Mednin Tablet (Methylprednisolone)

Adult dosage

The initial dose may vary from 4mg to 48mg per day as methylprednisolone, depending on the symptoms of the specific disease. In general, a low dose is 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 achieved. If a satisfactory clinical outcome 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. 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. Continued monitoring of the dose is required. Dose adjustment may be necessary in situations such as remission or worsening of the disease, individual differences in the patient's response to the medication, or 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 a satisfactory response in the patient. After long-term treatment, gradual dose reduction is recommended when discontinuing the medication. 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 (methylprednisolone 4mg is equivalent to prednisolone 5mg). Alternate-day therapy is a regimen in which twice the daily dose is administered on one morning every other day. Although a single morning dose produces considerably less adrenal suppression than dividing prednisolone (10mg) into 4 daily doses taken every 6 hours, there is evidence that, when pharmacologic doses are used, a slight suppressive effect on 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. Methylprednisolone, hydrocortisone, prednisone, prednisolone, and other corticosteroids are considered short-acting (a single dose suppresses the adrenal cortex for 1¼ to 1½ days), and therefore alternate-day therapy is recommended. The basic principles and indications for corticosteroid therapy should be applied. The advantages of ADT should not encourage indiscriminate use of corticosteroids. ADT is a treatment technique that should generally be planned for patients requiring long-term corticosteroid therapy. For less severe diseases for which corticosteroid therapy is indicated, ADT may be used initially. For more severe diseases, a regimen of high doses divided throughout the day will usually be required to achieve initial control of disease progression. The initial suppressive dose should be continued until a satisfactory clinical response is obtained, usually for 4 to 10 days in many allergic and collagen diseases. ① Switch to ADT and gradually reduce the amount of corticosteroid given on alternate days. ② Reduce the daily corticosteroid dose to the minimum effective dose as soon as possible, according to control of disease progression, and then switch to an alternate-day schedule. Theoretically, step ① is more desirable. 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). Since the HPA axis may already be suppressed in these patients, establishing ADT may be difficult and is not always successful. Nevertheless, regular attempts to make the switch are recommended. If difficulties arise, it is preferable to administer 3 times, or even 4 times, the daily dose on alternate days rather than simply doubling the daily dose. Once the patient is controlled again, attempts should be made to reduce this dose to the minimum. As noted above, some corticosteroids are not recommended for alternate-day therapy because they suppress adrenal function for a long time (for example, dexamethasone, betamethasone). Adrenal cortical activity is highest from 2 a.m. to 8 a.m. and lowest from 4 p.m. to midnight. When administered during the period of peak activity (morning), exogenous corticosteroids suppress adrenal cortical activity the least. As with any treatment approach, it is important to provide individualized and appropriate treatment for each patient when using ADT. Complete control of symptoms is not possible in every patient. Explaining the advantages of ADT can help patients understand and tolerate unstable symptoms that may occur later in the day on days when they do not receive corticosteroids. If necessary, other symptomatic treatments may be added or increased during this period. If an acute exacerbation occurs during disease progression, it may be necessary to return to a fully suppressive dose of corticosteroids divided throughout the day to achieve control. Once control is achieved, the established alternate-day regimen may be tried again. Although many adverse effects of corticosteroid therapy may be minimized with ADT, as with any treatment approach, the physician should carefully weigh the benefits and risks of treatment for each patient for whom corticosteroid therapy is being considered.

Children's dosage

The aim is to minimize adverse effects, including growth suppression in children.

