Menison 16mg Pymepharco medicine treats hormonal disorders, arthritis, collagen disease (3 blisters x 10 tablets)

Dosage form Box of 3 blisters x 10 tablets
Specifications Methylprednisolone

Ingredient

Composition informationContent
Methylprednisolone16mg

Uses

Indications

Menison 16mg is indicated for diseases that need glucocorticoid activity such as:

  • Endocrine disorders: primary and secondary adrenal disorders, congenital adrenal hyperplasia.
  • Rheumatoid disorders: rheumatoid arthritis , main spondylitis, chronic arthritis in children.
  • Collagen disease, artery inflammation: lupus erythematosus system, body dermatitis, acute heart rheumatitis, muscle -painful cell artery disease due to rheumatism.
  • Dermatological disease: conventional Earth Pemphigus.
  • allergies: Seasonal and year -round allergic rhinitis, hypersensitivity reaction, serum, allergic dermatitis due to contact, bronchial asthma.
  • Eyes of ophthalmic disease: Fecticular inflammation (iritis, eyelash inflammation), posterior inflammation, optic neuritis.
  • Respiratory disease: pulmonary sarcoid, acute or spreading tuberculosis (with appropriate anti -tuberculosis chemotherapy), lung damage due to inhalation.

    Hematology disorders: spontaneous thrombocytopenia, hemolytic anemia (autoimmune).

  • Tumia: leukemia (acute and lymphatic), malignant lymphoma.
  • Gastrointestinal disease: ulcerative colitis , Crohn's disease.

    Other: meningeal tuberculosis (with appropriate anti -tuberculosis chemotherapy), transplanting organs.

    Pharmacy

    Methylprednisolon is a synthetic glucocorticoid, derivative 6 - Alphamethyl of prednisolon. The drug is mainly used to prevent inflammation, or immunosuppressive. The drug is often used as esterification or non -esterification to treat diseases that corticosteroids have prescribed.

    Due to methylation Prednisolon, methylprednisolon has only mineralocorticoid effect (very little salt metabolism), not suitable to treat adrenal insufficiency. If using methylprednisolon in this case, mineralocorticoids must be used.

    methylprednisolon has anti -inflammatory, immunosuppressive and anti -cell anti -proliferative effects. The anti -tablet effect is due to methylprednisolon that reduces the production, release and activity of anti -inflammatory mediators (such as histamine, prostaglandin, leucotrien, etc.) thus reducing the initial manifestations of the inflammatory process.

    Methylprednisolon inhibits white blood cells that adhesion to the damaged venous walls and immigration in the damaged areas, reducing the permeability in that area, thus causing leukocytes to rarely go to the damaged area. This effect reduces vessel escape, swelling, edema, pain.

    The immunosuppressive properties reduce response to slow and instant reactions (type III and TYP IV). This is due to inhibition of toxic effects of antigen complex - antibodies that cause allergic vasculitis in the skin. By inhibiting the effects of lymphokin, target cells and macrophages, corticosteroids have reduced allergic contact dermatitis reactions.

    In addition, corticosteroids also prevent T lymphocytes and sensitive macrophages to target cells. Anti -cell proliferation effect reduces the characteristics of psoriasis.

    pharmacokinetic pharmacokinetics

    About 80%bioavailability. Plasma concentration reaches a maximum of 1-2 hours after taking the drug.

    Biological effect time is about 1 - 1/2 day, can be considered a short effect. Methylprednisolon is metabolized in the liver, like metabolism of hydrocortison, and metabolites are excreted through urine. Selling time is approximately 3 hours.

    Before taking Menison 16mg Pymepharco medicine treats hormonal disorders, arthritis, collagen disease (3 blisters x 10 tablets)

    How to use

    Use the oral Dumplee.

