Metcort

Primary or secondary adrenocortical insufficiency. Rheumatic & nervous system disorders. Collagen, dermatologic, ophth, GI, resp, hematologic, & neoplastic diseases. Allergic & edematous states.

Adult Initially 4-48 mg daily in 4 divided doses; acute severe disease Initially ≥100 mg [suggested initial daily dose: Severe RA 12-16 mg, moderately severe RA 8-12 mg, moderate RA & childn 4-8 mg. Systemic dermatomyositis 48 mg. SLE 20-100 mg. Acute rheumatic fever 48 mg until ESR normal for 1 wk. Allergic & ophth diseases 12-40 mg. Bronchial asthma Up to 64 mg single dose/alternate day up to max of 100 mg. Hematological disorders & leukemias; malignant lymphoma 16-100 mg. Ulcerative colitis 16-60 mg. Crohn's disease Up to 48 mg/day in acute episodes. Organ transplantation Up to 3.6 mg/kg/day. Pulmonary sarcoid 32-42 mg on alternate days. Giant cell arteritis/polymyalgia rheumatica 64 mg. Pemphigus vulgaris 80-360 mg. Multiple sclerosis 200 mg/day. Cerebral edema 200-1,000 mg/day]. Treatment of acute exacerbations of multiple sclerosis 200 mg daily for 1 wk, followed by 80 mg every other day for 1 mth. Childn Initially 0.117-1.66 mg/kg/day (3.3-50 mg/m²/day) in 3 or 4 divided doses.

Should be taken with food.

Hypersensitivity. Systemic infections, unless specific anti-infective therapy is given; systemic fungal infections. Administration of live or live attenuated vaccines in patients receiving immunosuppressive doses of corticosteroids.

Risk of immunosuppressive effects/increased susceptibility to infections; endocrine, CV-renal, GI, hepatobiliary, musculoskeletal, ophth & neuropsychiatric effects; hypersensitivity reactions. Metabolism & nutrition disorders. Not for the treatment of traumatic brain injury. Pregnancy & lactation. Childn & infants (prolonged therapy).

GI, musculoskeletal, endocrine-metabolic, psychiatric, nervous system, ophth, CV & immune system effects; skin & SC tissue, reproductive system & breast disorders; fluid & electrolyte disturbances; elevated serum liver enzyme levels, hypokalemia, increased Ca excretion/urine Ca; vertigo, impaired hearing; hiccups, leukocytosis, malaise, w/drawal symptoms & moon face.

Enhanced metabolism w/ CYP3A4 inducers eg, barbiturates, phenytoin, primidone, rifampicin, rifabutin, aminoglutethimide, carbamazepine & other drugs that stimulate hepatic metabolism. Decreased metabolism w/ CYP3A4 inhibitors eg, antifungals (itraconazole, ketoconazole), antiemetics (aprepitant, fosaprepitant), immunosuppressants (ciclosporin, cyclophosphamide, tacrolimus), macrolides (clarithromycin, erythromycin, troleandomycin), HIV-PIs, diltiazem, grapefruit juice. Inhibition or induction of hepatic clearance w/ CYP3A4 substrates eg, Ca antagonists (mibefradil), H₂-receptor antagonists (cimetidine), contraceptives (ethinylestradiol/norethindrone) & Ca channel blockers (nifedipine, felodipine). Increased risk of hypokalemia w/ sympathomimetics eg, salbutamol, salmeterol, terbutaline, formoterol (at high doses of corticosteroids). Increased plasma conc w/ PIs (ie, indinavir & ritonavir). Decreased absorption w/ antacids. Alterations in plasma protein-binding & metabolism w/ OCs & estrogen. Increased risk of GI effects eg, GI bleeding & ulceration w/ aspirin or other NSAIDs. Enhanced or diminished effects of anticoagulants. Hypokalemia w/ K-depleting diuretics (eg, furosemide & thiazide) or carbonic anhydrase inhibitors (eg, acetazolamide); amphotericin B. Reduced effect w/ mifepristone. Acute myopathy w/ anticholinergics eg, neuromuscular blockers (at high doses of corticosteroids). Increased blood glucose conc & impaired glucose tolerance w/ insulin & oral antidiabetics. Increased risk of arrhythmias due to hypokalemia w/ digitalis glycosides. Diminished response to toxoids & live or inactivated vaccines (prolonged use of corticosteroids).

Corticosteroid Hormones

H02AB04 - methylprednisolone ; Belongs to the class of glucocorticoids. Used in systemic corticosteroid preparations.

Rx