Withers Medipride Tablet (Methylprednisolone)

Adult dosage

1. The initial dose may vary from 4mg to 48mg per day of methylprednisolone, depending on the symptoms of the specific disease. A low dose is generally sufficient for less severe conditions, but a high initial dose may be required in certain patients. The initial dose should be maintained or adjusted until a satisfactory response is obtained. If there is no satisfactory clinical result after a reasonable period, treatment should be discontinued and another appropriate therapy initiated. The dose should be determined individually according to the various diseases being treated and the patient's response. After an adequate response is achieved, an appropriate maintenance dose should be determined by reducing the initial dose at suitable intervals until the lowest dose that maintains an adequate clinical response is reached. Continuous monitoring of the dose is required. Dose adjustment may be necessary in situations including improvement or worsening of the disease, individual patient responsiveness to the medication, and the effect on the patient of exposure to stressful circumstances that are not directly related to the symptoms of the disease being treated. In the latter case, it may be necessary to increase the dose for a period sufficient to achieve satisfactory control of the patient's condition. After long-term treatment, gradual dose reduction is recommended when discontinuing the medication. 2. Multiple sclerosis For treatment of acute exacerbations of multiple sclerosis, administration of prednisolone 200mg daily for 1 week, followed by prednisolone 80mg every other day for 1 month, is effective (4mg of methylprednisolone is equivalent to 5mg of prednisolone). 3. ADT (Alternate Day Therapy) Alternate-day therapy is a regimen in which twice the daily dose is administered on one morning of every 2 days. The purpose of this regimen is to enhance the effects of corticosteroids in patients requiring long-term medication and to minimize adverse effects such as pituitary-adrenal suppression, Cushingoid state, corticosteroid withdrawal symptoms, and growth suppression in children. The rationale for this treatment plan is based on the following 2 important premises: 1) The anti-inflammatory and therapeutic effects of corticosteroids persist longer than their physical presence and metabolic effects; and 2) Taking corticosteroids in the morning every other day restores nearly normal hypothalamic-pituitary-adrenal (HPA) activity on the days when corticosteroids are not administered. A brief summary of HPA physiology may help explain this rationale. Free cortisol acts primarily through the hypothalamus, so a decrease in free cortisol stimulates the pituitary gland to increase production of adrenocorticotropic hormone (ACTH), whereas an increase in free cortisol suppresses ACTH secretion. Normally, the HPA system is characterized by a 24-hour activity rhythm. Serum ACTH levels rise from a low level at 10 p.m. to a peak at 6 a.m. Increased ACTH levels stimulate adrenal cortical activity, causing plasma cortisol to peak between 2-8 a.m. This increase in cortisol reduces ACTH production and therefore also decreases adrenal cortical synthesis. Plasma corticosteroid levels gradually decline during the day, reaching their lowest levels around midnight. The 24-hour HPA rhythm is absent in Cushing's disease, a condition of adrenocortical hyperfunction characterized by symptoms such as obesity with central fat distribution, thin skin that bruises easily, weakness and muscle wasting, hypertension, latent diabetes, osteoporosis, and electrolyte imbalance. The clinical symptoms of the same hyperadrenocorticism may typically occur during long-term corticosteroid therapy when the medication is divided into doses throughout the day. If they occur, disruption of the diurnal rhythm due to maintenance of elevated corticosteroid levels during the night is likely to play an important role in the development of corticosteroid adverse effects. Avoiding persistently elevated plasma concentrations, even for a short period, may help prevent adverse effects. During typical pharmacologic-dose corticosteroid therapy, ACTH production is suppressed along with inhibition of cortisol production by the adrenal cortex. The time required for recovery of normal HPA activity varies with the dose and duration of treatment. During this period, the patient is sensitive to any stressful circumstances. Although a single morning dose of prednisolone (10mg) produces considerably less adrenal suppression than dividing the dose into 4 doses taken every 6 hours throughout the day, there is evidence that, at pharmacologic doses, some suppression of adrenal activity continues into the following day. In addition, a single dose of any corticosteroid has been shown to suppress the adrenal cortex for 2 days or longer. Other corticosteroids, including methylprednisolone, hydrocortisone, prednisone, and prednisolone, are considered short-acting (adrenocortical suppression occurs for 1¼ to 1½ days after a single dose) and are therefore suitable for alternate-day therapy. The following points should be kept in mind when using alternate-day therapy. 1) The basic principles and indications for corticosteroid therapy should be applied. The advantages of ADT should not encourage indiscriminate use of corticosteroids. 2) ADT is a treatment technique that should generally be planned for patients requiring long-term corticosteroid therapy. 3) For less severe diseases with indications for corticosteroid therapy, ADT may be used initially. For more severe conditions, a regimen of high doses divided throughout the day will usually be required for initial control of disease progression. The initial suppressive dose should be continued until a satisfactory clinical response is achieved, usually for 4 to 10 days in many allergic and collagen diseases. It is important to keep the initial suppressive-dose period as short as possible, particularly if continuous use of alternate-day therapy is intended. Once control is achieved, two approaches are possible. ① Switch to ADT and gradually reduce the amount of corticosteroid given every other day. ② Depending on control of disease progression, reduce the daily corticosteroid dose to the minimum effective level as soon as possible, and then switch to an alternate-day schedule. Theoretically, approach ① is more desirable. 4) Because of the advantages of ADT, this form of treatment is desirable for patients who have been taking corticosteroids daily for a long time (for example, rheumatoid arthritis). As these patients may already have suppression of the HPA axis, establishing an ADT regimen may be difficult and is not always successful. However, regular attempts to switch are recommended. If this is difficult, administering 3 or even 4 times the daily dose every other day is preferable to simply doubling the daily dose. Once the patient is controlled again, an attempt should be made to reduce this dose to the minimum. 5) As noted above, some corticosteroids suppress adrenal function for a prolonged period and are therefore not recommended for alternate-day therapy (for example, dexamethasone, betamethasone). 6) Maximum adrenal cortical activity occurs from 2 a.m. to 8 a.m., and the minimum from 4 p.m. to midnight. When administered during the period of maximum activity (in the morning), exogenous corticosteroids suppress adrenal cortical activity the least. 7) As with any treatment setting, it is important when using ADT to provide individualized and appropriate treatment for each patient. Complete control of symptoms is not possible in every patient. Explaining the advantages of ADT will help patients understand and tolerate unstable symptoms that may occur later in the day when they are not taking corticosteroids. If necessary, other symptomatic treatments may be added or increased during this period. 8) If an acute exacerbation occurs during disease progression, it may be necessary to return to a fully suppressive corticosteroid dose divided throughout the day to achieve control. Once control is achieved, the established alternate-day regimen may be tried again. 9) Although many adverse effects of corticosteroid therapy may be minimized with ADT, as in any treatment setting, the physician should carefully weigh the benefits and risks of treatment for each patient being considered for corticosteroid therapy.

