Concise Prescribing Info
Methylprednisolone acetate
IM: Endocrine, hematologic disorders & acute episodes/exacerbations of rheumatic disorders. Maintenance treatment/exacerbations of collagen diseases. Dermatologic diseases. Control of severe or incapacitating allergic conditions. Severe acute/chronic allergic & inflammatory ophth diseases. Tiding the patient over critical period of GI diseases. Resp diseases. Palliative management of neoplastic diseases. Induce diuresis or remission of proteinuria in edematous states. Acute exacerbations of multiple sclerosis. Adjunct to chemotherapy in TB meningitis w/ subarachnoid or impending block. Trichinosis w/ neurologic or myocardial involvement. Intrasynovial, or soft tissue including peri-articular or intrabursal: Acute episodes/exacerbations of rheumatic disease. Intralesional: Keloids, localized hypertrophic, infiltrated, inflammatory lesions of lichen planus, psoriatic plaques, discoid lupus erythematosus, necrobiosis lipoidica diabeticorum, granuloma annulare, lichen simplex chronicus (neurodermatitis), alopecia areata. Cystic tumors or aponeurosis or tendon (ganglia). Intrarectal instillation: Ulcerative colitis.
Dosage/Direction for Use
RA & OA Large joints: 20-80 mg; medium joints: 10-40 mg; small joints: 4-10 mg. Chronic case May repeat dose from 1-5 or more wk depending on initial relief. Ganglion, tendinitis, epicondylitis 4-30 mg. Repeat inj in recurrent or chronic conditions if necessary. Local effect in dermatologic conditions 20-60 mg inj to the lesion. Large lesions: Distribute dose from 20-40 mg by repeated local inj. IM Adrenogenital syndrome 40 mg every 2 wk. Maintenance of RA 40-120 mg wkly. Systemic effect in dermatologic lesions 40-120 mg at wkly intervals for 1-4 wk. Acute severe dermatitis due to poison ivy 80-120 mg as a single dose. Chronic contact dermatitis Repeated inj at 5-10-day intervals. Seborrheic dermatitis 80 mg wkly. Asthmatic patient 80-120 mg. Allergic rhinitis (hay fever) 80-120 mg. May be followed by relief of coryzal symptoms w/in 6 hr persisting for several days to 3 wk. Intrarectal Ulcerative colitis 40-120 mg as retention enemas or by continuous drip 3-7 times wkly for periods of ≥2 wk.
Hypersensitivity. Systemic fungal infections. Intrathecal, epidural & IV administration. Administration of live or live attenuated vaccine.
Special Precautions
Dermal &/or subdermal changes may form skin depression at the inj site. Avoid inj into the deltoid muscle due to high incidence of SC atrophy. Appropriate exam of any joint fluid present to exclude septic process. Avoid local inj into previously infected joint. Not to be injected into unstable joints. May increase susceptibility to infection, may mask some signs of infection & new infections may appear during use. Fulminating or disseminated TB. Patients w/ latent TB or tuberculin reactivity should receive chemoprophylaxis during prolonged therapy. Kaposi's sarcoma, septic shock. Allergic reactions. Patients on therapy subjected to unusual stress; w/ hypothyroidism. Prolonged therapy. Avoid abrupt w/drawal. Avoid use in patients w/ Cushing's disease. May increase blood glucose, worsen preexisting diabetes & predispose those on long-term therapy to DM. Psychic derangements. Seek medical attention if psychological symptoms develop in the patient especially if depressed mood or suicidal ideation is suspected. Seizure disorders, myasthenia gravis, epidural lipomatosis. Posterior subcapsular & nuclear cataracts (particularly in childn), exophthalmos or increased IOP w/ prolonged use. Ocular herpes simplex because of possible corneal perforation; central serous chorioretinopathy which may lead to retinal detachment. Patients w/ existing CV risk factors, CHF; who have or may be predisposed to thromboembolic disorders, HTN. Acute pancreatitis (high doses). May mask symptoms of peptic ulcer; peritonitis or other signs or symptoms associated w/ GI disorders eg, perforation, obstruction or pancreatitis. Non-specific ulcerative colitis; diverticulitis, fresh intestinal anastomoses, active or latent peptic ulcer. Hepatobiliary disorders. Acute myopathy, osteoporosis. Systemic sclerosis. Renal insufficiency. Dietary salt restriction & K supplementation. Not to be used to treat traumatic brain injury. Concomitant use w/ aspirin & NSAIDs. Pheochromocytoma crisis. May affect ability to drive or use machinery. Pregnancy & lactation. Growth suppression & risk from raised intracranial pressure on prolonged therapy in infants & childn. May produce pancreatitis in childn (high doses).
