1. Drug Interactions
1.1. Drug-food interactions
1.1.1. Grapefruit juice
1.2. Drug-drug interactions
1.2.1. Lyme Disease Vaccine, Measles Virus Vaccine, Mumps Virus Vaccine, Plague Vaccine, Pneumococcal Vaccine, Rabies Vaccine, Rotavirus Vaccine, Live Rubella Virus Vaccine, Warfarin, Yellow Fever Vaccine
2. Drug indication
2.1. Used as antiinflammatory or immunosuppressant.
2.2. Corticosteroids have multiple mechanisms of action including anti-inflammatory activity, immunosuppressive properties, and antiproliferative actions. Anti-inflammatory effects result from decreased formation, release and activity of the mediators of inflammation (eg, kinins, histamine, liposomal enzymes, prostaglandins, leukotrienes) which reduce the initial manifestations of the inflammatory process
3. How is it supplied?
3.1. Generic: injection suspension 40 MG/1 ML, 80 MG/1 ML
3.2. Depo-Medrol: Injection Suspension: 20 MG/1 ML, 40 MG/1 ML, 80 MG/1 M
3.3. Novaplus Depo-Medrol: Injection Suspension: 40 MG/1 ML, 80 MG/1 ML
4. Non-drug treatments for inflammation
4.1. Anti-inflammatory diet- eliminate grains/gluten, sugar, alcohol, allergenic foods, trans fats, aspartame, chemicals, caffeine, excess iron, and toxic heavy metals.
4.2. Resolve psychological traumas
4.3. Exercise
4.4. Meditation and deep breathing for ultimate relaxation
4.5. Turmeric
4.6. Licorice root
4.7. Serrapeptase; enzyme derived from silkworm
4.8. Pancreatin; enzyme extracted from porcine pancreas
4.9. Bromelain; enzyme derived from pineapple
4.10. Ginger
5. Drug Reconstitution
5.1. Methylprednisolone sodium succinate is soluble in water; it may be administered in a small volume of diluent and is well suited for intravenous use in situations where high blood levels of methylprednisolone are required rapidly.
5.2. IMPORTANT - Use only the accompanying diluent or Bacteriostatic Water For Injection with Benzyl Alcohol when reconstituting SOLU-MEDROL. Use within 48 hours after mixing.
5.3. When necessary, the pH of each formula was adjusted with sodium hydroxide so that the pH of the reconstituted solution is within the USP specified range of 7 to 8
5.4. Each vial of powder contains methylprednisolone sodium succinate 1326.0 mg equivalent to 1000 mg of methylprednisolone. After reconstitution in water for injections, each ml of solution contains the equivalent of 59.6 mg of methylprednisolone.
6. Antidote for patient reactions
6.1. If overdose is suspected, contact a poison control center or emergency room right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.
6.2. Treatment of acute overdosage is by supportive and symptomatic therapy. For chronic overdosage in the face of severe disease requiring continuous steroid therapy, the dosage of the corticosteroid may be reduced only temporarily, or alternate day treatment may be introduced.
6.3. Taking this medication for a long time may cause brittle bones (osteoporosis). Lifestyle changes that help promote healthy bones include increasing weight-bearing exercise, stopping smoking, getting enough calcium and vitamin D, and limiting alcohol. Consult your doctor for specific advice.
7. Ongoing Monitoring
7.1. Usually the first Solu-Medrol series is given in a hospital for the 3-5 day treatment so that your reaction can be monitored and you can be taken care of during this time. You can also go to a clinic or an infusion center, where you will be given the medicine while laying down in a bed or reclining in a chair. Arrangements may occasionally be made for a nurse to come to your home to administer the treatment, as well.
