Indicated for:

Endocrine Disorders:

Primary or secondary adrenocortical insufficiency (hydrocortisone or cortisone is the first choice; synthetic analogs may be used in conjunction with mineralocorticoids where applicable; in infancy mineralocorticoid supplementation is of particular importance).

 • Congenital adrenal hyperplasia

 • Nonsuppurative thyroiditis

 • Hypercalcemia associated with cancer

 Rheumatic Disorders:

As adjunctive therapy for short-term administration (to tide the patient over an acute episode or exacerbation) in:

 • Rheumatoid arthritis, including juvenile rheumatoid arthritis (selected cases may require low-dose maintenance therapy)

 • Ankylosing spondylitis

 • Acute and subacute bursitis

 • Synovitis of osteoarthritis

 • Acute nonspecific tenosynovitis

 • Post-traumatic osteoarthritis

 • Psoriatic arthritis

 • Epicondylitis

 • Acute gouty arthritis

Collagen Diseases:

 During an exacerbation or as maintenance therapy in selected cases of:

 • Systemic lupus erythematosus

 • Systemic dermatomyositis (polymyositis)

 • Acute rheumatic carditis

Dermatologic Diseases:

 • Bullous dermatitis herpetiformis

 • Severe erythema multiforme (Stevens-Johnson syndrome)

 • Severe seborrheic dermatitis

 • Exfoliative dermatitis

 • Mycosis fungoides

 • Pemphigus

 • Severe psoriasis

Allergic States:

Control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment:

 • Seasonal or perennial allergic rhinitis

 • Drug hypersensitivity reactions

 • Serum sickness

 • Contact dermatitis

 • Bronchial asthma

 • Atopic dermatitis

Ophthalmic Diseases:

Severe acute and chronic allergic and inflammatory processes involving the eye and its adnexa such as:

 • Allergic corneal marginal ulcers

 • Herpes zoster ophthalmicus

 • Anterior segment inflammation

 • Diffuse posterior uveitis and choroiditis

 • Sympathetic ophthalmia

 • Keratitis

 • Optic neuritis

 • Allergic conjunctivitis

 • Chorioretinitis

 • Iritis and iridocyclitis 

Respiratory Diseases:

 • Symptomatic sarcoidosis

 • Berylliosis

 • Loeffler’s syndrome not manageable by other means

 • Fulminating or disseminated pulmonary tuberculosis when used concurrently with appropriate antituberculous chemotherapy

 • Aspiration pneumonitis 

Hematologic Disorders:

 • Idiopathic thrombocytopenic purpura in adults

 • Secondary thrombocytopenia in adults

 • Acquired (autoimmune) hemolytic anemia

 • Erythroblastopenia (RBC anemia)

 • Congenital (erythroid) hypoplastic anemia

Neoplastic Diseases:

For palliative management of:

• Leukemias and lymphomas in adults

• Acute leukemia of childhood

Edematous States:

• To induce a diuresis or remission of proteinuria in the nephrotic syndrome, without uremia, of the idiopathic type or that due to lupus erythematosus.

Gastrointestinal Diseases:

To tide the patient over a critical period of the disease in:

• Ulcerative colitis

• Regional enteritis

Nervous System:

• Acute exacerbations of multiple sclerosis

Miscellaneous: 

• Tuberculous meningitis with subarachnoid block or impending block when used concurrently with appropriate antituberculous chemotherapy.

• Trichinosis with neurologic or myocardial involvement.

Prolonged use of corticosteroids may produce posterior subcapsular cataracts, glaucoma with possible damage to the optic nerves, and may enhance the establishment of secondary ocular infections due to fungi or viruses.

Average and large doses of hydrocortisone or cortisone can cause elevation of blood pressure, salt and water retention, and increased excretion of potassium.

The use of MEDROL Tablets 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.

Administration of live or live, attenuated vaccines is contraindicated in patients receiving immunosuppressive doses of corticosteroids. Killed or inactivated vaccines may be administered to patients receiving immunosuppressive doses of corticosteroids; however, the response to such vaccines may be diminished. Indicated immunization procedures may be undertaken in patients receiving non-immunosuppressive doses of corticosteroids.

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. In such children or adults who have not had these diseases particular care should be taken to avoid exposure.

Corticosteroids should be used cautiously in patients with ocular herpes simplex because of possible corneal perforation.

Growth and development of infants and children on prolonged corticosteroid therapy should be carefully observed.

Caution is required in patients with systemic sclerosis because an increased incidence of scleroderma renal crisis has been observed with corticosteroids, including methylprednisolone.

There is an enhanced effect of corticosteroids on patients with hypothyroidism and in those with cirrhosis.

Psychic derangements may appear when corticosteroids are used, ranging from euphoria, insomnia, mood swings, personality changes, and severe depression, to frank psychotic manifestations. Also, existing emotional instability or psychotic tendencies may be aggravated by corticosteroids.

Steroids should be used with caution in nonspecific ulcerative colitis, if there is a probability of impending perforation, abscess or other pyogenic infection; diverticulitis; fresh intestinal anastomosis; active or latent peptic ulcer; renal insufficiency; hypertension; osteoporosis; and myasthenia gravis.

Kaposi’s sarcoma has been reported to occur in patients receiving corticosteroid therapy.

Increases in alanine transaminase (ALT, SGPT), aspartate transaminase (AST, SGOT), and alkaline phosphatase have been observed following corticosteroid treatment.

Convulsions have been reported with concurrent use of methylprednisolone and cyclosporin.

Drugs that induce hepatic enzymes such as phenobarbital, phenytoin and rifampin may increase the clearance of methylprednisolone and may require increases in methylprednisolone dose to achieve the desired response.

Drugs such as troleandomycin and ketoconazole may inhibit the metabolism of methylprednisolone and thus decrease its clearance. Therefore, the dose of methylprednisolone should be titrated to avoid steroid toxicity.

Methylprednisolone may increase the clearance of chronic high dose aspirin. This could lead to decreased salicylate serum levels or increase the risk of salicylate toxicity when methylprednisolone is withdrawn.

Aspirin should be used cautiously in conjunction with corticosteroids in patients suffering from hypoprothrombinemia.

The effect of methylprednisolone on oral anticoagulants is variable. There are reports of enhanced as well as diminished effects of anticoagulant when given concurrently with corticosteroids. Therefore, coagulation indices should be monitored to maintain the desired anticoagulant effect.

Since adequate human reproduction studies have not been done with corticosteroids, the use of these drugs in pregnancy, nursing mothers or women of childbearing potential requires that the possible benefits of the drug be weighed against the potential hazards to the mother and embryo or fetus.

Infants born of mothers who have received substantial doses of corticosteroids during pregnancy, should be carefully observed for signs of hypoadrenalism.

GoToSource

• Acute disseminated encephalomyelitis. GoToSource

• Alopecia areata. GoToSource

• Goodpasture’s syndrome. GoToSource

• Idiopathic sudden sensorineural hearing loss. GoToSource

• Central post-stroke pain. GoToSource

• Pneumocystis (carinii) jiroveci pneumonia in AIDS patients. GoToSource

• Acute spinal cord injury. GoToSource

Conjunctival necrosis. GoToSource 

Fungal infections. GoToSource

Acute hepatitis (inflammation of the liver). GoToSource

Steroid psychosis. GoToSource

Neutrophil leukocytosis (elevated white blood cell count). GoToSource

Increased glucose levels. GoToSource

Avascular necrosis (death of bone tissue). GoToSource

Lawsuits filed for meningitis.