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
Solu Medrol Side Effects, and Drug Interactions - Methylprednisolone sodium succinate
Solu Medrol Side Effects, and Drug Interactions - Methylprednisolone sodium succinate
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 Tendon rupture, particularly of of
the Achilles tendon
|
|
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 Thin fragile skin Petechiae and ecchymoses
|
Facial erythema 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 in trauma, surgery or illness
|
|
Menstrual irregularities
|
|
Decreased carbohydrate tolerance Manifestations of latent
diabetes mellitus Increased requirements for 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 adverse reactions are related
to parenteral corticosteroid therapy: Hyperpigmentation or hypopigmentation
Subcutaneous and cutaneous atrophy 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. 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 methylpred-nisolone 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 sali-cylate 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 methyl-prednisolone
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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