Indications for use:
Endocrine diseases such as primary or secondary adrenal insufficiency, congenital hyperplasia (overgrowth)
adrenal glands, non-purulent thyroiditis (non-purulent inflammation of the thyroid gland), hypercalysmia (elevated levels of calcium in the blood) due to neoplastic disease. Rheumatic diseases short course as an adjuvant therapy in the exacerbation of the process. Inflammatory-degenerative and metabolic diseases of the joints, including psoriatic arthritis (inflammation of the joint in psoriasis), rhvmatoid arthritis (an infectious-allergic disease from the group of collagenoses, characterized by chronic progressive inflammation of the joints), juvenile (rheumatoid affection afferent fluid), juvenile (in childhood or juvenile) rheumatoid affection; spinal disease), acute and subacute bursitis (inflammation of the articular sac), acute and nonspecific tendosynovitis (combined inflammation of the tendon and inside arthritis arthritis (inflammation of the joint as a result of deposition of uric acid in the joint tissues), post-traumatic osteoarthrosis (non-inflammatory joint disease), synovitis (inflammation of the inner membrane of the joint) in osteoarthrosis, epicondylitis (inflammation of a limited area of the humerus, which is muscles and tendons).
Collagen diseases (in the period of exacerbation or in the form of maintenance therapy if necessary), such as systemic lupus erythematosus, systemic dermatomyositis (systemic muscle and skin disease, characterized by impaired motor activity and redness and swelling of open skin), acute rheumatic heart disease (inflammation of all or individual heart tissues for rheumatism), rheumatic polymyalgia (common muscle aches for rheumatism), periarteritis nodosa (inflammation of the artery walls, which leads to in tissues and organs necrosis sites - necrosis), giant cell arthritis (current embodiment inflammatory joint disease).
Skin diseases such as vesicles (a disease characterized by a rash of blisters on the outwardly unchanged skin and mucous membranes),bullous herpetiform dermatitis (a disease characterized by the appearance on the skin of the trunk and extremities of an itchy rash in the form of blisters and vesicles arranged in the form of rings and garlands), severe erythema multiforme (a diverse disease of the skin, manifested by reddening of damaged skin), exfoliative dermatitis (a disease characterized by reddening of the whole or almost all of the skin, accompanied by its large-plate peeling), fungoid mycosis (malignant tumor / cancer / lymphoid tissue), severe severe psoriasis, severe seborrheic dermatitis (a disease of the skin, mainly of the face and scalp, caused by dysfunction of the sebaceous glands). Allergic conditions (severe or disabling conditions that are not amenable to adequate conventional therapy), such as seasonal or chronic allergic rhinitis (inflammation of the nasal mucosa), serum sickness (allergic disease caused by parenteral / bypassing the digestive tract / by the introduction of large amounts of protein into the body) , bronchial asthma, drug allergy (allergy to any drug), contact (inflammation of the skin due to the direct effect of damaging fa torus / physical, chemical, and m. p. /) or atopic (skin disorder caused by dysfunction of the nervous system characterized by the formation of shallow itchy rash symmetrically arranged surfaces of the face, neck, and in the anus and genitals) dermatitis.
Eye diseases (severe acute and chronic processes), such as allergic regional corneal ulcers, Herpeszoster ophthalmic (eye disease caused by the herpes virus), anterior segment inflammation, diffuse posterior uveitis (inflammation of the choroid of the eyeball), sympathetic ophthalmia (anterior mucosal inflammation eye shell due to penetrating injury of the other eye), allergic conjunctivitis (inflammation of the outer membrane of the eye), keratitis (corneal inflammation), chorioretinitis (inflammation of the retina and eye vessels), not vrit (inflammation) of the optic nerve, iritis (inflammation of the iris) and iridocyclitis (inflammation of the iris and ciliary body of the eye).Respiratory diseases, such as symptomatic sarcoidosis (a disease characterized by the appearance of dense knots and tubercles under the skin and internal organs), Leffler syndrome (an allergic disease of the lungs, characterized by the formation in one or both of the lungs of transient dense formations consisting of a congestion of eosinophils - a special form leukocytes), berylliosis (occupational disease of the lungs caused by inhalation of beryllium or its compounds), focal or disseminated pulmonary tuberculosis (when anti-tuberculosis chemotherapy), aspiration pneumonitis (inflammation of the lungs due to ingestion of foreign bodies or fluids).
