Family Education

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Copyright
© 2003 Facts and Comparisons
David S. Tatro
A to Z Drug Facts