Adverse Reactions
Opportunistic infection, infection, peritonitis, inj site infection; leukocytosis; drug hypersensitivity, anaphylactic & anaphylactoid reaction; cushingoid, hypopituitarism, steroid w/drawal syndrome; metabolic acidosis, Na & fluid retention, hypokalemic alkalosis, dyslipidemia, impaired glucose tolerance, increased insulin requirement (or oral hypoglycemic agents in diabetics), lipomatosis, increased appetite (which may result to wt increase); affective, psychotic & mental disorders, personality change, confusional state, anxiety, mood swings, abnormal behavior, insomnia, irritability; epidural lipomatosis, increased intracranial pressure, seizure, amnesia, cognitive disorder, dizziness, headache; chorioretinopathy, blindness, cataract, glaucoma, exophthalmos; vertigo; congestive cardiac failure; thrombosis, HTN, hypotension; pulmonary embolism, hiccups; peptic ulcer, intestinal perforation, gastric hemorrhage, pancreatitis, ulcerative esophagitis, esophagitis, abdominal distention & pain, diarrhea, dyspepsia, nausea; angioedema, hirsutism, petechiae, ecchymosis, skin atrophy, erythema, hyperhidrosis, skin striae, rash, pruritus, urticaria, acne, skin hyper/hypopigmentation; muscular weakness, myalgia, myopathy, muscle atrophy, osteoporosis, osteonecrosis, pathological fracture, neuropathic arthropathy, arthralgia, growth retardation; irregular menstruation; sterile abscess, impaired healing, peripheral edema, fatigue, malaise, inj site reaction; increased IOP, urine Ca, ALT, AST, blood alkaline phosphatase & blood urea, decreased carbohydrate tolerance & blood K, suppression of reactions to skin tests; spinal compression fracture, tendon rupture.
Drug Interactions
Decreased hepatic clearance & increased plasma conc w/ CYP3A4 inhibitors (eg, INH, aprepitant, fosaprepitant, itraconazole, ketoconazole, diltiazem, ethinyl estradiol/norethindrone, grapefruit juice, clarithromycin, erythromycin, troleandomycin). Increased hepatic clearance & decreased plasma conc w/ CYP3A4 inducers (eg, rifampicin, carbamazepine, phenobarb, phenytoin). Affected hepatic clearance w/ CYP3A4 substrates (eg, cyclophosphamide, tacrolimus). May increase acetylation rate & clearance of INH. Enhanced/diminished effects of oral anticoagulants. Acute myopathy w/ anticholinergics eg, neuromuscular blocking drugs. Antagonism of neuromuscular blocking effects of pancuronium & vecuronium. May reduce effects of anticholinesterases in myasthenia gravis. Dosage adjustments of antidiabetics. Increased plasma conc w/ PIs eg, indinavir & ritonavir. May induce metabolism resulting in reduced plasma conc of HIV-PIs. Aminoglutethimide-induced adrenal suppression may exacerbate endocrine changes caused by prolonged glucocorticoid treatment. Mutual inhibition of metabolism occurs w/ concurrent use w/ cyclosporine which may increase plasma conc of either or both drugs. Increased incidence of GI bleeding & ulceration w/ NSAIDs. May increase clearance of high-dose aspirin, which can lead to decreased salicylate serum levels. Increased risk of hypokalemia w/ K-depleting agents (ie, diuretics), amphotericin B, xanthines or β2-agonists.
MIMS Class
Corticosteroid Hormones
ATC Classification
H02AB04 - methylprednisolone ; Belongs to the class of glucocorticoids. Used in systemic corticosteroid preparations.
Depo-Medrol inj 40 mg/mL
(vial) 1's (P315.5/vial)
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