1) Efficacy, effect
1. Endocrine disorders: Primary and secondary adrenocortical insufficiency (hydrocortisone or cortisone is the first choice drug,
If necessary, synthetic corticoids may be used in combination with mineralocorticoids, especially in infants.
It is important to use ticoids together), congenital adrenal abnormality hyperplasia, hypercalcemia accompanying cancer, non-purulent thyroiditis
2. Rheumatic disorder
As an adjuvant therapy for short-term administration to prevent acute progression or worsening, the following diseases: post-traumatic osteoarthritis, osteoarthritis
Rheumatoid arthritis, including synovitis and juvenile rheumatoid arthritis (in some cases, low-dose maintenance therapy is required)
may require), acute and subacute bursitis, epicondylitis, acute non-specific tenosynovitis, acute gouty arthritis, psoriatic joint
inflammation, ankylosing spondylitis
3. Collagen disease
The following diseases are in exacerbation or require maintenance therapy: Systemic lupus erythematosus (lupus nephritis), systemic dermatomyositis
myositis), acute rheumatoid carditis
4. Skin diseases: pemphigus, severe erythema multiforme (Stevens-Johnson syndrome), exfoliative dermatitis, dermatitis bullous herpetiformis, severe dermatitis
Lubricating dermatitis, severe psoriasis, mycosis fungoides
5. Allergic disease
Allergic diseases that are severe or disabling and do not respond to general treatment, including: Bronchial fibroids
Food, contact dermatitis, atopic dermatitis, serum sickness, seasonal or perennial allergic rhinitis, drug hypersensitivity reaction
6. Eye disease
Severe acute or chronic allergic or inflammatory diseases related to the eyes and their appendages: herpes zoster, iritis
and iridocyclitis, chorioretinitis, posterior scattered uveitis and choroiditis, optic neuritis, sympathetic ophthalmitis, anterior chamber inflammation.
Allergic conjunctivitis, allergic pericorneal ulcer, keratitis
7. Gastrointestinal diseases
The following diseases to overcome the critical crisis: ulcerative colitis, localized enteritis
8. Respiratory system diseases: symptomatic sarcoidosis, beryllium intoxication, fulminant or disseminated pulmonary tuberculosis (appropriate anti-tuberculosis chemotherapy)
(administered in combination with medication), Loeffler syndrome that does not improve with other methods, aspiration pneumonia
9. Blood diseases: acquired (autoimmune) hemolytic anemia, idiopathic thrombocytopenic purpura in adults, secondary thrombocytopenia in adults
Microcytosis, erythroblastopenia (erythrocytic anemia), congenital erythrocytic hypoplasia anemia
10. Malignant neoplastic disease
Palliative management of the following diseases: Acute leukemia in children, leukemia and lymphoma in adults
11. Edematous disease: Cause of increased urination in idiopathic renal syndrome without uremic symptoms or renal syndrome due to lupus erythematosus
Alleviation of excess fat and proteinuria
12. Nervous system disease: Acute exacerbation of multiple sclerosis
13.Other: Tuberculous meningitis (in cases of subarachnoid blockage or concerns about blockage, appropriate anti-tuberculosis chemotherapy drugs and
concomitant administration), trichinosis (if accompanied by neurogenic or myocardial complications)
2) Usage, dosage
1. The initial dose may vary from 4 mg to 48 mg per day as methylprednisolone depending on the symptoms of the specific disease. In general, a low dose is sufficient for non-severe conditions, but a high initial dose may be required in special patients. The initial dose is It should be maintained or adjusted until a satisfactory response is obtained. If there is no satisfactory clinical result even after a reasonable period of time, administration should be discontinued and switched to another appropriate treatment. The dosage is individualized depending on the various diseases being treated and the patient's responsiveness. After an appropriate response appears, the appropriate maintenance dose should be determined by reducing the initial dose at appropriate intervals until the minimum dose that can maintain an appropriate clinical response is reached. Continuous monitoring of the dose is required. .Situations that may require dose adjustment include the alleviation or worsening of the disease, the individual patient's drug responsiveness, the symptoms of the disease being treated, and the effects on the patient due to exposure to a stressful environment that does not directly affect the patient. In the latter case, it may be necessary to increase the dose for a period of time sufficient to satisfy the patient's condition. After long-term treatment, a slow decrease is expected when the drug is stopped. 2. Multiple Sclerosis (Multiplesclerosis) The treatment of acute exacerbations of multiple sclerosis is effective by administering 200 mg of prednisolone daily for one week, followed by 80 mg of prednisolone every other day for one month (4 mg of methylprednisolone is equivalent to 5 mg of prednisolone). 3. ADT (Alternate Day Therapy: Alternate Day Therapy) Alternate Day Therapy is a method of administering twice the daily dose on one of the two mornings. The purpose of this method is to increase the effect of corticosteroids in patients requiring long-term drug administration, and to increase the effectiveness of corticosteroids in patients requiring long-term drug administration. The goal is to minimize side effects such as adrenal suppression, Cushingoid state, corticosteroid symptoms, and growth inhibition in children. The theory of this treatment plan is based on the following two important premises. 