METHYLPREDNISOLONE, METHYLPREDNISOLONE ACETATE, METHYLPREDNISOLONE SODIUM SUCCINATE
Note: For more information refer to the monograph: Glucocorticoids, General Information or to themanufacturer's product information.
Chemistry - Also known as 6-alpha-methylprednislone, methylprednisolone is a syntheticallyproduced glucocorticoid. Both the free alcohol and the acetate ester occur as odorless, white orpractically white, crystalline powder. They are practically insoluble in water and sparingly soluble inalcohol.
Methylprednisolone sodium succinate occurs as an odorless, white or nearly white, hygroscopic, amorphous solid. It is very soluble in both water and alcohol.
Methylprednisolone sodium succinate injection is reportedly compatible with the followingfluids and drugs: amino acids 4.25%/dextrose 25%, amphotericin B (limited amounts), chloramphenicol sodium succinate, cimetidine HCl, clindamycin phosphate, dopamine HCl, heparin sodium, metoclopramide, norepinephrine bitartrate, penicillin G potassium, sodium iodide/aminophylline, and verapamil.
The following drugs and fluids have either been reported to be incompatible with methylprednisolone sodium succinate, compatible dependent upon concentration, or data conflicts:
D5/half normal saline, D5 normal saline (80 mg/l reported compatible), D5W (up to 5 grams/Lreported compatible), Lactated Ringer's (up to 80 mg/L reported compatible), normal saline (dataconflicts; some reports of up to 60 grams/liter compatible), calcium gluconate, cephalothin sodium(up to 500 mg/L in D5W or NS compatible), glycopyrrolate, insulin, metaraminol bitartrate, nafcillin sodium, penicillin G sodium and tetracycline HCl. Compatibility is dependent upon factorssuch as pH, concentration, temperature and diluents used. It is suggested to consult specializedreferences for more specific information (e.g., Handbook on Injectable Drugs by Trissel; seebibliography).
Contraindications/Precautions - The manufacturer (Upjohn Veterinary) states that the drug(tablets) should not be used in dogs or cats "in viral infections, ...animals with arrested tuberculosis, peptic ulcer, acute psychoses, corneal ulcer, and Cushinoid syndrome. The presence of diabetes, osteoporosis, chronic psychotic reactions, predisposition to thrombophlebitis, hypertension, CHF, renal insufficiency, and active tuberculosis necessitates carefully controlled use."
The injectable acetate product is contraindicated as outlined above when used systemically. Wheninjected intrasynovially, intratendinously, or by other local means, it is contraindicated in the"presence of acute local infections."
Chemistry - Also known as 6-alpha-methylprednislone, methylprednisolone is a syntheticallyproduced glucocorticoid. Both the free alcohol and the acetate ester occur as odorless, white orpractically white, crystalline powder. They are practically insoluble in water and sparingly soluble inalcohol.
Methylprednisolone sodium succinate occurs as an odorless, white or nearly white, hygroscopic, amorphous solid. It is very soluble in both water and alcohol.
Storage, Stability, Compatibility
Commercially available products of methylprednisoloneshould be stored at room temperature (15-30°C); avoid freezing the acetate injection. After reconstituting the sodium succinate injection, store at room temperature and use within 48 hours; only use solutions that are clear.Methylprednisolone sodium succinate injection is reportedly compatible with the followingfluids and drugs: amino acids 4.25%/dextrose 25%, amphotericin B (limited amounts), chloramphenicol sodium succinate, cimetidine HCl, clindamycin phosphate, dopamine HCl, heparin sodium, metoclopramide, norepinephrine bitartrate, penicillin G potassium, sodium iodide/aminophylline, and verapamil.
The following drugs and fluids have either been reported to be incompatible with methylprednisolone sodium succinate, compatible dependent upon concentration, or data conflicts:
D5/half normal saline, D5 normal saline (80 mg/l reported compatible), D5W (up to 5 grams/Lreported compatible), Lactated Ringer's (up to 80 mg/L reported compatible), normal saline (dataconflicts; some reports of up to 60 grams/liter compatible), calcium gluconate, cephalothin sodium(up to 500 mg/L in D5W or NS compatible), glycopyrrolate, insulin, metaraminol bitartrate, nafcillin sodium, penicillin G sodium and tetracycline HCl. Compatibility is dependent upon factorssuch as pH, concentration, temperature and diluents used. It is suggested to consult specializedreferences for more specific information (e.g., Handbook on Injectable Drugs by Trissel; seebibliography).
Contraindications/Precautions - The manufacturer (Upjohn Veterinary) states that the drug(tablets) should not be used in dogs or cats "in viral infections, ...animals with arrested tuberculosis, peptic ulcer, acute psychoses, corneal ulcer, and Cushinoid syndrome. The presence of diabetes, osteoporosis, chronic psychotic reactions, predisposition to thrombophlebitis, hypertension, CHF, renal insufficiency, and active tuberculosis necessitates carefully controlled use."
The injectable acetate product is contraindicated as outlined above when used systemically. Wheninjected intrasynovially, intratendinously, or by other local means, it is contraindicated in the"presence of acute local infections."