Metiron Tablet (Methylprednisolone)

Adult use

1. 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, 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 result is not obtained 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 minimum 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, individual patient response to the medicine, and the effect on the patient of exposure to stressful circumstances that do not directly affect 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 condition in the patient. After long-term treatment, gradual dose reduction is recommended when discontinuing the medicine. 2. Multiple sclerosis 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). 3. ADT(Alternate Day Therapy) Alternate-day therapy is a regimen in which twice the daily dose is administered on one morning out of every two days. Although a single morning dose has been shown to cause considerably less adrenal suppression than taking prednisolone(10mg) in 4 divided doses every 6 hours, 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. 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 level as soon as possible, according to control of disease progression, and then switch to an alternate-day schedule. If difficulties arise, administering 3 times or even 4 times the daily dose on alternate days is preferable to simply doubling the daily dose.

This medication should not be used in patients who are allergic to it or its components or who have hypersensitivity. This medication should not be administered to patients with infections that do not have appropriate antibacterial drugs available for treatment or systemic fungal infections as it may suppress immune function and worsen the infection. It is advisable to avoid using this medication in patients with viral infections such as herpes simplex, herpes zoster, and chickenpox. Patients receiving live vaccines or attenuated live vaccines should not use this medication concurrently as it may affect the immune response. This medication contains lactose and should not be administered to patients with genetic metabolic disorders such as galactose intolerance, lactase deficiency, or glucose-galactose malabsorption. In patients with glaucoma, increased intraocular pressure may worsen symptoms, so this medication should be used cautiously. Caution is needed for patients with tuberculous diseases or keratitis as the immunosuppressive effects may worsen symptoms. In cataract patients, this medication may affect the lens and worsen symptoms. Patients with electrolyte imbalances or hypertension may experience worsened symptoms due to this medication, so it should be administered carefully. Patients with thromboembolic disorders should be cautious as this medication may enhance coagulation and worsen their condition. Patients who have recently undergone bowel resection may experience delayed wound healing, necessitating caution when using this medication. Patients with a history of myocardial infarction should be carefully monitored as there is a risk of cardiac complications. Patients with diverticulitis or peptic ulcers may experience worsened symptoms or increased bleeding risk due to this medication, hence caution is warranted. Patients with psychiatric disorders may find that this medication affects neurotransmitters and worsens symptoms. For patients with osteoporosis, the effects such as inhibition of bone formation can worsen their condition, so it should be used cautiously. Patients with infections may experience exacerbated infections due to immune suppression; careful monitoring is essential. Patients with diabetes should manage their blood sugar levels carefully as this medication can elevate blood sugar and worsen diabetes. Patients with renal failure or congestive heart failure may experience worsened symptoms due to sodium retention in the body. Hypothyroid patients may experience prolonged half-life of this medication in the bloodstream, necessitating caution when administered. Patients with fatty liver or fat embolism should be monitored for worsening conditions, and cautious use is essential. Patients with severe myasthenia gravis may experience temporary symptom exacerbation upon initial use of this medication and should be observed closely. Elderly patients, patients with epilepsy, and those with ulcerative colitis should be monitored closely for adverse effects due to higher risks. Long term use may lead to adrenal insufficiency, and sudden discontinuation can cause severe withdrawal symptoms; therefore, tapering off should be done gradually. During stressful situations such as trauma, surgery, or infections, temporary increases in dosage may be required, and re-administration may be needed after long-term use has ended. Patients receiving this medication should take special care to avoid exposure to infectious diseases like chickenpox or measles due to increased susceptibility. During treatment, live vaccination should be avoided as vaccination efficacy may decrease. This medication can interact with various drugs, so it is essential to consult a doctor or pharmacist about other medications being taken. During pregnancy, it should be administered only under medical supervision as it may harm the fetus, and its use should be avoided during breastfeeding. In pediatric patients, growth retardation and other side effects may occur, so minimal dosing should be exercised with caution. Elderly patients may experience increased risks of side effects such as infections, osteoporosis, and hypertension; careful monitoring is necessary.

Edema, sodium retention, potassium loss, fluid retention, hypokalemic alkalosis, congestive heart failure, hypertension, myasthenia, aseptic necrosis of the femur and humerus, steroid myopathy, muscle wasting, pathologic fractures of the pelvis, osteoporosis, vertebral compression fractures, arthralgia, tendon rupture, increased ALT, increased AST, increased ALP, nausea, thirst, vomiting, gastric pain, anorexia, 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, alopecia, pigmentation, nipple edema, increased intracranial pressure, convulsions, dizziness, headache, insomnia, euphoria, depression, Cushing's syndrome, menstrual irregularities, growth suppression in children, symptoms 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, posterior subcapsular cataract, secondary infections of the eye caused by 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 medication should be stored in a tightly sealed container, protected from air and moisture. It is important to maintain the storage temperature between 1 degree and 30 degrees Celsius.

Appearance

White round tablet

Package unit

30 tablets/bottle, 300 tablets/bottle