methylprednisolone | Medrol tablets 32 mg 20 pcs.

release form

tablets

Packaging

20 pcs.

Indications

Endocrine diseases: primary and secondary adrenal insufficiency (drugs of the choice of hydrocortisone or cortisone, if necessary, synthetic analogues can be used in combination with mineralocorticoids, mineralocorticoids are of particular importance in pediatric practice)

congenital adrenal hyperplasia

chronic and subacute thyroiditis srdlcer necrosis.

Diseases of the musculoskeletal system (including rheumatic) (as an additional treatment for short-term withdrawal from an acute condition or during exacerbation): psoriatic arthritis

rheumatoid arthritis, including juvenile rheumatoid arthritis (in some cases, low-dose maintenance therapy may be required)

ankylosing spondylitis

acute and subacute bursitis

acute nonspecific tendosynitis

acute gouty arthritis

post-traumatic osteoarthritis osteoarthritis osteoarthritis osteoarthritis epithelitis.

Systemic connective tissue diseases (during an exacerbation or in some cases as maintenance therapy): acute rheumatic heart disease

systemic lupus erythematosus

systemic dermatomyositis (polymyositis)

rheumatic polymyalgia

giant cell arteritis.

Skin diseases: pemphigus

herpetiform bullous dermatitis

severe erythema multiforme (Stevens-Johnson syndrome)

exfoliative dermatitis

fungal mycosis

severe psoriasis

severe seborrheic dermatitis.

Allergic reactions (severe or disabling conditions in which conventional therapy is ineffective): seasonal or perennial allergic rhinitis

serum sickness

bronchial asthma

contact dermatitis

atopic dermatitis

drug hypersensitivity reactions.

Eye diseases (severe acute and chronic allergic and inflammatory processes with eye damage): allergic marginal ulcers of the cornea

inflammation of the anterior segment of the eye

diffuse posterior uveitis and choroiditis

sympathetic ophthalmia

allergic conjunctivitis

keratitis

chorioretinitis

neuritis of the optic nerve and nerve spondylitis.

Respiratory diseases: symptomatic sarcoidosis

Leffler's syndrome, not amenable to other therapy

berylliosis

fulminant or disseminated pulmonary tuberculosis in combination with appropriate anti-tuberculosis chemotherapy

aspiration pneumonitis.

Hematologic diseases: idiopathic thrombocytopenic purpura in adults

secondary thrombocytopenia in adults

acquired (autoimmune) hemolytic anemia

erythroblastopenia (erythrocyte anemia)

congenital (erythroid) hypoplastic anemia.

Oncological diseases (as palliative therapy): leukemia and lymphoma in adults

acute leukemia in children.

Edematous syndrome: to stimulate diuresis and achieve remission of proteinuria in patients with nephrotic syndrome without uremia, idiopathic type, or caused by systemic lupus erythematosus.

Gastrointestinal diseases (for removing a patient from a critical condition): ulcerative colitis

regional enteritis.

Nervous system diseases: exacerbations of multiple sclerosis

cerebral edema caused by a brain tumor.

Other indications for use: tuberculous meningitis with subarachnoid block or block threat (in combination with appropriate anti-tuberculosis chemotherapy)

trichinosis with damage to the nervous system or myocardium

organ transplantation.

Use during pregnancy and lactation

Use of Medrol during pregnancy is possible if the expected effect of therapy exceeds the potential risk to the fetus (adequate and strictly controlled studies of the safety of use have not been conducted). Women of childbearing age should be warned of the potential risk to the fetus (corticosteroids pass through the placenta). Nursing women are advised to stop either breastfeeding or the use of drugs, especially in high doses (corticosteroids pass into breast milk and can inhibit the production of endogenous corticosteroids, inhibit growth and cause unwanted effects in the offspring).

Composition

1 tablet contains:

Active ingredient: methylprednisolone 32 mg

Excipients: calcium stearate starch corn sucrose lactose.

Dosage and Administration

Inside. The dose can 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. In 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), cerebral edema (200-1000 mg / day) and organ transplantation (up to 7 mg / kg / day). If after a sufficient period of time a satisfactory clinical effect is not obtained, the drug should be discontinued and a different type of therapy should be prescribed to the patient.

For children, the dose is determined by the doctor based on weight or body surface. With adrenal insufficiency - 0.18 mg / kg or 3.33 mg / m2 / day in 3 doses, with other indications - 0.42–1.67 mg / kg or 12.5–50 mg / m2 / day 3 tricks.

Discontinuation of the drug after prolonged therapy is recommended to be carried out gradually. If a good effect is obtained during treatment, an individual maintenance dose should be selected for the patient by gradually reducing the initial dose at regular intervals until the lowest dose is found to maintain 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, for example, changes in the clinical condition due to the onset of remission or exacerbation of the disease, the patient’s individual reaction to the drug, as well as the effect on the patient of stressful situations not directly related to the underlying disease that the therapy is aimed at in the latter case, it may be necessary to increase the dose of the drug for a certain period of time depending on the condition of the patient.

Alternating therapy.

Alternating therapy is a dosing regimen in which a doubled daily dose of glucocorticosteroids is administered every other day in the morning. The aim 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, glucocorticosteroid withdrawal syndrome and growth retardation in children.

Side effects of

Metabolism: sodium retention, chronic heart failure in patients with an appropriate predisposition, increased blood pressure, fluid retention, loss of potassium and hypokalemic alkalosis, negative nitrogen balance due to protein catabolism.

From the musculoskeletal system: steroid myopathy, muscle weakness, osteoporosis, pathological fractures, compression fractures of the vertebrae, aseptic necrosis of the epiphyses of the tubular bones, tendon ruptures, especially the Achilles tendon.

From the digestive system: peptic ulcer with possible perforation and bleeding, gastric bleeding, pancreatitis, esophagitis, perforation of the intestine. After treatment with corticosteroids, an increase in serum ALT, ACT, and alkaline phosphatase activity was observed. Typically, these changes are insignificant, not associated with any clinical syndromes, and are reversible after discontinuation of treatment.

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

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

From the endocrine system: menstrual irregularities, hirsutism, the development of Cushing's syndrome, suppression of the pituitary-adrenal system, a decrease in carbohydrate tolerance, the manifestation of latent diabetes mellitus, an increase in the need for insulin or oral hypoglycemic agents in patients with diabetes mellitus, growth retardation in children.

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

Allergic reactions: hypersensitivity reactions, including allergic systemic reactions, it is possible to suppress reactions during skin tests.

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

overdose

The clinical syndrome of acute drug overdose has not been described. Acute toxicity reports of ACS overdose are extremely rare.

Symptoms: Repeated intake (daily or several times a week) for a long time may lead to the development of Cushing's syndrome and other complications characteristic of long-term ACS therapy.

Treatment: carrying out symptomatic therapy. Methylprednisolone is excreted in dialysis. There is no specific antidote.

Storage conditions

In the dark place at a temperature of no higher than 20 РC.

Expiration

5 years.

Deystvuyuschee substances

methylprednisolone

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