Medopred, 30 mg/ml 1 ml 10 pcs

Medopred is used for emergency therapy in conditions requiring rapid increase in the concentration of glucocorticosteroids in the body:

• Shock (burn, traumatic, surgical, toxic) – when vasoconstrictors, plasma substitute drugs and other symptomatic therapy are ineffective;
• Allergic reactions (acute severe forms), hemotransfusion shock, anaphylactic shock, anaphylactoid reactions;
• Brain edema (including.ч.
• Bronchial asthma (severe form), asthmatic status;
• Systemic connective tissue diseases (systemic lupus erythematosus, rheumatoid arthritis);
• Acute adrenal insufficiency;
• Thyrotoxic crisis;
• Acute hepatitis, hepatic coma;
• Limiting inflammation and prevention of scarring (in poisoning with cauterizing fluids).

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Active ingredient

Prednisolone

Composition

In 1 ampoule contains:

Active substance:

Prednisolone sodium phosphate in terms of prednisolone phosphate-30 mg

Auxiliary substances:

nicotinamide,

dinatrium edetate,

sodium disulfite,

phenol,

sodium hydroxide,

water for injection.

How to take, the dosage

Medoprene is given intravenously (by drip or stream) or intramuscularly. Intravenously, the drug is usually given first by trickle and then by drip.

The dose of the drug and the duration of treatment is determined by the physician individually, depending on the indication and the severity of the disease.

In acute adrenal insufficiency a single dose of the drug is 100 to 200 mg and daily 300 to 400 mg.

In severe allergic reactions, Medopred is administered in a daily dose of 100-200 mg for 3-16 days.

In bronchial asthma the drug is administered depending on the severity of the disease and the effectiveness of complex treatment from 75 to 675 mg for 3 to 16 days; in severe cases the dose may be increased to 1400 mg for a course of treatment or more with gradual reduction of the dose.

In asthmatic status, Medopred is administered in a dose of 500-1200 mg per day with subsequent reduction to 300 mg per day and transition to maintenance doses.

In thyrotoxic crisis, 100 mg of the drug is administered in a daily dose of 200-300 mg; if necessary, the daily dose may be increased to 1000 mg. The duration of administration depends on the therapeutic effect, usually up to 6 days.

In shock resistant to standard therapy, Medopred is usually administered by trickle at the beginning of therapy, after which it is switched to drip infusion. If within 10-20 minutes the blood pressure does not increase, the drug is repeated by trickle administration. After recovery from shock continue drip administration until the blood pressure stabilizes. The single dose is 50-150 mg (in severe cases up to 400 mg). The drug shall be repeatedly administered after 3-4 hours. The daily dose may be 300-1200 mg (with subsequent dose reduction).

In acute hepatic and renal failure (in acute poisoning, in postoperative and postpartum periods, etc.), Medopred is administered 25-75 mg per day; if indicated, the daily dose may be increased to 300-1500 mg per day and higher.
In rheumatoid arthritis and systemic lupus erythematosus Medopred is administered in addition to systemic administration of the drug in a dose of 75 -125 mg per day for not more than 7-10 days.

In acute hepatitis, Medopred is administered in 75-100 mg per day for 7-10 days.

In poisoning with cauterizing liquids with burns of the digestive tract and upper respiratory tract, Medopred is administered in a dose of 75-400 mg per day for 3-18 days.

If intravenous administration is not possible, Medopred is administered intramuscularly in the same doses. After the acute condition is relieved, oral prednisolone tablets are prescribed, with subsequent gradual reduction of the dose.

In long-term use of the drug, the daily dose should be reduced gradually. Long-term therapy should not be stopped suddenly!

Interaction

There may be pharmaceutical incompatibility between Medopred and other intravenous drugs – it is recommended to administer it separately from other drugs (intravenous bolus, or through another IV, as a second solution). When mixing Medopredad solution with heparin, a precipitate is formed.

Medopred can increase folic acid with prolonged therapy.

