Solu-Medrol 40mg Pfizer injection powder treats rheumatoid disorders, lupus erythematosus (1 vial x 1ml)

Dosage form Box x 1ml
Specifications Methylprednisolone

Ingredient

Composition information	Content
Methylprednisolone	40mg

Uses

indications

Solu - Medrol 40mg drug is indicated in the following cases:

Supplemented treatment for life -threatening cases. Due to chemotherapy about cancer.

Treatment of acute spinal damage. Learning

methylprednisolon is a synthetic glucocorticoid, 6-alpha-methyl derivative of prednisolon. The drug is mainly used to prevent inflammation, or immunosuppressive. The drug is often used in the form of esterification or no esterification to treat diseases that corticosteroid has 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, an additional mineralocorticoid.

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

methylprednisolon inhibits leukocytes that adhesion to the damaged and immigrant vessels in damaged areas, reducing permeability in that area, thus causing leukocytic cells to less damaged areas. 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 the contact dermatitis reactions caused by allergies.In addition, Corticosteroids also prevent T -cell lymphocytes and sensitive macrophages from target cells. Anti -cell proliferating effects reduces the characteristics of psoriasis.

Dynamic pharmacokinetics

Birth is approximately 80%. Maximum effect of 1-2 hours after taking the drug, 4 - 8 days after the injection, 1 week after the injection in the joint.

Succinat salt is large solubility, so it works quickly when intramuscularly and intravenously. Time depends on the line used: 30 - 36 hours for oral, 1-4 weeks with intramuscular injection, 1-5 weeks for injection in joints.

Acetate salt is low solubility, so it has a prolonged effect when intramuscularly. Distribution volume: 0.7 - 1.5 liters/kg. Methylprednisolon is metabolized in the liver, like metabolism of hydrocortison, and metabolites are excreted through urine. Half life eliminates approximately 3 hours, reduced for obese people.

Before taking Solu-Medrol 40mg Pfizer injection powder treats rheumatoid disorders, lupus erythematosus (1 vial x 1ml)

How to use

Prepare solutions

To prepare intravenous solution, first of all the methylprednisolon sodium sucinat solution as instructed. Methylprednisolon sodium sucinat may be started for at least 5 minutes (for example, up to 250 mg) until at least 30 minutes (for example, with doses of 250 mg or higher). The next dose may stop and use the same. When needed, it can be diluted to use by mixing with solvents such as 5% dextrose in water, 0.9% Naci, 5% Dextrose in NaCi 0.45% or 0.9%. The final solution will be chemical and physical stability in 48 hours.

Instructions for using mix-o-vial jars-2-compartment jars

Remove the protective lid, turn around 1/4 of the pit button and press to push the solvent into the lower compartment. Shake gently to have a solution. Use the solution within 48 hours.

Surail of the lid of the piston with appropriate sterilization.

Stabbing the needle in the middle of the pit button until the needle is visible. Reverse vials and remove all the medicine.

Injecting drugs should be tested by the naked eye every time they can check the solution and packaging to see if there are strange things or change color before injection.

Dosage

indications Dosage This dose can be repeated every 4 - 6 hours until 48 hours. This mode can be repeated if there is no improvement after 1 week of treatment, or due to the patient's conditions:

1g/1 day, 1-4 days, or 1g/1 month, for 6 months.

lupus erythematosus system does not respond to standard treatment (or in the stage of drama). This mode may be reminded if there is no improvement after 1 week of treatment, or due to the conditions of the patient's requirements. This mode may be reminded if there is no improvement after 1 week of treatment, or due to the patient's conditions required. This mode may be reminded if there is no improvement after 1 week of treatment, or due to the patient's conditions require 30mg/kg every 2 days, used for 4 days or 1 g/day for 3.5 or 7 days. Vomiting and vomiting due to chemotherapy about cancer. Solu-Medrol intravenous injection 250mg for at least 5 minutes at 1 hour before the beginning of chemotherapy. Recall the dose of methylprednisolon at the beginning of chemotherapy and stop using chemotherapy. The chlorine derivative of phenothiazine can also be combined when the first dose of methylprednisolon to increase the effect of anti -vomiting.

Serious vomiting chemotherapy:

Intravenous intravenous 250mg for at least 5 minutes, combined with the appropriate dose of metoclopramide or 1 butyrophenon 1 hour before chemotherapy, then repeat the dose of methylprednisolon at the beginning of the chemotherapy therapy and at the time of stopping therapy.

For patients to start treatment within 3 hours of infection: intravenous injection 30mg/kg for 15 minutes, then rest for 45 minutes, then intravenously continuously 5.4mg/kg/hour for 23 hours. For patients to start treatment within 3 - 8 hours when infected: intravenous injection 30mg/kg for 15 minutes and then 45 minutes off, then intravenously 5.4mg/kg/hour, for 47 hours.