This medication should not be used in patients with a known allergy or hypersensitivity to this drug or its ingredients. Patients with poorly treated infections or with systemic fungal infections should not receive this medication as it can suppress immune function and worsen infections. In patients with viral infections such as herpes simplex, shingles, and chickenpox, using this medication may worsen their symptoms. Patients receiving live vaccines or attenuated live vaccines should not use this medication simultaneously, as it may reduce the effectiveness of the vaccine or cause side effects. It contains lactose, so patients with galactose intolerance, lactase deficiency, or glucose-galactose malabsorption should not use it. Patients with glaucoma should be cautious as this medication may increase intraocular pressure. Patients with tuberculosis or keratitis should be careful as the immune suppressive effects can worsen their symptoms. Patients with cataracts should be cautious as this medication may exacerbate symptoms. Patients with electrolyte imbalance or hypertension should be careful as this medication may worsen electrolyte disturbances or increase blood pressure. Patients with thromboembolic disorders should be cautious as it may enhance blood coagulation and worsen symptoms. Patients who have recently had abdominal surgery should use this medication carefully due to delayed wound healing. Patients who have experienced a heart attack should be cautious as there is a risk of cardiac complications after administration of this medication. Patients with diverticulitis, peptic ulcers, psychosis, or severe osteoporosis should be cautious as this medication may worsen their symptoms. Patients with infections should be aware that this medication could suppress immune function, potentially exacerbating infections. Diabetic patients should be cautious as blood sugar levels may rise and worsen their condition. Patients with renal failure or congestive heart failure may experience worsening symptoms as this medication can increase sodium levels in the body. Patients with hypothyroidism should be aware that metabolism of this medication may slow down. Patients with fatty liver or fat embolism may find that this medication exacerbates symptoms. Patients with myasthenia gravis may experience temporary worsening of symptoms at the start of treatment. Elderly patients, patients with epilepsy, and patients with ulcerative colitis have a higher risk of side effects, so they should use this medication with caution. Various side effects may occur with this medication, so careful monitoring for fluid retention, muscle weakness, gastrointestinal symptoms, skin changes, and neurological symptoms is necessary. Long-term use may lead to adrenal insufficiency, so it should not be abruptly discontinued, but rather tapered gradually. Due to immune suppression, there may be an increased risk of infection, so preventive measures and prompt treatment for infections should be prioritized. Particularly avoid exposure to infections such as chickenpox or measles, and consult healthcare professionals immediately if exposed. This medication has many drug interactions, so always consult your physician or pharmacist before taking it with other medications. During pregnancy, this medication may be harmful to the fetus, so it should only be used when absolutely necessary, and during breastfeeding, it can be transmitted in breast milk, so stopping breastfeeding is advisable. In children, there may be effects like growth delay; therefore, the minimum effective dose should be used, and growth should be closely monitored. Elderly patients have a higher risk of side effects, so they should exercise extra caution when taking this medication.

Edema, sodium retention, potassium loss, fluid retention, hypokalemic alkalosis, congestive heart failure, hypertension, myasthenia, avascular necrosis of the femoral and humeral epiphyses, steroid myopathy, muscle wasting, pathological fractures of the pelvis, osteoporosis, vertebral compression fractures, arthralgia, tendon ruptures, increased ALT, increased AST, increased ALP, nausea, thirst, vomiting, abdominal pain, loss of appetite, increased appetite, peptic ulcer, abdominal distension, pancreatitis, ulcerative esophagitis, diarrhea, delayed wound healing, facial erythema, thin and fragile skin, abnormal sweating, petechiae, ecchymosis, suppressed skin reactions, purpura, acne, hirsutism, alopecia, pigmentation, increased intracranial pressure, papilledema, seizures, dizziness, headache, insomnia, euphoria, depression, Cushing's syndrome, menstrual irregularities, growth suppression, symptoms of latent diabetes, secondary adrenal insufficiency, pituitary unresponsiveness, impaired glucose tolerance, increased requirements for insulin or oral hypoglycemic agents, suppression of adrenocorticotropic hormone secretion, increased intraocular pressure, glaucoma, posterior capsule cataract, secondary infections, retinal disorders, exophthalmos, negative nitrogen balance, immune system disorders, allergic reactions, shock, urticaria, anaphylactic reaction, hypersensitivity reactions

This medication should be stored in a tightly closed container to prevent air and moisture from entering. It is advisable to keep it at room temperature between 1 to 30 degrees Celsius.

Appearance

White round tablet

Package unit

30 tablets/bottle, 300 tablets/bottle