    Dosage

    Methylprednisolon starting dose is recommended depending on the disease to be treated:

  • Rheumatoid arthritis: weighs 12 - 16mg/day, moderate 8 - 12mg/day, light and children 4 - 8mg/day.
  • Systemic dermatitis: 48mg/day.
  • Systemic Reds: 20 - 100mg/day.
  • Rheumatism: 48mg/day until the speed of red blood cell deposits (ESR) is about a week.
  • Allergic disease, ophthalmic disease: 12 - 40mg/day.
  • Bronchial asthma: can be up to a single dose 64mg/day way, can reach a maximum dose of 100mg.
  • Hematology and leukemia, malignant lymphoma: 16 - 100mg/day.
  • ulcerative colitis: 16 -60mg/day.
  • Crohn's disease: can be up to 48mg /day in the acute phase.
  • Agency transplant: can be up to 3.6mg/kg/day.

  • Pulmonary sarcoid disease: 32 - 48mg/day use.
  • Giant cell artery disease/muscle pain caused by rheumatism: 64mg/day.
  • Conventional Pemphigus disease: 80 - 360mg/day.
  • The total daily recommendation of daily recommendations can be indicated for a single dose or division of the dose (except for daily -distance therapy is the minimum daily dose of daily dose and use every 2 days at 8 am).

    Unwanted effects can be reduced to the minimum by using the lowest doses effectively in the shortest time.

    The initial inhibitory dose may vary depending on the disease being treated. This dose is maintained until the clinical response is achieved, about 3-7 days in rheumatism (except for acute heart rheumatism), skin allergies affecting skin or respiratory diseases and ophthalmology. If clinical response is not achieved in 7 days, it is necessary to re -evaluate the disease to determine the initial diagnosis.

    As soon as a satisfactory clinical response, daily doses should be reduced slowly until the end of treatment in acute diseases (for example: Seasonal asthma, flaking dermatitis, acute visual inflammation) or to the point of lack of effective maintenance in chronic diseases (for example, rheumatoid arthritis, systemic lupus erythematosus, tanken asthma, atopic dermatitis).

    In chronic diseases, especially in rheumatoid arthritis, it is important to reduce the dose from the original dose to the maintenance dose to achieve appropriate clinical. The recommended dose is not more than 2 mg over 7-10 days. In rheumatoid arthritis, steroid therapy is maintained at the lowest possible dose.

    In daily distance, corticosteroid dose is double the minimum daily doses and 1 single dose, every 2 days at 8 am. Dosage requirements depend on patients being treated and respected by patients.

    Elderly patients: The treatment of elderly patients especially if long -term treatment should consider and serious consequences of unwanted effects of corticosteroids in the elderly, especially osteoporosis, diabetes, hypertension, susceptible to bacterial and thinning skin.

    Children: Normally, the dose for children should be based on clinical response and according to the doctor's review. The treatment should be limited to the minimum doses in the shortest time. If possible, use a single dose and daily use.

    Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.

    What to do when overdose?

    When using too high doses for a long time, increase adrenal radio and adrenal inhibition may occur. In these cases, it is necessary to consider to be able to decide properly to suspend or stop using Glucocorticoid.

    What to do when you forget a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Note that it should not be used double the prescribed dose.

    Side Effects

    When using Menison 16mg, you may experience unwanted effects (ADR).

    Infection and infection:

  • Common: Infection (including increased sensitivity and severity of infection by hiding symptoms and clinical signs).
  • Unknown frequency: Opportunity infection, relapse of tuberculosis inactive.
  • benign, malignant and unknown (including cysts and small tumors (polyps)):

  • Unknown frequency: Kaposi's Sarcoma.
  • Blood and lymphatic disorders:

  • Unknown frequency: leukemia.
  • immune system disorders:

  • The frequency of unknown: sensitivity to the drug (ceramic reaction reaction), reducing reactions with skin tests.
  • Endocrine disorders:

  • Common: syndrome Cushing .
  • Unknown frequency: The decrease of the pituitary gland, sudden stop syndrome.
  • Metabolic and nutrition disorders:

  • Common: Keep sodium, keep water.
  • Unknown frequency: Hypotension infection, metabolic acidosis reduces glucose tolerance, increases demand with insulin or oral hypoglycemic drugs in diabetes, increases appetite (can lead to weight gain), epidural fat accumulation.

