Methsolon 500 IV/IM Vial

Indications

1. Endocrine Disorders:
   • Adrenocortical insufficiency (primary or secondary), acute adrenal crises, congenital adrenal hyperplasia, nonsuppurative thyroiditis, hypercalcemia in malignancy.
2. Rheumatic Disorders:
   • Rheumatoid arthritis (including juvenile), acute bursitis, epicondylitis, gouty arthritis, psoriatic arthritis, ankylosing spondylitis.
3. Collagen Diseases:
   • Systemic lupus erythematosus, dermatomyositis, acute rheumatic carditis.
4. Dermatological Conditions:
   • Pemphigus, severe erythema multiforme (Stevens-Johnson syndrome), exfoliative dermatitis, severe seborrheic dermatitis, psoriasis, and mycosis fungoides.
5. Allergic States:
   • Bronchial asthma, atopic/contact dermatitis, serum sickness, allergic rhinitis, drug hypersensitivity, anaphylactic reactions.
6. Ophthalmic Diseases:
   • Allergic and inflammatory eye conditions like iritis, iridocyclitis, chorioretinitis, optic neuritis, and keratitis.
7. Gastrointestinal Diseases:
   • Ulcerative colitis, Crohn’s disease.
8. Respiratory Diseases:
   • Sarcoidosis, aspiration pneumonitis, berylliosis, fulminating tuberculosis with concurrent antituberculosis therapy.
9. Hematological Disorders:
   • Autoimmune hemolytic anemia, idiopathic thrombocytopenic purpura (IV only), erythroblastopenia, thrombocytopenia.
10. Neoplastic Diseases:
    • Palliative treatment of leukemias and lymphomas.
11. Edematous States:
    • Nephrotic syndrome (without uremia), secondary to lupus erythematosus.
12. Miscellaneous:
    • Tuberculous meningitis with subarachnoid block, trichinosis with neurologic or myocardial involvement.

Pharmacology

• Methylprednisolone is a glucocorticoid analog of hydrocortisone, more potent in anti-inflammatory effects (5:4 potency vs. prednisolone) with reduced mineralocorticoid effects, lowering sodium/water retention. It affects metabolism, immune responses, and several body systems. It’s absorbed rapidly when administered intravenously or intramuscularly, with effects within one hour.

Dosage & Administration

• IM/IV Injection: Administer based on disease severity. For high-dose therapy (e.g., 30 mg/kg), administer via IV infusion over 30 minutes, repeated every 4-6 hours for 48 hours. Dosages vary from 10-40 mg depending on condition.
• Pediatrics: Dosage ranges from 0.11-1.6 mg/kg/day in divided doses. Careful monitoring for side effects is essential.

Drug Interactions

• Aminoglutethimide: May reduce corticosteroid effect.
• Anticholinesterases: Worsening of myasthenia gravis symptoms.
• Cyclosporine: Increased activity and risk of convulsions.
• Antidiabetics: Corticosteroids raise blood glucose, requiring dosage adjustments.
• Macrolides & Estrogens: May reduce corticosteroid clearance, increasing effects.
• NSAIDs & Aspirin: Increased risk of gastrointestinal side effects.

Contraindications

• Systemic fungal infections, hypersensitivity to components, and for intrathecal administration. Intramuscular administration is contraindicated in idiopathic thrombocytopenic purpura.

Side Effects

• Fluid/Electrolyte Imbalance: Sodium/potassium imbalance, hypertension, heart failure.
• Musculoskeletal: Weakness, osteoporosis, myopathy.
• Gastrointestinal: Peptic ulcers, pancreatitis.
• Neurological: Headaches, increased intracranial pressure.
• Endocrine: Cushing’s syndrome, growth suppression, hyperglycemia.

Precautions

• Use the lowest effective dose and taper gradually. Prolonged therapy requires regular monitoring of blood pressure, weight, and laboratory studies.

Use in Special Populations

• Pregnancy: Use only if benefits outweigh risks. Monitor newborns for adrenal suppression.
• Lactation: May affect infant growth and corticosteroid levels, so a risk-benefit decision is required.