Details
METHYPRED Indications
Endocrine diseases.
Primary and secondary insufficiency of the adrenal cortex (first-line drugs are hydrocortisone or cortisone; if necessary, synthetic analogues can be used in combination with mineralocorticoids; simultaneous use of mineralocorticoids is especially important for the treatment of children).
Congenital hyperplasia of the adrenal glands.
Non-purulent thyroiditis.
Hypercalcemia in cancer.
Non-endocrine diseases.
Rheumatic diseases.
As an additional therapy for short-term use (to remove the patient from an acute condition or exacerbation of the process) in the following diseases:
· Psoriatic arthritis;
· Rheumatoid arthritis, including juvenile rheumatoid arthritis (in some cases, low-dose maintenance therapy may be required);
· Ankylosing spondylitis;
· Acute and subacute bursitis;
· Acute nonspecific tendosynovitis;
· Acute gouty arthritis;
· Post-traumatic osteoarthritis;
· Synovitis in osteoarthritis;
· Epicondylitis.
Collagenosis.
In the period of exacerbation or in some cases as maintenance therapy for the following diseases:
· Systemic lupus erythematosus;
· Systemic dermatomyositis (polymyositis);
· Acute rheumatic heart disease;
· Rheumatic polymyalgia in giant cell arteritis.
Skin diseases.
· Bubbles;
· Bullous herpetiform dermatitis;
· Severe erythema multiforme (Stevens-Johnson syndrome);
· Exfoliative dermatitis;
· Fungal mycosis;
· Severe psoriasis;
· Severe seborrheic dermatitis.
Allergic conditions.
For the treatment of the following severe and allergic conditions in case of ineffectiveness of standard treatment:
· Seasonal or perennial allergic rhinitis;
· Serum sickness;
· Bronchial asthma;
· Drug allergy;
· Contact dermatitis;
· Atopic dermatitis.
Eye diseases.
Severe acute and chronic allergic and inflammatory processes with eye damage, such as:
· Allergic marginal corneal ulcers;
· Eye damage caused by Herpes zoster;
· Inflammation of the anterior segment of the eye;
· Diffuse posterior uveitis and choroiditis;
· Sympathetic ophthalmia;
· Allergic conjunctivitis;
· Keratitis;
· Chorioretinitis;
· Optic neuritis;
· Iritis and iridocyclitis.
Respiratory diseases.
· Symptomatic sarcoidosis;
· Lefler's syndrome, which is not amenable to treatment by other methods;
· Beryllium;
· Fulminant or disseminated pulmonary tuberculosis (used in combination with appropriate anti-tuberculosis chemotherapy);
· Aspiration pneumonitis.
Hematological diseases.
· Idiopathic thrombocytopenic purpura in adults;
· Secondary thrombocytopenia in adults;
· Acquired (autoimmune) hemolytic anemia;
· Erythroblastopenia (erythrocyte anemia);
· Congenital (erythroid) hypoplastic anemia.
Cancer.
As palliative therapy for the following diseases:
· Leukemia and lymphoma in adults;
· Acute leukemia in children.
Edema syndrome.
For the induction of diuresis or the treatment of proteinuria in nephrotic syndrome without uremia, idiopathic type or caused by systemic lupus erythematosus.
Diseases of the digestive tract.
To remove the patient from a critical condition in the following diseases:
· Ulcerative colitis;
· Regional enteritis (Crohn's disease).
Diseases of the nervous system.
· Multiple sclerosis in the acute phase;
· Brain edema caused by a brain tumor.
Diseases of other organs and systems.
· Tuberculous meningitis with subarachnoid block or at the risk of block development, in combination with appropriate anti-tuberculosis chemotherapy;
· Trichinosis with damage to the nervous system or myocardium.
Organ transplantation.
Contraindications
Tuberculosis and other acute or chronic bacterial or viral infections with insufficient antibiotic and chemotherapy, systemic fungal infections.
Hypersensitivity to methylprednisolone or to excipients.
Administration of live or live attenuated vaccines is contraindicated in patients receiving immunosuppressive doses of corticosteroids.
Dosage & Administration
The initial dose for adults can be from 4 mg to 48 mg of methylprednisolone per day, depending on the nature of the disease. In less severe diseases, lower doses are usually sufficient, although some patients may require higher starting doses. High doses can be used for diseases and conditions such as multiple sclerosis (200 mg / day), brain edema (200-1000 mg / day) and organ transplantation (up to 7 mg / kg / day).
If a satisfactory effect is achieved as a result of therapy, the patient should select an individual maintenance dose by gradually reducing the initial dose over time until the lowest dose is found that maintains the achieved clinical effect. Keep in mind that you need to constantly monitor the dosage of the drug. There may be situations in which the dose needs to be adjusted; these include changes in the clinical condition due to remission or exacerbation of the disease, the patient's individual response to the drug, as well as the impact on the patient of stressful situations not directly related to the underlying disease to which therapy is directed; in the latter case, it may be necessary to increase the dose of the drug for a certain period, depending on the patient's condition. The required dose may vary and should be selected individually, depending on the nature of the disease and the patient's response to therapy.
The dosage of the drug should be individual and based on the assessment of the course of the disease and the clinical effect.
Withdrawal of the drug can not be carried out suddenly - it should be done gradually.
Alternating therapy
Alternative therapy is a regimen of corticosteroid dosing in which a double daily dose of corticosteroid is administered every other day in the morning. The goal of this type of therapy is to achieve the maximum clinical effect in a patient in need of long-term therapy while minimizing some side effects, such as pituitary-adrenal suppression, Cushing's syndrome, corticosteroid withdrawal syndrome and growth inhibition in children.
Children.
The drug is used in pediatric practice.
It is necessary to carefully monitor the peculiarities of development and growth of children, including infants with long-term corticosteroid therapy.
Children who receive glucocorticoids daily for a long time several times a day may experience growth retardation. Therefore, this dosing regimen should be used only for urgent indications. The use of alternative therapy usually avoids or minimizes this side effect (see section "Method and Dosage").
Infants and children receiving long-term corticosteroid therapy are at particular risk of increased intracranial pressure.
High doses of corticosteroids can cause pancreatitis in children.
