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MEDRONE is a brand name for Methylprednisolone. The medicine, its uses, side effects and dosage are the same regardless of brand.
Used for: Medrone is indicated for conditions requiring glucocorticoid activity such as:- 1. Endocrine disorders Primary and secondary adrenal insufficiency Congenital adrenal hyperplasia 2. Rheumatic disorders Rheumatoid arthritis Juvenile chronic arthritis Ankylosing spondylitis 3. Collagen diseases/arteritis Systemic lupus…
Verbatim from this product's MHRA label. Tap a section to expand.
The dosage recommendations shown in the table below are suggested initial daily doses and are intended as guides. 00 am). 4). The initial suppressive dose level may vary depending on the condition being treated. This is continued until a satisfactory clinical response is obtained, a period usually of three to seven days in the case of rheumatic diseases (except for acute rheumatic carditis), allergic conditions affecting the skin or respiratory tract and ophthalmic diseases.
If a satisfactory response is not obtained in seven days, re-evaluation of the case to confirm the original diagnosis should be made. g. g. rheumatoid arthritis, systemic lupus erythematosus, bronchial asthma, atopic dermatitis). In chronic conditions, and in rheumatoid arthritis especially, it is important that the reduction in dosage from initial to maintenance dose levels be accomplished as clinically appropriate.
Decrements of not more than 2 mg at intervals of 7 - 10 days are suggested. In rheumatoid arthritis, maintenance steroid therapy should be at the lowest possible level. 00 am. Dosage requirements depend on the condition being treated and response of the patient.
4).
Paediatric population:
In general, dosage for children should be based upon clinical response and is at the discretion of the physician. Treatment should be limited to the minimum dosage for the shortest period of time. 4).
Dosage Recommendations:
Indications Recommended initial daily dosage Rheumatoid arthritis severe 12 - 16 mg moderately severe 8 - 12 mg moderate 4 - 8 mg children 4 - 8 mg Systemic dermatomyositis 48 mg Systemic lupus erythematosus 20 - 100 mg Acute rheumatic fever 48 mg until ESR normal for one week.
Allergic diseases 12 - 40 mg Bronchial asthma up to 64 mg single dose/alternate day up to 100 mg maximum. Ophthalmic diseases 12 - 40 mg Haematological disorders and leukaemias 16 - 100 mg Malignant lymphoma 16 - 100 mg Ulcerative colitis 16 - 60 mg Crohn's disease up to 48 mg per day in acute episodes.
6 mg/kg/day Pulmonary sarcoid 32 - 48 mg on alternate days. Giant cell arteritis/polymyalgia rheumatica 64 mg Pemphigus vulgaris 80 - 360 mg
4). # Panniculitis may occur following dose reduction or discontinuation of methylprednisolone and has been more frequently reported in the paediatric population. 4). Reporting of suspected adverse reactions Reporting suspected adverse reactions after authorisation of the medicinal product is important.
It allows continued monitoring of the benefit/risk balance of the medicinal product. uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.
Immunosuppressant Effects/Increased Susceptibility to Infections Corticosteroids may increase susceptibility to infection, may mask some signs of infection, exacerbate existing infections, increase the risk of reactivation or exacerbation of latent infections and new infections may appear during their use.
Suppression of the inflammatory response and immune function increases the susceptibility to fungal, viral and bacterial infections and their severity. The clinical presentation may often be atypical and may reach an advanced stage before being recognised.
Monitor for the development of infection and consider withdrawal of corticosteroids or dosage reduction as needed. Persons who are on drugs which suppress the immune system are more susceptible to infections than healthy individuals.
Chicken pox and measles, for example, can have a more serious or even fatal course in non-immune children or adults on corticosteroids. Chickenpox is of serious concern since this normally minor illness may be fatal in immunosuppressed patients.
Patients (or parents of children) without a definite history of chickenpox should be advised to avoid close personal contact with chickenpox or herpes zoster and if exposed they should seek urgent medical attention. Passive immunization with varicella/zoster immunoglobulin (VZIG) is needed by exposed non-immune patients who are receiving systemic corticosteroids or who have used them within the previous 3 months; this should be given within 10 days of exposure to chickenpox.
