Metypred – composition, action, indications, contraindications, dosage, side effects

Proven content

Metypred is a hormonal drug that contains a glucocorticosteroid. The active substance of Metypred is methylprednisolone, which has anti-inflammatory, antiallergic and immunosuppressive properties. This medicine can only be obtained with a prescription. What are the indications for the use of Metypred? Does the manufacturer indicate any contraindications to the use of this preparation? How to dose Metypred? Can taking the drug cause side effects in a patient? How much does Metypred cost and are alternatives available in pharmacies?

Metypred – drug characteristics

Metypred is a drug that can only be purchased in pharmacies with a prescription. In certain cases, this preparation may be reimbursed.

Metypred is available as tablets and as a powder for solution for injection. The active substance of the drug is methylprednisolone. Packages with different contents of the active substance in a tablet are available: Metypred 4 mg and Metypred 16 mg. The package contains 30 tablets.

In contrast, the following packs are available for the powder for solution for injection:

1. 125 mg: 1 x 4 ml vial;
2. 250 mg: 1 x 10 ml vial;
3. 500 mg: 1 x 20 ml vial;
4. 1000 mg: 1 x 30 ml vial.

Metypred has antiallergic, anti-inflammatory and immunosuppressive properties. It also affects the transformation of carbohydrates, fats and proteins. In addition, it affects the cardiovascular system, skeletal muscles and the central nervous system.

Orion Corporation is responsible for the production and distribution of Metypred. Orion Corporation is a globally operating Finnish pharmaceutical manufacturer. The company develops, manufactures and sells medicines, veterinary preparations and active substances. Orion primarily produces drugs for psychiatry, neurology, anesthesiology and intensive care, cardiology and pulmonology, as well as OTC products. The company was founded in 1917, while the Polish branch of this pharmaceutical concern was established in 2002 and currently employs over 100 employees.

What are glucocorticoids and when to use them? Read on: Glucocorticoid steroids

Metypred – composition and action

Metypred is a hormonal drug whose main ingredient is methylprednisolone – a synthetic glucocorticosteroid with anti-inflammatory, antiallergic and immunosuppressive properties.

Methylprednisolone is distinguished by a strong and long-lasting effect. Compared to prednisolone, it has a stronger anti-inflammatory effect, but has a lesser effect on sodium and water retention in the body.

This glucocorticosteroid does not affect the cause of inflammation, but it reduces its symptoms. This compound inhibits the permeability of capillaries, which reduces swelling. Methylprednisolone acts intracellularly, modifies the synthesis of some enzymes, and therefore the peak pharmacological activity is delayed compared to the peak blood levels.

Mechanism of action of methylprednisolone in a cell consists in inhibiting or stimulating the expression of genes whose protein products play an important role in inflammatory and immune processes. The action of all glucocorticosteroids is mediated by receptors that are found in the cytoplasm of the target cell and, when bound to the steroid, regulate the expression of the relevant genes, leading to a reduction in the inflammatory and immune responses.

Methylprednisolone also inhibits the production of cortisol, a natural hormone in the adrenal cortex, and when used long-term it can cause partial atrophy of the adrenal cortex. Due to the fact that glucocorticosteroids intensify the breakdown of fats within the limbs, and in the area of ​​the chest, neck and head in turn, they intensify their synthesis, the use of this type of drugs leads to characteristic changes in the figure.

The time it takes for a drug to reach its highest concentration in the body from the time it is given depends on the type of chemical for which the hormone is present in the drug. Methylprednisolone is metabolized in the liver, the resulting products are mainly excreted in the urine. Methylprednisolone crosses the placenta and is excreted into breast milk.

Auxiliary components of the drug Metypred in tablets are:

1. lactose monohydrate (70 mg);
2. corn starch;
3. gelatine;
4. magnesium stearate;
5. talk.

In turn, the powder for solution for injection additionally contains:

1. sodium dihydrogen phosphate dihydrate;
2. disodium hydrogen phosphate anhydrous;
3. sodium hydroxide.

How do steroids work and what are the indications for their use? Check: Steroids – action, use, side effects. The use of anabolic steroids

Metypred – indications for use

Drugs of the glucocorticoid group are usually used for symptomatic treatment. The exception may be endocrine disorders, when drugs are administered in substitution treatment.

