Methylprednisolone

Brand Name

Solu-medrolĀ®

Company

Pharmacia and Upjohn, Inc.

Class

Anti-inflammatory steroid

Mechanism of Action

Causes emigration of circulating T cells from intravascular tissue compartment to lymphoid tissue

Inhibits production of T-cell lymphokines that are needed to amplify macrophage and lymphocyte response

Applications in Transplantation

Immunosuppressive adjunct for the prevention and treatment of solid organ rejection

Attenuation of cytokine release syndrome in patients treated with muromonab-CD3

Contraindications

Hypersensitivity to methylprednisolone and/or its components Systemic fungal infections Prematurity in infants

Warnings

May produce posterior subcapsular cataracts, glaucoma, and may enhance the establishment of secondary ocular infections due to fungi or viruses Increased calcium excretion

Vaccination should not be undertaken during therapy Cardiac arrhythmias, circulatory collapse, and/or cardiac arrest have occurred after rapid administration

Adequate human reproduction studies have not been undertaken

Special Precautions

Use with caution in patients with hypothyroidism, cirrhosis, ocular herpes simplex, hypertension, congestive heart failure, and ulcerative colitis

Psychologic derangements may occur while on therapy

Adverse Reactions

Sodium and fluid retention, congestive heart failure in susceptible patients, potassium loss, hypokalemic alkalosis, hypertension Muscle weakness, steroid myopathy, loss of muscle mass, severe arthralgia, vertebral compression fractures, aseptic necrosis of humeral and femoral heads, pathologic fracture of long bones, osteoporosis

Peptic ulcer with possible perforation and hemorrhage, pancreatitis, abdominal distension, ulcerative esophagitis Impaired wound healing, thin fragile skin, petechiae and ecchymoses, facial erythema, increased sweating, suppressed reaction to skin tests

Pseudotumor cerebri, convulsions, vertigo, headache Cushingoid state, suppression of growth in children, secondary adrenocortical and pituitary unresponsiveness, menstrual irregularities, decreased carbohydrate tolerance, manifestations of latent diabetes mellitus, increased requirements for insulin or oral hypoglycemic agent

Posterior subcapsular cataracts, increased intraocular pressure, glaucoma, exophthalmos

Appendix I

Methylprednisolone (cont'd)

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