    Mental disorders:

  • Common: emotional disorders (including depression and refreshment).
  • Unknown frequency: mental disorders (including crazy, virtual wall, hallucinations, schizophrenia (worse)), mental behavior, emotional disorders (including unstable emotions, mental dependence, suicide intent), mental disorders, personality changes, lightheaded moods, irritability, abnormalities:

    Nervous system disorders:

  • Unknown frequency: convulsions, increased internal pressure (with visual gai disease (benign increased intracranial pressure)), forgetting, cognitive disorders, dizziness, headache.
  • In terms of disorders:

  • Common: cataracts under the bag.
  • Unknown frequency: glaucoma, convex eye, thinning cornea, thin epidural, retinopathy.
  • Disorders in and inner ears:

  • Unknown frequency: dizziness.
  • Heart disorders:

  • Unknown frequency: congestive heart failure (with sensitive patients), heart rupture after myocardial infarction.
  • Pleetal disorders:

  • Common: hypertension.
  • Unknown frequency: hypotension, arterial embolism, thrombosis.

    Respiratory, chest and medical disorders:

  • Unknown frequency: pulmonary embolism, hiccup.
  • Digestive disorders:

  • Common: gastrointestinal ulcer (capable of perforation and gastrointestinal hemorrhage).
  • Unknown frequency: perforation, stomach bleeding, pancreatitis, esophageal ulcer, bloating, esophagitis, abdominal pain, diarrhea, bloating, nausea.
  • Liver disorders:

  • Unknown frequency: Increased liver enzyme (increased alanin aminotransferase, increased aspartat aminotransferase).
  • Disorders on skin and subcutaneous tissue:

  • Common: Skin atrophy, acne.
  • Unknown frequency: Red rash, angioedema, tilt, urticaria, blood bruises, hemorrhagic spots, rashes, hairs, sweating, skin sweating, capillary dilatation.
  • Bone and connective muscle disorders:

  • Common: muscle weakness, developmental retardation.
  • Unknown frequency: pathological fractures, bone necrosis, muscle atrophy, joint diseases due to neurological causes, muscle diseases, osteoporosis, joint pain, muscle pain.
  • Reproductive and breast disorders:

  • Unknown frequency: irregular menstruation.
  • General disorders and at treatment:

  • Common: Slow healing wounds.
  • Unknown frequency: fatigue, difficulty, symptoms suddenly stop reducing corticosteroid dose after prolonged treatment) can lead to acute adrenal potential, lower blood pressure and death.
  • Studies:

  • Common: reducing blood potassium.
  • Unknown frequency: increased internal pressure, reducing carbohydrates, increasing alkalin phosphatase in the blood, increasing calcium urine.
  • Complications of surgery, wounds, poisoning:

  • The frequency of unknown: broken ligaments (especially Achilles tendons), spine fractures due to compression.
  • Instructions on how to handle ADR

    Notice the unwanted physician when using the drug.

    Warnings

    Before using the drug you need to read the instructions carefully and refer to the information below.

    Contraindicated

    Menison 16mg contraindicated in the following cases:

  • Patients with hypersensitivity to which part of the drug.
  • Using a live virus vaccine.

  • Skin damage caused by viruses, fungi or tuberculosis.
  • Severe bacterial infections except for bacterial and meningitis.

    Systemic fungal infection.

    Precautions when used

    Use cautiously in patients with osteoporosis, new blood vessels, mental disorders, stomach ulcers, duodenum ulcers, diabetes, hypertension, heart failure and growing children, liver failure, kidney failure, glaucoma, thyroid disease, cataract. Due to the risk of unwanted effects, methylprednisolone is carefully used for the elderly, with the lowest doses and in the shortest possible time.

