Methylprednisolone Sodium Succinate
Corticosteroid, Systemic · Corticosteroid
Indications
Sensitivity reactions. Transplantation. Cerebral oedema, secondary to tumour. Ulcerative colitis, Crohn's disease, Aspiration of gastric contents, Stevens-Johnson syndrome.
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/day once daily. IV: 10-40 mg over a period of several minutes and repeated IV or IM at intervals depending on clinical response; when high dosages are needed, give 30 mg/kg over a period of 30 minutes or more and may be repeated every 4-6 hr for 48 hr. Asthma exacerbations, including status asthmaticus (emergency medical care or hospital doses): IV: 40-80 mg/day in 1- 2 divided doses until peak expiratory flow is 70% of predicted or personal best. Dermatomyositis/polymyositis: IV: 1 gm/day for 3-5 days for severe muscle weakness, followed by conversion to oral prednisone. Lupus nephritis: High-dose \"pulse\"…
Administration
Methylprednisolone sodium succinate may be administered IM or IV. Inject IM form deep into gluteal muscle. Compatibility: Stable in D5W, NS. Incompatible with D5 1/2NS. Y-site administration: Drug to Drug IV Compatibility: Acyclovir, amikacin, amiodarone, aztreonam, bumetanide, cephazolin, cefepime, ceftriaxone, cimetidine, dexamethasone, dobutamine, dopamine, enalapril, epinephrine, famotidine, fentanyl, fluconazole, furosemide, gentamicin, heparin, hydromorphone, imipenem, insulin regular, labetalol, levofloxacin, linezolid, lorazepam, metoclopramide, metronidazole, midazolam, milrinone, morphine, nitroglycerin, nitroprusside, norepinephrine, phenylephrine, piperacillin/tazobactam, ranitidine, tobramycin, vancomycin, vasopressin. Drug to Drug IV Incompatibility: Allopurinol, amsacrine, calcium gluconate, ciprofloxacin, cisatracurium, diltiazem, diphenhydramine, docetaxel, etoposide…
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. Consult prescriber if you feel more stressed out than normal because dosage may need to be adjusted. Take diet rich in pyridoxine, vitamin C, vitamin D, folate, calcium, phosphorus and protein. Consult prescriber for dietary…
Pharmacokinetics
Onset of action: IV: Within 1 hr. 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. IV: 0.25 ± 0.1 hr. Time to peak, plasma: Oral: 2.1 ± 0.7 hrs. IV: 0.8 hrs. Excretion: Urine.
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
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