Mesolom Tablets (Methylprednisolone)

Adult use

1. The initial dose may vary from 4 mg to 48 mg 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 obtained. If a satisfactory clinical result is not achieved after a reasonable period, discontinue treatment and switch to another appropriate therapy. The dose should be individualized according to the various diseases being treated and the patient's response. After an adequate response is obtained, determine an appropriate maintenance dose 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. Situations that may require dose adjustment include remission or exacerbation of the disease, an individual patient's response to the medicine, and the effect on the patient of exposure to stressful circumstances unrelated to the symptoms of the disease being treated. In the latter situation, it may be necessary to increase the dose for a period sufficient to achieve a satisfactory response in the patient's condition. After long-term treatment, gradual dose reduction is recommended when discontinuing the medicine. 2. Multiple sclerosis Treatment of acute exacerbations of multiple sclerosis is effective with prednisolone 200 mg daily for 1 week, followed by prednisolone 80 mg every other day for 1 month (methylprednisolone 4 mg is equivalent to prednisolone 5 mg). 3. ADT (Alternate Day Therapy) 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 taking prednisolone (10 mg) in 4 divided doses every 6 hours throughout the day, there is evidence that, when pharmacologic doses are used, some suppressive effect on adrenal activity continues into the following day. In addition, even 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 produces adrenocortical suppression for 1¼ to 1½ days); therefore, alternate-day therapy is recommended. 3) For less severe diseases for which corticosteroid therapy is indicated, ADT may be used initially. More severe diseases generally require a regimen of divided daily doses of high-dose corticosteroids 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. ① Switch to ADT and gradually reduce the amount of corticosteroid given on alternate days. ② As disease progression comes under control, reduce the daily corticosteroid dose to the minimum effective dose as soon as possible, then change to an alternate-day schedule. Theoretically, approach ① is preferable. 4) Given the advantages of ADT, this form of treatment is desirable for patients who have taken corticosteroids daily for a long period (for example, patients with rheumatoid arthritis). Establishing an ADT regimen may be difficult and not always successful because the HPA axis may already be suppressed in these patients. However, regular attempts to switch are recommended. If this is difficult, it is preferable to administer 3 or even 4 times the daily dose on alternate days rather than merely doubling the daily dose. Once the patient is controlled again, attempt to reduce this dose to the lowest level. 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.

This medication should not be administered to certain patients. For example, it should not be used in patients who are allergic to this medication or its components, or in patients with infections without appropriate antibiotics. It should also not be administered to patients with herpes simplex, herpes zoster, chickenpox, or who are receiving live vaccines. It contains lactose, so patients with lactose intolerance or related genetic disorders should also exercise caution. This medication should be used cautiously in some patients. Patients with glaucoma or those with tuberculosis, keratitis, cataracts, electrolyte imbalances, or hypertension should be careful as symptoms may worsen. Caution is also necessary for patients with thrombosis, those who have recently undergone gastrointestinal surgery, patients with heart disease, peptic ulcer patients, patients with psychiatric disorders, or patients with osteoporosis. Patients with infections, diabetes, renal failure, hypothyroidism, fatty liver, myasthenia gravis, the elderly, epilepsy, and ulcerative colitis also require cautious administration. This medication can cause various side effects, so symptoms should be closely monitored during use. Fluid retention, electrolyte imbalances, muscle weakness, osteoporosis, gastrointestinal symptoms, skin changes, neuropsychiatric symptoms, endocrine abnormalities, and eye-related problems may occur. Special attention should be paid to increases in intraocular pressure, glaucoma, cataracts, and increased risk of infection. Long-term use may result in adrenal insufficiency, and sudden discontinuation can be dangerous; a gradual reduction is necessary. Resistance to infections will be decreased, so care must be taken to avoid exposure to infections such as chickenpox or measles, and vaccinations should be restricted. This medication interacts with various drugs, so it is important to consult with a specialist when taking other medications. Special care is needed when used with heart-related medications, antibiotics, anticoagulants, diuretics, and antihypertensive drugs. Women who are pregnant or breastfeeding should use this medication cautiously, as it may affect the fetus or newborn; it is advisable to discontinue breastfeeding if necessary. When used in children, it may affect growth, so the minimum dose should be administered, and growth should be observed carefully. In the elderly, side effects such as infections, diabetes, osteoporosis, cataracts, and glaucoma may occur more easily, so careful administration and close monitoring are needed. Finally, this medication can suppress immune function, increasing the risk of infections, so it is important to consult a healthcare provider immediately if symptoms of infection appear.

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

This medication should be stored in a tightly sealed container to protect it from air and moisture. It is best to keep the medication at room temperature between 1°C and 30°C.

Appearance

White oval tablets

Package unit

30 tablets, 500 tablets