A1,
A2,
B,
C1,
C2,
D,
E,
F,
G-H,
I-K,
L,
M,
N,
O,
P1,
P2,
Q-R,
S,
T,
U-V,
W-Z
Medrol Side Effects, and Drug Interactions - Methylprednisolone
Medrol Side Effects, and Drug Interactions - Methylprednisolone
SIDE EFFECTS
Fluid and Electrolyte Disturbances: Sodium retention,
congestive heart failure
in susceptible patients,
hypertension, fluid retention,
potassium loss, hypokalemic alkalosis, hypertension.
Musculoskeletal: Muscle weakness; loss
of muscle mass; steroid
myopathy; osteoporosis; tendon
rupture, particularly of the Achilles tendon; vertebral
compression fractures;
aseptic necrosis of
femoral and humeral
heads; pathologic
fracture of long bones.
Gastrointestinal: Peptic ulcer
with possible perforation and hemorrhage; pancreatitis; abdominal
distention; ulcerative
esophagitis; 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.
Dermatologic: Impaired wound
healing, petechiae
and ecchymoses, may suppress reactions to skin
tests, thin fragile skin, facial
erythema, increased sweating.
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 in trauma, surgery or illness; menstrual irregularities; decreased
carbohydrate tolerance;
manifestations of latent diabetes mellitus; increased requirements
of insulin 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 Reactions Have Been Reported Following
Oral as Well as Parenteral Therapy: Urticaria and other
allergic, anaphylactic or hypersensitivity reactions.
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 increased 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.
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