The concomitant administration of Medopred with: “hepatic” microsomal enzyme inducers (phenobarbital, rifampicin, phenytoin, theophylline, ephedrine) leads to a decrease in its concentration;

Diuretics (especially “thiazide” and carboanhydrase inhibitors) and amphotericin B may lead to increased K+ excretion and an increased risk of heart failure;

With sodium-containing drugs – development of edema and increased arterial pressure;

with cardiac glycosides – their tolerance worsens and the risk of ventricular extrasystole increases (due to hypokalemia);

Indirect anticoagulants – decreases (less often increases) their effect (requires dose adjustment);

Anticoagulants and thrombolytics – increases the risk of bleeding from ulcers in the gastrointestinal tract;

Ethanol and nonsteroidal anti-inflammatory drugs (NSAIDs)-increases the risk of gastrointestinal erosive-ulcerative lesions and bleeding (in combination with NSAIDs, treatment of arthritis may decrease the dose of glucocorticosteroids due to summation of therapeutic effect);

Paracetamol – increased risk of hepatotoxicity (induction of liver enzymes and formation of the toxic metabolite of paracetamol);

Acetylsalicylic acid – accelerates its elimination and reduces its concentration in blood (when Medopred is withdrawn, the level of salicylates in blood increases and the risk of side effects increases);

Insulin and oral hypoglycemic drugs, hypotensive agents – their effectiveness decreases;

m-cholinoblockers (including antihistamines and tricyclic antidepressants) and nitrates – promotes increased intraocular pressure;

Tricyclic antidepressants – may increase the severity of depression caused by glucocorticosteroids (not indicated for therapy of these side effects).

Isoniazid and mexiletine – increases their metabolism (especially in “slow” acetylators), which leads to a decrease in their plasma concentrations.

Carboanhydrase inhibitors and “loop” diuretics may increase the risk of osteoporosis.
Indomethacin, by displacing prednisolone from binding to albumin, increases the risk of its side effects.
ACTH increases the effects of Medopred.

Ergocalciferol and parathormone prevent the development of osteopathy caused by Medopred.

Cyclosporine and ketoconazole, while slowing the metabolism of Medopred, may in some cases increase its toxicity.

The simultaneous administration of androgens and steroid anabolic drugs with Medopred promotes the development of peripheral edema and hirsutism and the appearance of acne.

Estrogens and oral estrogen-containing contraceptives decrease the clearance of Medopred, which may be accompanied by an increase in the severity of its effects.

The concomitant use with live antiviral vaccines and with other types of immunizations increases the risk of virus activation and infections.

Antipsychotics (neuroleptics) and azathioprine increase the risk of cataracts when Medopred.
Concurrent administration of antacids decreases absorption of Medopred.

Concomitant use with antithyroid drugs decreases and with thyroid hormones increases Medopred clearance.

Hypokalemia caused by glucocorticosteroids may increase the severity and duration of muscle block with myorelaxants.

Mitotan and other adrenal cortex inhibitors may necessitate increasing the dose of prednisolone.
Immunosuppressants increase the risk of infection and lymphoma or other lymphoproliferative disorders associated with Epstein-Barr virus.

Special Instructions

During treatment with Medopred (especially long-term), an ophthalmologist should be observed, blood pressure, water-electrolyte balance, and peripheral blood count and blood glucose levels should be monitored.

In order to reduce side effects, antacids may be prescribed, as well as to increase the K+ intake in the body (diet, potassium preparations). The food should be rich in proteins, vitamins, with restriction of fats, carbohydrates and table salt.
The action of the drug is increased in patients with hypothyroidism and cirrhosis.

The drug may aggravate existing emotional instability or psychotic disorders. If a history of psychosis is indicated, Medopred in high doses is prescribed under strict medical supervision.

Contraindications

For short-term use for vital signs, the only contraindication is hypersensitivity to Medopred or components of the drug.

In children during growth, GCS should only be used for absolute indications and under the special close supervision of the attending physician.

The drug should be prescribed with caution in the following diseases and conditions:

Gastrointestinal diseases – gastric and duodenal ulcer, esophagitis, gastritis, acute or latent peptic ulcer, newly created intestinal anastomosis, non-specific ulcerative colitis with threat of perforation or abscessing, diverticulitis.

Parasitic and infectious diseases of viral, fungal or bacterial nature (current or recent, including recent contact with a patient) – herpes simplex, herpes zoster (viremic phase), varicella, measles; amebiasis, strongyloidosis; systemic mycosis; active and latent tuberculosis. Application in severe infectious diseases is allowed only against the background of specific therapy.

Pre and postvaccination period (period of 8 weeks before and 2 weeks after vaccination), lymphadenitis after BCG vaccination. Immunodeficiency conditions (including AIDS or HIV infection).

