Solu-Medrol 40mg Act-O- vial Injection
Methylprednisolone Sodium Succinate
              40mg/ml  
              
              Pfizer, Belgium
                  
              
              | Pack size | 1 vial's pack | 
|---|---|
| Unite Price | 400.00 BDT | 
Indications
Solu-Medrol 40mg Act-O- vial Injection is used for: 
    Endocrine Disorders
    Acute adrenocortical insufficiency
    Preoperatively and in the event of serious trauma or illness, in patients with known adrenal insufficiency or when adrenocortical reserve is doubtful
    Shock unresponsive to conventional therapy if adrenocortical insufficiency exists or is suspected
    Congenital adrenal hyperplasia
    Hypercalcemia associated with cancer
    Nonsuppurative thyroiditis
    Rheumatic Disorders
    As adjunctive therapy for short-term administration in:
    Post-traumatic osteoarthritis
    Synovitis of osteoarthritis
    Rheumatoid arthritis, including juvenile rheumatoid arthritis (selected cases may require low-dose maintenance therapy)
    Acute and subacute bursitis
    Epicondylitis
    Acute nonspecific tenosynovitis
    Acute gouty arthritis
    Psoriatic arthritis
    Ankylosing spondylitis
    Collagen Diseases
    During an exacerbation or as maintenance therapy in selected cases of:
    Systemic lupus erythematosus
    Systemic dermatomyositis (polymyositis)
    Acute rheumatic carditis
    Dermatologic Diseases
    Pemphigus
    Severe erythema multiforme (Stevens-Johnson syndrome)
    Exfoliative dermatitis
    Bullous dermatitis herpetiformis
    Severe seborrheic dermatitis
    Severe psoriasis
    Mycosis fungoides
    Allergic States
    Control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment in:
    Bronchial asthma
    Contact dermatitis
    Atopic dermatitis
    Serum sickness
    Seasonal or perennial allergic rhinitis
    Drug hypersensitivity reactions
    Urticarial transfusion reactions
    Acute noninfectious laryngeal edema (epinephrine is the drug of first choice)
    Ophthalmic Diseases
    Severe acute and chronic allergic and inflammatory processes involving the eye, such as:
    Herpes zoster ophthalmicus
    Iritis, iridocyclitis
    Chorioretinitis
    Diffuse posterior uveitis and choroiditis
    Optic neuritis
    Sympathetic ophthalmia
    Anterior segment inflammation
    Allergic conjunctivitis
    Allergic corneal marginal ulcers
    Keratitis
    Gastrointestinal Diseases
    To tide the patient over a critical period of the disease in:
    Ulcerative colitis (systemic therapy)
    Regional enteritis (systemic therapy
    Respiratory Diseases
    
    Hematologic Disorders
    Acquired (autoimmune) hemolytic anemia
    Idiopathic thrombocytopenic purpura in adults (IV only; IM administration is contraindicated)
    Secondary thrombocytopenia in adults
    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 diuresis or remission of proteinuria in the nephrotic syndrome, without uremia, of the idiopathic type or that due to lupus erythematosus
    Nervous System
    Acute exacerbations of multiple sclerosis
    
                                              
                        Adult Dose
Intramuscular
Anti-inflammatory or immunosuppressive
Adult: As methyprednisolone Na succinate: 10-80 mg once daily. 
Anti-inflammatory or immunosuppressive
Adult: As methylprednisolone Na succinate: 10-500 mg daily. Doses <250 mg are given by inj over at least 5 min while doses >250 mg are given slowly over at least 30 min.
Status asthmaticus
Adult: As methylprednisolone Na succinate: 40 mg, repeated according to patient's response.
Acute allograft rejection in organ transplant recipients
Adult: As methylprednisolone Na succinate: 0.5-1 g daily; continue until the patient has stabilised, usually not beyond 48-72 hr.
                                              
                        Child Dose
Intramuscular
Anti-inflammatory or immunosuppressive
Child: As methylprednisolone Na succinate: 0.5-1.7 mg/kg daily or 5-25 mg/m2 daily in divided doses 6-12 hrly. 
"Pulse" therapy: 15-30 mg/kg/dose over >30 min given once daily for 3 days.
Intravenous
Anti-inflammatory or immunosuppressive
Child: As methylprednisolone Na succinate: 0.5-1.7 mg/kg daily or 5-25 mg/m2 daily in divided doses 6-12 hrly. 
"Pulse" therapy: 15-30 mg/kg/dose over >30 min given once daily for 3 days.
Status asthmaticus
Child: As methylprednisolone Na succinate: 1-4 mg/kg daily for 1-3 days.
Acute allograft rejection in organ transplant recipients
Child: As methylprednisolone Na succinate: 10-20 mg/kg daily for up to 3 days. Max: 1,000 mg daily.
                                              
                        Renal Dose
Administration
IV/IM Preparation
Reconstitute for IM/IV injection with BWI containing 0.9% benzyl alcohol
IV Administration
Inject directly into vein or into tubing of running IV
Injection: Administer over at least 1 minute
Infusion: Further dilute reconstituted mixture with D5W, NS, D5/NS, or other compatible solution
Push: Administer over 10-20 minutes
                                              
                        Contra Indications
Systemic fungal infections and known hypersensitivity to components.
                                              