The indication for the use of Metypred is to support the treatment of:

1. endocrine disorders, especially in primary or secondary adrenal insufficiency, in congenital adrenal hyperplasia, non-inflammatory thyroid gland or in the course of hypercalcemia that accompanies the ongoing cancer in the patient’s body;
2. short-term patients with rheumatic diseases as adjunctive therapy, during exacerbations or significant deterioration of health in the course of: psoriatic arthritis, rheumatoid arthritis, juvenile RA, ankylosing spondylitis, acute or subacute bursitis, in acute nonspecific tenosynovitis, in acute gouty inflammation joints, in inflammation of the synovial membrane of the joints associated with osteoarthritis, in epicondylitis;
3. systemic connective tissue diseases – systemic lupus erythematosus, polymyositis, dermatomyositis, rheumatic myocarditis;
4. dermatological diseases – pemphigus, bullous herpetic dermatitis, in the severe form of erythema multiforme accompanying the course of Stevens-Johnson disease, in the treatment of exfoliative dermatitis, mycosis fungoides, in severe forms of psoriasis and seborrheic dermatitis;
5. allergic diseases – seasonal or perennial allergic rhinitis, bronchial asthma, serum sickness. The drug helps to combat drug hypersensitivity reactions, in the course of contact dermatitis and lesions such as atopic dermatitis;
6. severe and chronic allergic and inflammatory diseases of the eyes and its appendages – in allergic, borderless corneal ulceration, ophthalmic herpes zoster, inflammation of the iris and ciliary body, retina and choroid;
7. respiratory diseases – symptomatic sarcoidosis, beryllium or aspiration pneumonia, tuberculosis or Loeffler’s disease;
8. hematological diseases – haemolytic anemia, idiopathic thrombocytopenic purpura, secondary thrombocytopenia or congenital hypoplastic anemia;
9. neoplastic diseases – palliative treatment, leukemia, lymphoma, acute leukemia in children;
10. edema in the course of nephrotic syndrome;
11. digestive system diseases – ulcerative colitis or Crohn’s disease;
12. neurological diseasesespecially when there are cerebral edema caused mainly by the presence of a tumor or in the event of an exacerbation of the patient’s condition in the course of multiple sclerosis.

What is RA, How Do I Recognize Symptoms and Treat Rheumatoid Arthritis? Read: Rheumatoid arthritis

Metypred – contraindications

The drug Metypred, despite its effectiveness in combating the symptoms of inflammatory, allergic or immune conditions, cannot be used by every patient struggling with this type of ailments.

Contraindications to the use of Metypred are:

1. allergy to the active substance or any of the other ingredients of this medicine;
2. systemic fungal infection;
3. simultaneous administration of live or live attenuated vaccines

What should you know about drug allergy? Read: Drugs are also allergenic

Metypred – precautions

Before and during the use of Metypred, you should follow the precautions, which are included in the package leaflet.

Precautions to keep in mind include:

1. the drug may mask the symptoms of infection and impair the body’s defenses and make it more susceptible to new infections, infections may be more severe (including fatal);
2. the use of the drug in people with active tuberculosis should be limited to severe or disseminated cases. When administration of glucocorticoids is indicated in patients with latent tuberculosis or tuberculin test positive, observation of the patient is necessary, as the disease may reactivate. In these patients, chemoprophylaxis should be given during long-term corticosteroid therapy;
3. Cases of epidural lipomatosis have been reported in patients taking corticosteroids, usually with long-term use of high doses;
4. this medicine should not be given to patients with Cushing’s disease as it may worsen the symptoms of the disease;
5. the drug should be used with caution in patients with hypothyroidism, diabetes, hypertension or other disorders of the cardiovascular system, with thromboembolic disorders or the risk of their occurrence; with suspected or known phaeochromocytoma;
6. the drug should be used with caution in patients with mental disorders;
7. the drug should be used with caution in elderly patients;
8. long-term use of the drug can lead to the development of posterior subcapsular cataracts and nuclear cataract exophthalmos or an increase in intraocular pressure, which can cause glaucoma with potential damage to the optic nerves;
9. the use of the drug is associated with the risk of central serous retinopathy, which may lead to retinal detachment;
10. Metypred should not be used as a routine drug in the treatment of traumatic brain injury;
11. long-term administration of therapeutic doses of Metypred may lead to suppression of the hypothalamic-pituitary-adrenal axis, that is, secondary adrenal insufficiency;
12. Abrupt discontinuation of treatment may result in acute, fatal adrenal insufficiency. Drug-induced secondary adrenal insufficiency can be minimized by gradual dose reduction; 
13. in children receiving the medicine for a long time, their growth may be stunted;
14. infants and children on long-term use of corticosteroids are at particular risk of increased intracranial pressure;
15. Due to the lactose content, do not use the preparation in patients with hereditary galactose intolerance, lactase deficiency or malabsorption of glucose-galactose.

