Depo-Medrol Review Article |
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 Methylprednisolone, known as Depo-Medrol, is a synthetic glucocorticoid drug which is sold in the USA and Canada under the brand names Phocenta, Medrol, Solu-Medrol or Cadista. It is typically used for its anti-inflammatory effects, like most adrenocortical steroids, but it can change the metabolism and the immune responses. The list of medical conditions for which methlyprednisolone is prescribed is rather long, and is similar to other corticosteroids such as prednisolone. Common uses include arthritis therapy and short-term treatment of bronchial inflammation or acute bronchitis due to various respiratory diseases. It is used both in the treatment of acute periods and long-term management of autoimmune diseases, most notably Systemic lupus erythematosus.
Depo-Medrol, also known by the name of methylprednisolone is basically a synthetic glucocortocoid drug. In countries like Canada and USA, it is sold under the brand names like Phocenta, Medrol, Cadista and Solu-Medrol. It falls under the category of adrenocortical steroids that are used for their anti-inflammatory effects and there are numerous purposes for which methylprednisolone are used. However, glucocorticoids are used for other purposes related to metabolism and immune responses. Some of the common problems for which it is used include short-term treatment for bronchial inflammation and arthritis therapy. It can be used for both long-term and short-term treatment of autoimmune diseases, especially lupus erythematosus. Continue reading...
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Indications
Prescribed for Endocrine Disorders
• Primary as well as Secondary adrenocortical insufficiency
• Acute adrenocortical insufficiency
• Congenital adrenal hyperplasia
• Hypercalcemia associated with cancer
• Nonsuppurative thyroiditis
Rheumatic Disorders
• Post-traumatic osteoarthritis
• Synovitis of osteoarthritis
• Acute and subacute bursitis
• Acute nonspecific tenosynovitis
• Epicondylitis
• Psoriatic arthritis
• Acute gouty arthritis
Collagen diseases
• Systemic dermatomyositis (polymyositis)
• Acute rheumatic carditis
• Systemic lupus erythematosus
Dermatologic Diseases
• Mycosis fungoides
• Severe psoriasis
• Severe seborrheic dermatitis
• Bullous dermatitis herpetiformis
• Exfoliative dermatitis
• Severe erythema multiforme (Stevens-Johnson syndrome)
• Pemphigus
In state of Allergy
• Bronchial asthma
• Contact dermatitis
• Seasonal or perennial allergic rhinitis
• Atopic dermatitis
• Serum sickness
• Drug hypersensitivity reactions
• Acute noninfectious laryngeal edema (epinephrine is the drug of first choice)
• Urticarial transfusion reactions
Ophthalmic Diseases
• Chorioretinitis
• Herpes zoster ophthalmicus
• Iritis, iridocyclitis
• Sympathetic ophthalmia
• Diffuse posterior uveitis and choroiditis
• Optic neuritis
• Anterior segment inflammation
• Keratitis
• Allergic conjunctivitis
• Allergic corneal marginal ulcers
Gastrointestinal Diseases
• Regional enteritis (systemic therapy)
• Ulcerative colitis (systemic therapy)
Respiratory Diseases
• Aspiration pneumonitis
• Loeffler's syndrome
• Symptomatic sarcoidosis
• Berylliosis
Hematologic Disorders
• Congenital (erythroid) hypoplastic anaemia
• Secondary thrombocytopenia in adults
• Erythroblastopenia (RBC anaemia)
• Acquired (autoimmune) haemolytic anaemia
Neoplastic Diseases
• Acute leukaemia of childhood
• Leukaemia and lymphomas in adults
Nervous System
• Exacerbations of multiple sclerosis
Dosage
Due to physical incompatibilities, Depo-Medrol should not be mixed with other solutions.
Administration for Local Effect
In case of Rheumatoid and Osteoarthritis
The dosage in these cases varies with the size of the joints and the severity of the condition of the patient. In severe cases, the dosage is repeated from one to five weeks depending on the relief that it provides to the patient.
In case Dermatologic Conditions
The dosage in this case varies from 20 mg to 60 mg and divided doses of 20 mg to 40 mg in case of large lesions.
Administration for Systemic Effect
For patients who are suffering from adrenogenital syndrome, a single dose of 40 mg in every two weeks is enough. In case of patients suffering from rheumatoid arthritis, the intramuscular dose varies from 40 mg to 120 mg. For patients with dermatologic lesions, the dosage caries from 40 to 120 mg of methylprednisolone acetate intramuscularly for one to four weeks.
Side effects
Fluid and electrolyte disturbances
• Sodium retention
• Potassium loss
• Congestive heart failure in susceptible patients
• Hypertension
• Hypokalemic alkalosis
• Fluid retention
Ophthalmic
• Exophthalmos
• Posterior subcapsular cataracts
• Increased intraocular pressure
• Glaucoma
Endocrine
• Development of Cushingoid state
• Decreased carbohydrate tolerance
• Suppression of growth in children
• Menstrual irregularities
• Secondary adrenocortical and pituitary unresponsiveness, particularly in times of stress, as in trauma, surgery or illness
• Increased requirements for insulin or oral hypoglycemic agents in diabetes
• Manifestations of latent diabetes mellitus
Musculoskeletal
• Steroid myopathy
• Muscle weakness
• Loss of muscle mass
• Tendon rupture, particularly of the Achilles tendon
• Osteoporosis
• Aseptic necrosis of femoral and humeral heads
• Vertebral compression fractures
• Pathologic fracture of long bones
Gastrointestinal
• Pancreatitis
• Peptic ulcer with possible subsequent perforation and haemorrhage
• Abdominal distention
• Increases in alanine transaminase (ALT, SGPT), aspartate transaminase (AST, SGOT), and alkaline phosphatase have been observed following corticosteroid treatment. These changes are usually small, not associated with any clinical syndrome and are reversible upon discontinuation.
• Ulcerative esophagitis
Dermatologic
• Petechiae and ecchymoses
• Impaired wound healing
• Facial erythema
• Thin fragile skin
• May suppress reactions to skin tests
• Increased sweating
Neurological
• Convulsions
• Vertigo
• Increased intracranial pressure with papilledema (pseudotumor cerebri) usually after treatment
• Headache
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