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Medrol

Medrol
Medrol is a corticosteroid that is used to treat severe allergies, arthritis, asthma, certain blood disorders, and skin conditions.

Brand: Methylprednisolone

Availability: In Stock
Average Delivery Time: 9 Days
Exp. Date: February 2024
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Medrol 16 mg
270 pills - 16 mg
+ 12 free Viagra 100 mg, 7% discount for future orders
$501.91 $1.86 $568.64 Add to cart
180 pills - 16 mg
+ 12 free Viagra 100 mg, 7% discount for future orders
$357.93 $1.99 $355.77 Add to cart
120 pills - 16 mg
+ 8 free Viagra 100 mg, 5% discount for future orders
$261.99 $2.18 $213.81 Add to cart
90 pills - 16 mg
+ 8 free Viagra 100 mg, 5% discount for future orders
$214.99 $2.39 $141.86 Add to cart
60 pills - 16 mg
+ 4 free Viagra 100 mg, 3% discount for future orders
$166.51 $2.78 $71.39 Add to cart
30 pills - 16 mg
+ 4 free Viagra 100 mg, 3% discount for future orders
$118.95 $3.97 No Add to cart
Medrol 4 mg
360 pills - 4 mg
+ 8 free Viagra 100 mg, 5% discount for future orders
$249.95 $0.69 $164.41 Add to cart
270 pills - 4 mg
+ 4 free Viagra 100 mg, 3% discount for future orders
$190.27 $0.70 $120.50 Add to cart
180 pills - 4 mg
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$132.99 $0.74 $74.19 Add to cart
120 pills - 4 mg $93.99 $0.78 $44.13 Add to cart
90 pills - 4 mg $73.99 $0.82 $29.60 Add to cart
60 pills - 4 mg $55.91 $0.93 $13.15 Add to cart
30 pills - 4 mg $34.53 $1.15 No Add to cart

Product description

Drug Name

Medrol (Methylprednisolone)

Pharmacological action

GCS. penetrating through cell membranes, forms complexes with specific cytoplasmic receptors. Then these complexes penetrate into the cell nucleus, bind to DNA (chromatin) and stimulate mRNA transcription and subsequent synthesis of various enzymes, which explains the effect of GCS when used systemically. GCS not only have a significant effect on the inflammatory process and immune response, but also affect carbohydrate, protein and fat metabolism. They also affect the cardiovascular system, skeletal muscles and the central nervous system.


Effects on the inflammatory process and immune response. Methylprednisolone (like other GKS) has anti-inflammatory, immunosuppressive, and anti-allergic properties. Due to these properties the following therapeutic effects are achieved: reduction of the number of immunoactive cells near the focus of inflammation; reduction of vasodilation; stabilization of lysosomal membranes; inhibition of phagocytosis; reduction of prostaglandin and related compounds production.


Methylprednisolone acetate at a dose of 4.4 mg (4 mg of methylprednisolone) has the same anti-inflammatory effect as hydrocortisone at a dose of 20 mg.


Methylprednisolone has only minor mineralocorticoid activity (200 mg of methylprednisolone is equivalent to 1 mg of deoxycorticosterone).


Effect on carbohydrate and protein metabolism. Methylprednisolone (like other GKS) has a catabolic effect on proteins. Released amino acids are converted into glucose and glycogen during gluconeogenesis in the liver. Glucose uptake in peripheral tissues decreases, which can lead to hyperglycemia and glucosuria, especially in patients at risk of developing diabetes mellitus.


Effects on fat metabolism. Methylprednisolone (like other GCS) has lipolytic effects, which are primarily seen in the extremities. It also has a lipogenetic effect, which is most pronounced in the chest, neck and head. All this leads to redistribution of fat deposits.


The maximal pharmacological activity of GCS is not manifested at the peak plasma concentration, but after it, therefore, the GCS action is primarily determined by the effect on enzyme activity.


Pharmacokinetics

Absorption and distribution


Absorption of methylprednisolone occurs mainly in proximal part of small intestine, where it is approximately 2 times higher than in distal part.


Binding of methylprednisolone to proteins (albumin and transcortin) is approximately 40-90%.


Metabolism


Metabolism of methylprednisolone occurs in the liver and is qualitatively similar to that of cortisol. The main metabolites are 20p-hydroxymethylprednisolone and 20p-hydroxy-6a-methylprednisolone.


