Conisolone Tablets 4 mg (Methylprednisolone)

Adult dosage

The initial dose may vary from 4mg to 48mg of methylprednisolone per day, depending on the symptoms of the specific disease. In general, a low dose is sufficient for less severe conditions, although a high initial dose may be required in certain patients. The initial dose should be maintained or adjusted until a satisfactory response is achieved. If a satisfactory clinical result is not achieved 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. Once 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. Circumstances that may require dose adjustment include remission or worsening of the disease, an individual patient’s response to the medicine, and the effects 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 meet the patient’s condition. After long-term treatment, gradual reduction of the dose upon discontinuation is recommended. For the 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). Alternate-day therapy means administering twice the daily dose on one morning out of every two days. Although a single morning dose causes considerably less adrenal suppression than administering prednisolone (10mg) in 4 divided doses every 6 hours throughout the day, there is evidence that, when pharmacologic doses are used, a slight suppressive effect on adrenal activity may persist 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. Methylprednisolone, hydrocortisone, prednisone, prednisolone, and other corticosteroids are considered short-acting (a single dose causes adrenal cortical suppression for 1¼ to 1½ days), and alternate-day therapy is therefore recommended. ADT is a therapeutic technique that should generally be considered for patients requiring long-term corticosteroid drug therapy. For less severe diseases for which corticosteroid therapy is indicated, ADT may be used from the outset. For more severe diseases, a divided high-dose daily regimen will usually be required initially to control 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 when continued 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 administered on alternate days. 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 preferable. If difficulties arise, it is preferable to administer 3 or even 4 times the daily dose on alternate days rather than simply doubling the daily dose. Once the patient is again controlled, attempts should be made to reduce this dose to the minimum. Maximum adrenal cortical activity occurs from 2 a.m. to 8 a.m., and minimum activity occurs 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. If an acute exacerbation occurs during the course of the disease, 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 resumed.

This medication should not be given to certain patients under any circumstances. For example, patients who are allergic to this drug or its components, or have had hypersensitivity reactions, should not use it. Also, patients with infections for which there are no available antimicrobial agents or systemic fungal infections should not be treated with this medication, as it can suppress immune function and worsen the infection. Patients with herpes simplex, herpes zoster, or chickenpox should not use this drug, nor should it be administered to individuals receiving live vaccines or attenuated live vaccines. Since this drug contains lactose, it should not be given to patients with lactose intolerance or related genetic disorders. This medication should be used cautiously in some patients. For example, patients with glaucoma may experience worsening as intraocular pressure may increase. Patients with tuberculous disease or herpes simplex keratitis may experience worsening of symptoms due to immunosuppressive effects. Patients with subcapsular cataracts may have worsening symptoms due to effects on the lens. Patients with electrolyte imbalances, hypertension, and thrombosis should also be cautious as this drug could exacerbate symptoms. Patients recently undergoing bowel anastomosis may experience delayed wound healing. Patients with a history of acute myocardial infarction, diverticulitis, peptic ulcers, psychiatric disorders, and severe osteoporosis should also use this drug with caution. Patients with infections or diabetes, renal failure, hypothyroidism, fatty liver, severe myasthenia gravis, elderly patients, epilepsy, and ulcerative colitis should be monitored closely. While taking this drug, various side effects may appear, so symptoms should be observed closely. Fluid retention, edema, sodium retention, potassium loss, etc., may occur, and symptoms of hypertension or heart failure may present. Musculoskeletal problems such as muscle weakness, osteoporosis, fractures, arthralgia, and tendon ruptures may occur. Gastrointestinal symptoms may include nausea, vomiting, stomach pain, appetite changes, peptic ulcers, and pancreatitis. Skin changes such as thinning of the skin or delayed wound healing, acne, hair loss, and pigmentation may also occur. Neuropsychiatric effects may include headaches, dizziness, insomnia, and depression, while endocrine abnormalities may lead to Cushing's syndrome, growth suppression, and worsening diabetes. Ocular side effects may include increased intraocular pressure, glaucoma, cataracts, and secondary infections, so regular check-ups are necessary. Long-term use of this drug may lead to adrenal insufficiency, and sudden discontinuation may lead to severe withdrawal symptoms, so it should be tapered off gradually. During long-term treatment, the minimal effective dose should be used, and treatment should be as brief as possible. Due to immunosuppressive effects, there is an increased susceptibility to infections, so care should be taken to avoid exposure to infectious diseases such as chickenpox or measles. During treatment, administration of live vaccines should be avoided, and if infection is suspected, immediate consultation with healthcare professionals is required. This medication can interact with various drugs, so it is essential to consult with a doctor or pharmacist about other medications being taken. Particular caution is needed when used in combination with medications affecting cardiac rhythm, anticoagulants, antidiabetic agents, diuretics, antibiotics, and others. During pregnancy, this medication may pose risks to the fetus, so it should only be administered when absolutely necessary. If taken during breastfeeding, nursing should be discontinued. In children, side effects such as growth retardation may occur, so it should be administered at the minimum effective dose with close monitoring of growth status. In elderly patients, the risk of complications such as infections, diabetes, osteoporosis, and hypertension is high, so they should use this medication with extra caution. Health status should be regularly monitored during the course of treatment with this medication, and any abnormal symptoms should be reported to healthcare professionals immediately.

Edema, sodium retention, potassium loss, fluid retention, hypokalemic alkalosis, congestive heart failure, hypertension, myasthenia, avascular necrosis of the femoral and humeral epiphysis, steroid myopathy, muscle wasting, pathologic fracture of the pelvis, osteoporosis, spinal compression fractures, arthralgia, tendon rupture, increased ALT, increased AST, increased ALP, nausea, thirst, vomiting, abdominal pain, anorexia, hyperphagia, peptic ulcer, abdominal distension, pancreatitis, esophagitis, diarrhea, wound healing delay, facial erythema, thin and fragile skin, abnormal sweating, petechiae, purpura, suppression phenomenon of skin reaction, purpura, acne, hirsutism, hair loss, pigmentation, nipple swelling, increased intracranial pressure, convulsions, dizziness, headache, insomnia, euphoria, depression, Cushing's syndrome, menstrual irregularities, growth retardation in children, signs of latent diabetes, secondary adrenal insufficiency, pituitary unresponsiveness, decreased insulin sensitivity, increased requirement for insulin or oral hypoglycemic agents, suppression of adrenocorticotropic hormone secretion, increased intraocular pressure, glaucoma, subcapsular cataract, secondary eye infections due to fungi or viruses, retinal disorders, exophthalmos, negative nitrogen balance due to protein catabolism, immune system disorders, allergic reactions, shock, urticaria, anaphylactic reaction, hypersensitivity reactions

This medication may be sensitive to air or moisture, so it should be stored in a tightly closed container. The recommended storage temperature is between 1 degree and 30 degrees Celsius at room temperature. Storing it this way will help maintain its effectiveness and safety for a longer period.

Appearance

White oval tablet

Package unit

30 tablets/bottle, 300 tablets/bottle