Methylprednisolone

Should be taken with food.

Untreated systemic fungal infections; idiopathic thrombocytopenic purpura (IM inj). Administration of live or live, attenuated vaccines (in patients receiving immunosuppressive doses of corticosteroids). Parenteral inj: Administration via intrathecal route.

Patient with known or suspected parasitic infections (e.g. Strongyloides infestation), history of any drug allergy, thyroid disease, diabetes mellitus or family history of diabetes; existing or previous history of severe affective disorders; history of seizure disorder, myasthenia gravis, existing or family history of glaucoma, ocular herpes simplex; CHF, hypertension, acute MI, predisposition to thromboembolic disorders; peptic ulceration, fresh intestinal anastomoses, abscess or other pyogenic infections, diverticulitis, non-specific ulcerative colitis (if with possible impending perforation); latent TB and/or TB reactivity, osteoporosis, systemic sclerosis; suspected or confirmed phaeochromocytoma. Patient subjected to unusual stress. Avoid in patient with Cushing's disease; exposure to chickenpox or measles. Consider gradual withdrawal in patients who have repeated courses (particularly if given for >3 weeks), have taken a short course within a year of cessation of long-term therapy (months or years), may have reasons for adrenocortical insufficiency aside from exogenous corticosteroid therapy, are receiving doses >32 mg daily, or are repeatedly taking doses in the evening. Renal and hepatic impairment. Children. Pregnancy and lactation. Monitoring Parameters Monitor blood pressure, weight, intraocular pressure (if >6 months of use); growth and development (in children), BMD. Obtain electrolyte and blood glucose levels. Monitor for signs of infection, HPA axis suppression, and changes in mood or behaviour.

Significant: Immunosuppression, increased susceptibility to infection, mask signs of infection; Kaposi's sarcoma, adrenal cortical atrophy (prolonged use); hypercortisolism or suppression of hypothalamic-pituitary-adrenal (HPA) axis (particularly in younger children or in those receiving high doses for long periods), withdrawal syndrome, new-onset or exacerbate Cushing's syndrome; increased blood glucose, worsen pre-existing diabetes; psychiatric disturbances (e.g. severe depression, mood swings, insomnia); epidural lipomatosis (prolonged use at high doses), visual disturbance; posterior subcapsular cataracts and nuclear cataracts (prolonged use, particularly in children), exophthalmos, increased intraocular pressure which may result in glaucoma with possible optic nerve damage; dyslipidaemia, hypertension, thrombosis (including venous thromboembolism); acute pancreatitis, acute myopathy (high dose); growth retardation (children); Charcot-like arthropathies (particularly after repeated intra-articular inj), fluid retention, electrolyte disturbances, scleroderma renal crisis. Rarely, anaphylactic or anaphylactoid reactions, hepatobiliary disorders. Gastrointestinal disorders: Peptic ulcer. General disorders and administration site conditions: Impaired healing; application site burning or pruritus (topical). Musculoskeletal and connective tissue disorders: Muscle weakness. Skin and subcutaneous tissue disorders: Acne, skin atrophy.
Potentially Fatal: Phaeochromocytoma crisis, serious hepatic injury.

Decreased plasma concentration with CYP3A4 inducers (e.g. rifampicin, phenobarbital, phenytoin, primidone). May increase the risk of adverse events with other CYP3A4 substrates (e.g. tacrolimus, cyclophosphamide). Increased plasma concentration with CYP3A4 inhibitors (e.g. ketoconazole, troleandomycin, mibefradil, cimetidine). May increase the acetylation rate and clearance of isoniazid. Incidence of gastrointestinal bleeding and ulceration may be increased when used concomitantly with NSAIDs. May increase the clearance of high dose aspirin, which may result in decreased salicylate levels. Concomitant use of high dose methylprednisolone and anticholinergics (e.g. neuromuscular blocking agents) may cause acute myopathy. May antagonise the effects of neuromuscular blockers (e.g. pancuronium, vecuronium). Effects of anticholinesterases in myasthenia gravis may be reduced by methylprednisolone. May enhance the efficacy of coumarin anticoagulants. Increased risk of hypokalaemia with K-depleting agents (e.g. diuretics, amphotericin B). Adrenal suppression induced by aminoglutethimide may exacerbate the endocrine changes caused by prolonged methylprednisolone therapy. Ciclosporin may enhance the seizure-potentiating effect of methylprednisolone.

Corticosteroid Hormones / Topical Corticosteroids

D07AA01 - methylprednisolone ; Belongs to the class of weak (group I) corticosteroids. Used in the treatment of dermatological diseases.
H02AB04 - methylprednisolone ; Belongs to the class of glucocorticoids. Used in systemic corticosteroid preparations.
D10AA02 - methylprednisolone ; Belongs to the class of topical corticosteroids used in the treatment of acne.