Hematological diseases (diseases of the blood system), such as idiopathic (caused by unclear reasons) thrombocytopenic purpura (multiple small hemorrhages in the skin and mucous membranes associated with a reduced level of platelets in the blood) in adults, secondary thrombocytopenia (reduced level of platelets in the blood) in adults , autoimmune hemolytic anemia (increased erythrocyte breakdown in the blood due to impaired immune status of the body), erythroblastopenia (lowering, mainly in braid brain, erythroid cells - the precursor cells of the blood cells), congenital (erythroid) hypoplastic anemia (decrease in the level of hemoglobin in the blood due to inhibition of the hematopoietic function of the bone marrow). Leukemia (malignant tumors arising from hematopoietic cells and affecting the bone marrow / blood cancer /) and lymphomas (common name for tumors arising from lymphoid tissue) adults - as part of combination therapy. Children's acute leukemia - in combination therapy. The terminal (prior to death) stage of the process in cancer patients is to improve the quality of life. Gastrointestinal diseases, such as ulcerative colitis (inflammation of the colon with the formation of ulcers and regional enteritis (inflammation of a separate part of the small intestine) - as part of systemic therapy during the critical period of the disease.
Diseases of the nervous system, such as multiple sclerosis (systemic disease of the membranes of the nerve cells of the brain and spinal cord) during exacerbation, traumatic injuries of the spinal cord (no later than 8 hours after the injury), swelling of the brain due to a tumor (primary or metastatic) and / or trauma, with surgery or radiation therapy.Shock due to adrenocorticoid insufficiency (insufficient function of the adrenal cortex) or shock resistant (resistant) to standard therapy - in situations where insufficiency of the adrenal cortex cannot be ruled out. Trichinnelosis (human disease caused by parasitic worms - trichinella) with damage to the nervous system or myocardium (heart muscle). Transplantation (transplant) of organs. Prevention of nausea and vomiting associated with anticancer chemotherapy. The drug is also used to increase diuresis (urination) or to achieve remission (temporary weakening or disappearance of the manifestations of the disease) in nephrotic syndrome (a disease state characterized by massive edema and high protein content in the urine; it is observed in diseases of the kidneys), in tuberculous meningitis (inflammation of the lining of the brain caused by mycobacteria tuberculosis) with a subarachnoid block (violation of the outflow of cerebrospinal fluid in the space between the arachnoid and the soft sheaths of the brain) or When the block threat -with simultaneous TB therapy.
Mode of application:
As an adjuvant therapy for life-threatening conditions, a dose of 30 mg / kg body weight is recommended. The drug is administered intravenously for at least 30 minutes. The administration can be repeated every 4-6 hours.
In rheumatoid arthritis, 1 g per day is prescribed for 1, 2, 3 or 4 days or 1 g per month intravenously. With systemic lupus erythematosus - 1 g per day intravenously for 3 days. With multiple sclerosis - 1 g per day intravenously for 3 or 5 days. For edematous conditions (glomerulonephritis, lupus nephritis), 30 mg / kg is administered intravenously for 4 days every other day or 1 g per day for 3, 5 or 7 days.
To improve the quality of life in the terminal stages of neoplastic diseases, samedrol is prescribed at a dose of 125 mg per day intravenously for up to 8 weeks.
The drug should be administered for at least 30 minutes. The administration can be repeated if there is no improvement within a week after the end of therapy, or depending on the condition of the patient.
For the prevention of nausea and vomiting caused by antitumor therapy, the dose of the drug is prescribed depending on the emethogenicity (severity of the vomiting effect) of chemotherapy.Usually, administration of 250 mg solumedrol intravenously for at least 5 minutes an hour before the administration of anticancer drugs, at the beginning and after the end of their administration is recommended.
In acute traumatic injuries of the spinal cord, solumedrol is administered intravenously at the rate of 30 mg per kg of body weight for at least 15 minutes, then by continuous infusion at a rate of 5.4 mg / kg per hour for 23 hours. The drug should be administered at aid infusion pump into the vein without mixing with other drugs. Treatment should begin within the first 8 hours after injury.
For other indications, the initial dose may range from 100 to 500 mg, depending on the clinical situation.
Short-term therapy for severe and acute conditions may require higher doses. The initial dose of up to 250 mg should be administered for at least 5 minutes, and if the dose is more than 250 mg, then it should be administered for at least 30 minutes. Subsequent injections can be made intramuscularly or intravenously at intervals, the duration of which is determined by the clinical condition and effect in the patient.
Children slededrol prescribed in smaller doses, but the dosage is largely determined by the effect and severity of the condition than age or body weight. The dose should not be less than 0.5 mg per kg of body weight every 24 hours.
The drug should be used with caution in premature babies, as there are reports that benzyl alcohol that is part of the drug can cause a choking syndrome with a lethal (fatal) outcome. Since the complications of therapy with soluedrol depend on the size of the dose and the duration of treatment, in each case it is necessary to evaluate the ratio of the possible risk and benefit both in relation to the dosage and duration of treatment, and to the treatment regimen - daily or intermittent.