In addition, Metypred should not be used after the expiry date which is stated on the carton. The expiry date refers to the last day of that month. The drug should not be disposed of via wastewater or household waste. It’s best to ask your pharmacist how to dispose of medicines you no longer use.

What should you know about proper drug storage? Check: Medications that are stored wrongly are poisonous

Metypred – dosage

Always use Metypred exactly as described in the package leaflet or as directed by your doctor or pharmacist.

Metypred tablets are intended for oral use.

Correct dosage of Metypred tablets depends on:

1. the patient is diagnosed with the disease. The starting dose may vary from 4 mg to 48 mg methylprednisolone per day;
2. higher doses of the drug are used in the case of multiple sclerosis (200 mg / day), brain edema (200-1000 mg / day) and organ transplantation (up to 7 mg / kg / day);
3. the doctor will determine the maintenance dose, gradually reducing the starting dose over time to obtain the lowest dose appropriate to the beneficial effect of the treatment;
4. your doctor may initiate treatment by giving you twice the daily dose, every other day in the morning.

In the case of powder for solution for injection, proper dosing and administration is the responsibility of appropriately qualified healthcare professionals. It is given as an injection into a vein or into a muscle, or as an infusion into a vein. The patient is administered the lowest possible dose that leads to a clinical effect.

In turn, use of Metypred in children and the dose that is right for you depends on the severity of the disease and how your child responds to treatment. It is always the doctor who selects the right dose, with the note that for the treatment to be effective, it should not be less than 0,5 mg per kilogram of body per day.

How to take medication correctly? Check: How to take medications effectively?

Metypred – side effects

Metypred, like any other drug, may cause side effects in patients. It is important to report any suspected adverse reactions after authorization of the medicinal product so that the benefit / risk balance of the medicinal product can be monitored.

The frequency classification of adverse body reactions (ADRs) is based on the following principles: very common (≥1 / 10), common (≥1 / 100 to <1/10), uncommon (≥1 / 1 to <000/1), rare (≥ 100 / 1 to <10 / 000), very rare (<1 / 1), not known (cannot be estimated from the available data).

Contact your doctor immediately if you experience any of the following side effects:

1. severe symptoms of an allergic reaction – skin rash, face swelling or wheezing, a sharp drop in blood pressure and difficulty breathing;
2. symptoms of pancreatitis – abdominal pain extending to the back, vomiting, shock and loss of consciousness;
3. symptoms of gastric or intestinal ulcers Rectal bleeding, black or bloody stools, vomiting blood;
4. signs of infection – chills, fever, general feeling of being unwell;
5. symptoms of a blood clot in the lung Sudden sharp pain in the chest, shortness of breath and coughing up blood;
6. symptoms of a blood clot Painful, swollen, red and tight blood vessels
7. symptoms of increased pressure inside the skull – headache with vomiting, lack of energy and drowsiness.

Common side effects of Metypred (less than 1 in 10 patients):

1. infections;
2. face rounding and weight gain;
3. sodium and fluid retention in the body;
4. mood drop;
5. euphoria;
6. cataract;
7. increase in blood pressure;
8. stomach or intestinal ulcers;
9. skin bruises;
10. acne;
11. osteoporosis;
12. muscle weakness;
13. slow wound healing;
14. low level of potassium in the blood.

