Medrol
Medrol Medication Information:
Medrol medication comes in several different strengths; click on the strength you need to view prices from pharmacies competing to earn your business.
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Medrol 2 mg
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Medrol 4 mg
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Medrol Dosepak 4 mg
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Medrol 16 mg
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Precautions
Drug Interactions
The pharmacokinetic interactions listed below 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 increase in methylprednisolone dose to achieve 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 ASA. This could lead to a decrease in salicylate serum levels or increase the risk of salicylate toxicity when methylprednisolone is withdrawn. ASA 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.
Lactation
Corticosteroids are excreted in breast milk.
Supplied
16 mg
Each white, elliptical, cross-scored tablet, engraved “Medrol 16”, contains: methylprednisolone 16 mg. Nonmedicinal ingredients: calcium stearate, cornstarch, lactose, mineral oil and sucrose. Gluten-free. Bottles of 100.
4 mg
Each white, elliptical, cross-scored tablet, engraved “Medrol 4”, contains: methylprednisolone 4 mg. Nonmedicinal ingredients: calcium stearate, cornstarch, lactose, mineral oil and sucrose. Gluten-free. Bottles of 100.
Warnings
Lactation
Corticosteroids are excreted in breast milk.
Pregnancy
Some animal studies have shown that corticosteroids, when administered to the mother at high doses, may cause fetal malformations. Adequate human reproductive studies have not been done with corticosteroids. Therefore, the use of this drug in pregnancy, nursing mothers, or women of childbearing potential requires that the benefits of the drug be carefully weighed against the potential risk to the mother and embryo or fetus. Since there is inadequate evidence of safety in human pregnancy, this drug should be used in pregnancy only if clearly needed.
Corticosteroids readily cross the placenta. Infants born of mothers who have received substantial doses of corticosteroids during pregnancy must be carefully observed and evaluated for signs of adrenal insufficiency. There are no known effects of corticosteroids on labor and delivery.
Contraindications
Systemic fungal infections; known hypersensitivity to methylprenisolone.
Adverse Effects
Gastrointestinal
peptic ulceration with possible perforation and hemorrhage; gastric hemorrhage; pancreatitis; esophagitis; perforation of the bowel.
Musculoskeletal
muscle weakness; steroid myopathy; osteoporosis; vertebral compression fractures; aseptic necrosis; pathologic fractures; loss of muscle mass; tendon rupture—particularly of the Achilles tendon.
Fluid and electrolyte disturbances
sodium retention; fluid retention; congestive heart failure in susceptible patients; potassium loss, hypokalemic alkalosis; hypertension.
Immune System
masking of infections; latent infections becoming active; opportunistic infections; hypersensitivity reactions including anaphylaxis; may suppress reactions to skin tests.
Increases in ALT, AST and alkaline phosphatase have been observed following corticosteroid treatment. These changes are usually small, not associated with any clinical syndrome and are reversible upon discontinuation.
Endocrine
menstrual irregularities; development of cushingoid state; suppression of pituitary/adrenal axis; decreased carbohydrate tolerance; manifestations of latent diabetes mellitus; increased requirements for insulin or oral hypoglycemic agents in diabetes; suppression of growth in children.
Dermatologic
impaired wound healing; thin fragile skin; petechiae and ecchymoses; facial erythema; may suppress reactions to skin tests; increased sweating.
Metabolic
negative nitrogen balance due to protein catabolism.
Neurological
increased intracranial pressure; pseudotumor cerebri; psychic derangements; seizures.
Ophthalmic
posterior subcapsular cataracts; increased intraocular pressure; exophthalmos; glaucoma.
Indications
Endocrine Disorders: Primary or secondary adrenocortical insufficiency (hydrocortisone or cortisone is the first choice; synthetic analogs may be used in conjunction with mineralocorticoids where applicable; in infancy mineralocorticoid supplementation is of particular importance). Congenital adrenal hyperplasia. Nonsuppurative thyroiditis. Hypercalcemia associated with cancer.
Nonendocrine Disorders: Rheumatic Disorders: As adjunctive therapy for short-term administration (to tide the patient over an acute episode or exacerbation) in: psoriatic arthritis; rheumatoid arthritis, including juvenile rheumatoid arthritis (selected cases may require low-dose maintenance therapy); ankylosing spondylitis; acute and subacute bursitis; acute nonspecific tenosynovitis; acute gouty arthritis; post-traumatic osteoarthritis; synovitis of osteoarthritis; epicondylitis.