    Acute adrenal insufficiency may occur when the drug is stopped suddenly after a long time of treatment or when stressed.

    When using high doses, it can affect the effect of vaccination.

    The immunosuppressive effect/increased sensitivity to corticosteroid infections may increase the sensitivity to infection, concealing some signs of infection and new infections that may occur when using corticosteroids. This may reduce resistance and lose their localities of infection when using corticosteroids.

    Pathogenic microorganisms include viral, bacteria, fungi, single or helminths in any position of the body, which may be related to the use of separate corticosteroids or in combination with other immunosuppressants that have an impact on cell immune, immune immune or neutral leukemia. These infections may be mild, but can also be serious, sometimes fatal. When increased the dose of corticosteroids, the rate of complications due to infections increases.

    Patients who are taking immune system inhibitors are more susceptible to infections than others.

    Can use dead vaccines or vaccines for patients who are taking corticosteroids with immunosuppressive doses, but responding to these vaccines may reduce. Immune methods may be used for patients taking non -inhibiting doses of corticosteroids.

    It is necessary to limit the use of corticosteroids in operating tuberculosis, in case of scattered tuberculosis or transmission, of which corticosteroids are used to manage the disease, combined with appropriate anti -tuberculosis mode.

    When corticosteroid is indicated in potential tuberculosis patients or reacting with turbeculin, it is necessary to observe closely because the disease may recur. If used for prolonged corticosteroids, these patients need to prevent antiviral drugs.

    There has been a report on Sarcom Kaposi in patients with corticosteroid therapy. When stopping corticosteroids, it may be clinically relieved.

    The role of corticosteroids in infections is unclear.

    immune system

    may occur allergic reactions (for example, angioedema).

    Because some rare cases of skin allergies and anaphylaxis/anaphylactic reactions occur in patients treated with corticosteroid therapy, it is necessary to take appropriate prevention measures before special treatment is for patients with a history of allergies for any drug.

    Endocrine

    In patients who are in the period of corticosteroid treatment, they are under abnormal pressure, which should be indicated to increase the dose of corticosteroid type quickly before, during and after that pressure.

    When using corticosteroids at the dose has pharmacological effects during the time (long can lead to inhibition of hypothalamus axes - pituitary - adrenal (HPA) (secondary adrenal energy).

    The level and time of secondary adrenal insufficiency vary between patients and depends on the dose, frequency, use time and the time of treatment with glucocorticoid therapy.

    This effect can be minimized by using alternating therapy. In addition, adrenal disabilities also lead to death if stopping glucocorticoids suddenly.

    Secondary adrenal energy is because the drug can be minimized by gradually reducing the dose. This type of adrenal disabilities may exist for months after stopping the drug, so in any stress occurs during this period, the hormone therapy should begun. Because mineral corticosteroid secretion can be reduced, it is recommended to be used on time with salt or a mineral corticosteroid.

    Steroid "sudden stop syndrome" is not related to adrenal insufficiency may appear after stopping the use of sudden glucocorticoid. This syndrome includes symptoms such as anorexia, nausea, vomiting, vomiting, coma, headache, fever, joint pain, peeling, muscle pain, weight loss or hypotension.

    These effects are thought to be due to a sudden change in glucorticoid concentration than low corticosteroid concentration.

    Due to glucorticoids can cause or worsen Cushing syndrome, do not use glucocorticoids for patients with Cushing disease.

    The effect of corticosteroids increases in patients with thyroid disabilities.

    The following groups of patients need to consider reducing the dose slowly with all over the body immediately after 3 -week or less treatment:

  • Patients with systemic corticosteroid treatment are repeated, especially if there is a period of treatment over 3 weeks.
  • When the short -term treatment is assigned within a year after the end of the long -term treatment (for months or years).
  • Patients with adrenal disability except for external corticosteroid therapy. Acute adrenal disabilities can lead to death if suddenly stopped glucocorticoid.
  • Patients with methylprednisolon patient with methylprednisolon.
  • Patients with repeated dose in the evening.
  • Metabolism and nutrition

    Methylprednisolon corticosteroids may increase blood glucose, making diabetes worse and if used in corticosteroids for a long time can lead to diabetes.