This medication should not be administered to certain patients. For example, patients with allergies to this drug or its components, and those with infections lacking effective antibacterial therapies or systemic fungal infections may experience worsening of their infections if administered. Patients with herpes simplex, shingles, or chickenpox, as well as those receiving live vaccines, should also avoid using this drug. Additionally, this medication contains lactose, so individuals with genetic conditions such as galactose intolerance should avoid taking it. This drug must be used cautiously in the following patients. For instance, patients with glaucoma might experience worsened symptoms due to increased intraocular pressure. Tuberculosis patients or those with herpetic keratitis and patients with posterior subcapsular cataracts could also see worsening of their symptoms from this medication. Patients with electrolyte imbalances, hypertension, thromboembolism, and those who have recently undergone surgery should also be careful due to the risk of delayed wound healing or worsening symptoms. Furthermore, diabetes patients may see increased blood sugar levels and osteoporosis patients may have decreased bone density. Those with renal or heart failure may also experience worsening of their symptoms, thus consultation with healthcare providers is necessary. When using this medication, various side effects may occur, so caution is required. Symptoms such as edema, hypertension, muscle weakness, osteoporosis, gastrointestinal issues, skin changes, and mental symptoms can arise. Additionally, eye issues such as glaucoma or cataracts may develop, necessitating regular examinations. Immune function suppression can lead to heightened infection risk, so any symptoms of infection should prompt immediate notification to healthcare providers. Long-term use of this drug can lead to adrenal suppression, and suddenly discontinuing it can result in serious health problems. Therefore, when reducing or stopping this medication, it must be done gradually under the guidance of a healthcare provider. In stressful situations such as trauma, surgery, or infection, temporary dosage increases may be required. This medication can interact with several other drugs, so any concurrent medications must be reported to healthcare providers. Co-administration with certain antiarrhythmics, antibiotics, diuretics, and hypoglycemic agents may result in side effects or changes in efficacy. Women who are pregnant or may become pregnant should consult their physician before taking this medication, as it may affect the fetus. It is also recommended that breastfeeding be discontinued, as this drug can be passed into breast milk. When administering this medication to children or adolescents, there is a risk of growth retardation, so the minimum effective dose should be used and growth should be closely monitored. Elderly patients are at higher risk for side effects such as infections, diabetes, osteoporosis, and hypertension, thus should be managed more cautiously. Infection with chickenpox or measles during treatment with this drug may be very dangerous, so it is crucial to check a patient's past medical history and vaccination status, and if an infection is suspected or occurs, immediately notify healthcare providers for appropriate treatment.

Edema, sodium retention, potassium loss, fluid retention, hypokalemic metabolic alkalosis, congestive heart failure, hypertension, myasthenia, aseptic necrosis of the femoral and humeral epiphyses, steroid myopathy, loss of muscle mass, pathological fractures of the pelvis, osteoporosis, spinal compression fractures, arthralgia, tendon rupture, increased ALT, increased AST, increased ALP, nausea, thirst, vomiting, abdominal pain, anorexia, increased appetite, peptic ulcer, abdominal distension, pancreatitis, ulcerative esophagitis, diarrhea, delayed wound healing, facial erythema, thin and fragile skin, abnormal sweating, petechial hemorrhages, purpura, suppressed skin reactions, purpura, acne, hypertrichosis, hair loss, pigmentation, areolar edema, increased intracranial pressure, convulsions, dizziness, headache, insomnia, euphoria, depression, Cushing's syndrome, menstrual irregularities, growth suppression in children, latent diabetes symptoms, secondary adrenal insufficiency, pituitary unresponsiveness, decreased insulin sensitivity, increased requirements for insulin or oral hypoglycemics, inhibition of adrenocorticotropic hormone secretion, increased intraocular pressure, glaucoma, posterior subcapsular cataract, secondary infection of the eye due to fungi or viruses, retinal disorders, exophthalmos, negative nitrogen balance due to protein catabolism, immune system disorders, allergic reactions, shock, urticaria, anaphylactic reactions, hypersensitivity reactions

This medicine should be stored in a tightly closed container to prevent exposure to air or moisture, and the storage temperature should be maintained between 1 degree and 30 degrees Celsius at room temperature. Storing it this way will help maintain the effectiveness of the medication for a longer period.

Appearance

White round tablet

Package unit

30 tablets/bottle, 500 tablets/bottle