عندما يكون العلاج عن طريق الفم غير ممكن، A-Methapred (سكسينات ميثيل الصوديوم) مسحوق معقم للاستخدام عن طريق الحقن العضلي أوالوريدي في
اضطرابات الغدد الصماء
قصور قشرة الكظر الابتدائية أو الثانوية (الهيدروكورتيزون أو الكورتيزون هو الدواء المفضل، ويمكن استخدام النظير الاصطناعية بالتعاون مع mineralocorticoids عند الاقتضاء، في مرحلة الرضاعة، والتغذية التكميلية المعدنية ذات أهمية خاصة)
قصور قشرة الكظر الحاد (الهيدروكورتيزون أو الكورتيزون هو الدواء المفضل؛ مكملات المعدنية قد يكون من الضروري، لا سيما عندما تستخدم النظير الاصطناعية)
وقبل الجراحة في حال صدمة أو مرض خطير، في المرضى الذين يعانون من قصور الغدة الكظرية معروفة أو عندما الاحتياطي قشرة الكظر أمر مشكوك فيه
صدمة لا تستجيب للعلاج التقليدي إذا قصور قشرة الكظر وجود أو يشتبه في و
فرط تنسج الكظر الخلقي
فرط كلس الدم المرتبطة بسرطان
اللاقيحي الدرقية
اضطرابات الروماتيزمية
كعلاج مساعد على المدى القصير ادارة (للتغلب على المريض خلال حلقة الحادة أو تفاقم) في:
ما بعد الصدمة هشاشة العظام
الزليل من هشاشة العظام
التهاب المفاصل الروماتويدي، بما في ذلك التهاب المفاصل الرثواني الشبابي (حالات مختارة قد تتطلب جرعة منخفضة من العلاج الصيانة)
الحادة وتحت الحادة التهاب كيسي
التهاب اللقيمة
غير محدد التهاب غمد الوتر الحاد
التهاب المفاصل النقرسي الحاد
التهاب المفاصل الصدفي
التهاب الفقار المقسط
الأمراض الكولاجينية
خلال تفاقم أو كعلاج وقائي في حالات مختارة من:
الذئبة الحمامية الجهازية
التهاب الجلد والعضلات النظامية (التهاب العضلات)
التهاب القلب الروماتزمي الحاد
أمراض جلدية
الفقاع داء مرضي
حاد حمامي متعددة forme (متلازمة ستيفنز جونسون)
التهاب الجلد التقشري
التهاب الجلد الحلئي الشكل الفقاعي
التهاب الجلد الزهمي حاد
الصدفية الحادة
الفطار الفطراني
حالات الحساسية
التحكم في ظروف شديدة الحساسية أو المسببة للعجز مستعصية على الحل لمحاكمات كافية من العلاج التقليدي في:
ربو
أكزيما تماس
التهاب الجلد التأتبي
داء المصل
حساسية الأنف الموسمية أو الدائمة
تفاعلات فرط الحساسية للمخدرات
تفاعلات نقل الدم شروية
وذمة الحنجرة الحاد غير المعدية (ادرينالين هو الدواء الخيار الأول)
أمراض العيون
الحاد والمزمن العمليات التي تنطوي على حساسية والتهابات العين، مثل:
الحلأ النطاقي العيني
التهاب القزحية، الجسم الهدبي
التهاب المشيمية و الشبكية
التهاب العنبية الخلفي منتشر والتهاب المشيمية
التهاب العصب البصري
متعاطف الرمد
الجزء الأمامي للالتهاب
حساسية الملتحمة
حساسية تقرحات القرنية الهامشية
التهاب القرنية
أمراض الجهاز الهضمي
للتغلب على المريض خلال فترة حرجة من المرض في:
التهاب القولون التقرحي (العلاج المنهجي)
التهاب الأمعاء الناحي (العلاج المنهجي)
أمراض الجهاز التنفسي
أعراض ساركويد
التسمم بالبريليوم
الخاطف أو السل الرئوي نشرها عند استخدامها بشكل متزامن مع العلاج الكيميائي المناسبة المضادة للتدرن
لوفلر متلازمة لا يمكن السيطرة عليها من قبل وسائل أخرى
طموح التهاب رئوي
اضطرابات الدموية
المكتسب (الذاتية) فقر الدم الانحلالي
مجهول السبب نقص الصفيحات الأساسية في البالغين (الرابع فقط، هو بطلان IM الإدارة)
قلة الصفيحات الثانوية في البالغين
قلة أرومات الحمر (RBC فقر الدم)
الخلقية (محمر) فقر الدم الناجم عن نقص التنسج
أمراض الأورام
لالملطفة إدارة:
سرطانات الدم والأورام اللمفاوية لدى البالغين
سرطان الدم الحاد في مرحلة الطفولة
الولايات ذمي
للحث على إدرار البول أو مغفرة بروتينية في المتلازمة الكلوية، دون تبولن الدم، من نوع مجهول السبب أو ذاك بسبب الذئبة الحمامية
الجهاز العصبي
التفاقم الحاد من مرض التصلب المتعدد
متفرقات
التهاب السحايا السلي مع كتلة تحت العنكبوتية أو كتلة وشيكة عندما يستخدم بالتزامن مع العلاج الكيميائي المناسبة المضادة للتدرن
مرض دودة الخنزير بمشاركة عصبية أو عضلة القلب
DOSAGE AND ADMINISTRATION
