Generic Name and Formulations:
Methylprednisolone 2mg, 4mg, 8mg, 16mg, 32mg; scored tabs.
Indications for MEDROL:
Adults and Children:
See full labeling. Individualize. 4–48mg daily.
Systemic fungal infections. Live vaccines. Depo-Medrol, Solu-Medrol: also premature infants (benzyl alcohol content), intrathecal administration, idiopathic thrombocytopenic purpura (IM preparations).
Not for epidural use; serious neurologic events may occur. Cerebral malaria, optic neuritis: not recommended. Latent or active amebiasis. Strongyloides infestation. Ocular herpes simplex. Cirrhosis. Tuberculosis. If exposed to chickenpox or measles, consider prophylactic passive immune therapy. Ulcerative colitis if perforation pending. Peptic ulcer. Diverticulitis. Intestinal anastomoses. Myasthenia gravis. Recent MI. CHF. Hypertension. Renal insufficiency. Osteoporosis. Diabetes. Hypothyroidism. Kaposi's sarcoma. Supplement with additional steroids in physiologic stress. Avoid abrupt cessation. May increase risk and mask signs of infection. May cause electrolyte imbalances, adrenocortical insufficiency, psychotic derangements. Alternate, intermittent, or single-daily doses at 8 AM minimize adrenal suppression. Use lowest effective dose. Monitor weight, growth, fluid and electrolyte balance. IV: drug-induced liver injury; discontinue if toxic hepatitis occurs. Intrasynovial: avoid previously infected or unstable joints. Pregnancy (Cat.C). Nursing mothers: not recommended.
Potentiated by CYP3A4 inhibitors (eg, ketoconazole, macrolides), cyclosporine, estrogens. Antagonized by CYP3A4 inducers (eg, barbiturates, phenytoin, carbamazepine, rifampin), cholestyramine. May potentiate cyclosporine (seizure risk). May antagonize oral anticoagulants (monitor), isoniazid. Increased risk of arrhythmias with digitalis. May need to adjust dose of antidiabetic agents. Monitor for hypokalemia with potassium-depleting drugs (eg, amphotericin B, diuretics). Concomitant neuromuscular blocking agents; increased risk of myopathy. Withdraw anticholinesterase agents at least 24hrs before initiating corticosteroid therapy. Aminoglutethimide may lead to loss of corticosteroid-induced adrenal suppression. Increased GI effects with aspirin, other NSAIDs. Caution with aspirin in hypoprothrombinemia. May suppress reactions to skin tests.
HPA axis suppression, increased susceptibility to infection, glaucoma, cataracts, secondary infections, hypokalemia, hypocalcemia, hypernatremia, hypertension, CHF, psychic disorders, myopathy, osteoporosis, peptic ulcer, dermal atrophy, increased intracranial pressure, carbohydrate intolerance. Parenteral: atrophy, flare at site; intrasynovial: septic arthritis.
Tabs, dosepak (YES); Depo-medrol: 20mg/mL (NO); 40mg/mL, 80mg/mL (YES); Solu-medrol: 40mg, 125mg, 500mg, 1g (YES); 2g (NO)
Tabs 2mg—100; 4mg—100, 500; 8mg, 32mg—25; 16mg—50; Dosepak—21; Depo-Medrol multi-dose vial (20mg/mL)—1; (40mg/mL, 80mg/mL)—1, 25; Single-dose vial (40mg/mL, 80mg/mL)—1; Solu-Medrol single-dose vial (500mg, 1g)—1; (40mg, 125mg)—25; Multi-dose vial (500mg, 1g)—1; Vial with diluent (2g)—1
Endocrinology Advisor Articles
- Triple-Goal Achievement Reduces Risk for Complications in Type 2 Diabetes
- Inverse Association Between Serum 25(OH)D Levels and Risk for Diabetes
- ADA Issues White Paper Addressing Escalating Cost of Insulin
- Neprilysin Inhibition May Reduce Renal Function Deterioration in Comorbid T2D and Chronic Heart Failure
- Serum Chemerin May Predict Risk for Spontaneous Abortion in Women With PCOS
- Diabetes Treatments
- Incretins, Thiazolidinediones Associated With Better Glycemic Control in T2D
- No Link Between HbA1c Levels and Wound Healing in Patients With Diabetic Foot Ulcers
- Risk for Fetal Loss Early in Pregnancy Not Greater With Noninsulin vs Insulin Therapy
- Use of In-Hospital Continuous Subcutaneous Insulin Infusion: A Consensus Statement
- Effects of Gender on Clinical Outcomes in Empagliflozin-Treated Type 2 Diabetes
- Increased Risk for Type 2 Diabetes in Adolescents, Young Adults With ADHD
- Ideal Systolic Blood Pressure for CVD Prevention in Diabetes, Hypertension
- Smoking Associated With Lower Serum Thyroid-Stimulating Hormone Levels
- Inverse Link for Plasma 25(OH)D Concentration, Risk of T2D