Rolls using 2 different venous lines to pump.

pneumonia caused by pneumocystis carinii in AIDS patients. One mode that can be performed is an intravenous injection of 40mg each 6-12 hours until a maximum of 21 days or until the end of the Pneumocystis treatment process. Due to increasing the activation of tuberculosis in AIDS patients, it is necessary to consider anti -tuberculosis drugs when using corticosteroids for these high -risk subjects. It is also necessary to monitor patients may suffer from other potential infections. The total treatment time should be at least 2 weeks. It may need higher doses to manage short -term and serious conditions. The starting dose up to 250mg requires intravenous injection for at least 5 minutes, and if the dose is higher, the injection for at least 30 minutes. The next dose may be intramuscularly or venous according to the distance depending on the response of the patient and according to clinical conditions required. Can be injected by types: venous push, or intravenous intravenously through "chamber" or such as "Piggy-back" intravenous solution.

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? Methylprednlsolon can be separated.

What to do when you forget 1 dose? However, if the time to relax with the next dose is too short, skip the dose and continue the calendar of the drug. Do not use double dose to compensate for missed dose.

Side Effects

When using Solu - Medrol 40mg , you may experience unwanted effects (ADR).

Infections and parasites infection : Covering bacterial infections, potential bacterial infections become active, chance bacterial infections.

Immune system disorders: Hypersensitive reaction including anaphylaxis, with or without vascular collapse, cardiac arrest, bronchospasm.

Endocrine disorders: Cushing state development, pituitary-renal axis inhibitors.

Disorders of metabolism and nutrition: Sodium accumulation, epidemic accumulation, potassium -reduced alkaline infection, Hydratcarbon intolerance, expression of potential diabetes, increased insulin demand or diabetes anti -diabetes in diabetics.

Mental disorders: disturbing mind.

Nervous system disorders: Total intracranial pressure such as vision (fake tumor in the brain), convulsions.

Eye disorders: Music under the back of the glass, protruding eyes.

Heart disorders: congestive heart failure in sensitive patients, heart muscle breakdown after myocardial infarction, arrhythmia.

vascular disorders: hypertension, hypotension, hemorrhagic spots.

Respiratory disorders, chest and mediastinum: persistent hiccups when using high doses of corticosteroids.

Gastrointestinal disorders : mouth ulcers, perforation and stomach bleeding, pancreatitis, esophagitis, intestinal perforation.

Skin and tissue disorders: Blood, thin skin.

Disorders of muscle and connective tissue: Steroid muscle disease, muscle weakness, osteoporosis, aseptic necrosis.

Reproductive and breast disorders: Menstrual abnormalities.

Common disorders and conditions to indicate: difficulty healing wounds, slow growth in children.

Research: Potassium loss, increase ALT (SGPT), AST (SGOPT), Alkaline phosphatase, negative nitrogen balance due to catabolism, increased intraocular pressure, decreased reactions with skin tests. Damage, poisoning and complications according to procedures: pathological fractures, spinal fractures, tendon broken (especially Achilles tendons).

Instructions on how to handle ADR

When experiencing side effects of the drug, it is necessary to stop using and notify the doctor or go to the nearest medical facility for timely treatment.

Warnings

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

contraindicated

Solu - Medrol 40mg contraindicated in the following cases:

Contraindicated methylprednisolon sodium sucinat in patients with systemic fungal infections, patients with hypersensitivity to methylprednisolon and other ingredients in the preparation.

Caution when using

Some unknown studies have the effect of methylprednisolon sodium sucinat and in bacterial stunnings and think that increased death may be encountered in some higher risk groups (such as secondary infection patients or higher creatinine levels higher than 2.0 mg/dL). For patients using corticosteroids that encounter abnormal stress, will specify the dose of corticosteroids to work quickly before, during and after stress.

The results of a central multi -central study have shown that methylprednisolon sodium sucinat should not be used as usual to treat head damage. The results of the study showed that each death rate in 2 weeks after the injury in patients was prescribed methylprednisolon sodium sucinat compared to the placebo (1.18 relatively risk). The reason is associated with Methyl-Prednisolon Sodium Succinat.

Immune inhibiting effects/hypercertia with infections: corticosteroids can cover some signs of infection and some new infections that appear while taking the drug. When using corticosteroids, resistance can be reduced and losing the ability to localize infections.

Infections of germ germ gills due to many causes such as viruses, bacteria, fungi, unicellular or helminths wherever the body can be accompanied by separate corticosteroids or in combination with other immunosuppressive drugs that affect cell immunity or immunomemosis or to the function of neutrophils.

These infections may be mild, but may also be serious and sometimes death. When increased corticosteroid dose, the incidence of infection complications increases.

Contraindicated or living vaccine has decreased poison in patients with corticosteroidal doses that cause immunodeficiency. Dead or inactivated vaccines may be used for patients with corticosteroids, causing immunodeficiency; However, the patient's response to these vaccines can be reduced.

The specified immunosuppressant processes can be used for patients using corticosteroidal doses that do not cause immunodeficiency. Using methylprednisolon sodium sucinat in tuberculosis should be limited in cases of spreading or sudden tuberculosis when using corticosteroids to manage diseases in combination with appropriate anti -tuberculosis drugs. If using corticosteroids in patients with tuberculosis or reacting with tuberculin, it is necessary to have closely monitoring because it may experience the activity of tuberculosis. While using long corticosteroids, patients need to use prophylaxis with chemical therapy.