When high dose therapy is desired, the recommended dose of A-Methapred (methylprednisolone sodium succinate) sterile powder is 30 mg/kg administered intravenously over at least 30 minutes. This dose may be repeated every 4 to 6 hours for 48 hours.
In general, high dose corticosteroid therapy should be continued only until the patient's condition has stabilized; usually not beyond 48 to 72 hours.
Although adverse effects associated with high dose short-term corticoid therapy are uncommon, peptic ulceration may occur. Prophylactic antacid therapy may be indicated.
In other indications initial dosage will vary from 10 to 40 mg of methylprednisolone depending on the clinical problem being treated. The larger doses may be required for short-term management of severe, acute conditions. The initial dose usually should be given intravenously over a period of several minutes. Subsequent doses may be given intravenously or intramuscularly at intervals dictated by the patient's response and clinical condition. Corticoid therapy is an adjunct to, and not replacement for conventional therapy.
Dosage may be reduced for infants and children but should be governed more by the severity of the condition and response of the patient than by age or size. It should not be less than 0.5 mg/kg every 24 hours.
Dosage must be decreased or discontinued gradually when the drug has been administered for more than a few days. If a period of spontaneous remission occurs in a chronic condition, treatment should be discontinued. Routine laboratory studies, such as urinalysis, two-hour postprandial blood sugar, determination of blood pressure and body weight, and a chest X-ray should be made at regular intervals during prolonged therapy. Upper GI X-rays are desirable in patients with an ulcerhistory or significant dyspepsia.
A-Methapred (methylprednisolone sodium succinate) may be administered by intravenous or intramuscular injection or by intravenous infusion, the preferred method for initial emergency use being intravenous injection. To administer by intravenous (or intramuscular) injection, prepare solution as directed. The desired dose may be administered intravenously over a period of several minutes.
To prepare solutions for intravenous infusion, first prepare the solution for injection as directed. This solution may then be added to indicated amounts of 5% dextrose in water, isotonic saline solution or 5% dextrose in isotonic saline solution.
Multiple Sclerosis
In treatment of acute exacerbations of multiple sclerosis, daily doses of 200 mg of prednisolone for a week followed by 80 mg every other day for 1 month have been shown to be effective (4 mg of methylprednisolone is equivalent to 5 mg of prednisolone).
Directions for Reconstitution
- Remove protective cap.
- Cleanse stopper with suitable germicide.
- Aseptically add 1 mL Bacteriostatic Water for Injection, USP (with benzyl alcohol) for the 40 mg vial or 2 mL Bacteriostatic Water for Injection, USP (with benzyl alcohol) for the 125 mg vial.
- Agitate to effect solution.
- Invert vial. Insert needle through target area of stopper until tip is just visible. Withdraw dose.
Storage Conditions
Protect from light.
Store unreconstituted product at 20 to 25°C (68 to 77°F). [See USP Controlled Room Temperature.]
Store solution at 20 to 25°C (68 to 77°F). [See USP Controlled Room Temperature.]
Use solution within 48 hours after mixing.
