methylprednisolone (cont.)
NURSING MOTHERS: Methylprednisolone has not been adequately evaluated
in nursing mothers.
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. Side effects include fluid
retention, weight gain, high blood pressure, potassium loss, headache, muscle
weakness, puffiness of the face, hair growth on the face, thinning and easy
bruising of the skin, glaucoma, cataracts,
peptic ulceration, worsening of
diabetes,
irregular menses, growth retardation in children, convulsions, and
psychic disturbances. Psychic disturbances may include depression, euphoria,
insomnia, mood swings, personality changes, and even
psychotic behavior.
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.
Reference: FDA Prescribing Information
Last Editorial Review: 11/16/2007
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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