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 (Suspension)
Depo-Medrol Side Effects, and Drug Interactions - Methylprednisolone (Suspension)
SIDE EFFECTS
|
Fluid and electrolyte disturbances
|
| Sodium retention |
Potassium loss
|
| Fluid retention |
Hypokalemic alkalosis |
| Congestive heart failure in susceptible patients |
Hypertension |
| Musculoskeletal |
| Muscle weakness |
Tendon rupture, particularly of the Achilles tendon
|
| Steroid myopathy |
Vertebral compression fractures |
| Loss of muscle mass |
Aseptic necrosis of femoral and humeral heads |
| Osteoporosis |
Pathologic fracture of long bones |
| Gastrointestinal |
| Peptic ulcer with possible subsequent perforation |
Increases in alanine transaminase (ALT, SGPT), aspartate
transaminase (AST, SGOT), andalkaline phosphatase have been observed
following corticosteroid treatment. These changes are usually small,
not associated with any clinical syndrome and are reversible upon
discontinuation. |
| and hemorrhage |
| Pancreatitis |
| Abdominal distention |
| Ulcerative esophagitis |
|
Dermatologic
|
| Impaired wound healing |
Facial erythema
|
| Thin fragile skin |
Increased sweating |
| Petechiae and ecchymoses |
May suppress reactions to skin tests |
| Neurological |
| Convulsions |
Vertigo |
| Increased intracranial pressure with papilledema (pseudotumor
cerebri) usually after treatment |
Headache |
| Endocrine |
|
Menstrual irregularities
|
Decreased carbohydrate tolerance
|
| Development of Cushingoid state |
Manifestations of latent diabetes mellitus |
| Suppression of growth in children |
Increased requirements for insulin or
oral hypoglycemic agents in diabetes |
|
Secondary adrenocortical and pituitary unresponsiveness, particularly
in times of stress, as in trauma, surgery or illness
|
|
Ophthalmic
|
| Posterior subcapsular cataracts |
Glaucoma
|
| Increased intraocular pressure |
Exophthalmos |
|
Metabolic
|
| Negative nitrogen balance due to protein catabolism |
|
| The following additional adverse reactions are related
to parenteral corticosteroid therapy: |
| Anaphylactic reaction |
Sterile abscess
|
| Allergic or hypersensitivity reactions |
Injection site infections following non-sterile
administration (see WARNINGS) |
| Urticaria |
| Hyperpigmentation or hypopigmentation |
Postinjection flare, following intrasynovial use |
| Subcutaneous and cutaneous atrophy |
Charcot-like arthropathy |
Adverse Reactions Reported with the Following Routes of Administration
|
Intrathecal/Epidural
|
|
Arachnoiditis
|
Bowel/bladder dysfunction |
| Meningitis |
Headache |
| Paraparesis/paraplegia |
Seizures |
| Sensory disturbances |
|
| Intranasal |
| Allergic reactions |
Rhinitis |
| Ophthalmic |
| Temporary/permanent visual impairment |
Infection |
|
including blindness
|
Residue or slough at injection site |
| Increased intraocular pressure |
|
| Ocular and periocular inflammation |
|
| including allergic reactions |
|
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 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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