Diseases of the cardiovascular system including recent myocardial infarction (patients with acute and subacute myocardial infarction may have disseminated necrosis, slowed formation of scar tissue and, therefore, – rupture of the heart muscle), severe chronic heart failure, arterial hypertension, hyperlipidemia.

Endocrine diseases – diabetes (including impaired carbohydrate tolerance), hyperthyroidism, hypothyroidism, Icenko-Cushing’s disease, obesity (III-IV stage).

Severe chronic renal and/or hepatic failure, nephrourolithiasis. Hypoalbuminemia and conditions predisposing to its occurrence (liver cirrhosis, nephrotic syndrome).

Systemic osteoporosis, myasthenia gravis, acute psychosis, poliomyelitis (except for bulbar encephalitis), open and closed angle glaucoma,
Pregnancy.

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Side effects

The frequency and severity of side effects depend on the duration of use, the amount of dose used, and the ability to maintain the circadian rhythm of Medopred.

When using Medopred, side effects may be noted:

Endocrine system disorders: decreased glucose tolerance, steroid diabetes mellitus or manifestation of latent diabetes mellitus, depression of adrenal function, Icenko-Cushing’s syndrome (moon-shaped face, pituitary-type obesity, hirsutism, increased blood pressure, dysmenorrhea, amenorrhea, muscle weakness, stretch marks), delayed sexual development in children.

Digestive system disorders: nausea, vomiting, pancreatitis, steroid gastric and duodenal ulcer, erosive esophagitis, gastrointestinal bleeding and perforation of the gastrointestinal tract wall, increased or decreased appetite, digestive disorders, flatulence, hiccups. In rare cases – increased activity of “liver” transaminases and alkaline phosphatase.

Cardiovascular system disorders: arrhythmias, bradycardia (up to cardiac arrest); development (in susceptible patients) or increase of severity of heart failure, electrocardiogram changes typical for hypokalemia, increased arterial pressure, hypercoagulation, thrombosis. In patients with acute and subacute myocardial infarction – expansion of the focus of necrosis, delayed formation of scar tissue, which may lead to rupture of the heart muscle.

Nervous system disorders: delirium, disorientation, euphoria, hallucinations, manic-depressive psychosis, depression, paranoia, increased intracranial pressure, nervousness or anxiety, insomnia, dizziness, vertigo, cerebellar pseudotum, headache, seizures.

Senses: posterior subcapsular cataract, increased intraocular pressure with possible damage to the optic nerve, tendency to develop secondary bacterial, fungal or viral eye infections, trophic changes of the cornea, exophthalmos, sudden vision loss (when parenteral administration in the head, neck, nasal cavities, scalp may cause deposition of crystals of the drug in the vessels of the eye). Metabolism disorders: increased calcium excretion, hypocalcemia, weight gain, negative nitrogen balance (increased protein breakdown), increased sweating.
Mineralocorticoid activity – fluid and sodium retention (peripheral edema), hypernatremia, hypokalemic syndrome (hypokalemia, arrhythmia, myalgia or muscle spasm, unusual weakness and fatigue).

Musculoskeletal system disorders: delayed growth and ossification processes in children (premature closure of epiphyseal growth areas), osteoporosis (very rarely – pathological bone fractures, aseptic necrosis of the humeral and femoral head), rupture of muscle tendons, steroid myopathy, decrease of muscle mass (atrophy).

Skin and mucous membranes: delayed wound healing, petechiae, ecchymosis, skin thinning, hyper- or hypopigmentation, steroid acne, stretch marks, tendency to pyoderma and candidiasis.

Allergic reactions: skin rash, itching, anaphylactic shock, local allergic reactions.

Local when parenteral administration: burning, numbness, pain, tingling at the injection site, infection at the injection site, rarely – necrosis of the surrounding tissues, scar formation at the injection site; atrophy of the skin and subcutaneous tissue in case of injection (injection into the deltoid muscle is especially dangerous).

Other: development or exacerbation of infections (the appearance of this side effect is promoted by coadministration of immunosuppressants and vaccination), leukocyturia, withdrawal syndrome.

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Overdose

The side effects described above may increase. The dose of Medopred should be reduced. Treatment is symptomatic.

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Similarities

Prednisol, Prednisolone