HOW SUPPLIED
A-Methapred (methylprednisolone sodium succinate) sterile powder is available in the following packages:
List
Container
Concentration
3217
Single-Dose Vial
40 mg/vial
3218
Single-Dose Vial
125 mg/vial
SIDE EFFECTS
Fluid and Electrolyte Disturbances
Sodium retention, Fluid retention, Congestive heart failure in susceptible patients,Potassium loss, Hypokalemic alkalosis, Hypertension
Musculoskeletal
Muscle weakness, Steroid myopathy, Loss of muscle mass, Severe arthralgia, Vertebral compression fractures, Aseptic necrosis of femoral and humeral heads,Pathologic fracture of long bones, Osteoporosis
Gastrointestinal
Peptic ulcer with possible perforation and hemorrhage, Pancreatitis, Abdominaldistention, and Ulcerative esophagitis
Dermatologic
Impaired wound healing, Thin fragile skin, Petechiae and ecchymoses, Facialerythema, Increased sweating, May suppress reactions to skin tests
Neurological
Increased intracranial pressure with papilledema (pseudo-tumor cerebri) usually after treatment, Convulsions, Vertigo, Headache
Endocrine
Development of Cushingoid state, Suppression of growth in children, Secondary adrenocortical and pituitary unresponsiveness, particularly in times of stress, as intrauma, surgery or illness, Menstrual irregularities, Decreased carbohydratetolerance, Manifestations of latent diabetes mellitus, Increased requirements forinsulin or oral hypoglycemic agents in diabetics
Ophthalmic
Posterior subcapsular cataracts, Increased intraocular pressure, Glaucoma,Exophthalmos
Metabolic
Negative nitrogen balance due to protein catabolism
The following additional adverse reactions are related to parenteral corticosteroidtherapy: Hyperpigmentation or hypopigmentation, Subcutaneous and cutaneousatrophy, Sterile abscess, Anaphylactic reaction with or without circulatory collapse,cardiac arrest, bronchospasm, Urticaria, Nausea and vomiting, Cardiac arrhythmias;hypotension or hypertension
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.
WARNINGS
While on corticosteroid therapy patients should not be vaccinated against smallpox. Other immunization procedures should not be undertaken in patients who are on corticosteroids, especially on high dose, because of possible hazards of neurological complications and a lack of antibody response.
In patients on corticosteroid therapy subjected to any unusual stress, increased dosage of rapidly acting corticosteroids before, during, and after the stressful situation is indicated.
Corticosteroids may mask some signs of infection, and new infections may appear during their use. There may be decreased resistance and inability to localize infection when corticosteroids are used.
A study has failed to establish the efficacy of Methylprednisolone Sodium Succinate for Injection, USP in the treatment of sepsis syndrome and septic shock. The study also suggests that treatment of these conditions with Methylprednisolone Sodium Succinate for Injection, USP may increase the risk of mortality in certain patients (ie, patients with elevated serum creatinine levels or patients who develop secondary infections after Methylprednisolone Sodium Succinate for Injection, USP.
Prolonged use of corticosteroids may produce posterior subcapsular cataracts, glaucoma with possible damage to the optic nerves, and may enhance the establishment of secondary ocular infections due to fungi or viruses.
Usage in pregnancy
Since adequate human reproduction studies have not been done with corticosteroids, the use of these drugs in pregnancy, nursing mothers, or women of child-bearing potential requires that the possible benefits of the drug be weighed against the potential hazards to the mother and embryo or fetus. Infants born of mothers who have received substantial doses of corticosteroids during pregnancy should be carefully observed for signs of hypoadrenalism.
Average and large doses of cortisone or hydrocortisone can cause elevation of blood pressure, salt and water retention, and increased excretion of potassium. These effects are less likely to occur with the synthetic derivatives except when used in large doses. Dietary salt restriction and potassium supplementation may be necessary. All corticosteroids increase calcium excretion.
While on corticosteroid therapy patients should not be vaccinated against smallpox. Other immunization procedures should not be undertaken in patients who are on corticosteroids, especially on high dose, because of possible hazards of neurological complications and a lack of antibody response.
The use of Methylprednisolone Sodium Succinate for Injection, USP sterile powder inactive tuberculosis should be restricted to those cases of fulminatingor disseminated tuberculosis in which the corticosteroid is used for the management of the disease in conjunction with appropriate antituberculous regimen.
