Nisolon M Tablet (Methylprednisolone)

Adult dosage

The initial dosage may vary from 4mg to 48mg per day of methylprednisolone, 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 obtained. If a satisfactory clinical result is not achieved after a reasonable period, treatment should be discontinued and another appropriate treatment initiated. The dosage must be determined individually according to the various diseases being treated and the patient’s response. After an adequate response is obtained, 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 dosage is required. Situations that may require dosage adjustment include relief or worsening of the disease, individual patient responsiveness to the drug, 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 provide satisfactory control of the patient’s condition. After long-term treatment, gradual dose reduction is recommended when discontinuing the drug. 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 (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 causes considerably less adrenal suppression than taking prednisolone (10mg) in 4 divided doses every 6 hours, there is evidence that, when pharmacological doses are used, a slight suppressive effect on adrenal activity persists into the following day. In addition, a single dose of any corticosteroid has been shown to suppress the adrenal cortex for 2 days or more. Methylprednisolone, hydrocortisone, prednisone, prednisolone, and other corticosteroids are considered short-acting (a single dose suppresses the adrenal cortex for 1¼ to 1½ days), and alternate-day therapy is therefore recommended. ADT is a therapeutic technique that should be considered as a basic treatment plan for patients requiring long-term corticosteroid drug therapy. For less severe diseases for which corticosteroid therapy is indicated, ADT may be used initially. In more severe conditions, a regimen of divided daily doses is usually required, using high doses to achieve 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 period of suppressive dosing as short as possible, especially if continued use of alternate-day therapy is intended. Once control is achieved, two options are available. ① Switch to ADT and gradually reduce the amount of corticosteroid given every other day. ② Reduce the daily corticosteroid dose to the minimum effective level as soon as possible, according to control of disease progression, and then switch to an alternate-day schedule. Theoretically, option ① is preferable. Because of the advantages of ADT, this form of treatment is desirable for patients who have been taking corticosteroids daily for a long period (for example, for rheumatoid arthritis). Since these patients may already have suppression of the HPA axis, establishing an ADT regimen may be difficult and is not always successful. Nevertheless, regular attempts to make the change are recommended. If this is difficult, it is preferable to administer 3 or even 4 times the daily dose every other day rather than merely doubling the daily dose. Once the patient is again controlled, attempts should be made to reduce this dose to the lowest level. As mentioned above, certain corticosteroids are not recommended for alternate-day therapy because they suppress adrenal function for a prolonged period (for example, dexamethasone, betamethasone). Adrenal cortical activity is greatest from 2 a.m. to 8 a.m. and lowest from 4 p.m. to midnight. When administered during the period of greatest 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 over the day to achieve control. Once control is achieved, the established alternate-day regimen may be tried again.

Children's dosage

Minimize adverse effects such as growth suppression in children

This medication should not be used in patients with allergic reactions or hypersensitivity. Be cautious in patients with infections or systemic fungal infections, as this medication may suppress immune function and worsen infections. It should not be administered to patients with herpes simplex, shingles, or chickenpox, nor to those receiving live vaccines or attenuated live vaccines. This medication contains lactose and should not be given to patients with lactose intolerance or related genetic issues. Patients with specific diseases such as glaucoma, tuberculosis, cataracts, hypertension, thrombosis, heart disease, peptic ulcers, psychiatric disorders, osteoporosis should use this medication with caution. Particular attention should be paid to patients with infections, diabetes, renal insufficiency, hypothyroidism, fatty liver, elderly patients, and those with epilepsy, monitoring their condition closely during treatment. This medication can cause various side effects, so side effects such as edema, muscle weakness, gastrointestinal issues, skin changes, neurological symptoms, and endocrine abnormalities should be carefully observed. Long-term use may lead to adrenal function suppression, so abrupt discontinuation should be avoided and dosage should be tapered gradually. Dosage adjustments may be necessary in stressful situations. Due to its immunosuppressive action, the risk of infection may increase and vaccine effectiveness may decrease, necessitating careful attention to infection prevention and management. This medication can interact with other drugs, so if taking other medications, it is imperative to consult with a healthcare professional. During pregnancy, it should be administered only after carefully assessing necessity and risks, and use should be avoided during breastfeeding. In children, minimum doses should be used due to the risk of growth retardation, and their growth status must be monitored closely. Elderly patients are at a higher risk of side effects, so administration should be more cautious with frequent assessment of their condition. During the use of this medication, careful monitoring for hypokalemia, infections, skin reactions, and neurological symptoms is essential.

Edema, sodium retention, potassium loss, fluid retention, hypokalemic alkalosis, congestive heart failure, hypertension, myasthenia, aseptic necrosis of the femoral and humeral heads, steroid myopathy, muscle atrophy, pathological fractures of the iliac bone, osteoporosis, vertebral compression fractures, arthralgia, tendon rupture, increased ALT, increased AST, increased ALP, nausea, thirst, vomiting, stomach pain, anorexia, increased appetite, perforation, bleeding, abdominal distension, pancreatitis, ulcerative esophagitis, diarrhea, delayed wound healing, facial erythema, thin and fragile skin, abnormal sweating, petechiae, purpura, skin reaction suppression, purpura, acne, hirsutism, alopecia, hyperpigmentation, nipple edema, increased intracranial pressure, convulsions, dizziness, headache, insomnia, euphoria, depression, Cushing's syndrome, menstrual disorders, growth retardation in children, latent diabetes symptoms, secondary adrenal insufficiency, pituitary non-responsiveness, reduced glucose tolerance, increased demand for insulin or oral hypoglycemic agents, suppression of adrenocorticotropic hormone secretion, increased intraocular pressure, glaucoma, posterior capsule cataract, secondary eye infections, retinal disorders, exophthalmos, nitrogen balance deficiency, immune system disorders, allergic reactions, shock, urticaria, anaphylactic reactions, hypersensitivity reactions

This medication must be stored in a tightly sealed container to protect it from air or moisture. It is essential to maintain a storage temperature between 1 degree and 30 degrees Celsius room temperature. Proper storage will help maintain the drug's effectiveness and safety.

Appearance

White round tablet

Package unit

30 tablets/bottle, 500 tablets/bottle