DEPO-MEDROL + LIDOCAINA ® Methylprednisolone + Lidocaine

DEPO- MEDROL + LIDOCAINA ® is a drug based on Methylprednisolone acetate and lidocaine hydrochloride

THERAPEUTIC GROUP: Associated corticosteroids

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

Indications DEPO-MEDROL + LIDOCAINA ® Methylprednisolone + Lidocaine

DEPO- MEDROL + LIDOCAINA ® is used in the short-term treatment of acute and painful episodes of synovitis, rheumatoid arthritis, bursitis, gouty arthritis, epicondylitis, tenosynovitis and osteoarthritis.

Mechanism of action DEPO-MEDROL + LIDOCAINE ® Methylprednisolone + Lidocaine

DEPO-MEDROL + LIDOCAINA ® combines two active ingredients with different mechanisms of action but useful for overcoming painful pathological conditions on an inflammatory basis.

Methylprednisolone, like other corticosteroids, acts by inhibiting the inflammatory process upstream modulating gene expression through the inhibition of cyclooxygenase 2 expression and the induction of lipocortin, an enzyme able to reduce the availability of arachidonic acid, hence the synthesis of pro-inflammatory derivatives such as leukotrienes and prostaglandins.

Lidocaine, on the other hand, is a medium-duration local anesthetic that by inhibiting the voltage-dependent sodium channels of neurons, prevents the nerve fiber from carrying out the painful stimulus, both at the superficial and deep level.

Both active ingredients are metabolised to the liver level after a few hours and subsequently eliminated via the kidney.

Studies carried out and clinical efficacy

1. EXTRAARTICULAR INJECTION OF STEROIDS AND RECIDIVA

The extra-articular administration of steroids plus lidocaine, in reducing joint pain in patients suffering from tenosynovitis has proved useful in reducing painful symptoms in a very short time. However, about 33% of treated patients showed a relapse in the days following the treatment.

2. DEPO-MEDROL + LIDOCAINE IN THE TREATMENT OF THE CARPAL TUNNEL SYNDROME

The conventional treatment of carpal tunnel syndrome is the daily injection of lidocaine and methylprednisolone. The complexity of the treatment and the potential side effects have pushed clinicians towards the use of a 5% lidocaine patch that has proved equally effective in reducing symptoms, significantly simplifying the complexity of the intervention.

3. INFILTRATIONS IN SPORTS PRACTICE

Injections of lidocaine and methylprednisolone in the cleft of the symphysis were found to be particularly effective in the treatment of pubeosteitis in athletes. The procedure proved to be well tolerated and able to facilitate the resumption of competitive activity.

Method of use and dosage

DEPO- MEDROL + LIDOCAINA ® sterile aqueous injectable suspension with 40 mg of methylprendisolone acetate and 10 mg of lidocaine hydrochloride per ml or 80 mg of methylprendisolone acetate and 20 mg of lidocaine hydrochloride per 2 ml:

the particular methods of administration (soft tissues, intrasynovial and intralesional) require the execution by properly trained medical or paramedical personnel.

The dosages, generally between 4 and 80 mg, can vary in low to the clinical picture and to the region to be treated.

The high complexity of this therapy therefore requires medical supervision.

Warnings DEPO-MEDROL + LIDOCAINA ® Methylprednisolone + Lidocaine

Despite the local administration of corticosteroids should reduce the potential side effects found during systemic therapy, it is appropriate, given the complexity and the particularity of the therapy, that the entire therapeutic course is supervised by medical personnel.

An adjustment of the dosages could be required during therapy in case of particular stress, incidence of side effects or disappearance of the symptomatology.

The administration of DEPO-MEDROL + LIDOCAINA ® should be done with particular care in patients suffering from diabetes, osteoporosis, endocrine diseases, cardiovascular, gas-intestinal, neurological and psychiatric diseases, given the ability of methylprednisolone to aggravate the clinical picture.

It is necessary to periodically monitor the site and the injection joint in order to ascertain the absence of ongoing septic processes and of hypersensitivity side reactions.

PREGNANCY AND BREASTFEEDING

The ability of both lidocaine and methylprednisolone to cross the hematoplacental barrier and the breast filter could expose the fetus to serious risks.

Experimental models conducted on laboratory animals in fact demonstrate the toxic effects of corticosteroids on fetal health when taken during pregnancy.

It is therefore important to use this medicine during pregnancy, only under strict medical supervision and in the case of real and inevitable necessity.

Interactions

The presence of two different active ingredients significantly increases the risk of clinically and pharmacologically important interactions.

More precisely, while methylprednisolone may interact with rifampicin, phenytoin, barbiturates, estrogens, ketoconazole, erythromycin, troleandomycin, salicylates, etacrinic acid, thiazides, furosemide, etacrinic acid, indomethacin, acetylsalicylic acid, NSAIDs, cyclophosphamide, amphotericin and antidiabetic activity. lidocaine could be altered by muscle relaxants, cimetidine and propanol.

Contraindications DEPO-MEDROL + LIDOCAINE ® Methylprednisolone + Lidocaine

DEPO-MEDROL + LIDOCAINA ® is contraindicated in case of hypersensitivity to the active ingredients or excipients, latent fungal and viral infections.

The danger of intravenous, intrathecal and epidural intake should be borne in mind.

Undesirable effects - Side effects

Taking DEPO-MEDROL + LIDOCAINA ® may expose the patient to the risks of corticosteroid therapy and medium-duration anesthetics.

More precisely, methylprednisolone could increase the incidence of side effects at the musculoskeletal, nervous, cardiovascular, metabolic-endocrine, ophthalmic, and dermatological levels, while lidocaine could be responsible for neurological symptoms such as nervousness, apprehension, euphoria, confusion, dizziness, numbness, depression, alterations of the state of consciousness; cardiovascular with hypotension, bradycardia, collapse and cardiac arrest and allergy.

The injection site could be subjected to local lesions and side effects from hypersensitivity.