Excretion


Metabolites are excreted mainly with urine in unbound form, as well as in the form of glucuronides and sulfates, which are formed mainly in the liver and partially in the kidneys.


Methylprednisolone is a GKS with intermediate duration of action. Due to intracellular activity, there is a marked difference between the T1/2 from plasma (approximately 3.3 hours) and the T1/2 from the body as a whole (approximately 12-36 hours). The pharmacotherapeutic effect is maintained even when the blood levels of the active substance are no longer detected.

Contraindications to use

  • Hypersensitivity to the components of the drug.

The drug should be used with caution in case of gastric and duodenal ulcer, esophagitis, gastritis, acute or latent peptic ulcer, intestinal anastomosis (in the immediate history), non-specific ulcerative colitis with risk of perforation or abscess, diverticulitis; diabetes mellitus and predisposition to it; hyperlipidemia; Myasthenia gravis, osteoporosis, hypothyroidism, hyperthyroidism, acute psychosis, acute or subacute myocardial infarction, congestive heart failure, arterial hypertension, severe liver function disorders (especially with associated hypoalbuminemia) or renal function disorders, open-angle glaucoma, herpes simplex (eye form), chicken pox, measles, strongyloidosis, AIDS, HIV; in active and latent tuberculosis, severe bacterial or viral infectious diseases (increases the risk of superinfection, masks the symptoms of the disease), it is allowed to use the drug only against the background of specific therapy. In systemic fungal infections, it is not recommended to use the drug.


Use during pregnancy and lactation

Experimental studies on animals showed that administration of GCS in high doses to females may cause fetal deformities. Because there are no known studies on the effects of GCS on human reproduction, their use during pregnancy, in breastfeeding mothers, or in women of childbearing age requires evaluation of the likely beneficial effects of the drug versus the potential risk to the mother, fetus, or foetus. GCSs should be administered in pregnancy only for absolute indications.


GCS readily cross the placental barrier. Children born to mothers who have received high-dose GCS in pregnancy should be carefully evaluated for possible symptoms of adrenal hypofunction. The effect of GCS on the course and outcome of labor is unknown. GCSs are excreted with breast milk, so if it is necessary to prescribe Medrol during lactation, breastfeeding should be stopped.


Administration in patients with liver dysfunction

Caution should be exercised when using with severe hepatic dysfunction (especially with concomitant hypoalbuminemia).

Administration in patients with impaired renal function

This drug should be used with caution in case of serious renal dysfunction.

Administration in children

The dose should be determined in children by physician taking into account the body weight or body surface area. In adrenal insufficiency the oral dose is 0.18 mg/kg or 3.33 mg/m2 per day in 3 intakes, in other indications - 0.42-1.67 mg/kg or 12.5-50 mg/m2 per day in 3 intakes. It should be emphasized that the required dose may vary and the selection of the dose should be performed individually, depending on the nature of the disease and the patient's response to therapy. Withdrawal of the drug after prolonged therapy is recommended to be carried out gradually. If the treatment has a good effect, an individual maintenance dose should be selected by gradually reducing the initial dose at certain intervals until the lowest dose is found to maintain the achieved clinical effect. Keep in mind that continuous monitoring of the drug dosing regimen is necessary.

Indications for Medrol

Endocrine disorders:

  • primary and secondary adrenal insufficiency (the drugs of choice are hydrocortisone or cortisone; if necessary, synthetic analogues can be used in combination with mineralocorticoids; the addition of mineralocorticoids is particularly important in pediatric practice);
  • Congenital adrenal hyperplasia;
  • chronic and subacute thyroiditis;
  • hypercalcemia in malignant neoplasms.

Diseases of the musculoskeletal system (including rheumatic) (as adjunctive therapy for short-term elimination from acute condition or exacerbation):

  • psoriatic arthritis;
  • Rheumatoid arthritis, including juvenile rheumatoid arthritis (low-dose maintenance therapy may be required in individual cases);
  • ankylosing spondylitis;
  • Acute and subacute bursitis;
  • Acute nonspecific tenosynovitis;
  • acute gouty arthritis;
  • Posttraumatic osteoarthritis;
  • Synovitis in osteoarthritis;
  • epicondylitis.

Systemic connective tissue diseases (during exacerbation or in some cases as supportive therapy):


  • acute rheumocarditis;
  • systemic lupus erythematosus;
  • systemic dermatomyositis (polymyositis);
  • rheumatic polymyalgia;
  • gigantocellular arteritis.

