Methylprednisolone
Keep this leaflet, you may need to read it again.
In case of any doubts, consult your doctor or pharmacist.
This medicine has been prescribed to you specifically. Do not pass it on to others. It may harm them, even if their symptoms are the same as yours.
If you experience any side effects, including those not listed in this leaflet, please inform your doctor or pharmacist. See section 4.
The active substance of Medrol, methylprednisolone, belongs to a group of glucocorticosteroids. Medrol is intended for oral use.
Like other glucocorticosteroids, Medrol affects, among others:
Medrol is used as symptomatic treatment, except in cases of endocrine disorders, when it is used as replacement therapy (substitution).
Disorders other than endocrine
Rheumatic diseases
Supportive treatment for short-term use (during episodes of exacerbation or worsening of health) in the course of:
psoriatic arthritis;
rheumatoid arthritis, including juvenile rheumatoid arthritis (in some cases, low-dose administration may be required as maintenance treatment);
ankylosing spondylitis;
acute and subacute bursitis;
acute non-specific tenosynovitis;
acute gouty arthritis;
post-traumatic degenerative joint disease;
synovitis in the course of degenerative joint disease;
epicondylitis.
Systemic connective tissue diseases
During exacerbation or as maintenance treatment in the course of:
systemic lupus erythematosus (and kidney inflammation in the course of lupus);
polymyositis and dermatomyositis;
acute rheumatic myocarditis;
polymyalgia rheumatica;
giant cell arteritis.
Dermatological diseases
pemphigus;
pemphigoid blistering skin inflammation;
severe form of erythema multiforme (Stevens-Johnson syndrome);
exfoliative dermatitis;
fungal granuloma;
severe form of psoriasis;
severe form of seborrheic dermatitis.
Allergic diseases
Treatment of severe allergic diseases, in cases where other treatment methods are ineffective:
seasonal or perennial (non-seasonal) allergic rhinitis;
posoriasis;
asthma;
drug hypersensitivity reactions;
contact dermatitis (contact eczema);
atopic dermatitis.
Ophthalmic diseases
Severe acute and chronic allergic and inflammatory processes affecting the eye and its appendages, such as:
allergic marginal corneal ulcers;
herpes zoster ophthalmicus;
inflammation in the anterior segment of the eye;
diffuse choroiditis of the posterior segment of the eye and choroiditis;
sympathetic choroiditis;
allergic conjunctivitis;
keratitis;
choroiditis and retinitis;
optic neuritis;
uveitis and iridocyclitis.
Respiratory system diseases
symptomatic sarcoidosis;
Loeffler's syndrome not responding to other medications;
berylliosis;
fulminant or disseminated pulmonary tuberculosis, concurrently with appropriate antitubercular chemotherapy;
aspiration pneumonia.
Blood diseases
Oncological diseases
Palliative treatment:
Edema
to induce diuresis (urine excretion) or remission of proteinuria (proteinuria) in nephrotic syndrome, without azotemia, idiopathic or in the course of systemic lupus erythematosus.
Gastrointestinal diseases
In the exacerbation of:
Nervous system diseases
Other
Endocrine disorders
In patients taking immunosuppressive doses of corticosteroids (i.e., suppressing antibody production and immune cells), live or live attenuated vaccines are contraindicated (these vaccines contain live microorganisms with weakened pathogenic properties).
Medrol may increase susceptibility to infections and may mask some symptoms of infection.
During its use, new infections may occur. While taking Medrol, there may be a decrease in the body's resistance and inability to limit local infections.
Patients may be susceptible to infections with any pathogen, including viral, bacterial, fungal, protozoal, or parasitic infections, in any part of the body. These infections can be mild, but also severe, sometimes fatal. The frequency of infectious complications increases with increasing doses of corticosteroids.
Patients taking Medrol are more susceptible to infections than healthy individuals, e.g., chickenpox and measles can have a more severe course or even be fatal in children or adults with impaired immunity.
The use of live vaccines is contraindicated in patients taking immunosuppressive doses of corticosteroids.
In patients with active tuberculosis, Medrol should only be used in cases of fulminant or disseminated tuberculosis, in combination with other antitubercular medications. If it is necessary to administer Medrol to a patient with latent or positive tuberculin test tuberculosis, close monitoring of the patient is required, as the disease may reactivate. In these patients, during long-term corticosteroid therapy, the doctor will decide on the need for additional treatment.
Kaposi's sarcoma has been reported in patients taking corticosteroids. Discontinuation of these drugs may lead to clinical remission.
During Medrol treatment, allergic reactions (e.g., angioedema) may occur.
