Medrol pills 16mg, 50pcs

Composition

1 tablet contains:

Active ingredient:

methylprednisolone 16 mg;

Auxiliary substances:

calcium stearate;

corn starch;

lactose;

sucrose.

Pharmacological action

Synthetic glucocorticoid with anti-inflammatory, anti-allergic, and immunosuppressive activity.

Under the influence of Medrol, there is a decrease in the number of immunoactive cells around the inflammatory focus, a decrease in vasodilation, stabilization of lysosomal membranes, inhibition of phagocytosis, and a decrease in the production of prostaglandins and related substances.

Medrol at a dose of 4 mg has the same anti-inflammatory effect as hydrocortisone at a dose of 20 mg. The drug has a minimal mineralocorticoid effect (200 mg of the drug is equivalent to 1 mg of deoxycorticosterone).

The drug has a catabolic effect. Reduces glucose uptake by peripheral tissues, which can lead to hyperglycemia and glucosuria, especially in patients predisposed to diabetes.

Medrol has a lipolytic effect, mainly in the extremities, as well as a lipogenic effect, most pronounced on the chest, neck and head, leading to a redistribution of fat deposits. May cause osteoporosis.

Indications

• systemic lupus erythematosus, rheumatoid arthritis
• severe psoriasis, neurodermatitis
• severe allergic diseases
• bronchial asthma
• glomerulonephritis.

Use during pregnancy and lactation

The use of Medrol during pregnancy is possible if the expected effect of therapy exceeds the potential risk to the fetus (adequate and strictly controlled safety studies have not been conducted).

Women of childbearing age should be warned about the potential risk to the fetus (corticosteroids pass through the placenta).

Nursing women are advised to stop either breastfeeding or using drugs, especially in high doses (corticosteroids enter breast milk and can inhibit the production of endogenous corticosteroids, inhibit growth and cause undesirable effects in offspring).

Contraindications

• severe arterial hypertension, severe heart failure
• diabetes mellitus
• peptic ulcer of the stomach and duodenum
• mental diseases
• glaucoma
• viral infections
• fungal infections
• hypersensitivity to the drug Medrol.

Side effects

From the side of metabolism:  sodium retention, chronic heart failure in patients with a corresponding predisposition, increased blood pressure, fluid retention in the body, loss of potassium and hypokalemic alkalosis, negative nitrogen balance due to protein catabolism.

Musculoskeletal disorders:  steroid myopathy, muscle weakness, osteoporosis, pathological fractures, compression fractures of the vertebrae, aseptic necrosis of the epiphysis of tubular bones, tendon ruptures, especially the Achilles tendon.

From the digestive system:  peptic ulcer with possible perforation and bleeding, gastric bleeding, pancreatitis, esophagitis, intestinal perforation. After treatment with corticosteroids, there was an increase in the activity of ALT, ACT and ALP in the blood serum. These changes are usually minor, not associated with any clinical syndromes, and are reversible after discontinuation of treatment.

Dermatological reactions:  slow healing of wounds, petechiae and ecchymosis, thinning and reduced skin strength.

Nervous system disorders:  increased intracranial pressure, pseudotumor of the brain, mental disorders, convulsions.

From the endocrine system:  menstrual disorders, hirsutism, development of Cushing’s syndrome, suppression of the pituitary-adrenal system, decreased tolerance to carbohydrates, manifestation of latent diabetes mellitus, increased need for insulin or oral hypoglycemic agents in diabetic patients, growth retardation in children.

From the side of the visual organ:  posterior subcapsular cataract, increased intraocular pressure with a risk of damage to the optic nerve, exophthalmos.

Allergic reactions:  hypersensitivity reactions, including allergic systemic reactions, possible suppression of reactions during skin tests.

Other services:  erased clinical picture in infectious diseases, activation of latent infections, occurrence of infections caused by opportunistic pathogens, corticosteroid withdrawal syndrome.