Skin diseases:


  • vesicles;
  • herpetiform bullous dermatitis;
  • severe erythema multiforme (Stevens-Johnson syndrome);
  • exfoliative dermatitis;
  • fungal mycosis;
  • severe psoriasis;
  • severe seborrheic dermatitis.

Allergic reactions (severe or disabling conditions in which conventional therapy is ineffective):


  • Seasonal or year-round allergic rhinitis;
  • serum sickness;
  • bronchial asthma;
  • contact dermatitis;
  • atopic dermatitis;
  • Hypersensitivity reactions to medications.

Eye diseases (severe acute and chronic allergic and inflammatory processes with eye involvement):


  • Allergic marginal corneal ulcers;
  • inflammation of the anterior segment of the eye;
  • diffuse posterior uveitis and chorioiditis;
  • sympathetic ophthalmia;
  • allergic conjunctivitis;
  • keratitis;
  • chorioretinitis;
  • optic neuritis;
  • iritis and iridocyclitis.

Respiratory diseases:


  • symptomatic sarcoidosis;
  • Leffler's syndrome, not amenable to therapy by other means;
  • berylliosis;
  • Lightning-type or disseminated pulmonary tuberculosis in combination with appropriate antituberculosis chemotherapy;
  • aspiration pneumonitis.

Hematologic diseases:


  • Idiopathic thrombocytopenic purpura in adults;
  • secondary thrombocytopenia in adults;
  • Acquired (autoimmune) hemolytic anemia;
  • Erythroblastopenia (erythrocytic anemia);
  • Congenital (erythroid) hypoplastic anemia.

Cancer (as palliative therapy):


  • Leukemias and lymphomas in adults;
  • Acute leukemia in children.

Edema syndrome:


  • To stimulate diuresis and achieve remission of proteinuria in patients with nephrotic syndrome without uremia, idiopathic type, or caused by systemic lupus erythematosus.

Gastrointestinal diseases (to bring the patient out of critical condition):


  • ulcerative colitis;
  • Regional enteritis.

Diseases of the nervous system:


  • exacerbations of multiple sclerosis;
  • cerebral edema due to a brain tumor.

Other indications for use:


  • Tuberculous meningitis with subarachnoid block or with threatened block (in combination with appropriate anti-TB chemotherapy);
  • Trichinellosis with involvement of the nervous system or myocardium;
  • organ transplantation.

Dosing regimen

Depending on the nature of the disease, the starting dose of the drug may be from 4 mg to 48 mg per day. In less severe diseases the drug is usually used in lower doses, although some patients may require higher doses. Medrol in high doses may be needed for diseases and conditions such as multiple sclerosis 200 mg/day, brain edema 200-1000 mg/day, and organ transplants up to 7 mg/kg/day. If a satisfactory clinical effect is not obtained after a sufficient period of time, the drug should be withdrawn and another type of therapy should be prescribed to the patient.


In children, the dose is determined by the physician taking into account the body weight or body surface area. In adrenal insufficiency, an oral dose of 0.18 mg/kg or 3.33 mg/m2 per day in 3 doses; for other indications, 0.42-1.67 mg/kg or 12.5-50 mg/m2 per day in 3 doses. It should be emphasized that the required dose may vary and the selection of the dose should be performed individually, depending on the nature of the disease and the patient's response to therapy. Withdrawal of the drug after prolonged therapy is recommended to be carried out gradually. If the treatment has a good effect, an individual maintenance dose should be selected by gradually reducing the initial dose at certain intervals until the lowest dose is found to maintain the achieved clinical effect. Keep in mind that continuous monitoring of the drug dosing regimen is necessary.


There may be situations in which a dose adjustment may be required, such as changes in clinical condition due to the onset of remission or exacerbation of the disease, the patient's individual response to the drug, as well as the effect on the patient of stressful situations not directly related to the underlying disease for which the therapy is aimed; in the latter case, it may be necessary to increase the drug dose for a certain period of time, depending on the patient's condition.


Altering therapy


Altering therapy is a dosing regimen in which twice the daily dose of GCS is administered every other day in the morning. The goal of this therapy is to maximize the clinical benefit of the long-term patient while minimizing some undesirable effects such as pituitary adrenal suppression, Cushing's syndrome, withdrawal syndrome, and growth retardation in children.