1) The anti-inflammatory and therapeutic effects of corticosteroids last longer than their physical presence and metabolic effects, and 2) Taking corticosteroids every other morning helps maintain almost normal hypothalamus-pituitary-adrenal (Hypothalamus-pituitary-) function on days when corticosteroids are not administered. It leads to the re-establishment of adrenal (HPA) activity. A brief summary of HPA physiology may help understand this theoretical interpretation. Free cortisol acts primarily through the hypothalamus, so a decrease in free cortisol stimulates the pituitary gland to increase production of adrenocorticotropic hormone (ACTH). , the rise in free cortisol inhibits ACTH secretion. Normally, the HPA system is characterized by a 24-hour activity rhythm. Serum levels of ACTH increase from low levels at 10 PM to peak levels at 6 AM. Increased levels of ACTH stimulate adrenocortical activity, causing a peak increase in plasma cortisol between 2 and 8 AM. This increase in cortisol is It reduces ACTH production and thus adrenal cortical synthesis. This causes plasma corticoids to drop gradually throughout the day, reaching minimal levels in the middle of the night. The 24-hour rhythm axis of the HPA is lost in Cushing's disease, which causes obesity with concentric fat distribution, thin skin that bruises easily, and weak muscle disease. It is a symptom of adrenal cortex hyperfunction, which is characterized by thin skin that bruises easily, weakness and muscle loss, high blood pressure, latent diabetes, osteoporosis, and electrolyte imbalance. Same as hyperadrenocorticism (hyperadrenocorticism). Clinical symptoms may appear during long-term pharmacological corticosteroid therapy, which is typically administered in divided daily doses. Relief from persistently elevated plasma levels, even for short periods of time, may be helpful in preventing side effects. During typical pharmacological doses of corticosteroid therapy, along with the suppression of cortisol production by the adrenal cortex, ACTH production is also suppressed. The recovery time to HPA activity varies depending on the dose and duration of treatment. During this period, the patient is sensitive to any stressful environment. Take prednisolone (10 mg) once in the morning, divided into 4 times a day, every 6 hours. Although they produce significantly less adrenal suppression, there is evidence that some suppressive effects on adrenal activity may persist into the next day at pharmacological doses. Moreover, a single dose of any corticosteroid may last for up to two days or more. Renocortical suppression has been shown. Other corticosteroids, including methylprednisolone, hydrocortisone, prednisone, and prednisolone, are considered short-acting (a single dose produces adrenocortical suppression for 1¼ to 1½ days) and therefore treatment on alternate days is desired. . The following points should be kept in mind when performing alternate-day treatment: 1) Basic principles and indications must be applied in corticosteroid therapy. The advantages of ADT should not encourage indiscriminate use of corticosteroids. 2) ADT is a treatment technique that should be basically planned for patients requiring long-term pharmacocorticoid treatment. 3) For less severe diseases with indications for corticosteroid therapy, ADT may be used initially. In more severe diseases, high doses divided into daily doses will usually be required for early control of disease progression. Initial suppressive dose Treatment should be continued until a satisfactory clinical response is achieved, usually for 4 to 10 days in many allergic and collagen diseases. It is doubly important to keep the initial suppressive dose period as short as possible, especially if continued use of the alternate-day regimen is intended. Once control is achieved, two situations are possible. (1) Switch to ADT and gradually reduce the amount of corticosteroids given every other day. ② Depending on the control of disease progression, reduce the daily dose of corticosteroids to the minimum effective value as quickly as possible and then change the schedule to every other day. Theoretically, process ① is more preferable. 4) Because of the advantages of ADT, this form of treatment is desirable for patients who have been taking corticosteroids daily for a long period of time (e.g. rheumatoid arthritis). In these patients, the HPA axis may already be suppressed, making it difficult to establish ADT therapy. This may be difficult to establish and may not always be successful. However, regular attempts to change are recommended. However, regular attempts to change are recommended. If difficulties are encountered, simply double the daily dose. It is advisable to administer 3 or even 4 times every other day. Once the patient is again under control, attempt to reduce these doses to the lowest possible level. 5) As mentioned above, some corticosteroids suppress adrenal function for long periods of time and are not recommended for alternate-day therapy (e.g., dexamethasone, betamethasone). 6) The maximum activity of the adrenal cortex is from 2 am to 8 am, and the lowest is from 4 pm to midnight. When administered during the time of maximum activity (morning), exogenous corticoids suppress adrenal cortex activity the least. 7) In the use of ADT, as in all treatment settings, it is important to individualize and appropriate treatment for each patient. Complete control of symptoms is not possible for all patients. An explanation of the advantages of ADT is given in It will help you understand and tolerate any unsettling symptoms that may appear during the second half of the non-dosing day. If necessary, other symptomatic treatments may be added or increased during this period. 8) If an acute exacerbation occurs during the course of the disease, it may be necessary to divide the corticosteroid dose per day and return to a completely suppressive dose for control. Once control is achieved, the established alternate-day regimen can be retried. 9) Although many of the side effects of corticosteroid therapy can be minimized with ADT, as in all treatment settings, physicians must carefully consider the ratio of treatment benefits and risks for each patient for whom corticosteroid treatment is being considered.
3) Packaging unit
30 tablets
4) Ingredients, content
Methylprednisolone 4.0 mg
5) Period of use
36 months from date of manufacture
6) Storage method
Store in an airtight container at room temperature (1-30°C).
