Methylprednisolone precautions

List of precautions
Drug-induced secondary adrenocortical insufficiency Hypothyroidism Ocular herpes simplex Psychic derangements Ulcerative colitis Growth and development of infants Kaposi’s sarcoma Acute exacerbations

Drug-induced secondary adrenocortical insufficiency
Drug-induced secondary adrenocortical insufficiency may be minimized by gradual reduction of dosage. This type of relative insufficiency may persist for months after discontinuation of therapy; therefore, in any situation of stress occurring during that period, hormone therapy should be reinstituted. Since mineralocorticoid secretion may be impaired, salt and/or a mineralocorticoid should be administered concurrently. Return to top

Hypothyroidism
There is an enhanced effect of corticosteroids on patients with hypothyroidism and in those with cirrhosis. 'Return to top''

Ocular herpes simplex
Corticosteroids should be used cautiously in patients with ocular herpes simplex because of possible corneal perforation. 'Return to top''

Psychic derangements
Psychic derangements may appear when corticosteroids are used, ranging from euphoria, insomnia, mood swings, personality changes, and severe depression, to frank psychotic manifestations. Also, existing emotional instability or psychotic tendencies may be aggravated by corticosteroids. 'Return to top''

Ulcerative colitis
Steroids should be used with caution in nonspecific ulcerative colitis, if there is a probability of impending perforation, abscess or other pyogenic infection; diverticulitis; fresh intestinal anastomoses; active or latent peptic ulcer; renal insufficiency; hypertension; osteoporosis; and myasthenia gravis. 'Return to top''

Growth and development of infants
Growth and development of infants and children on prolonged corticosteroid therapy should be carefully observed. 'Return to top''

Kaposi’s sarcoma
Kaposi’s sarcoma has been reported to occur in patients receiving corticosteroid therapy. Discontinuation of corticosteroids may result in clinical remission. 'Return to top''

Acute exacerbations
Although controlled clinical trials have shown corticosteroids to be effective in speeding the resolution of acute exacerbations of multiple sclerosis, they do not show that corticosteroids affect the ultimate outcome or natural history of the disease. The studies do show that relatively high doses of corticosteroids are necessary to demonstrate a significant effect. 'Return to top''