Generic Name and Formulations:
Methylprednisolone acetate 20mg/mL, 40mg/mL, 80mg/mL; susp for IM, intraarticular, soft tissue, or intralesional inj; contains preservative (benzyl alcohol); single-dose vial 40mg/mL, 80mg/mL; preservative-free.
Indications for DEPO-MEDROL:
Steroid-responsive disorders when oral therapy not feasible. Local inflammation.
See full labeling. Individualize. Locally: 4–80mg. Systemically: 40–120mg IM/week for 1–4 weeks.
See full labeling. Individualize. Initially 0.11–1.6mg/kg/day.
Systemic fungal infections. Live vaccines. Depo-Medrol, Solu-Medrol: also premature infants (benzyl alcohol content), intrathecal administration, idiopathic thrombocytopenic purpura (IM preparations). Allergy to cow's milk or other dairy products (Solu-Medrol 40mg).
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. Systemic sclerosis. Recent MI. CHF. Hypertension. Renal insufficiency. Osteoporosis. Diabetes. Hypothyroidism. Kaposi's sarcoma. Supplement with additional steroids in physiologic stress. 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. Monitor weight, growth, fluid and electrolyte balance. IV: drug-induced liver injury; discontinue if toxic hepatitis occurs. Intrasynovial: avoid previously infected or unstable joints. Solu-Medrol 40mg: consider allergy to cow's milk if new or worsening allergic symptoms occur; use alternatives. Avoid abrupt cessation. Use lowest effective dose. 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
- Testosterone Use Remains High Among Men With Coronary Artery Disease
- Primary Characteristics of PCOS Predictive of Obstetric Complications
- Comparing Osteoporosis Screening, Treatment Strategies in Postmenopausal Women
- Maternal Thyroid Function in Pregnancy Linked to Childhood Risk for Disease
- Cerebral Small Vessel Disease More Common in Individuals With T1D vs General Population
- ADA's 2019 Standards of Medical Care in Diabetes Focus on Patient-Centered Care
- Sleep Habits Affect Insulin Sensitivity in Adolescents With Overweight, Obesity
- Levothyroxine Associated With Increased Mortality in Patients With Heart Failure
- Head-to-Head Comparison of Professional vs Personal CGM Systems in T1D
- Dual vs Triple Therapy for Metformin Treatment Intensification in Type 2 Diabetes
- Risk for Congenital Heart Defects in Offspring of Mothers With Obesity
- Is the MiniMed 670G System Safe for Children With Type 1 Diabetes?
- Gender-Affirming Hormonal Treatment and Long-Term Bone Safety
- Obesity Linked to Lower Gray Matter Brain Volume
- No Evidence for Health Benefits of Nonsugar Sweeteners