Interaction

Increases the toxicity of cardiac glycosides (due to the resulting hypokalemia, the risk of arrhythmias increases). Accelerates the elimination of ASA, reduces its concentration in the blood (when methylprednisolone is discontinued, the concentration of salicylates in the blood increases and the risk of side effects increases).

When used concomitantly with live antiviral vaccines and against the background of other types of immunizations, it increases the risk of virus activation and the development of infections. Increases the metabolism of isoniazid, mexiletine (especially in “fast” acetylators), which leads to a decrease in their plasma concentrations. Increases the risk of hepatotoxic reactions of paracetamol (induction of “liver” enzymes and formation of a toxic metabolite of paracetamol).

Increases (with long-term therapy) the content of folic acid. Hypokalemia caused by corticosteroids may increase the severity and duration of muscle block with muscle relaxants.

In high doses, it reduces the effect of somatropin. Antacids reduce the absorption of corticosteroids. Reduces the effect of hypoglycemic drugs; enhances the anticoagulant effect of coumarin derivatives. Weakens the effect of vitamin D on the absorption of Ca2+ in the intestinal lumen.

Ergocalciferol and parathyroid hormone prevent the development of osteopathy caused by corticosteroids. Reduces the concentration of praziquantel in the blood. Ketoconazole reduces clearance and increases the toxicity of methylprednisolone. Combined use with cyclosporine causes mutual inhibition of metabolism – the risk of side effects of both drugs (when used together, cases of seizures have been noted).

Thiazide diuretics, carbonic anhydrase inhibitors, other corticosteroids and amphotericin B increase the risk of hypokalemia, Na+-containing drugs-edema and increased blood pressure. NSAIDs and ethanol increase the risk of ulceration of the gastrointestinal mucosa and bleeding, in combination with NSAIDs for the treatment of arthritis, it is possible to reduce the dose of corticosteroids due to the summation of the therapeutic effect. Indometacin, by displacing methylprednisolone from the albumin bond, increases the risk of side effects.

Amphotericin B and carbonic anhydrase inhibitors increase the risk of osteoporosis. The therapeutic effect of corticosteroids decreases under the influence of phenytoin, barbiturates, ephedrine, theophylline, rifampicin, etc. inducers of” hepatic ” microsomal enzymes (increased metabolic rate). Mitotan and other inhibitors of the adrenal cortex function may cause the need to increase the dose of corticosteroids. The clearance of corticosteroids increases against the background of thyroid hormones.

Immunosuppressants increase the risk of developing infections and lymphoma or other lymphoproliferative disorders associated with the Epstein-Barr virus. Estrogens (including oral estrogen-containing contraceptives) reduce the clearance of corticosteroids, prolong T1 / 2 and their therapeutic and toxic effects. The appearance of hirsutism and acne is promoted by the simultaneous use of other steroid hormonal drugs-androgens, estrogens, anabolics, oral contraceptives.

Tricyclic antidepressants may increase the severity of depression caused by corticosteroids (not indicated for the treatment of these side effects). The risk of developing cataracts increases when used against the background of other corticosteroids, antipsychotic drugs (neuroleptics), carbutamide and azathioprine.

Concomitant use with m-holinoblokatorami (including antihistamines, tricyclic antidepressants), nitrates contributes to the development of increased intraocular pressure.

How to take it, course of use and dosage

Inside. The dose may vary and should be selected individually, depending on the nature of the disease and the patient’s response to therapy. The initial dose is from 4 to 48 mg / day, depending on the nature of the disease. For less severe diseases, lower doses are usually sufficient, although some patients may require higher doses.

High doses may be required for diseases and conditions such as multiple sclerosis (200 mg / day), brain edema (200-1000 mg/day), and organ transplantation (up to 7 mg/kg/day). If a satisfactory clinical effect is not obtained after a sufficient period of time, the drug should be discontinued and another type of therapy should be prescribed to the patient.

