Melpred 2

Generic

Methyl prednisolone

Indications

Pharmacology

Pharmacodynamic properties: methylprednisolone is a powerful anti-inflammatory agent that has the ability to significantly inhibit the immune system. Glucocorticoids are mainly related to enabled intracellular glucocorticoid receptors and bind to the DMA promoter region and activate transcription factors resulting in gene inactivation through histone hydrophilization. A. Methylprednisolone affects the balance of kidney and liquid and electrolytic, lipids, proteins and carbohydrate metabolism, skeletal muscle, cardiovascular system, immune system, nervous system and endocrine system.

Pharmacokinetic properties: The absolute bioavailability of methylpreadonic gloone after oral administration after oral administration is generally high (82% to 89%) and maximum and maximum plasma concentrations are normal health achieved from 1.5 to 2.3 hours beyond of the dose after oral administration in adults. Methylprednisolone is widely distributed in tissues, and its amount of distribution is 4161.5 liters.  Breast milk is secreted through the barrier and barrier of the placenta. The union to the plasma protein of methylprednisolone in humans is approximately 77%. Methylprednisolone is metabolized in inert metabolites in the liver. The adjustment of the administration is not necessary for renal failure. Methylprednisolone can be hyphodialized.  
 

Dosage & Administration

The usual range is 2-48 mg daily in divided doses, depending on the specific disease being treated. 

As anti-inflammatory or immunosuppressive initial dosage: As anti-inflammatory or immunosuppressive, the initial dosage of Methylprednisolone tablets may vary from 4-48 mg per day depending on the specific disease entity being treated, in situations of less severity lower doses will generally suffice while in selected patients higher initial doses may be required. The initial dosage should be maintained or adjusted until a satisfactory response is noted. If after a reasonable period of time there is a lack of satisfactory dirtied response, Methylprednisolone should be discontinued and the patient transferred to other appropriate therapy. It should be emphasized that dosage requirements are variable and must be Individualized on the basis of the disease under treatment and the response of the patient.

As anti-inflammatory or immunosuppressive maintenance dosage: After a favorable response is noted, the proper maintenance dosage should be determined by decreasing the initial drug dosage in small decrements at appropriate time intervals until the lowest dosage which will maintain an adequate clinical response is reached. It should be kept in mind that constant monitoring is needed in regard to drug dosage. If after long-term therapy the drug is to be stopped, it is recommended that it be withdrawn gradually rather than abruptly.

Multiple Sclerosis: In the treatment of acute exacerbations of multiple sclerosis, daily doses of 160 mg of Methylprednisolone for a week followed by 64 mg every other day for 1 month have been shown to be effective.

Methylprednisolone 4 mg tablet can be used to treat and to control severe allergy end dermatitis following the guideline listed below to minimize the steroid withdrawal syndromes:

• Day 1: 2 tablets before breakfast + 1 tablet after lunch + 1 tablet after dinner + 2 tablets at bedtime
• Day 2: 1 tablet before breakfast + 1 tablet after lunch + 1 tablet after dinner + 2 tablets at bedtime
• Day 3: 1 tablet before breakfast + 1 tablet after lunch + 1 tablet after dinner + 1 tablet at bedtime
• Day 4: 1 tablet before breakfast + 1 tablet after lunch + 1 tablet at bedtime
• Day 5: 1 tablet before breakfast + 1 tablet at bedtime
• Day 6: 1 tablet before breakfast

Alternate-day therapy (ADT): Alternate-day therapy is a corticosteroid dosing regimen in which twice the usual daily dose of corticoid is administered every other morning. The purpose of this mode of therapy is to provide the patient requiring long-term pharmacologic dose treatment with the beneficial effects of corticoids, white minimizing certain undesirable effects, including pituitary-adrenal suppression, Cushingoid stats, Corficoid withdrawal symptoms, and growth suppression in children.

The following should be kept in mind when considering alternate-day therapy:

• Basic principles and indications for corticosteroid therapy should be applied.
• Alternate-day therapy is a therapeutic technique primarily designed for pefienis in whom long-term pharmacologic corticoid therapy is anticipated.
• In less severe disease processes in which corticoid therapy is indicated, it may be possible to initiate treatment with alternate-day therapy. More severe disease state usually will require daily divided high dose therapy for initiai control of the disease process. The initial suppressive dose level should be continued until a satisfactory clinical response is obtained, usually four to ten days in the case of many allergic and collagen diseases.

Interaction 

Contraindications

Systemic fungal infections and known hypersensitivity to components.

Side effects

Short-term use of methylprednisolone is generally well tolerated, with few and mild side effects. Long-term, high-dose methylprednisone can have predictable and potentially serious side effects. Whenever possible, the lowest effective dose of methylprednisolone should be used in the shortest time possible to minimize side effects. Alternate day dosing can also help reduce side effects. The side effects of methylprednisolone and other corticosteroids range from mild discomfort to severe irreversible physical damage. Side effects include fluid retention, weight gain, high blood pressure, potassium loss, headaches, muscle weakness, facial hair growth, glaucoma, cataracts, peptic ulcers, growth retardation in children, seizures, and mental disorders , which include depression, euphoria, and insomnia. Long-term use of methylprednisolone will inhibit the ability of the human adrenal glands to produce corticosteroids. Sudden discontinuation of methylprednisolone in these individuals can cause symptoms of corticosteroid insufficiency, accompanied by nausea, vomiting, and even shock. Therefore, withdrawal of methylprednisolone is usually achieved by gradually reducing the dose. Gradually reducing the amount of methylprednisolone can not only minimize symptoms of corticosteroid insufficiency, but also reduce the risk of sudden onset of the disease being treated.

Pregnancy & Lactation

Pregnancy category C. Stool should be given only when the potential benefit justifies the potential risk to the fetus. Mefhyiprednisofone has not been fully evaluated in breastfeeding mothers.

Precautions & Warnings

After stopping treatment, adrenal insufficiency can last for several months; therefore, in any stressful situation that occurs during this period, hormone therapy should be restarted. As mineralocorticoid secretion may be impaired, salt and/or mineralocorticoid should be taken at the same time. Corticosteroids have an enhanced effect on patients with hypothyroidism and liver cirrhosis. Because of the possibility of corneal perforation, patients with ocular herpes simplex should use corticosteroids with caution. Aspirin and corticosteroids should be used with caution when used in hypothrombinemia. The growth and development of babies and children who take corticosteroids for a long time should be carefully observed.

Therapeutic Class

Glucocorticoids

Storage Conditions

Store in a cool and dry place, away from light. Keep out of reach of children.

Pharmaceutical Name

Pharmasia Limited