Solu-Medrone

What is it?

A glucocorticoid available as a powder in vials for reconstitution in 3 strengths containing 40mg, 125mg and 500mg of methylprednisolone as sodium succinate. Also, SOLUMEDRONE 2G, in vials with diluent containing 2g of methylprednisolone as sodium succinate.

Medical Uses

Solu-Medrone, allergies, transplant surgery, acute flare-ups in relapsing multiple sclerosis, Crohn's disease, ulcerative colitis, cerebral oedema caused by tumour, Stevens- Johnson syndrome, aspiration of stomach contents. Solu-Medrone 2g, acute injuery to spinal cord.

Dosage

Adults, Solu-Medrone, 10 to 500mg at first by slow intravenous injection over half an hour or longer, or by intramuscular injection. Transplants, lg each day; multiple sclerosis, lg each day for 3 consecutive days given by intravenous infusion lasting at least half an hour. Solu-Medrone 2g, adults only, 30mg per kg of body weight given by slow intravenous injection over 15 minutes, beginning within 8 hours of injury. Then, after 45 minutes, 5.4mg per kg of body weight per hour for 23 hours by intravenous infusion. Children, up to 30mg per kg of body weight each day, depending upon condition. For status asthmaticus, 1 to 4mg per kg of body weight each day for 1 to 3 days. Transplants, 10 to 20mg per kg of body weight each day for 1, 2 or 3 days to a maximum of lg daily.

Special Care

Elderly, pregnancy, breast- feeding, only for short-term treatment in children. Infections, especially tuberculosis, fungal and viral. Liver failure, cirrhosis, kidney disorders, congestive heart failure, recent heart attack, diarrhoea of unknown cause, ulcerative colitis, stomach ulcer, diverticulitis, recent scar tissue affecting digestive tract, inflammatory conditions of the veins, glaucoma. Also, cancers that have spread, diabetes, certain skin diseases, high blood pressure, psychotic conditions, epilepsy, osteoporosis, herpes simplex infections affecting the eyes, cerebral malaria, under-active thyroid gland, stress, previous steroid myopathy, intercurrent illnesses, myasthenia gravis. Also, accidental injuries and planned surgery - patient must be monitored. Patients should avoid exposure to measles infection - if inadvertently exposed, preventative treatment with immunoglobulins may be needed. Likewise, exposure to chickenpox or herpes zoster should be avoided - treatment with varicellazoster immunoglobulin may be required. Taking drug in morning or every second day helps to reduce risk of suppression of adrenal glands. Patients should carry a 'steroid treatment card', treatment should be short-term. Withdraw treatment gradually.

Avoid Use

Whole body fungal infections, unless particular counter measures are being employed.

Possible Drug and Food Interactions

Anticholinesterases, phenobarbitone, cardiac glycosides, diuretics, carbamazapine, antihypertensives, anticoagulants taken by mouth, rifampicin, oestrogens, hypoglycaemics, phenytoin, aminoglutethimide, primidone, ephedrine, rifabutin. Also, salicylates, NSAIDs, cyclosporin, live vaccines, azole antifungals, carbenoxolone, erythromycin, methotrexate.

Known Side Effects

Depending upon dose and duration of treatment, steroid side effects including electrolyte disturbances and fluid imbalances, water retention, loss of potassium, gastrointestinal disturbance, central nervous system effects, salt retention, impaired wound healing, effects on bones, osteoporosis, cataracts, cushingoid effects, skin changes, depression, high blood pressure, glaucoma. Also, muscle weakness, stomach ulcer, hyperglycaemia, changes in sperm mobility, euphoria, mood swings. Also, retarded growth in children.