Methyl-D Tablets (Methylprednisolone)

Adult use

The initial dose may vary from 4 mg to 48 mg per day of methylprednisolone, depending on the symptoms of the specific disease. In general, a low dose is sufficient for less severe conditions, although an initially high 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, discontinue treatment and switch to another appropriate therapy. The dose must 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. Situations that may require dose adjustment include improvement or worsening of the disease, the individual patient's response to the medicine, 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 satisfy the patient's condition. After long-term treatment, gradual dose reduction is recommended when discontinuing the medicine. 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 (4 mg of methylprednisolone is equivalent to 5 mg of prednisolone). Alternate-day therapy means administering twice the daily dose on one morning out of every two days. Although a single morning dose is associated with substantially less adrenal suppression than taking prednisolone (10 mg) in four divided doses every 6 hours, there is evidence that, when pharmacologic doses are used, slight 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 (a single dose produces adrenal cortical suppression for 1¼ to 1½ days); therefore, alternate-day therapy is 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. More severe diseases will usually require a regimen of high doses divided throughout the day 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 for many allergic and collagen diseases. Once control has been achieved, 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 level as soon as possible, according to control of disease progression, and then switch to an alternate-day schedule. In theory, approach ① is preferable. If difficulties arise, it is preferable to administer three or even four times the daily dose on alternate days rather than only doubling the daily dose. Once the patient is again controlled, attempt to reduce this dose to the minimum. Maximum adrenal cortical activity occurs from 2 a.m. to 8 a.m., and minimum activity from 4 p.m. to midnight. When administered during the period of maximum activity (morning), exogenous corticosteroids suppress adrenal cortical activity the least. If an acute exacerbation occurs during disease progression, it may be necessary to return to a fully suppressive dose of corticosteroid divided throughout the day for control. Once control is achieved, the established alternate-day regimen may be tried again.

This medication should not be used in certain patients. For example, individuals with allergies to this drug or its components, those with infections or systemic fungal infections that do not have effective antibiotics, should not take this medication as it may worsen the infection. Additionally, patients with herpes simplex, shingles, chickenpox, or those vaccinated with live vaccines should not use this medication. This drug contains lactose, so those with lactose intolerance or related genetic disorders should avoid it. Caution is required when using this medication in certain patients. Patients with glaucoma may experience an increase in intraocular pressure that can worsen their condition, while those with tuberculosis or herpes simplex keratitis may see symptoms worsen due to immunosuppressive effects. Moreover, patients with posterior capsule cataract, electrolyte imbalance, hypertension, or thrombosis should use this drug cautiously, as their conditions may worsen. Special care should be taken in patients recovering from surgery, those with a history of myocardial infarction, diverticulitis, peptic ulcers, mental disorders, and severe osteoporosis. Individuals with infections, diabetes, renal failure, hypothyroidism, fatty liver, myasthenia gravis, elderly patients, or those with epilepsy also require careful monitoring. Various side effects may occur during the course of treatment with this medication, so careful observation is necessary. Fluid and electrolyte imbalances such as edema, sodium retention, and potassium loss may occur, along with musculoskeletal problems like muscle weakness, osteoporosis, fractures, joint pain, and tendon rupture. Gastrointestinal effects may include elevated liver enzymes, nausea, vomiting, abdominal pain, changes in appetite, peptic ulcers, and diarrhea. In terms of skin, delayed wound healing, thinning skin, hair loss, acne, and rashes may occur. Neurological effects can include headaches, dizziness, insomnia, and depression, while endocrine effects may lead to Cushing's syndrome, growth suppression, and increased blood sugar levels. Eye issues like glaucoma, cataracts, and secondary infections require regular checks. Prolonged use of this medication can lead to adrenal insufficiency, making abrupt discontinuation risky. Therefore, the dosage should be gradually reduced, and if withdrawal symptoms appear, immediate resumption of the medication is necessary. Additionally, stress situations such as trauma, surgery, or infections may require temporary dosage increases. This medication can suppress immune function, making individuals more susceptible to infections, so special caution should be taken to avoid exposure to diseases like chickenpox or measles. This medication can interact with various other drugs, so if there are any concomitant medications, it is essential to inform the doctor or pharmacist and take caution. Particularly, there may be side effects or changes in drug efficacy when used with medications affecting heart rhythm, anticoagulants, glucose-lowering agents, diuretics, antibiotics, and antifungal agents. Pregnant or breastfeeding women should consult a doctor before using this medication, as it may pose risks to the fetus or newborn, and discontinuation of breastfeeding is recommended. When used in children or adolescents, there may be side effects such as growth retardation or increased intracranial pressure, so dosages should be minimized and closely monitored. Elderly patients are more vulnerable to side effects such as infections, diabetes, osteoporosis, and hypertension, thus requiring extra caution. When using this medication, one should fully recognize the above cautions and side effects, follow the doctor's instructions, and report any unusual symptoms to medical professionals immediately.

Edema, sodium retention, potassium loss, fluid retention, hypokalemic alkalosis, congestive heart failure, hypertension, myasthenia, aseptic necrosis of the femoral and humeral epiphysis, steroid myopathy, muscle wasting, pathological fractures of the iliac bone, osteoporosis, spinal compression fractures, arthralgia, tendon rupture, increased ALT, increased AST, increased ALP, nausea, thirst, vomiting, gastric 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, purpura, skin reaction suppression, purpura, acne, hirsutism, hair loss, hyperpigmentation, nipple edema, increased intracranial pressure, seizures, dizziness, headache, insomnia, euphoria, depression, Cushing's syndrome, menstrual irregularities, growth suppression in children, signs of latent diabetes, secondary adrenal insufficiency, pituitary unresponsiveness, decreased glucose tolerance, increased requirement for insulin or oral hypoglycemic agents, suppression of adrenocorticotropic hormone secretion, increased intraocular pressure, glaucoma, posterior capsule opacification, secondary infection, retinal disorders, exophthalmos, negative nitrogen balance due to proteolysis, immune system disorders, allergic reactions, shock, urticaria, anaphylactic reactions, hypersensitivity reactions

This medication should be stored in a tightly closed container to protect it from air and moisture, and it is best to keep it at room temperature between 1 to 30 degrees Celsius. Storing it this way helps maintain the drug's effectiveness for a longer period.

Appearance

White round tablets

Package unit

30 tablets/bottle, 500 tablets/bottle