In patients taking Medrol, rare cases of skin and anaphylactic reactions and (or) anaphylactoid reactions have been reported. Before administering Medrol, the doctor will take appropriate precautions, especially if the patient has a history of allergic reactions to any medication.
Medrol contains lactose monohydrate derived from cow's milk. Caution should be exercised in patients with known or suspected hypersensitivity to cow's milk or its components or other dairy products, as the medicine may contain trace amounts of milk components.
If a patient undergoing Medrol treatment experiences severe stress, the doctor may recommend increasing the dose of rapidly acting corticosteroids before, during, and after the stressful situation.
During Medrol treatment, adrenal insufficiency may occur, which may persist for several months after discontinuation of treatment. Patients should inform their doctor about any stressful situations that occur during this period. The doctor will consider initiating hormone therapy. The doctor may also decide to gradually reduce the dose of Medrol.
Sudden discontinuation of Medrol may cause acute adrenal insufficiency, leading to death.
After sudden discontinuation of Medrol, a "steroid withdrawal syndrome" may also occur, which is apparently unrelated to adrenal insufficiency. This syndrome includes symptoms such as loss of appetite, nausea, vomiting, lethargy, headache, fever, joint pain, skin peeling, muscle pain, weight loss, and (or) hypotension. It is believed that these effects result from the sudden change in Medrol concentration rather than its low concentration.
Patients with Cushing's syndrome should not take Medrol, as it may cause or exacerbate Cushing's syndrome.
If you have hyperthyroidism before starting Medrol, you should discuss this with your doctor or pharmacist.
Medrol may have a stronger effect in patients with hypothyroidism.
You should immediately consult your doctor if you experience weakness or muscle pain, cramps, and stiffness while taking methylprednisolone. These may be symptoms of a condition called thyrotoxic periodic paralysis, which can occur in patients with hyperthyroidism treated with methylprednisolone. Additional treatment may be necessary to alleviate this condition.
Medrol may increase blood glucose levels and worsen existing diabetes.
Patients taking Medrol for a long time may be more likely to develop diabetes.
During Medrol treatment and after its discontinuation, psychiatric disorders may occur.
They usually occur within a few days or weeks of starting Medrol treatment.
Most of them resolve after dose reduction or discontinuation of Medrol. Patients and their caregivers should consult a doctor if the patient experiences psychiatric symptoms, especially if they suspect depressive mood or suicidal thoughts.
Patients and their caregivers should be particularly attentive to psychiatric disorders that may occur during treatment, immediately after dose reduction, or after discontinuation of Medrol.
Medrol should be used with caution in patients with seizure disorders.
Medrol is effective in accelerating the resolution of severe multiple sclerosis relapses, but its effect on the ultimate outcome of the natural course of the disease has not been confirmed.
In patients with myasthenia gravis, the doctor will exercise caution when using Medrol.
There have been reports of tetracosactide-induced Cushing's syndrome in patients taking Medrol, usually with long-term use of high doses.
Caution should be exercised in patients with ocular herpes or ocular zoster, with symptoms affecting the eyeball, as Medrol treatment may increase the risk of corneal perforation.
In patients taking Medrol for a long time, posterior subcapsular cataracts and nuclear cataracts (especially in children) may develop, as well as exophthalmos or increased intraocular pressure, which can lead to glaucoma with potential optic nerve damage. Patients taking Medrol may also be more likely to develop secondary fungal or viral eye infections.
Medrol treatment is associated with an increased risk of central serous chorioretinopathy, which can lead to retinal detachment.
If you experience blurred vision or other vision disturbances, you should consult a doctor.
Medrol has an unfavorable effect on the cardiovascular system, including dyslipidemia (abnormal serum lipid levels) and hypertension, so patients with existing cardiovascular risk factors may be at increased risk of cardiovascular effects when taking high doses and long-term Medrol treatment. In these patients, the doctor will exercise caution when using Medrol and may recommend monitoring the cardiovascular system. The doctor may recommend using Medrol in low doses and in an alternate-day regimen, as this may reduce the frequency of Medrol treatment complications.
In patients with congestive heart failure, Medrol treatment should be used with caution and only when necessary.
During Medrol treatment, thrombosis has been reported, including venous thromboembolic disease. Therefore, caution should be exercised in patients with thromboembolic disorders or those who may be prone to their occurrence.
In patients with hypertension, Medrol treatment should be used with caution.
High doses of Medrol may cause acute pancreatitis. Medrol may mask symptoms of peptic ulcer disease, so perforations or bleeding may occur without accompanying significant pain. Medrol treatment may mask peritonitis or other symptoms related to gastrointestinal disorders, such as perforation, obstruction, or pancreatitis. In combination with non-steroidal anti-inflammatory drugs (NSAIDs), the risk of developing peptic ulcer disease of the stomach and intestines increases.
