Methylpredenisolone Acetate

Indications & Dose:

Systemic: Antiinflammatory or immunosuppressant agent in the treatment of a variety of diseases of hematologic, allergic, inflammatory, neoplastic, and autoimmune-origin

Intra-articular: Synovitis, osteoarthritis

Intradermal: Keloids, alopecia areata, inflammatory skin lesions 

• BY INTRAMUSULAR

Adult: By deep 1/m intragluctal muscle 40-120mg, a 2nd injection may be given after 2-3 weeks if requirements. 

Contraindications:

Systemic fungal infections, idiopathic thrombocytopenic purpura (IM), premature infants (sodium succinate, acetate, secondary gasping syndrome from benzyl alcohol), intrathecal administration. 

Side Effects:

CNS: Depression, headache, moodchanges, seizures, vertigo
CV:CHF, hypertension, tachycardia, thromboembolism, thrombophlebitis
EENT : Blurred vision, cataract, increased intraocular pressure
GI: Abdominal distension, diarrhea, GI hemorrhage,increased appetite, nausea, pancreatitis
METAB: Cushingoid state, decreased glucose tolerance, growth suppression in children, HPA suppression
MS: Aseptic necrosis of femoral and humeral heads, fractures, muscle mass loss, osteoporosis, weakness
SKIN: Acne, bruising, ecchymosis, petechiae, poor wound healing, striae, thin fragile skin. 

Cautions:

Precautions:

Psychosis, diabetes mellitus, glaucoma, osteoporosis, seizure disorders, ulcerative colitis (intestinal perforation), CHF, hypertension, myesthenia gravis (if used with anticholinesterase agents), renal disease, esophagitis, peptic ulcer, latent tuberculosis or amebiasis (reactivation of disease). Topical: use on face, groin, or axilla, ocular herpes simplex.

Pregnancy: Use only if clearly indicated.

Breastfeeding: Use with caution.

Old age: Use with caution

Interaction:

Drugs

Aminoglutethamide: Enhanced elimination of corticosteroids; marked reduction in corticosteroid response: increased clearance of methylprednisolone; doubling of dose may be necessary

Antidiabetics: Increased blood glucose

Barbiturates, carbamazepine: Reduced serum concentrations of corticosteroids; increased clearance of methylprednisolone

Cholestyramine colestipol: Possible reduced absorption of corticosteroids

Cyclosporine: Possible increased concentration of both drugs, seizures

Erythromycin, troleandomycin, clarithromycin,ketoconazole: Possible enhanced steroid effect

Estrogens, oral contraceptives: enhanced effects of corticosteroids

Isoniazid: Reduced plasma concentrations of isoniazid

IUDs: Inhibition of inflammation may decrease contraceptive effect

NSAIDs: Increased risk GI ulceration

Rifampin: Reduced therapeutic effect of corticosteroids; may reduce hepatic clearance of methylprednisolone

Salicylates: Subtherapeutic salicylate concentrations possible 

Warnings:

Adverse Effects:

Lactations:

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

Patient And Carer Advice: