Methylprednisolone

DEA Class; Rx

Common Brand Names; Medrol, Medrol Dosepak, DepoMedrol, SoluMedrol, A-Methapred

Indicated for the treatment of status asthmaticus, asthma exacerbation, Allergic Conditions

For Acute Exacerbations of Multiple Sclerosis

For the treatment of the acute respiratory distress syndrome (ARDS).

Untreated serious infections

Documented hypersensitivity to drug or components (eg, lactose monohydrate from cow milk)

Intrathecal administration

Systemic fungal infection (except intra-articular injection in localized joint conditions)

IM route is contraindicated in idiopathic thrombocytopenic purpura

Premature infants (formulations containing benzyl alcohol only)

Traumatic brain injury (high doses)

Administration of live or live, attenuated vaccines is contraindicated in patients receiving immunosuppressive doses of corticosteroids

• Acne
• Adrenal suppression
• Amenorrhea
• Delayed wound healing
• Delirium
• Diabetes mellitus
• Edema
• Emotional instability
• Erythema
• Fluid retention
• GI perforation
• Glucose intolerance
• Growth suppression (children)
• Hallucinations
• Headache
• Hepatomegaly
• Hepatitis
• Hypokalemic alkalosis
• Increased transaminases
• Insomnia
• Leukocytosis
• Menstrual irregularity
• Myopathy
• Neuritis
• Osteoporosis
• Peptic ulcer
• Perianal pruritus
• Pituitary adrenal axis suppression
• Protein catabolism
• Pseudotumor cerebri (on withdrawal)
• Psychosis
• Sodium and water retention
• Seizure
• Tachycardia
• Ulcerative esophagitis
• Urticaria
• Vasculitis
• Vertigo
• Weight gain

Use with caution in cirrhosis, ocular herpes simplex, hypertension, diverticulitis, hypothyroidism, myasthenia gravis, peptic ulcer disease, osteoporosis, ulcerative colitis, psychotic tendencies, renal insufficiency, pregnancy, diabetes mellitus, history of seizure disorders, multiple sclerosis, thromboembolic disorders, myocardial infarction

Long-term treatment: Risk of osteoporosis, myopathy, delayed wound healing

Minimal mineralocorticoid activity

Use in septic shock or sepsis syndrome not proven effective and may increase mortality in some patients including patients with elevated serum creatinine and patients who develop secondary infections

Clearance of corticosteroids may increase in hyperthyroid patients and decrease in hypothyroid ones; dose adjustments may be necessary

Patients receiving corticosteroids should avoid chickenpox or measles-infected persons if unvaccinated

Latent tuberculosis may be reactivated (patients with positive tuberculin test should be monitored)

Some suggestion (not fully substantiated) of slightly increased cleft palate risk if corticosteroids are used in pregnancy

May cause hypothalamic-pituitary-adrenal (HPA) axis suppression, Cushing syndrome, or hyperglycemia

Prolonged corticosteroid use may result in elevated IOP, glaucoma, or cataracts

Killed or inactivated vaccines may be administered; however, the response to such vaccines cannot be predicted

Immunization procedures may be undertaken in patients who are receiving corticosteroids as replacement therapy in physiologic doses (eg, for Addison’s disease)

Injection may result in dermal and/or subdermal changes forming depressions in the skin at injection site; to minimize incidence of dermal and subdermal atrophy, care must be exercised not to exceed recommended doses in injections; avoid injection into deltoid muscle due to high incidence of subcutaneous atrophy

Increased dosage of rapidly acting corticosteroids indicated in patients on corticosteroid therapy subjected to any unusual stress before, during, and after the stressful situation

Not for use in the treatment of traumatic brain injury

Pregnancy category: C

Lactation: Drug enters milk; use with caution