In children, long-term therapy with soluedrol is possible only for the most serious indications due to the possible suppression of growth.
For the preparation of solutions of the drug solumedrol use a special solvent attached to the package. If necessary, the drug can be used in the form of diluted solutions after mixing the initial solution with 5% glucose in water, with saline, 5% glucose by 0.45% or 0.9% sodium chloride solution.The resulting solutions are physically and chemically stable for 48 hours.
Disruption of the menstrual cycle, the development of Cushing's syndrome (obesity, accompanied by a decrease in sexual function, increased bone fragility due to increased release of adrenocorticotropic hormone of the pituitary gland), suppression of the pituitary gland (suppression of the secretion of pituitary hormones that regulate adrenal function), reduction of tolerance (tolerance of the pituitary gland), reduction of tolerance of the pituitary axis diabetes (increased blood sugar levels in patients with latent diabetes mellitus), increased insulin requirements or and oral (oral) hypoglycemic (lowering blood sugar) drugs in diabetics, growth suppression in children. Steroid myopathy (muscular weakness caused by impaired steroid hormone metabolism), osteoporosis (impaired nutrition of the bone tissue, accompanied by an increase in its fragility), pathological fractures, compression (under the influence of compression) vertebral fractures, aseptic necrosis (tissue death) of the joints. Peptic ulcers (a stomach ulcer, intestine or esophagus, developed as a result of the destructive action of gastric juice on the mucous membrane) with the possibility of perforation (the occurrence of a through-wall defect of the organ) and bleeding, gastric hemorrhage, pancreatitis (inflammation of the pancreas), esophagitis (inflammation of the esophagus), perforation guts. Impaired wound healing, petechiae (dot hemorrhages under the skin or mucous membranes) and ecchymosis (extensive hemorrhages under the skin or mucous membranes), thinning and fragility of the skin. Increased intracranial pressure, mental disorders, depression (depression), mood swings, seizures, posterior subcapsular cataract (eye disease characterized by partial or complete clouding of the lens of the eye, with localization of the lesion under the lens capsule), increased intraocular pressure, exophthalmos (displacement the eyeball ahead, accompanied by expansion of the palpebral fissure, secondary eye infections caused by viruses and fungi. Erasing the clinical picture of infectious abolevany, activation of latent (hidden) infections, suppress reactions to allergens in a skin test, increased susceptibility to fungal, viral and bacterial infections.Sodium retention, loss of potassium, hypokalemic alkalosis (sticking of the blood, accompanied by a decrease in the content of potassium ions), increased excretion (excretion) of calcium, fluid retention. Negative nitrogen balance due to protein metabolism (decomposition). Allergic reactions, cardiac arrest, bronchospasm (sharp narrowing of the lumen of the bronchi), cardiac arrhythmia, hypertension (rise in blood pressure) or hypotension (decrease in blood pressure).
There are indications of the occurrence of cardiac rhythm disturbances and / or vascular collapse (a sharp drop in blood pressure) and / or cardiac arrest after the rapid intravenous administration of large doses of solumedrol (more than 0.5 g in less than 10 minutes).
When occurring during the time of stress with salt medication, the use of high-speed corticosteroids in high doses is indicated.
The relative adrenal insufficiency caused by soluedrol may persist for several months after discontinuation of the drug. As a result, in any stressful situation arising during this period, hormone therapy is resumed with the simultaneous administration of salts and / or preparations of mineralocorticoids (adrenal hormones that regulate mineral metabolism).
Solumedrol can exacerbate previous emotional instability or psychotic tendencies.
To reduce the severity of side effects from the water electrolyte balance, a diet with sodium restriction (sodium chloride) and an increased content of potassium is prescribed.
Systemic fungal infections; hypersensitivity to methylprednisolone.
During treatment with a drug, vaccination against smallpox and other immunization procedures cannot be performed due to the possibility of neurological complications and the absence of antibody production.
Solumedrol is used with caution when nonspecific ulcerative colitis, diverticulitis (inflammation of the diverticulum due to stagnation of its contents / diverticulum - protrusion of the wall of the hollow organ communicating with its cavity /) stomach or duodenum, with abscesses (abscesses) or other purulent infections, renal failure, arterial hypertension, osteoporosis, myasthenia (muscle weakness).
The use of solumedrol during pregnancy and lactation requires a careful assessment of the ratio of benefits from the use of the drug and the potential risk to the mother and fetus, it is prescribed only when there is an obvious need. Children born to women who received significant doses of soluderol during pregnancy should be carefully monitored for signs of adrenal insufficiency.
It is a drug. Consultation with a doctor is required.