Effects on the immune system: Because it may be encountered (rarely) anaphylactic reactions (for example, bronchospasm) in patients using corticosteroids by injection, it is necessary to take appropriate careful measures before using corticosteroids, especially when patients have a history of allergies to a certain drug.

Effects on the heart: After quick injection of high doses of methylprednisolon sodium sucinat (more than 0.5 grams for less than 10 minutes), there is arrhythmia and/ or vascular or/ or cardiac arrest. During and after using high doses of methylprednisolon sodium sucinat sometimes have slow heart rate and may not be related to speed and injection time.

Effects on the eye: Corticoid caution should be used in patients with herpes Simplex in the eye because it may have corneal perforation.

Neurological effects: Mental disorders can be encountered when using corticosteroids, ranging from refreshment, insomnia, oscillation in temperament, changing personality and serious depression to real mental illnesses, emotional instability and existing mental illness can also be serious when using corticoids.

Effects on the gastrointestinal tract: Use Corticosteroids in patients with non-specific colon ulcers when there is a possibility of perforation, abscess or other pus infections. Corticoids should also be used carefully in new patients with intestinal connectivity, excess bags, oral ulcers that connect activity or potential, kidney failure, hypertension, osteoporosis or muscle weakness.

Effects on the skeletal muscle system: There is acute muscle disease when taking high doses of corticosteroids, people often have neurotransmitter disorders (for example, muscle weakness), or in patients using a nerve-blocker in combination (e.g. pancuronium). Acute muscle disease is in many places, which can affect eye muscles, respiratory muscles and can lead to limbs. Can increase the content of creatin-kinase (CK). Clinical improvement and clinical recovery after stopping corticosteroids sometimes need to go after weeks to many years.

Other side effects: Sarcom kaposi is found in corticosteroid users. Stopping the drug may cause clinical improvement. The following status is only applicable to water that uses benzylic alcohol in the formula: This product contains Benzylic alcohol. Benzylic alcohol has been seen causing 'gosping syndrome' leading to death in premature babies.

The ability to drive and operate machinery

has not systematically evaluated the effect of methylprednisolon sodium sucinat on driving and operating machinery.

Pregnancy

Research on animals shows that corticosteroids when taking high doses for maternal animals can cause fetal deformities. However, corticosteroids seem to not cause congenital abnormalities when used for pregnant mothers. Research research shows that there is a slight increase in weight rate in babies born from mothers using corticosteroids.

Although there are exploration on animals, possibly the risk of pregnancy is the difference when taking the drug during pregnancy. However, because human studies cannot exclude risks, only methylprednisolon sodium sucinat during pregnancy is needed.

corticosteroids through the placenta fence. Although adrenal failure at birth is rare in children when they are still in the womb infected with corticosteroids from the mother, children who are exposed to significant doses of corticosteroids that the mother has used should be carefully monitored and evaluated for signs of adrenal insufficiency. Corticosteroids have not yet been seen affected by giving birth and pushing.

breastfeeding period

corticosteroids (including prednisolon) excreted through breast milk. Because there is no full research on humans, only corticosteroids for breastfeeding women when benefits are superior to the risk of being able to meet in breastfeeding.

Drug interaction

Mutual inhibition of metabolism encountered when used with cyclosporin and methylprednisolon, so maybe the harmful phenomena in each drug will be more likely to meet again.

There have been convulsions when combining methylprednisolon with cyclosporin. The liver enzyme induction (such as phenobarbital, phenytoin, rifampicin) may increase the purification of methylprednisolon and may need to increase the dose of methylprednisolon to meet the desired response.

CYP3A4 inhibitors (such as macrolid group, triazole antifungal drugs, some calcium channel blockers) can inhibit the metabolism of methylprednislon and thus reduce the purification of this drug. Therefore, methylprednisolon is required to avoid the toxicity of steroids. Methylprednisolon may increase the purification of high doses of Aspirin for a long time. This can lead to a reduction in serum salicylate or increase the risk of Salicylate poisoning when stopping methylprednisolon.

Need to be carefully used for Aspirin and corticoids in patients with reduced blood prothrombin. The effect of methylprednisolon on anticoagulant oral medications may change. There are reports of an increase in anticoagulant drugs sometimes reduced when coordinated with corticosteroids. Therefore, it is necessary to monitor blood clotting indicators to maintain the desired anticoagulant effect.

Cavalry: The compatibility and stability when intravenously methylprednisolon sodium sucinat and when mixed with other solutions also intravenously depend on the pH of the mixing solution, on the concentration, time, temperature and the solubility of methylprednisolon. Thus, to avoid the problem of correlation and affect the stability, if possible, the methylprednisolon solution should be injected separately, not mixed with other drugs.

Storage

Products have not been prepared: Storage below 30 ° C.

Products prepared: Store mixed solution at control room temperature

15 ° C - 30 ° C. Use the mixed solution within 48 hours after mixing.

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