Methylprednisolone Acetate
Corticosteroid, Systemic · Corticosteroid
Indications
Corticosteroid responsive conditions such as hay fever, asthma, rheumatoid arthritis, osteoarthrosis, collagen diseases, dermatoses.
Dosage
Adults: Only sodium succinate may be given IV; methylprednisolone sodium succinate is highly soluble and has a rapid effect by IM and IV routes. Methylprednisolone acetate has a low solubility and has a sustained IM effect. Anti-inflammatory or immunosuppressive: IM: 10-80 mg every 1-2 wk. Arthritis: Intra-articular: Administer every 1-5 wk. Large joints (e.g. knee, ankle): 20-80 mg; Medium joints (e.g. elbow, wrist): 10-40 mg; Small joints: 4-10 mg. Dermatitis: Acute severe: IM: 80-120 mg as a single dose. Chronic: IM: 40-120 mg every 5-10 days. Dermatologic conditions (e.g. keloids, lichen planus): Intralesional: 20-60 mg.
Administration
Do not use intrathecally. Intra-articular: A sterile 20- to 24-gauge needle (on a dry syringe) is quickly inserted into the synovial cavity. Procaine infiltration is elective. The aspiration of only a few drops of joint fluid proves the joint space has been entered by the needle. The inj site for each joint is determined by that location where the synovial cavity is most superficial & most free of large vessels & nerves. With the needle in place, the aspirating syringe is removed and replaced by a second syringe containing the desired amount of methylprednisolone. The plunger is then pulled outward slightly to aspirate synovial fluid and to make sure the needle is still in the synovial space after inj, the joint is moved gentle a few times to aid mixing of the synovial fluid and the suspension. The site is covered with a small dressing. Intralesional: Make multiple small injections into…
Adverse Effects
Endocrine irregularities including menstrual problems, Cushingoid state, adrenal suppression, growth suppression in children. Increased susceptibility to infection, increased severity of infection. Fluid/electrolyte disturbance, hypertension, negative protein, nitrogen and calcium balance. Myopathy, tendon rupture, osteoporosis, osteonecrosis and fractures. Impaired wound healing, sweating, hirsutism, striae, telangiectasia, acne. GI disturbance, peptic ulceration, acute pancreatitis, candidiasis. Psychiatric effects, neurological effects, insomnia. Diabetes, impaired glucose tolerance, weight gain, increased appetite. Ocular disturbances including cataracts, raised intraocular pressure, optic nerve damage, corneal changes, glaucoma. Thromboembolism, leukocytosis.
Risk Factor (Pregnancy/Lactation)
Pregnancy: Risk cannot be ruled out. Lactation: Caution advised or effect undetermined. Contraindications: Systemic fungal infections unless specific anti-infective therapy is used. Head injury, stroke. Precautions: Active infections not controlled by antibiotics. Latent or active amoebiasis. History of TB, septicaemia, symptoms may be masked. Avoid or maintain extreme cautions in chickenpox, measles, psychiatric disorders, renal impairment, hepatic failure, cirrhosis, active peptic ulcer, Myasthaenia gravis, previous steroid myopathy, osteoporosis, epilepsy, hypothyroidism, diabetes, adrenal suppression, hypertension, recent MI, congestive heart failure, thromboembolic disorders, glaucoma, corneal perforation. WITHDRAWAL: Withdraw gradually. Withdrawal symptoms may include fever, myalgia, arthralgia, rhinitis, itchy skin nodules and weight loss.
Interactions
Live vaccines or other vaccines, anticoagulants, hypoglycaemia agents, antihypertensives, diuretics, erythromycin, rifamycin, amphotericin, azole antifungals, ritonavir, cyclosporin, cardiac glycosides. Oestrogens including oral contraceptives, somatropin. Carbamazepine, phenytoin, primidone, barbiturates. Muscle relaxants, NSAIDs, salicylates, sympathomimetics, mifepristone, methotrexate, theophylline, aprepitant.
Advice to Patient
Take oral form with meals or milk. Do not stop taking medication abruptly, gradually lower down the dose then stop. If a dose is missed, take it as soon as you remember, unless it is time for the next dose. Do not double the dose. Contact prescriber if there is increased swelling/redness/pain in area under treatment, rapid or sudden weight gain, muscle weakness or pain, joint pain, difficulty in breathing, swelling of ankles/hands/feet, signs of hyperglycemia, menstrual irregularity, vision changes, chill, fever, dizziness, mouth sores, vaginal discharge, perianal itching, dark or black coloured stool or if there is worsening of condition or no improvement. Take diet rich in pyridoxine, vitamin C, vitamin D, folate, calcium, phosphorus and protein. Consult prescriber for dietary instructions. To maintain muscle mass, exercise regularly. Avoid alcohol during therapy. Avoid highly crowded…
Pharmacokinetics
Onset of action: Intra-articular (IV): 1 wk. Duration: Intra-articular (IV): 1-5 wks. Absorption: Oral: Well absorbed. Bioavailability: Oral: 88% ± 23%. Metabolism: Hepatic. Half-life elimination: Adolescents: IV: 1.9 ± 0.7 hrs (age range: 12-20 yrs). Adults: Oral: 2.5 ± 1.2 hrs. Time to peak, plasma: Oral: 2.1 ± 0.7 hrs. Excretion: Urine.
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
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