In patients with non-specific ulcerative colitis, Medrol should be used with caution, especially if there is a risk of perforation, abscess, or other forms of purulent infection, diverticulitis, recent intestinal anastomosis, active or latent peptic ulcer disease.
Rare cases of liver and bile duct disorders have been reported, most of which resolved after discontinuation of treatment. Therefore, monitoring is necessary.
During Medrol treatment, acute myopathy may occur, most often in patients with neuromuscular transmission disorders (e.g., myasthenia gravis) or in patients taking drugs that block this transmission (e.g., pancuronium). Elevated creatine kinase levels may also occur. Recovery after discontinuation of Medrol may take time and can last from several weeks to years.
In patients taking high doses of Medrol for a long time, osteoporosis may occur.
Caution should be exercised in patients with systemic sclerosis, as an increased frequency of scleroderma renal crisis has been observed with corticosteroids, including methylprednisolone.
Medrol should be used with caution in patients with renal impairment.
The use of medium and high doses of Medrol may increase blood pressure, sodium and water retention, and potassium excretion. Therefore, the doctor may recommend restricting salt intake in the diet and supplementing potassium. All glucocorticosteroids, including Medrol, increase calcium excretion.
Medrol should not be used to treat traumatic brain injury.
The complications of glucocorticosteroid therapy depend on the dose and duration of treatment. The doctor will decide on the dosage and duration of treatment individually for each patient.
The doctor will decide on the use of the smallest effective dose necessary to control symptoms. Dose reduction should be gradual.
You should inform your doctor about all medications you are currently taking or have recently taken, including those available without a prescription.
Some medications may enhance the effect of Medrol, and the doctor may want to closely monitor the patient's condition when taking such medications (including some HIV medications: ritonavir, cobicistat).
Patients should exercise caution when taking aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) with Medrol.
After Medrol administration, a crisis in the course of pheochromocytoma has been reported, sometimes fatal. The doctor will decide on the use of Medrol only after careful assessment of the risk-benefit ratio in patients suspected of having pheochromocytoma.
Tumor lysis syndrome may occur during corticosteroid treatment for cancer. You should inform your doctor if you have cancer and experience symptoms of tumor lysis syndrome, such as muscle cramps, weakness, confusion, irregular heartbeat, vision loss, or shortness of breath.
Infants and children who are undergoing long-term Medrol treatment should be closely monitored for growth and development.
In children undergoing long-term Medrol treatment, in divided daily doses, growth retardation may occur. The doctor should limit this type of treatment to the most severe indications. Adverse effects can be avoided or minimized by using an intermittent treatment regimen.
Infants and children undergoing long-term Medrol treatment are particularly susceptible to increased intracranial pressure.
High doses of Medrol may cause pancreatitis in children.
You should inform your doctor about all medications you are currently taking or plan to take. Medrol may affect the action of other medications, and other medications may affect the action of Medrol.
It may be necessary to adjust the dose of Medrol when used concurrently with the following medications:
antibacterial medications: isoniazid
antitubercular antibiotic: rifampicin
If you are pregnant or breastfeeding, think you may be pregnant, or plan to have a child, consult your doctor or pharmacist before taking this medication.
In animal studies, Medrol has been shown to have a detrimental effect on fertility.
Until appropriate studies are conducted on the effect of Medrol on human reproductive processes, this medication should not be given to pregnant women unless a thorough assessment of the risk-benefit ratio for the mother and fetus has been made.
Some corticosteroids easily cross the placental barrier. In one retrospective study, an increased frequency of low birth weight infants was found in mothers taking corticosteroids. In humans, the risk of low birth weight appears to be dose-dependent. This risk may be reduced by administering lower doses of corticosteroids.
If it is necessary to discontinue chronic Medrol treatment during pregnancy, it should be done gradually. In some situations (e.g., replacement therapy for adrenal insufficiency), it may be necessary to continue or even increase the dose. Children born to mothers who took Medrol during pregnancy should be closely monitored and examined for adrenal insufficiency.
The effect of Medrol on the course of labor is unknown.
In infants born to mothers who took Medrol for a long time during pregnancy, cataract development has been observed.
Medrol passes into breast milk.
This medication can be used by breastfeeding women only after a thorough assessment of the risk-benefit ratio for the mother and infant.
The effect of Medrol on the ability to drive and use machines has not been evaluated.
During Medrol treatment, side effects such as dizziness, vision disturbances, and fatigue are possible. If you experience such symptoms, you should not drive or operate machinery.