    Mental

    Mental disorder may appear when using corticosteroids, from refreshment, insomnia, mood change, oscillation and severe depression to real mental manifestations. Unstable emotions or mental trends may also be more severe by corticosteroids.

    The ability to fold unwanted mental effects that can occur when using steroids in the body. Special symptoms appear for a few days or the first few weeks of treatment. Most of the reactions are lost when reducing the dose or stopping the drug, although it is necessary to have specific treatments. Mental influence has been reported when stopping corticosteroids, unknown frequency.

    Patients/medical staff should be noted if the mental manifestations appear in patients, especially if they suspect that the patient is depressed or intends to kill himself. The patient/medical staff should be warned that the possibility of mental disorders occurs during treatment or immediately after reducing the dose or stopping steroids in systemic.

    Nervous system

    Be cautious when taking corticosteroids in patients with seizures, patients with severe myasthenia gravis.

    There have been reports on epidural fat accumulation in patients using corticosteroids, often using high doses for a long time.

    Eyes

    Be cautious when using corticosteroids in patients with herpes simplex in the eye because it can cause corneal perforation.

    Use of corticosteroids for a long time can cause cataracts under the following bags and cataracts in the center (especially in children), eye errors, or internal hypertension can lead to hypertension that can cancel the energy body activity. In patients using glucocorticoids may increase the likelihood of fungal infection or secondary virus in cool. Corticosteroid therapy has been related to the central retinopathy, which can lead to retina.

    heart

    The adverse effects of glucocorticoids for the cardiovascular system, such as dyslipidemia and hypertension, can cause patients to be being treated and have cardiovascular risk factors to suffer more effects on the cardiovascular disease, if treated with high and prolonged doses. Therefore, it is necessary to use corticosteroids cautiously in these patients and pay attention to the implementation of risks and follow the heart for further monitoring if necessary. Low doses and daily distance can reduce the incidence of complications in corticosteroid therapy.

    In case of congestive heart failure, should be cautious when using systemic corticosteroids and only used only when necessary.

    Special care is needed when considering the use of systemic corticosteroids for patients who have just stuffed myocardial machine (the heart rupture has been reported) and need to monitor patients regularly.

    Be careful for patients who are using cardiac drugs such as steroids causing electrolyte imbalance.

    circuit

    Need to take special care and monitor patients regularly when considering the use of systemic corticosteroids in patients with the following diseases: Hypertension, risk of thrombosis, thrombosis including venous thrombosis that has been reported occurring with corticosteroids. Therefore, caution should be used with corticosteroids for patients with or may be at risk of thrombosis.

    digestive

    Use corticosteroids can cover the symptoms of gastrointestinal ulcers, causing perforation or bleeding without obvious pain. Increased risk of developing gastrointestinal ulcers when used in combination with nonsteroidal anti -inflammatory drugs (NSAID).

    Be cautious when using corticosteroids in nausical colon ulcers if there is a perforation, toll - car or other pus infections: excess bag inflammation, new small intestine connectivity, suffering from a history of gastrointestinal ulcer.

    honey

    Corticosteroid high doses can cause acute pancreatitis. Special care is required when considering the use of body corticosteroids for patients with liver or cirrhosis and need to monitor patients regularly. Liver disorders are rarely reported, most of these cases are restored after stopping treatment. Therefore, appropriate monitoring.

    skeletal muscle

    There has been a report on acute muscle disease when using high doses of corticosteroids, which often occurs in patients with neurotrotomic disorders (for example, severe myastheniagia or patients taking cholinergic drugs such as neurotrological inhibitors (for example, Panicuronium).