                        Precautions
Patient w/ heart failure, HTN, DM, GI disease (e.g. diverticulitis, intestinal anastomoses, peptic ulcer, ulcerative colitis), multiple sclerosis, myasthenia gravis, acute MI, cataracts, glaucoma, osteoporosis, history of seizure disorder, thyroid disease. Avoid abrupt withdrawal. Renal and hepatic impairment (including cirrhosis). Childn. Pregnancy and lactation. Monitoring Parameters Monitor BP, blood glucose, electrolytes, growth in childn.
Lactation: Drug enters milk; use with caution
                                              
                        Pregnancy-Lactation
Pregnancy category: C
Lactation: Drug enters milk; use with caution
                                              
                        Interactions
Decreases effect of anticholinesterases in myasthenia gravis. May decrease the hypoglycaemic effects of antidiabetic agents. Decreases serum concentrations of salicylates. Increased hypokalemic effects of potassium-depleting diuretics (thiazides or furosemide), amphotericin B, bronchodilator therapy with xanthines or beta2 agonists. Increase incidence of GI bleeding and ulceration with NSAIDs. May increase the anticoagulant effects of warfarin. 
Decreased levels/effects with CYP3A4 inducers (aminoglutethimide, carbamazepine, nafcillin, nevirapine, phenobarbital, phenytoin, and rifamycins). Increased levels/effects with CYP3A4 inhibitors (azole antifungals, clarithromycin, diclofenac, doxycycline, erythromycin, imatinib, isoniazid, nefazodone, nicardipine, propofol, protease inhibitors, quinidine, telithromycin, and verapamil). May decrease the effects of vaccines (dead organism) or increase the risk of vaccinal infection (live organism). Antacids and bile sequestrants may decrease the absorption of corticosteroids, separate admin by 2 hr. Increased risk of myopathy with neuromuscular-blocking agents, tendinopathies with fluoroquinolones.
                                              
                        Side Effects
Side effects of Methylprednisolone Sodium Succinate : 
 Allergic Reactions
Allergic or hypersensitivity reactions,  anaphylactoid reaction,  anaphylaxis,  angioedema.
Cardiovascular
Bradycardia,  cardiac arrest,  cardiac arrhythmias,  cardiac enlargement,  circulatory collapse,  congestive heart failure,  fat embolism,  hypertension,  hypertrophic cardiomyopthy in premature infants,  myocardial rupture following recent mycocardial infarction ,  pulmonary edema,  syncope,  tachycardia,  thromboembolism,  thrombophlebitis,  vasculitis.
Dermatologic
Acne,  allergic dermatitis,  cutaneous and subcutaneous atrophy,  dry scaly skin,  ecchymoses and petechiae,  edema,  erythema,  hyperpigmentation,  hypopigmentation,  impaired wound healing,  increase sweating,  rash,  sterile abscess,  striae,  suppressed reactions to skin tests,  thin fragile skin,  thinning scalp hair,  urticaria.
Endocrine
Decreased carbohydrate and glucose tolerance,  development of cushingoid state,  glycosuria,  hirsutism,  hypertrichosis,  increased requirements for insulin or oral hypoglycemic agents in diabetes,  manifestations of latent diabetes mellitus,  menstrual irregularities,  secondary adrenocortical and pituitary unresponsiveness (particularly in times of stress,  as in trauma,  surgery,  or illness),  suppression of growth in pediatric patients.
Fluid and Electrolyte Disturbances
Congestive heart failure in susceptible patients,  Fluid retention,  hypokalemic alkalosis,  potassium loss,  sodium retention.
Gastrointestinal
Abdominal distention,  bowel/bladder dysfunction (after intrathecal administration),  elevation in serum liver enzymes levels (usually reversible upon discontinuation),  hepatomegaly,  increased appetite,  nausea,  pancreatitis,  peptic ulcer with possible subsequent perforation and hemorrhage,  perforation of the small and large intestine (particularly in patients with inflammatory bowel disease),  ulcerative esophagitis.
Musculoskeletal
Aseptic necrosis of femoral and humeral heads,  calcinosis (following intra-articular or intra-lesional use),  Charcot-like arthropathy,  loss of muscle mass,  muscle weakness,  osteoporosis,  pathologic fracture of long bones,  postinjection flare (following intra-articular use),  steroid myopathy,  tendon rupture,  vertebral compression fractures.
Neurologic/Psychiatric
Convulsions,  depression,  emotional instability,  euphoria,  headache,  increased intracranial pressure with papilledema (pseudotumor cerebri) usually following discontinuation of treatment,  insomnia,  mood swings,  neuritis,  neuropathy,  paresthesia,  personality changes,  psychic disorders,  vertigo.
Ophthalmic
Exophthalmoses,  glaucoma,  increased intraocular pressure,  posterior subcapsular cataracts.
                                              
                        Mode of Action
Methylprednisolone is a synthetic corticosteroid with mainly glucocorticoid activity and minimal mineralocorticoid properties. It decreases inflammation by suppression of migration of polymorphonuclear leukocytes and reversal of increased capillary permeability.
                                              
                        Note
Solu-Medrol 40mg Act-O- vial 40mg/ml Injection generic name is Methylprednisolone Sodium Succinate. Solu-Medrol 40mg Act-O- vial 40mg/ml Injection is manufactured by Pfizer, BelgiumSolu-Medrol 40mg Act-O- vial is availble in all over Bangladesh.
 Mes BD drug index information on Solu-Medrol 40mg Act-O- vial Injection is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.