If corticosteroids are indicated in patients with latent tuberculosis or tuberculin reactivity, close observation is necessary as reactivation of the disease may occur. During prolonged corticosteroid therapy, these patients should receivechemoprophylaxis.
Because rare instances of anaphylactic (eg, bronchospasm) reactions have occurred in patients receiving parenteral corticosteroid therapy, appropriate precautionary measures should be taken prior to administration, especially when the patient has a history of allergy to any drug.
There are reports of cardiac arrhythmias and/or circulatory collapse and/or cardiac arrest following the rapid administration of large IV doses of Methylprednisolone Sodium Succinate for Injection, USP (greater than 0.5 gram administered over a period of less than 10 minutes). Bradycardia has been reported during or after the administration of large doses of Methylprednisolone sodium succinate, and may be unrelated to the speed or duration of infusion.
Persons who are on drugs which suppress the immune system are more susceptible to infections than healthy individuals. Chicken pox and measles, for example, can have a more serious or even fatal course in non-immune children or adults on corticosteroids. In such children or adults who have not had these diseases, particular care should be taken to avoid exposure. How the dose, route and duration of corticosteroid administration affects the risk of developing a disseminated infection is not known. The contribution of the underlying disease and/or prior corticosteroid treatment to the risk is also not known. If exposed to chicken pox,prophylaxis with varicella zoster immune globulin (VZIG) may be indicated. If exposed to measles, prophylaxis with pooled intramuscular immunoglobulin (IG) may be indicated. (See the respective package inserts for complete VZIG and IG prescribing information.) If chicken pox develops, treatment with antiviral agents may be considered.
PRECAUTIONS
General Precautions
Drug-induced secondary adrenocortical insufficiency may be minimized by gradual reduction of dosage. This type of relative insufficiency may persist for months after discontinuation of therapy; therefore, in any situation of stress occurring during that period, hormone therapy should be reinstituted. Since mineralocorticoid secretion may be impaired, salt and/or a mineralocorticoid should be administered concurrently.
There is an enhanced effect of corticosteroids on patients with hypothyroidism and in those with cirrhosis.
Corticosteroids should be used cautiously in patients with ocular herpes simplex because of possible corneal perforation.
The lowest possible dose of corticosteroid should be used to control the condition under treatment, and when reduction in dosage is possible, the reduction should be gradual.
Psychic derangements may appear when corticosteroids are used, ranging fromeuphoria, insomnia, mood swings, personality changes, and severe depression, to frank psychotic manifestations. Also, existing emotional instability or psychotic tendencies may be aggravated by corticosteroids.
Aspirin should be used cautiously in conjunction with corticosteroids in hypoprothrombinemia.
Steroids should be used with caution in nonspecific ulcerative colitis, if there is a probability of impending perforation, abscess or other pyogenic infection; diverticulitis; fresh intestinal anastomoses; active or latent peptic ulcer; renal insufficiency;hypertension; osteoporosis; and myasthenia gravis.
Growth and development of infants and children on prolonged corticosteroid therapy should be carefully observed.
Although controlled clinical trials have shown corticosteroids to be effective in speeding the resolution of acute exacerbations of multiple sclerosis, they do not show that corticosteroids affect the ultimate outcome or natural history of the disease. The studies do show that relatively high doses of corticosteroids are necessary to demonstrate a significant effect. (See DOSAGE AND ADMINISTRATION.)
Since complications of treatment with glucocorticoids are dependent on the size of the dose and duration of treatment, a risk/benefit decision must be made in each individual case as to dose and duration of treatment and as to whether daily or intermittent therapy should be used.
OVERDOSE
No information provided.
CONTRAINDICATIONS
The use of A-Methapred (methylprednisolone sodium succinate) sterile powder is contraindicated in premature infants because the reconstitution diluent contains benzyl alcohol. Benzyl alcohol has been reported to be associated with a fatal "Gasping Syndrome" in premature infants. A-Methapred (methylprednisolone sodium succinate) sterile powder is also contraindicated in systemic fungal infections and patients with known hypersensitivity to the product and its constituents.
CLINICAL PHARMACOLOGY
Methylprednisolone is a potent anti-inflammatory steroid with greater anti-inflammatory potency than prednisolone and even less tendency than prednisolone to induce sodium and water retention.