    The increase in creatinine kinase can occur. In order to have clinical or recovery progress, it is necessary to take the drug within a few weeks to a few years. Osteoporosis is an unwanted effect, but is less noticeable, occurs when using high and prolonged doses of glucocorticoids.

    Kidney and urinary tract

    Be cautious when using corticosteroids in patients with renal failure.

    Studies

    The average and high doses of hydrocortison or cortison can cause hypertension, salt and water accumulation and increase potassium elimination. These effects are less common if using synthetic corticosteroids, unless high doses. It may be necessary to limit salt intake and add potassium. All corticosteroids increase calcium elimination.

    Trauma, poisoning and surgical complications

    Do not take high doses of corticosteroids by systemic lines to treat wounds due to brain injury.

    Other warnings

    Due to complications when treating with glucocorticoid depends on willow and the duration of treatment, the decision to treat must be based on the consideration between the risk/benefit of each specific case and the duration of treatment is also considered or used daily or used in distance.

    Should take the lowest dose of corticosteroids to control the treatment situation and when the dose can be reduced, it should be gradually reduced.

    Aspirin and nonsteroidal anti -inflammatory drugs should be used cautiously when combined with corticosteroids.

    Chrome -preferred cell tumor can be reported after using corticosteroids by systemic lines. Corticosteroids should only be used for suspected patients or have been determined to have chromine skin tumors after conducting an appropriate risk/benefit assessment.

    Use in children

    should carefully monitor the development and growth of children when using prolonged corticosteroid therapy.

    Children may grow slowly when using glucocorticoid daily for a long time. The use of this therapy with a small dosage should be limited, only for urgent indications. This effect can be avoided or minimized when using corticosteroid therapy.

    Babies and children are treated with long -term corticosteroids, especially at risk of increased intracranial pressure.

    Corticosteroid high doses can lead to pancreatitis in children.

    Used in elderly patients

    The common unwanted effects of systemic corticosteroids can combine with serious consequences in old age, especially osteoporosis, hypertension, hypokalemia, diabetes, susceptible to infections and thinning the skin. Clinical monitoring should be closely monitored to avoid life -threatening reactions.

    Be cautious about the ingredients in the finished product

    The drug contains lactose. Patients with Galactose intolerant, lactase deficiency or glucose - Galactose should not be used by this drug.

    The ability to drive and operate machinery

    There is no evidence of the effect of drugs on driving and operating machinery.

    Pregnancy

    Taking prolonged medication for pregnant women can lead to mitigation of the babies of infants. It is necessary to consider the benefits that can be achieved compared to the risk that may occur for mothers and children when used in pregnant women.

    breastfeeding period

    kidneys while used in nursing women.

    Drug interaction

    methylprednisolon is the substrate of the cytochrom P450 enzyme (CYP) and is mainly metabolized by CYP3A4 enzyme. It catalyzes the process of 6β - hydroxylation steroids, the essential stage in the metabolic step for both endogenous and synthetic corticosteroids. There are also many other substances that are also the substrate of CYP3A4, some of these substances as well as other drugs) change the metabolism of glucocorticoid by causing the air conditioner induction) or inhibiting CYP3A4 enzyme.

    CYP3A4 induction substances (such as antibiotics, antiviral drugs (Rifampin, Rifabutin), anti -seizure drugs (primidon, phenobarbital, phenytoin)) - CYP3A4 induction drugs in general increase the clearance of the liver, leading to reducing the concentration of drugs that are the substrate of CYP3A4. Methylprednisolon may be increased when used with these drugs to achieve the desired treatment results.

    substances are both a substrate and CYP3A4 touch (such as carbamazepin) - the case of CYP3A4 induction, see the above "CYP3A4 induction substances". The case is the substrate of CYP3A4, the liver clearance of methylprednisolon may be affected (inhibited or induced), so the corresponding dose adjustment of methylprednisolon is required. It is possible that unwanted reactions when used each of one of one of the two drugs will be more likely to occur.

