Depo Medrol
SIDE EFFECTS
| Fluid and electrolyte disturbances | |
| Sodium retention | Potassium loss |
| Fluid retention | Hypokalemic alkalosis |
| Congestive heart failure in susceptible patients | Hypertension |
| Musculoskeletal | |
| Muscle weakness | Vertebral compression fractures |
| Steroid myopathy | Aseptic necrosis of femoral and |
| Loss of muscle mass | humeral heads |
| Osteoporosis | Pathologic fracture of long bones |
| Tendon rupture, particularly of the Achilles tendon | |
| Gastrointestinal | |
| Peptic ulcer with possible subsequent perforation and hemorrhage | Increases in alanine transaminase (ALT, SGPT), aspartate transaminase (AST, SGOT), and alkaline phosphatase have been observed following corticosteroid treatment. These changes are usually small, not associated with any clinical syndrome and are reversible upon discontinuation. |
| Pancreatitis | |
| Abdominal distention | |
| Ulcerative esophagitis | |
| Dermatologic | |
| Impaired wound healing | Facial erythema |
| Thin fragile skin | Increased sweating |
| Petechiae and ecchymoses | May suppress reactions to skin tests |
| Neurological | |
| Convulsions | Vertigo |
| Increased intracranial pressure with papilledema (pseudotumor cerebri) usually after treatment | Headache |
| Endocrine | |
| Menstrual irregularities | Decreased carbohydrate tolerance |
| Development of Cushingoid state | Manifestations of latent diabetes mellitus |
| Suppression of growth in children | Increased requirements for insulin or oral hypoglycemic agents in diabetes |
| Secondary adrenocortical and pituitary unresponsiveness, particularly in times of stress, as in trauma, surgery or illness | |
| Ophthalmic | |
| Posterior subcapsular cataracts | Glaucoma |
| Increased intraocular pressure | Exophthalmos |
| Metabolic | |
| Negative nitrogen balance due to protein catabolism | |
| The following additional adverse reactions are related to parenteral corticosteroid therapy: | |
| Anaphylactic reaction | Injection site infections following non-sterile administration |
| Allergic or hypersensitivity reactions | |
| Urticaria | (see WARNINGS) |
| Hyperpigmentation or hypopigmentation | Postinjection flare, following intrasynovial use |
| Subcutaneous and cutaneous atrophy | |
| Sterile abscess | Charcot-like arthropathy |
| Adverse Reactions Reported with the Following Routes of Administration | |
| Intrathecal/Epidural | |
| Arachnoiditis | Bowel/bladder dysfunction |
| Meningitis | Headache |
| Paraparesis/paraplegia | Seizures |
| Sensory disturbances | |
| Intranasal | |
| Temporary/permanent visual impairment including blindness | Allergic reactions |
| Rhinitis | |
| Ophthalmic | |
| Temporary/permanent visual impairment including blindness | Infection |
| Residue or slough at injection site | |
| Increased intraocular pressure | |
| Ocular and periocular inflammation including allergic reactions | |
Miscellaneous injection sites (scalp, tonsillar fauces, sphenopalatine ganglion)-blindness
DRUG INTERACTIONS
The pharmacokinetic interactions listed below are potentially clinically important. Mutual inhibition of metabolism occurs with concurrent use of cyclosporin and methylprednisolone; therefore, it is possible that adverse events associated with the individual use of either drug may be more apt to occur. Convulsions have been reported with concurrent use of methylprednisolone and cyclosporin. Drugs that induce hepatic enzymes such as phenobarbital, phenytoin and rifampin may increase the clearance of methylprednisolone and may require increases in methylprednisolone dose to achieve the desired response. Drugs such as troleandomycin and ketoconazole may inhibit the metabolism of methylprednisolone and thus decrease its clearance. Therefore, the dose of methylprednisolone should be titrated to avoid steroid toxicity.
Methylprednisolone may increase the clearance of chronic high dose aspirin. This could lead to decreased salicylate serum levels or increase the risk of salicylate toxicity when methylprednisolone is withdrawn. Aspirin should be used cautiously in conjunction with corticosteroids in patients suffering from hypoprothrombinemia.
The effect of methylprednisolone on oral anticoagulants is variable. There are reports of enhanced as well as diminished effects of anticoagulant when given concurrently with corticosteroids. Therefore, coagulation indices should be monitored to maintain the desired anticoagulant effect.
Generic Name: Methylprednisolone
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