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
Depo Medrol Side Effects, and Drug Interactions - Methylprednisolone
Depo Medrol Side Effects, and Drug Interactions - Methylprednisolone
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
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 subsequent 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
Petehiae and ecchymoses
Facial erythema
Increased sweating
May suppress reactions to skin tests
Neurological
Convulsions
Increased intracranial pressure with papilledema (pseudotumor cerebri) usually
after treatment
Vertigo
Headache
Endocrine
Menstrual irregularities
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
Decreased carbohydrate tolerance
Manifestations of latent diabetes mellitus
Increased requirements for insulin or oral hypoglycemic agents in diabetes
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:
Anaphylactic reaction
Allergic or hypersensitivity reactions
Urticaria
Hyperpigmentation or hypopigmentation
Subcutaneous and cutaneous atrophy
Sterile abscess
Injection site infections following non-sterile administration (see WARNINGS
)
Postinjection flare, following intrasynovial use
Charcot-like atrophy
Adverse Reactions Reported with the Following Routes of Administration
Intrathecal/Epidural
Arachnoiditis
Meningitis
Paraparesis/paraplegia
Sensory disturbances
Bowel/bladder dysfunction
Headaches
Seizures
Intranasal
Temporary/permanent visual impairment including blindness
Allergic reactions
Rhinitis
Ophthalmic
Temporary/permanent visual impairment including blindness
Increased intraocular pressure
Ocular and periocular inflammation including allergic reactions
Infection
Residue or slough at injection site
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 reprots 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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