Wednesday, April 11, 2012

SOLU-MEDROL

Chemotherapy Drugs

Solu-Medrol ®

Generic name: Methylprednisolone
Other trade names: Duralone®, Medralone®, Medrol®, M-Prednisol®
Other names: 6-Methylprednisolone, Methylprednisolone Acetate, Methylprednisolone Sodium Succinate
Medrol, Duralone, Medralone, M-Prednisol, and Solu-Medrol are all trade names for generic drug Methylprednisolone. 6-Methylprednisolone, Methylprednisolone Acetate, and Methylprednisolone Sodium Succinate are other names for generic drug Methylprednisolone. In some cases, health care professionals may use the trade names Medrol, Duralone, Medralone, M-Prednisol, and Solu-Medrol or other names 6-Methylprednisolone, Methylprednisolone Acetate, and Methylprednisolone Sodium Succinate when referring to the generic drug name Methylprednisolone.
Drug type: Solu-Medrol has many uses in the treatment of cancer. Solu-Medrol is used most often as a supportive care medication. Solu-Medrol is classified as a glucocorticosteroid. (For more detail, see "How this drug works" section below).
What Solu-Medrol is used for:
  • As an anti-inflammatory medication.  Prednisolone relieves inflammation in various parts of the body. 
  • To treat or prevent allergic reactions.
  • As treatment of certain kinds of autoimmune diseases, skin conditions, asthma and other lung conditions.
  • As treatment for a variety of cancers, such as leukemia, lymphoma, and multiple myeloma.  
  • To treat nausea and vomiting associated with some chemotherapy drugs.
  • Used to stimulate appetite in cancer patients with severe appetite problems. 
  • Also used to replace steroids in conditions of adrenal insufficiency (low production of needed steroids produced by the adrenal glands).
  • Used as prevention and treatment of graft-versus-host disease following allogeneic bone marrow transplantation.
Note:  If a drug has been approved for one use, physicians sometimes elect to use this same drug for other problems if they believe it might be helpful.
How Solu-Medrol is given:
  • This medication may be given to you in many forms. In a pill form, it is available in 2 mg, 4 mg, 8mg, 16mg, 24mg and 32 mg tablets. If you are on a daily dose of methylprednisolone, and you miss a dose, take the dose as soon as you remember. 
  • Take pills with food or after meals.  
  • This medication may also be given by injection into the muscle (intramuscular, IM) or into the vein (intravenously, IV), by a healthcare provider. 
  • The amount of hydrocortisone you will receive depends on many factors, including your height and weight, your general health or other health problems, and the reason you are receiving this drug.  Your doctor will determine your exact dosage and schedule.
Side effects of Solu-Medrol:
Important things to remember about the side effects of methylprednisolone include:
  • Most people do not experience all of the side effects listed.
  • Side effects are often predictable in terms of their onset and duration. 
  • Side effects are almost always reversible and will go away after treatment is complete.
  • There are many options to help minimize or prevent side effects.
The following side effects are common (occurring in greater than 30%) for patients taking Solu-Medrol:
  • Increased appetite
  • Irritability
  • Difficulty sleeping (insomnia)
  • Swelling in your ankles and feet (fluid retention)
  • Nausea, take with food
  • Heartburn
  • Muscle weakness
  • Impaired wound healing
  • Increased blood sugar levels. (Persons with Diabetes may need to have blood sugar levels monitored more closely and possible adjustments to diabetes medications).
The following are less common side effects (occurring in 10 to 29%) for patients receiving Solu-Medrol:
  • Headaches
  • Dizziness
  • Mood swings
  • Cataracts and bone thinning (with long-term use)
This list includes common and less common side effects for individuals taking methylprednisolone.  Side effects that are very rare, occurring in less than 10% of patients, are not listed here.  However, you should always inform your health care provider if you experience any unusual symptoms.
When to contact your doctor or health care provider:
Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:
  • Fever of 100.5º F (38º C), chills (possible signs of infection)
  • If you feel an irregular or fast heart beat, shortness of breath, or chest or jaw pain, seek emergency help and notify your healthcare provider.
  • If you become suddenly confused.
The following symptoms require medical attention, but are not emergency situations.  Contact your health care provider within 24 hours of noticing any of the following:
  • Extreme fatigue (unable to carry on self-care activities)
  • Any unusual bleeding or bruising
  • Black or tarry stools, or blood in your stools or urine
  • Nausea (interferes with ability to eat and unrelieved with prescribed medications)
  • Vomiting (vomiting more than 4-5 times in a 24-hour period)
  • Dizziness or lightheadedness, feeling faint.
  • Persistent headache
  • Severe hot flashes or mood swings
  • Inability to sleep (insomnia)
  • Severe skeletal (bone) pain
  • Difficult or painful urination; increased urination, or severe thirst
  • Changes in vision, blurred vision, eye pain, enlarged pupils, discharge
  • Any new rashes or changes in your skin
  • Swelling of the feet or ankles.  Sudden weight gain (greater than 3 pounds a week)
  • Swelling, redness and/or pain in one leg or arm and not the other
Always inform your health care provider if you experience any unusual symptoms.
Precautions:
  • Before starting methylprednisolone treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.).  Do not take aspirin, or products containing aspirin unless your doctor specifically permits this.
  • Do not receive any kind of immunization or vaccination without your doctor's approval while taking methylprednisolone.
  • If you have been on methylprednisolone pills daily, for a long period of time, serious side effects may occur if you discontinue the medication abruptly. Do not stop taking this medication unless directed by your healthcare provider. Do not change the dose of methylprednisolone on your own.
  • Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment.  Pregnancy category C (use in pregnancy only when benefit to the mother outweighs risk to the fetus). 
  • For both men and women: Do not conceive a child (get pregnant) while taking methylprednisolone. Barrier methods of contraception, such as condoms, are recommended. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.
  • Do not breast feed while taking this medication.
Self Care Tips:
  • If you are on this medication for a long period of time, you may be more susceptible to infection. Wash your hands well, and report any symptoms of infection to your healthcare provider if noted.
  • In a pill form: Take this medication with food to lessen an upset stomach. Also take this medication early on in the day (before 12:00 noon, if possible), so you will be able to sleep better at night.
  • If you have diabetes, this medication may increase your blood sugar levels. Notify your healthcare provider that you are diabetic. You may need close monitoring.
  • Drink 2 to 3 quarts of fluid every 24 hours, unless you were told to restrict your fluid intake, and maintain good nutrition. 
  • To reduce nausea, take anti-nausea medications as prescribed by your doctor, and eat small, frequent meals.
  • In general, drinking alcoholic beverages should be avoided.  You should also limit caffeine intake (colas, tea, coffee and chocolate, especially). These beverages may irritate your stomach.
  • If you experience symptoms or side effects, especially if severe, be sure to discuss them with your health care team.  They can prescribe medications and/or offer other suggestions that are effective in managing such problems.
Monitoring and testing:
You will be checked regularly by your health care professional while you are taking methylprednisolone, to monitor side effects and check your response to therapy.  Periodic blood work to monitor your complete blood count (CBC) as well as the function of other organs (such as your kidneys and liver) will also be ordered by your doctor.   
How Solu-Medrol works:

Corticosteroids are naturally produced by the adrenal gland in the body. Corticosteroids influence the functioning of most of the body's systems (heart, immune, muscles and bones, endocrine and nervous system).  They exert a wide array of effects including effects on the metabolism of carbohydrates, protein and fats.  They help to maintain balance of fluids and electrolytes.
Methylprednisolone is classified as a corticosteroid (more precisely a glucocorticosteroid), and has many uses in the treatment of cancer.
One way that it works is to decrease inflammation (swelling).  It does this by preventing infection- fighting white blood cells (polymorphonuclear leukocytes) from traveling to the area of swelling in your body. (This is why you are more prone to infection while taking steroids).  Taking advantage of the anti-inflammatory properties of the medication, corticosteroids are used to decrease the swelling around tumors.  For example, by decreasing swelling around tumors in the spine, brain, or bone, it can decrease the pressure of the tumor on nerve endings and relieve pain or other symptoms caused by the pressing tumor.
Another way this drug works is by altering the body's normal immune system responses.  Corticosteroids are used to treat certain conditions that effect the immune system such as aplastic anemia (AA), Immune Thrombocytopenia Purpura (ITP), Thrombotic Thrombocytopenia Purpura (TTP), or hemolytic anemia.
In addition, it is thought that corticosteroids may help in the treatment of patients with blood disorders, such as multiple myeloma.  Corticosteroids may work by causing programmed cell death (apoptosis) of certain cells, which may help to fight your disease.
Corticosteroids are also used in the short-term treatment of nausea caused by chemotherapy.  How it does this is not fully understood.  They also have been used to stimulate appetite for patients with severe appetite problems.
Corticosteroids are used to replace steroids in conditions of adrenal insufficiency (low production of needed steroids produced by the adrenal glands).
Note:  We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.

Source:  http://www.chemocare.com/bio/solumedrol.asp

 This medication is used to treat various conditions such as severe allergic reactions, arthritis, blood diseases, breathing problems, certain cancers, eye diseases, intestinal disorders, and skin diseases. It decreases your body's natural defensive response and reduces symptoms such as swelling and allergic-type reactions. Methylprednisolone is a corticosteroid hormone (glucocorticoid). This injectable form of methylprednisolone is used when a similar drug cannot be taken by mouth or when a very fast response is needed, especially in patients with severe medical conditions.