    CYP3A4 inhibitors (such as antibiotics Macrolid (troleandomycin), grapefruit juice, chosen drugs are calcium channels (Miberiadil), H2 H2 (cimetidine), antibiotics (Isoniazid) - CYP3A4 inhibitors in general reducing the liver's amplitude and increased concentration Methylprednisolon in plasma. If CYP3A4 inhibitors are available, methylprednisolon should be adjusted to avoid steroid poisoning. In addition, methylprednisolon may increase the speed of acetylation and isoniazid clearance.

    The substances are both a substrate and inhibit CYP3A4 (such as anti -vomiting drugs (aprepitant, tosaprepltant), antifungal drugs (iTraconazol, ketoconazol), Calci channel blockers (diltiazem), oral contraceptives (ethinylestradiol/norethindron), macrolidin antibiotic inhibitors) (Clarithromycin, erythromycin), antiviral drugs (HIV Protease inhibitors)) - The case is CYP3A4 inhibitor, see the above "CYP3A4 inhibitors". In the case of the substrate of CYP3A4, the liver clearance of methylprednisolon may be inhibited or touched, so the corresponding dose adjustment of methylprednisolon is required. It is possible that unwanted reactions when used each of one of one of the two drugs will be more likely to occur.

    Mutual metabolic inhibition occurs when using simultaneously cyclosporin and methylprednisolon, resulting in an increase in the concentration of one of the remedies or both drugs. Therefore, it is possible that unwanted reactions when used each of one of either of the drugs will be more likely to occur when used simultaneously.

    HIV protease inhibitors such as indinavir, ritonavir may increase corticosteroid levels in plasma. Corticosteroids can touch the metabolism of HIV Protease inhibitors that lead to reduced plasma concentrations.

    Substances are substrates of CYP3A4 (such as immunosuppressant (cyclophosphamide, tacrolimus)) - If both substances are substances of CYP3A4, the liver removal process of methylprednisolon may be affected (inhibitor or touch), so there should be corresponding dose adjustments of methylprednisolon. It is possible that unwanted reactions when used each of one of one of the two drugs will be more likely to occur.

    Medications without intermediaries CYP3A4 - Interactions and other influences occur with methylprednisolon presented as follows:

  • NSAIDS: The rate of bleeding and stomach ulcers can increase when using methylprednisolon along with NSAID drugs (nonsteroidal anti -inflammatory drugs).
  • aspirin: Methylprednisolon may increase the clearance of aspirin, leading to a decrease in serum salicylate concentration. Methylprednisolon can be stopped, which may increase serum levels, leading to an increased risk of salicylate poisoning.

    Cholinergic drugs: There have been reports on acute cardiomyopathy when using high doses of corticosteroids with anti -cholinergic drugs such as neurotransmitter. There has been a report on antagonism of the neurotransmitter effect of pancuronium and vecuronium in patients using corticosteroids. This interaction can occur with all competitive nerve blockers.

    steroids may reduce the effects of the opzel inhibitors of cholinesterase used in the treatment of myasthenia gravis. corticosteroid may increase blood glucose levels, need to adjust the dosage of diabetes.

  • Antaginalned oral substance: The effectiveness of coagulants can increase when used with corticosteroids. Therefore, it is necessary to closely monitor blood coagulation indicators such as prothrombin (PT) time and normalization index (INR) to avoid spontaneous bleeding.
  • When using corticosteroids simultaneously with drugs that reduce potassium (such as diuretics), patients need to be closely monitored the appearance of anti -potassium. The risk of hypoglycemia also increases when using Corticosteroids with amphotericin B, xanthen or Beta 2 -driving medicine.
  • The adrenal inhibitor caused by aminoglutethinid can worsen the hormonal changes arising from the prolonged glucocorticoid therapy.

    Storage

    The cool dry place (below 300C). Avoid light.

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