METHYLPREDNISOLONE SODIUM SUCCINATE

• Severe erythema multiforme
• Stevens-Johnson syndrome
• Allergic and inflammatory disease
• Ulcerative colitis
• Crohn's disease
• Cerebral oedema associated with malignancy
• Rheumatic disease

IV doses up to 250 mg should be given over at least 5 minutes, higher doses over at least 30 minutes

• Reconstitute initially with water for injections, then administer by continuous or intermittent or via drip tubing in Glucose 5% or Sodium chloride 0.9%

• Hypersensitivity

• Acute pancreatitis
• Osteoporosis
• Growth suppression in prolonged use in children
• Raised intracranial pressure
• Hypertension
• Hypokalaemia, diabetes
• Thinning of skin
• Increased susceptibility to and severity of infections

• Ciclosporin: (high doses increase risk of convulsions)
• Vaccines: (high doses cause impaired immune response)
• Warfarin: (may enhance or reduce anticoagulant effect; high doses enhances warfarin metabolism)
• Carbamazepine, Phenobarbital, phenytoin, rifampicin: (metabolism of methylprednisolone accelerated)
• Amphotericin: (increased risk of hypokalaemia)

• Avoid exposure to measles or chicken pox

• Can be used

• Can be used

• Gradual withdrawal should be considered depending on the duration of treatment, condition being treated, and individual patient factors. Abrupt withdrawal after a prolonged period can lead to acute adrenal insufficiency
• In case of significant intercurrent illness, trauma, or surgical procedure, increase dose temporarily
• May mask serious infections such as septicaemia and tuberculosis
• Increased risk of severe chicken pox if a patient has never had chicken pox. In case of chicken pox, increase dose of methylprednisolone. Do not stop treatment
• Irreversible growth restriction may occur in children and adolescents if used for prolonged periods
• Use cautiously and in lower doses in hepatic and renal impairment
• Do not use for management of head injury or stroke; it is unlikely to be of benefit and may even be harmful