 Before using methylprednisolone, tell your doctor or pharmacist if you are allergic to it; or to other corticosteroids (e.g., prednisone); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: current fungal infections.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: other infections (such as tuberculosis, threadworm), bleeding problems, blood clots, brittle bones (osteoporosis), high blood pressure, certain heart problems (such as congestive heart failure, recent heart attack), diabetes, certain eye diseases (such as cataracts, herpes infection, glaucoma), kidney disease, severe liver disease (cirrhosis), mental/mood conditions (such as psychosis, anxiety, depression), seizures, stomach/intestinal problems (such as diverticulitis, ulcer, ulcerative colitis), thyroid problems (both underactive and overactive conditions), untreated mineral problems (such as low potassium or calcium).
This drug may make you dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely.
This medication may mask signs of infection or put you at greater risk of developing very serious infections. Report to your doctor any injuries or signs of infection (e.g., persistent sore throat/cough/fever, pain during urination, muscle aches) that occur while using this medication or within 12 months after stopping it.
Using corticosteroid medications for a long time can make it more difficult for your body to respond to physical stress. Therefore, before having surgery or emergency treatment, or if you get a serious illness/injury, tell your doctor or dentist that you are using this medication or have used this medication within the past 12 months. Tell your doctor right away if you develop unusual/extreme tiredness or weight loss. If you will be using this medication for a long time, carry a warning card or medical ID bracelet that identifies your use of this medication.
Do not have immunizations, vaccinations, or skin tests unless specifically directed by your doctor. Live vaccines may cause serious problems (e.g., infection) if given while you are using this medication. Avoid contact with people who have recently received oral polio vaccine or flu vaccine inhaled through the nose.
Avoid contact with people who have chickenpox or measles unless you have previously had these diseases (e.g., in childhood). If you are exposed to one of these infections and you have not previously had it, seek immediate medical attention.
If you have a history of ulcers, or if you take large doses of aspirin or other arthritis medication, limit alcoholic beverages while using this medication to decrease the risk of stomach/intestinal bleeding. Consult your doctor or pharmacist for more details.
If you have diabetes, this drug may increase your blood sugar levels. Check your blood glucose levels regularly as directed by your doctor. Tell your doctor immediately if you have symptoms such as increased thirst and urination. Your anti-diabetic medication or diet may need to be adjusted.
Caution is advised when using this drug in the elderly because they may be more sensitive to its side effects, especially osteoporosis. Talk with your doctor about ways to prevent bone loss.
This medication may slow down a child's growth if used for a long time. Consult the doctor or pharmacist for more details. See the doctor regularly so your child's height and growth can be checked.
This medication should be used only when clearly needed during pregnancy. There have been rare reports of harm to an unborn baby when corticosteroids are used during pregnancy. Discuss the risks and benefits with your doctor. Infants born to mothers who have been using this medication for an extended time may have low levels of corticosteroid hormone. Tell your doctor immediately if you notice symptoms such as persistent nausea/vomiting, severe diarrhea, or weakness in your newborn.

Source:  http://www.webmd.com/drugs/drug-6135-Solu-Medrol+Inj.aspx?drugid=6135&drugname=Solu-Medrol+Inj

 Solu-Medrol Side Effects - for the Professional

Solu-Medrol

Fluid and Electrolyte Disturbances
Sodium retention
Fluid retention
Congestive heart failure in susceptible patients
Potassium loss
Hypokalemic alkalosis
Hypertension
Musculoskeletal
Muscle weakness
Steroid myopathy
Loss of muscle mass
Severe arthralgia
Vertebral compression fractures
Aseptic necrosis of femoral and humeral heads
Pathologic fracture of long bones
Osteoporosis
Tendon rupture, particularly of the Achilles tendon
Gastrointestinal
Peptic ulcer with possible perforation and hemorrhage
Pancreatitis
Abdominal distention
Ulcerative esophagitis
Increases in alanine transaminase (ALT, SGPT), aspartate transaminase (AST, SGOT), and alkaline phosphatase have been observed following corticosteroid treatment. These changes are usually small, not associated with any clinical syndrome and are reversible upon discontinuation.
Dermatologic
Impaired wound healing
Thin fragile skin
Petechiae and ecchymoses
Facial erythema
Increased sweating
May suppress reactions to skin tests
Neurological
Increased intracranial pressure with papilledema (pseudo-tumor cerebri) usually after treatment
Convulsions
Vertigo
Headache
Endocrine
Development of Cushingoid state
Suppression of growth in children
Secondary adrenocortical and pituitary unresponsiveness, particularly in times of stress, as in trauma, surgery or illness
Menstrual irregularities
Decreased carbohydrate tolerance
Manifestations of latent diabetes mellitus
Increased requirements for insulin or oral hypoglycemic agents in diabetics
Ophthalmic
Posterior subcapsular cataracts
Increased intraocular pressure
Glaucoma
Exophthalmos
Metabolic
Negative nitrogen balance due to protein catabolism
The following additional adverse reactions are related to parenteral corticosteroid therapy:
Hyperpigmentation or hypopigmentation
Subcutaneous and cutaneous atrophy
Sterile abscess
Anaphylactic reaction with or without circulatory collapse, cardiac arrest, bronchospasm
Urticaria
Nausea and vomiting
Cardiac arrhythmias; hypotension or hypertension

Source:  http://www.drugs.com/sfx/solu-medrol-side-effects.html

(seems to be quite a list of side-effects that are told to doctors.  Apparently they overlook these complications and possibilites)









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