For children, the dose is determined by the doctor, taking into account the mass or surface of the body. With adrenal insufficiency — 0.18 mg / kg or 3.33 mg / m%^%2/day in 3 doses, with other indications-0.42-1.67 mg / kg or 12.5-50 mg / m%^%2/day in 3 doses.

Discontinuation of the drug after prolonged therapy is recommended to be carried out gradually. If a good effect is obtained during treatment, the patient should be selected for an individual maintenance dose by gradually reducing the initial dose at certain intervals until the lowest dose is found that allows maintaining the achieved clinical effect. It should be remembered that constant monitoring of the dosage regimen of the drug is necessary.

There may be situations in which dose adjustment is required, such as changes in the clinical condition due to the onset of remission or exacerbation of the disease, the individual response of the patient to the drug, as well as the impact on the patient of stressful situations that are not directly related to the main disease being treated; in the latter case, it may be necessary to increase the dose of the drug for a certain period of time, depending on the patient’s condition.

Alternative therapy.

Alternative therapy is a dosage regimen in which twice the daily dose of glucocorticosteroids is administered every other day in the morning. The goal of such therapy is to achieve the maximum clinical effect in a patient taking the drug for a long time, while minimizing some undesirable effects, such as suppression of the pituitary-adrenal system, glucocorticoid withdrawal syndrome and growth retardation in children.

Overdose

The clinical syndrome of acute drug overdose is not described. Reports of acute toxicity from an overdose of corticosteroids are extremely rare.

Symptoms: frequent repeated use (daily or several times a week) for a long time can lead to the development of Cushing’s syndrome and other complications characteristic of long-term corticosteroid therapy.

Treatment: conducting symptomatic therapy. Methylprednisolone is eliminated on dialysis. There is no specific antidote.

Special instructions

Before starting treatment, the patient should be examined for possible contraindications. Clinical examination should include a study of the cardiovascular system, X-ray examination of the lungs, examination of the stomach and duodenum 12; urinary system, visual organs.

Before and during steroid therapy, it is necessary to monitor a general blood test, the concentration of glucose in the blood and urine, and electrolytes in the plasma. In case of intercurrent infections, septic conditions and tuberculosis, simultaneous antibiotic therapy is necessary. Do not immunize during treatment.

With sudden withdrawal, especially in the case of previous use of high doses, there is a syndrome of “withdrawal” of corticosteroids: decreased appetite, nausea, lethargy, generalized musculoskeletal pain, asthenia. After withdrawal, relative insufficiency of the adrenal cortex persists for several months.

If stressful situations occur during this period, they are prescribed (according to indications) for the duration of corticosteroids, if necessary-in combination with MCS. Children who have been in contact with measles or chickenpox patients during treatment are given specific Igs as a preventive measure. To reduce side effects, the use of anabolic steroids and an increase in the intake of K+ from food is justified.

In Addison’s disease, simultaneous use of barbiturates should be avoided – the risk of developing acute adrenal insufficiency (Addison’s crisis). Use during pregnancy in the first trimester and during lactation: prescribed taking into account the expected therapeutic effect and negative impact on the fetus and child.

With long – term therapy during pregnancy-impaired fetal growth. In the third trimester of pregnancy, there is a risk of atrophy of the adrenal cortex in the fetus, which may require replacement therapy in the newborn.

In children during the growth period, corticosteroids should be used only for absolute indications and under the careful supervision of the attending physician.

Form of production

Tablets

Storage conditions

At a temperature of 20-25 °C

Shelf life

5 years

Active ingredient

Methylprednisolone

Conditions of release from pharmacies

By prescription

Dosage form

Tablets

Purpose

For adults as directed by your doctor

Indications

Osteoarthritis, Psoriasis, Bursitis, Hepatitis, Neurodermatitis, Allergies, Bronchial Asthma, Rheumatoid Arthritis, Eczema, Crohn’s Disease, Dermatitis, Kidney Disease, Arthritis