If a diagnosis of chickenpox is confirmed, the illness warrants specialist care and urgent treatment. Corticosteroids should not be stopped and the dose may need to be increased. Exposure to measles should be avoided. Medical advice must be sought immediately if exposure occurs.
Prophylaxis with normal intramuscular immunoglobulin may be needed. Similarly corticosteroids should be used with great care in patients with known or suspected parasitic infections such as Strongyloides (threadworm) infestation, which may lead to Strongyloides hyperinfection and dissemination with widespread larval migration, often accompanied by severe enterocolitis and potentially fatal gram-negative septicemia.
1 Administration of live or live, attenuated vaccines is contraindicated in patients receiving immunosuppressive doses of corticosteroids.
Not medical advice. Always read the patient information leaflet and follow your prescriber or pharmacist.
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Administration of live or live, attenuated vaccines is contraindicated in patients receiving immunosuppressive doses of corticosteroids. The antibody response to other vaccines may be diminished. The use of corticosteroids in active tuberculosis should be restricted to those cases of fulminating or disseminated tuberculosis in which the corticosteroid is used for the management of the disease in conjunction with an appropriate antituberculous regimen.
If corticosteroids are indicated in patients with latent tuberculosis or tuberculin reactivity, close observation is necessary as reactivation of the disease may occur. During prolonged corticosteroid therapy, these patients should receive chemoprophylaxis.
Kaposi’s sarcoma has been reported to occur in patients receiving corticosteroid therapy. Discontinuation of corticosteroids may result in clinical remission. The role of corticosteroids in septic shock has been controversial, with early studies reporting both beneficial and detrimental effects.
More recently, supplemental corticosteroids have been suggested to be beneficial in patients with established septic shock who exhibit adrenal insufficiency. However, their routine use in septic shock is not recommended. A systematic review of short-course high-dose corticosteroids did not support their use.
However, meta- analyses, and a review have suggested that longer courses (5-11 days) of low-dose corticosteroids might reduce mortality. Immune System Because rare instances of skin reactions and anaphylactic/anaphylactoid reactions have occurred in patients receiving corticosteroid therapy, appropriate precautionary measures should be taken prior to administration, especially when the patient has a history of allergy to any drug.
This medicine contains lactose produced from cow’s milk. Caution should be exercised in patients with a known or suspected hypersensitivity to cow’s milk or its components or other dairy products because it may contain trace amounts of milk ingredients.
Endocrine Effects In patients on corticosteroid therapy subjected to unusual stress, increased dosage of rapidly acting corticosteroids before, during, and after the stressful situation is indicated. Adrenal cortical atrophy develops during prolonged therapy and may persist for months after stopping treatment.
In patients who have received more than physiological doses of systemic corticosteroids (approximately 6 mg methylprednisolone) for greater than 3 weeks, withdrawal should not be abrupt. How dose reduction should be carried out depends largely on whether the disease is likely to relapse as the dose of systemic corticosteroids is reduced.
Clinical assessment of disease activity may be needed during withdrawal. If the disease is unlikely to relapse on withdrawal of systemic corticosteroids, but there is uncertainty about HPA suppression, the dose of systemic corticosteroid may be reduced rapidly to physiological doses.
Once a daily dose of 6 mg methylprednisolone is reached, dose reduction should be slower to allow the HPA-axis to recover. Abrupt withdrawal of systemic corticosteroid treatment, which has continued up to 3 weeks is appropriate if it considered that the disease is unlikely to relapse.
Abrupt withdrawal of doses up to 32 mg daily of methylprednisolone for 3 weeks is unlikely to lead to clinically relevant HPA-axis suppression, in the majority of patients. In the following patient groups, gradual withdrawal of systemic corticosteroid therapy should be considered even after courses lasting 3 weeks or less: • Patients who have had repeated courses of systemic corticosteroids, particularly if taken for greater than 3 weeks.
• When a short course has been prescribed within one year of cessation of long-term therapy (months […]