GENERIC NAME: methylprednisolone
BRAND NAME: Medrol, Depo-Medrol, Solu-Medrol, A-Methapred
GENERIC AVAILABLE: Yes
USES: Methylprednisolone is used to achieve prompt suppression of inflammation. Examples of inflammatory conditions for which methylprednisolone is used include:
- rheumatoid arthritis,
- systemic lupus erythematosus,
- acute gouty arthritis,
- psoriatic arthritis,
- ulcerative colitis, and
- Crohn's disease.
Severe allergic conditions that fail conventional treatment also may respond to methylprednisolone. Examples include:
Chronic skin conditions treated with methylprednisolone include:
SIDE EFFECTS: Adverse effects of methylprednisolone depend on dose, duration and frequency of administration. Short courses of methylprednisolone are usually well-tolerated with few, mild side effects. Long term, high doses of methylprednisolone may produce predictable and potentially serious side effects. Whenever possible, the lowest effective doses of methylprednisolone should be used for the shortest length of time to minimize side effects. Alternate day dosing also can help reduce side effects.
Side effects of methylprednisolone and other corticosteroids range from mild annoyances to serious irreversible bodily damage. Commonly reported side effects include:
- fluid retention,
- weight gain,
- high blood pressure,
- potassium loss,
- muscle weakness,
- puffiness of the face,
- hair growth on the face,
- thinning and easy bruising of the skin,
- peptic ulceration,
- worsening of diabetes,
- irregular menses,
- growth retardation in children,
- convulsions, and
- psychic disturbances.
Important psychic disturbances may include:
MORE SERIOUS SIDE EFFECTS:Prolonged use of methylprednisolone can depress the ability of the body's adrenal glands to produce corticosteroids. Abruptly stopping methylprednisolone in these individuals can cause symptoms of corticosteroid insufficiency, with accompanying nausea, vomiting, and even shock. Therefore, withdrawal of methylprednisolone usually is accomplished by gradually lowering the dose. Gradually tapering methylprednisolone not only minimizes the symptoms of corticosteroid insufficiency, it also reduces the risk of an abrupt flare of the disease being treated.
Methylprednisolone and other corticosteroids can mask signs of infection and impair the body's natural immune response to infection. Patients on corticosteroids are more susceptible to infections and can develop more serious infections than individuals not on corticosteroids. For example, chickenpox and measles viruses can produce serious and even fatal illnesses in patients on high doses of methylprednisolone. Live virus vaccines, such as smallpox vaccine, should be avoided in patients taking high doses of methylprednisolone since even vaccine viruses may cause disease in these patients. Some infectious organisms, such as tuberculosis (TB) and malaria, can remain dormant in patients for years. Methylprednisolone and other corticosteroids can allow these infections to reactivate and cause serious illness. Patients with dormant TB may require anti-TB medications while undergoing prolonged corticosteroid treatment.
By interfering with the patient's immune response, methylprednisolone can prevent vaccines from being effective. Methylprednisolone also can interfere with the TB skin test and cause falsely negative results in patients with dormant TB infections.
Methylprednisolone impairs calcium absorption and new bone formation. Patients on prolonged treatment with methylprednisolone and other corticosteroids can develop osteoporosis and an increased risk of bone fractures. Supplemental calcium and vitamin D are encouraged to slow this process of bone thinning. In rare individuals, destruction of large joints can occur while undergoing treatment with methylprednisolone or other corticosteroids (aseptic necrosis). These patients experience severe pain in the joints involved, and can require joint replacement. The reason behind such destruction is not clear. Methylprednisolone can be used in pregnancy, but is generally avoided.
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