8. What does it treat?
8.1. Chron's Disease
8.2. Exacerbation of multiple sclerosis
8.3. Leukemia/Palliative therapy
8.4. Malignant Lymphoma/palliative therapy
8.5. Osteoarthritis
9. Adverse Effects (No BlackBox warnings)
9.1. Cardiovascular effects
9.2. Dermatological effects
9.3. Endocrine/Metabolic Effects
9.4. Gastrointestinal Effects
9.5. Hematologic effects
9.6. Hepatic effects
9.7. Immunologic effects
9.8. Musculoskeletal effects
9.9. Neurologic Effects
9.10. Opthamalic effects
9.11. Psychiatric effects
9.12. Renal effects
9.13. Respiratory effects
10. Dosing/Administration (dosing varies by condition)
10.1. Adrenal insufficiency
10.1.1. 40 mg IM bi-weekly
10.2. Allergic condition
10.2.1. dosage varies; administer the equivalent of a total daily oral dose as a single IM injection in a 24-h period
10.3. Allergic rhinitis
10.3.1. 80-120 mg IM, relief in 6 hours, may persist up to 3 weeks
10.4. Asthma
10.4.1. 80-120 mg IM, relief in 6-48 hours
10.4.2. (in place of oral short burst; vomiting or nonadherent patients) 240 mg IM as one-time dose
10.5. Bursitis
10.5.1. 4-30 mg injected into the bursal structure
10.6. Carcinoma of breast
10.6.1. Optimal dosing and timing not yet defined
10.7. Collagen disease
10.7.1. Optimal dosing and timing not yet defined
10.8. Contact dermititis due to poison ivy (severe)
10.8.1. 80-120 mg IM once; relief within 8 to 12 hours
10.9. Chron's Disease
10.9.1. dosage varies; administer the equivalent of a total daily oral dose as a single IM injection in a 24-h period
10.10. Disorder of eye
10.10.1. dosage varies; administer the equivalent of a total daily oral dose as a single IM injection in a 24-h period
10.11. Disorder of hematopoetic structure
10.11.1. dosage varies; administer the equivalent of a total daily oral dose as a single IM injection in a 24-h period
10.12. Disorder of respiratory system
10.12.1. dosage varies; administer the equivalent of a total daily oral dose as a single IM injection in a 24-h period
10.13. Disorder of skin
10.13.1. IM, 40 to 120 mg/wk for 1-4 weeks
10.13.2. INTRALESIONALLY, 20 to 60 mg; for large lesions, 20 to 40 mg by repeated injections
10.14. Epicondylitis
10.14.1. 4 mg to 30 mg administered locally
10.15. Exacerbation of multiple sclerosis
10.15.1. 160 mg IM daily for 1 wk, followed by 64 mg every other day for 1 month
10.16. Fever due to malignancy
10.16.1. Optimal dosing and timing not yet defined
10.17. Ganglion of aponeurosis
10.17.1. 4 mg to 30 mg administered INTRALESIONALLY
10.18. Inflammatory disorder of musculoskeletal system
10.18.1. dosage varies; administer the equivalent of a total daily oral dose as a single IM injection in a 24-h period
10.19. Intracranial tumor
10.19.1. Optimal dosing and timing not yet established
10.20. Malignant lymphoma/
10.20.1. dosage varies; administer the equivalent of a total daily oral dose as a single IM injection in a 24-h period
10.21. Multiple Myeloma
10.21.1. Optimal dosing and timing not yet established
10.22. Mycosis fungoides
10.22.1. dosage varies; administer the equivalent of a total daily oral dose as a single IM injection in a 24-h period
10.23. Nephrotic syndrome
10.23.1. Dosage varies; administer equivalent of a total daily oral dose as a single IM injection in a 24-hour period
10.24. Osteoarthritis
10.24.1. INTRA-ARTICULAR, 20-80 mg for large joint; 10-40 mg for medium joint; 4-10 mg for small joint, may be repeated every 1-5 weeks or more
10.25. Prostate Cancer
10.25.1. Optimal dosing and timing not yet defined
10.26. Rheumatoid arthritis
10.26.1. IM, maintenance, 40-120 mg/wk
10.26.2. INTRA-ARTICULAR, 20-80 mg for large joint; 10-40 mg for medium joint; 4-10 mg for small joint, may be repeated every 1-5 weeks or more
10.27. Tenosynovitis
10.27.1. 4 mg to 30 mg administered locally into the tendon sheath
10.28. Trichinosis with neurologic and myocardial involvement
10.28.1. dosage varies; administer the equivalent of a total daily oral dose as a single IM injection in a 24-h period
10.29. Tuberculosis of meninges
10.29.1. dosage varies; administer the equivalent of a total daily oral dose as a single IM injection in a 24-h perio
10.30. Ulcerative Colitis
10.30.1. dosage varies; administer the equivalent of a total daily oral dose as a single IM injection in a 24-h period
11. Drug classification
11.1. Corticosteroid
12. Dosing
12.1. Pediatric
12.1.1. Pediatric specific dosing not provided by the manufacturer; dosage will be reduced but should be governed more by the severity of the condition and response of the patient than by age or size
12.2. Adult
12.2.1. Dosage varies depending on condition
12.3. Geriatric
12.3.1. Dose selection should start low