MEDROL ® Methylprednisolone

MEDROL ® a drug based on Methylprednisolone

THERAPEUTIC GROUP: Non-associated corticosteroids

IndicationsAction mechanismStudies and clinical effectiveness Usage and dosage instructionsWarnings Pregnancy and lactationInteractionsContraindicationsUndesirable effects

Indications MEDROL ® Methylprednisolone

MEDROL ® used in the treatment of all those inflammatory states that require the use of corticosteroid drugs.

Rheumatological diseases, collagen diseases, dermatological diseases, allergic states, ophthalmic, respiratory, gastro-intestinal and neoplastic diseases are just some of the morbid conditions for which treatment with MEDROL ® can be useful to alleviate the related symptoms.

Mechanism of action MEDROL ® Methylprednisolone

Methylprendisolone, a synthetic glucocorticoid contained in MEDROL ® taken orally and rapidly absorbed by the small intestine, is bound by weak bonds to plasma proteins such as albumin and transcortin which guarantee transport to the blood level.

Concentrated mainly at the level of endothelial cells and platelets, methylprednisolone carries out its impressive anti-inflammatory activity, modulating the expression of different genes and inducing the expression of some proteins such as Lipocortin capable of inhibiting the enzyme phospholipase A2.

This enzyme, initiator of the inflammatory process, breaks down some membrane phospholipids originating arachidonic acid, a direct precursor of inflammatory mediators such as leukotrienes, prostaglandins and prostacyclins responsible for the various vascular adaptations useful for recalling and receiving cells of the inflammatory response.

This useful and valuable process in physiological conditions can become particularly harmful to the affected tissue in pathological conditions characterized by chronic inflammatory states, so much so that it requires the use of active ingredients such as methylprednisolone capable of extinguishing the cascade of inflammatory events upstream.

Studies carried out and clinical efficacy

1. CORTICOSTEROIDS AND NEURODEGENERATIVE DISEASES

Demyelinating neurological pathologies lead to a progressive and inexorable loss of some important motor and sensory skills. Despite the existence of pathological conditions characterized by a very slow and progressive course, the "pulsating" therapy with corticosteroids has proved particularly useful in delaying the onset of these symptoms and improving the quality of life of affected patients.

2. METILPREDNSIOLONE AND POSTOPERATIVE COURSE

In recent years, methylprednisolone treatment has taken on an important value in significantly improving the post-operative course of surgical patients. In this study, for example, with the "preventive" therapy with methylprednisolone it is possible to reduce nausea and vomiting in patients undergoing total knee and hip arthroplasty.

3. METHYLPREDNISOLONE AND CHRONIC LYMPHOCYTIC LEUKEMIA

High-dose treatment with methylprednisolone has been shown to be useful in inducing remission of the disease in patients with chronic lymphocytic leukemia and not responsive to conventional therapy.

Method of use and dosage

MEDROL ® tablets of 4 - 16 mg of methylprendisolone:

the high number of pathologies for which this active ingredient is indicated determines the presence of a particularly wide range of dosages which in a general line ranges from 4 to 48 mg per day.

The dosage formulation is entirely up to the doctor after a careful evaluation of the patient's physiopathological conditions, of the clinical picture and of the related therapeutic objectives.

Medical supervision throughout the therapeutic process is also useful for defining the optimal dose for the patient undergoing therapy, able to effectively carry out their anti-inflammatory role, minimizing potential side effects.

Warnings MEDROL ® Methylprednisolone

The entire therapeutic procedure should be supervised by expert medical personnel in order to adapt the dosage to any change in the patient's health status, to the actual therapeutic needs and to the relative efficacy.

The important anti-inflammatory and immunomodulatory effect of cortisone drugs could reduce the patient's protective ability by exposing him to recurrent infections, reactivation of silent infectious diseases or reducing the effectiveness of immunization preventive strategies.

Patients suffering from diabetes, cardiovascular diseases, kidney diseases, liver diseases, neurological and psychiatric diseases should use this medicine only in cases of real need, given the ability of methylprednisolone to significantly aggravate the clinical picture of these individuals.

The metabolic, endocrine and relative effects on the osteo-muscular apparatus could clearly compromise the development of patients undergoing cortisone therapy during the growth phase.

The "nervous" side effects of methylprednisolone could also make it dangerous to use machinery, drive vehicles or all those activities that require a perceptive and intellectual commitment.

PREGNANCY AND BREASTFEEDING

With the exception of some experimental studies conducted on animals, in which the administration of high doses of corticosteroids induced fetal malformations, at the moment there are no significant clinical trials able to evaluate the real safety profile of these drugs.

Consequently the use of MEDROL ® in pregnancy is generally not recommended or limited to cases of real need and under strict specialist medical supervision.

The "newborn" should also be subjected to birth, to tests useful for assessing adrenal function.

Interactions

Several active ingredients can interact with methylprednisolone altering its normal therapeutic properties.

More precisely the concomitant assumption of rifampicin, antiepileptics and barbiturates can reduce the therapeutic efficacy of MEDROL ® while that of erythromycin, ketoconazole and troleandromycin is able to enhance its biological activity.

Changes in metabolism and therapeutic efficacy of oral anticoagulants, salicylates, hypoglycemics, psychotropic drugs such as anxiolytics and mimetic sympathetic has been documented in the literature following the simultaneous administration of methylprednisolone.

Contraindications MEDROL ® Methylprednisolone

MEDROL ® contraindicated in case of systemic fungal infections and in case of hypersensitivity to its active ingredient and its excipients.

The administration of corticosteroids could aggravate the clinical picture of diabetic, hypertensive patients suffering from neurological and psychiatric diseases.

Undesirable effects - Side effects

Extensive clinical experience and a thriving post-marketing monitoring highlight the particular danger of long-term and high-dose corticosteroid therapy.

The greatest number of side effects has in fact been observed in long-term therapies of chronic inflammatory states, in which the patient is exposed to risks related to the health of the musculoskeletal system (osteoporosis, myopathies and bone fragility), of the endocrine system ( alterations of the hypothalamic-pituitary axis function), of the visual apparatus, of the gastro-intestinal and cardiovascular system.

Furthermore, important metabolic alterations related to glucose metabolism, nitrogen balance and hydroelectrolyte balance were observed in patients undergoing cortisone therapy.