If you have previously been diagnosed with intolerance to some sugars, you should consult your doctor before taking this medication.
Take this medication always as directed by your doctor. In case of doubts, consult your doctor or pharmacist.
The doctor will decide on the initial dose, which may range from 4 mg to 48 mg of methylprednisolone per day, depending on the disease. In cases of milder diseases, smaller doses are usually used, but in some patients, higher doses may be necessary. High-dose treatment is used in cases of: brain edema (200-1000 mg/day) and organ transplantation (up to 7 mg/kg/day) and multiple sclerosis. In the treatment of multiple sclerosis relapses, oral doses of 500 mg/day for 5 days or 1000 mg/day for 3 days have been effective. If there is no clinical improvement, the doctor will decide to discontinue Medrol treatment and use other treatment. If it is necessary to discontinue long-term treatment, it is recommended to gradually reduce the dose.
In case of clinical improvement, the doctor will establish a maintenance dose by gradually reducing the initial dose at appropriate intervals until the smallest dose that maintains the beneficial clinical effect is achieved. The dose should be constantly monitored. In case of remission or exacerbation of the disease process, individual patient reaction to treatment, or stressful situations, the doctor may decide to modify the dose. In patients exposed to stress, it may be necessary to increase the dose of Medrol during the stressful situation.
The dose is variable and must be determined individually, depending on the type of disease and individual patient response.
Alternate-day treatment regimen
The doctor may decide to use an alternate-day treatment regimen: administering a double daily dose every other day in the morning. The purpose of this regimen is to ensure the beneficial effect of corticosteroids and minimize some side effects, such as: suppression of the hypothalamic-pituitary-adrenal axis, Cushing's syndrome (a syndrome of disease symptoms associated with increased cortisol levels), growth retardation in children, and symptoms of sudden discontinuation of corticosteroid treatment.
WARNING! The score line on the tablet is not intended for breaking the tablet.
In case of taking too much Medrol, consult your doctor or pharmacist immediately. There are no clinical symptoms of acute Medrol overdose. There is no specific antidote in case of Medrol overdose. In such cases, supportive and symptomatic treatment is used. Chronic overdose causes typical symptoms of Cushing's syndrome. Dialysis is an effective method of removing Medrol from the body.
Do not take a double dose of Medrol to make up for a missed dose.
Like all medications, Medrol can cause side effects, although not everybody gets them.
In case of experiencing any of the following symptoms, consult your doctor or go to the nearest hospital immediately:
Frequency not known (frequency cannot be estimated from available data)
Peritonitis may be the first symptom of gastrointestinal disorders, such as perforation, obstruction, or pancreatitis.
Reporting side effects
If you experience any side effects, including those not listed in this leaflet, please inform your doctor or pharmacist. Side effects can be reported directly to the Department of Drug Safety Monitoring of the Office for Registration of Medicinal Products, Medical Devices, and Biocidal Products
Al. Jerozolimskie 181C
02-222 Warsaw
Phone: +48 22 49 21 301
Fax: +48 22 49 21 309
Website: https://smz.ezdrowie.gov.pl
Side effects can also be reported to the marketing authorization holder or its representative.
By reporting side effects, you can help provide more information on the safety of this medication.
Store the medication at a temperature below 25°C.
Store the medication out of sight and reach of children.
Do not use this medication after the expiration date stated on the packaging (EXP). The expiration date refers to the last day of the month indicated.
Medications should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medications that are no longer needed. This will help protect the environment.
4 mg tablets are:
half-oval, elliptical, white tablets with the inscription "MEDROL 4" on one side and a double score line on the other side.
16 mg tablets are:
elliptical, convex, white tablets with the inscription "MEDROL 16" on one side and a double score line on the other side.
Medrol 4 mg is available in PVC/Al blisters or a high-density polyethylene (HDPE) bottle with a polypropylene (PP) cap with an aluminum/polyethylene seal, a child-resistant closure, placed in a cardboard box. The packaging contains 10, 30, 100 tablets in blisters or in a bottle.
Medrol 16 mg is available in PVC/Al blisters or a high-density polyethylene (HDPE) bottle with a polypropylene (PP) cap with an aluminum/polyethylene seal, a child-resistant closure, placed in a cardboard box. The packaging contains 50 tablets in blisters or 50 tablets in a bottle.
Pfizer Europe MA EEIG
Boulevard de la Plaine 17
1050 Brussels
Belgium
Pfizer Italia S.r.l.
63 100 Localitá Marino del Tronto
Ascoli Piceno
Italy
To obtain more detailed information about this medication, please contact the local representative of the marketing authorization holder:
Pfizer Polska Sp. z o.o.
phone: 22 335 61 00
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