Collagen Diseases: During an exacerbation or as maintenance therapy in selected cases of: systemic lupus erythematosus; systemic dermatomyositis (polymyositis); acute rheumatic carditis; polymyalgia rheumatica; giant cell arteritis.
Dermatologic Diseases: pemphigus; bullous dermatitis herpetiformis; severe erythema multiforme (Stevens-Johnson syndrome); exfoliative dermatitis; mycosis fungoides; severe psoriasis; severe seborrheic dermatitis.
Allergic State: Control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment: seasonal or perennial allergic rhinitis; serum sickness; bronchial asthma; drug hypersensitivity reactions; contact dermatitis; atopic dermatitis.
Ophthalmic Diseases: Severe acute and chronic allergic and inflammatory processes involving the eye and its adnexa such as: allergic corneal marginal ulcers; herpes zoster ophthalmicus; anterior segment inflammation; diffuse posterior uveitis and choroiditis; sympathetic ophthalmia; allergic conjunctivitis; keratitis; chorioretinitis; optic neuritis; iritis and iridocyclitis.
Respiratory Diseases: symptomatic sarcoidosis; Löffler's syndrome not manageable by other means; berylliosis; fulminating or disseminated pulmonary tuberculosis when used concurrently with appropriate antituberculous chemotherapy; aspiration pneumonitis.
Hematologic Disorders: idiopathic thrombocytopenic purpura in adults; secondary thrombocytopenia in adults; acquired (autoimmune) hemolytic anemia; erythroblastopenia (RBC anemia); congenital (erythroid) hypoplastic anemia.
Neoplastic Disorders: For palliative management of: leukemias and lymphomas in adults; acute leukemia of childhood.
Edematous States: To induce a diuresis or remission of proteinuria in the nephrotic syndrome, without uremia, of the idiopathic type or that due to lupus erythematosus.
Gastrointestinal Diseases: To tide the patient over a critical period of the disease in: ulcerative colitis; regional enteritis.
Nervous System: acute exacerbations of multiple sclerosis; management of edema associated with brain tumor.
Miscellaneous: Tuberculous meningitis with subarachnoid block or impending block when used concurrently with appropriate antituberculous chemotherapy. Trichinosis with neurologic or myocardial involvement.
Organ Transplantation.
Dosage
The initial dosage of methylprednisolone may vary from 4 to 48 mg of methylprednisolone/day depending on the specific disease entity being treated. In situations of less severity, lower doses will generally suffice while in selected patients higher initial doses may be required. Clinical situations in which high dose therapy may be indicated include multiple sclerosis (200 mg/day), cerebral edema (200 to 1000 mg/day), and organ transplantation (up to 7 mg/kg/day). If after a reasonable period of time there is a lack of satisfactory clinical response, methylprednisolone should be discontinued and the patient transferred to other appropriate therapy. If after long-term therapy the drug is to be stopped, it is recommended that it be withdrawn gradually rather than abruptly.
After a favorable response is noted, the proper maintenance dosage should be determined by decreasing the initial drug dosage in small decrements at appropriate time intervals until the lowest dosage which will maintain an adequate clinical response is reached. It should be kept in mind that constant monitoring is needed in regard to drug dosage. Included in the situations which may make dosage adjustments necessary are changes in clinical status secondary to remissions or exacerbations in the disease process, the patient's individual drug responsiveness, and the effect of patient exposure to stressful situations not directly related to the disease entity under treatment; in this latter situation it may be necessary to increase the dosage of methylprednisolone for a period of time consistent with the patient's condition.
It should be emphasized that dosage requirements are variable and must be individualized on the basis of the disease under treatment and the response of the patient.
ADT Alternate Day Therapy: Alternate day therapy is a corticosteroid dosing regimen in which twice the usual daily dose of corticosteroid is administered every other morning. The purpose of this mode of therapy is to provide a patient requiring long-term, pharmacologic dose treatment with the beneficial effects of corticoids while minimizing certain undesirable effects, including pituitary-adrenal suppression, the cushingoid state, corticoid withdrawal symptoms, and growth suppression in children.
Overdose
For management of a suspected drug overdose, CPhA recommends that you contact your regional Poison Control Centre. See the eCPS Directories section for a list of Poison Control Centres.
No data supplied by the manufacturer.