Methylprednisolone sodium succinate has the same metabolic and anti-inflammatory actions as methylprednisolone. When given parenterally and in equimolar quantities, the two compounds are equivalent in biologic activity. The relative potency of A-Methapred (methylprednisolone sodium succinate) sterile powder and hydrocortisone sodium succinate, as indicated by depression of eosinophil count, following intravenous administration, is at least four to one. This is in good agreement with the relative oral potency of methylprednisolone and hydrocortisone.
PATIENT INFORMATION
Persons who are on immunosuppressant doses of corticosteroids should be warned to avoid exposure to chicken pox or measles. Patients should also be advised that if they are exposed, medical advice should be sought without delay.
A-METHAPRED CONSUMER
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
METHYLPREDNISOLONE SODIUM SUCCINATE - INJECTION
(METH-ull-pred-NISS-oh-lone)
COMMON BRAND NAME(S): Solu-Medrol
USES:This medication is used to treat various conditions such as severe allergic reactions, arthritis, blood diseases, breathing problems, certain cancers, eye diseases, intestinal disorders, and skin diseases. It decreases your body's natural defensive response and reduces symptoms such as swelling and allergic-type reactions. Methylprednisolone is a corticosteroid hormone (glucocorticoid). This injectable form of methylprednisolone is used when a similar drug cannot be taken by mouth or when a very fast response is needed, especially in patients with severe medical conditions.
This drug may also be used with other medications as a replacement for certain hormones.
HOW TO USE:This medication is usually given as directed by your doctor. Some brands/strengths are given by slow injection into a vein or directly into a muscle. Other brands/strengths should only be injected into a vein. The way you inject this medicine will depend on the brand/strength that you are using. Dosage is based on your medical condition and response to treatment. Do not increase your dose or use this drug more often than prescribed without consulting your doctor.
If you are giving this medication to yourself at home, learn all preparation and usage instructions from your health care professional. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Learn how to store and discard medical supplies safely.
If you have been using this medication for a long time, do not suddenly stop using it without your doctor's approval. Your dose may need to be gradually decreased to reduce symptoms such as weakness, weight loss, nausea, or extreme tiredness.
Tell your doctor if your condition persists or worsens.
SIDE EFFECTS:Stomach upset, headache, dizziness, menstrual period changes, trouble sleeping, increased appetite, weight gain, or pain/redness/swelling at the injection site may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
Tell your doctor right away if you have any serious side effects, including: bone/joint pain, easy bruising/bleeding, black stools, vomit that looks like coffee grounds, severe stomach/abdominal pain, increased thirst/urination, fast/slow/pounding/irregular heartbeat, shortness of breath, swelling of the ankles/feet, tendon pain, persistent weight gain, puffy face, unusual hair growth, thinning skin, slow wound healing, signs of infection (such as persistent fever/cough/sore throat, painful urination, eye pain/discharge), muscle weakness/pain, mental/mood changes (such as mood swings, depression, agitation), vision changes, seizures, unusual skin growths.
A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
In the US -
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS:Before using methylprednisolone, tell your doctor or pharmacist if you are allergic to it; or to other corticosteroids (e.g., prednisone); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: current fungal infections.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: other infections (such as tuberculosis, threadworm), bleeding problems, blood clots, brittle bones (osteoporosis), high blood pressure, certain heart problems (such as congestive heart failure, recent heart attack), diabetes, certain eye diseases (such as cataracts, herpes infection, glaucoma), kidney disease, severe liver disease (cirrhosis), mental/mood conditions (such as psychosis, anxiety, depression), seizures, stomach/intestinal problems (such as diverticulitis, ulcer, ulcerative colitis), thyroid problems (both underactive and overactive conditions), untreated mineral problems (such as low potassium or calcium).
This drug may make you dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely.
This medication may mask signs of infection or put you at greater risk of developing very serious infections. Report to your doctor any injuries or signs of infection (e.g., persistent sore throat/cough/fever, pain during urination, muscle aches) that occur while using this medication or within 12 months after stopping it.
Using corticosteroid medications for a long time can make it more difficult for your body to respond to physical stress. Therefore, before having surgery or emergency treatment, or if you get a serious illness/injury, tell your doctor or dentist that you are using this medication or have used this medication within the past 12 months. Tell your doctor right away if you develop unusual/extreme tiredness or weight loss. If you will be using this medication for a long time, carry a warning card or medical ID bracelet that identifies your use of this medication.
Do not have immunizations, vaccinations, or skin tests unless specifically directed by your doctor. Live vaccines may cause serious problems (e.g., infection) if given while you are using this medication. Avoid contact with people who have recently received oral polio vaccine or flu vaccine inhaled through the nose.
Avoid contact with people who have chickenpox or measles unless you have previously had these diseases (e.g., in childhood). If you are exposed to one of these infections and you have not previously had it, seek immediate medical attention.
If you have a history of ulcers, or if you take large doses of aspirin or other arthritis medication, limit alcoholic beverages while using this medication to decrease the risk of stomach/intestinal bleeding. Consult your doctor or pharmacist for more details.
If you have diabetes, this drug may increase your blood sugar levels. Check your blood glucose levels regularly as directed by your doctor. Tell your doctor immediately if you have symptoms such as increased thirst and urination. Your anti-diabetic medication or diet may need to be adjusted.
Caution is advised when using this drug in the elderly because they may be more sensitive to its side effects, especially osteoporosis. Talk with your doctor about ways to prevent bone loss.
This medication may slow down a child's growth if used for a long time. Consult the doctor or pharmacist for more details. See the doctor regularly so your child's height and growth can be checked.
This medication should be used only when clearly needed during pregnancy. There have been rare reports of harm to an unborn baby when corticosteroids are used during pregnancy. Discuss the risks and benefits with your doctor. Infants born to mothers who have been using this medication for an extended time may have low levels of corticosteroid hormone. Tell your doctor immediately if you notice symptoms such as persistent nausea/vomiting, severe diarrhea, or weakness in your newborn.
This medication passes into breast milk and is unlikely to cause harm to a nursing infant. Consult your doctor before breast-feeding.
DRUG INTERACTIONS:(See also the How to Use section).
Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.
Some products that may interact with this drug include: live vaccines, aldesleukin, large doses of aspirin and aspirin-like drugs (such as salicylates), birth control pills, blood thinners (such as warfarin), bupropion, cyclosporine, drugs for diabetes, drugs that cause potassium loss (such as amphotericin B, hydrochlorothiazide, furosemide), estrogens, mifepristone, natalizumab, nonsteroidal anti-inflammatory drugs (NSAIDs such as indomethacin, ibuprofen), herbal products (e.g., licorice).
Other medications can affect the removal of methylprednisolone from your body, which may affect how methylprednisolone works. Examples include azole antifungals (such as ketoconazole), macrolide antibiotics (such as erythromycin), rifampin, certain anti-seizure medications (such as phenytoin and phenobarbital), among others.
Check all prescription and nonprescription medicine labels carefully since many medications contain pain relievers/fever reducers (NSAIDs such as aspirin, ibuprofen, or naproxen) that may increase the risk of stomach bleeding from this drug. Low-dose aspirin should be continued if prescribed by your doctor for specific medical reasons such as heart attack or stroke prevention (usually at dosages of 81-325 milligrams per day). Consult your doctor or pharmacist for more details.
This product may interfere with certain lab tests (including skin tests), possibly causing false test results. Make sure laboratory personnel and your doctors know you use this drug.
OVERDOSE:If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US National Poison Hotline at 1-800-222-1222. Canada residents can call a provincial poison control center.
NOTES: Laboratory and/or medical tests (e.g., blood counts, blood glucose/mineral levels, blood pressure, bone density tests, height/weight measurements, eye examinations, X-rays) should be performed periodically to monitor your progress or check for side effects during long-term treatment. Consult your doctor for more details.
Lifestyle changes that help reduce the risk of bone loss (osteoporosis) during long-term treatment include doing weight-bearing exercise, getting adequate calcium and vitamin D, stopping smoking, and limiting alcohol. Talk with your doctor about lifestyle changes that might benefit you.
If you use this medication for prolonged periods, you should wear or carry identification stating that you are using it.
MISSED DOSE:For the best possible benefit, it is important to receive each scheduled dose of this medication as directed. If you miss a dose, contact your doctor or pharmacist immediately to establish a new dosing schedule.
STORAGE:Consult the product instructions and your pharmacist for storage details. Keep all medications away from children and pets.
Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
MEDICAL ALERT:Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-800-854-1166 (USA) or 1-800-668-1507 (Canada).
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