The use of Metypred may also cause side effects, the frequency of which is unknown. These side effects include:

1. neoplasms – benign, malignant and unspecified;
2. infections and infestations;
3. blood and lymphatic system disorders;
4. immune system disorders;
5. metabolism and nutrition disorders – impaired glucose tolerance, hypokalemic alkalosis, dyslipidemia, metabolic acidosis, increase in insulin demand, negative nitrogen balance, increase in blood urea concentration, increased appetite, steatosis, epidural lipomatosis;
6. mental disorders – mood changes, psychological dependence, suicidal thoughts, mania, delusions, hallucinations and schizophrenia, confusion, anxiety, personality changes, insomnia, irritability;
7. nervous system disorders – increased intracranial pressure, convulsions, amnesia, cognitive disorders, dizziness, headaches;
8. eye disorders – exophthalmos, glaucoma, central serous retinopathy, thinning of the cornea, thinning of the sclera, swelling of the optic nerve disc with possible damage to the optic nerve, exacerbation of viral or fungal diseases of the eyes, blurred vision;
9. heart problems – congestive heart failure, arrhythmias, arterial hypertension;
10. digestive system disorders – gastric bleeding, intestinal perforation, inflammation of the pancreas, peritoneum, esophagus, ulcerative oesophagitis, abdominal pain, abdominal swelling, diarrhea, indigestion, nausea, oesophageal candidiasis, vomiting, bad taste in the mouth;
11. disorders of the liver and bile ducts- hepatitis, increase in liver enzymes;
12. musculoskeletal and connective tissue disorders;
13. skin and subcutaneous tissue disorders – swelling, ecchymosis, stretch marks, discoloration or discoloration of the skin, hirsutism, rash, erythema, itching, hives;
14. disorders of the kidneys and urinary tract – scleroderma renal crisis;
15. reproductive system and breast disorders – menstrual disorders;
16. abnormal results in diagnostic tests – increase in alanine aminotransferase, aspartate aminotransferase and alkaline phosphatase in the blood, increase in intraocular pressure, impaired carbohydrate tolerance, increase in calcium in urine, inhibition of skin test reactions;
17. injuries, poisoning and procedural complications.

Does the use of steroids affect the skin? Check: Steroids and acne

Metypred – interactions with other drugs

Before starting treatment with Metypred, please inform your doctor or pharmacist about all the medicines you are taking or have taken recently. You should also inform what medications the patient plans to take in the near future.

The active substance in Metypred may interact with other drugs and substances that are contained in medicinal products.

Particular care should be taken when taking:

1. drugs that inhibit the activity of acetylcholinesterase – in patients with myasthenia gravis, corticosteroids used in parallel with acetylcholinesterase inhibitors may cause muscle weakness;
2. muscle relaxants, neuromuscular blocking drugs – the use of corticosteroids may aggravate muscle paralysis;
3. anticoagulants – glucocorticoids may interfere with the action of anticoagulants and increase the risk of gastrointestinal bleeding;
4. salicylates and other non-steroidal anti-inflammatory drugs – parallel use of corticosteroids increases the risk of gastric ulceration and gastrointestinal bleeding;
5. insulin or oral antidiabetic drugs – this may reduce the hypoglycaemic effect of these drugs, which may require dose adjustment;
6. drugs that increase the hepatic metabolism of methylprednisolonesuch as carbamazepine, phenobarbital, phenytoin, primidone and rifampicin;
7. drugs that inhibit the activity of the cytochrome P3 isoenzyme 4A450such as ketoconazole, itraconazole, clarithromycin, erythromycin, troleandomycin;
8. estrogen, including estrogens contained in contraceptives;
9. amphotericin B, diuretics, laxatives;
10. immunosuppressive drugs, e.g. cyclosporins – risk of worsening immunosuppression and possible side effects, including seizures;
11. other corticosteroids – e.g. asthma inhalers, ointments, creams or other steroids.

In addition, while taking Metypred, you should limit your intake of grapefruits and grapefruit juice, and especially not take it with them. Grapefruit and grapefruit juice increase the concentration of the drug in the body, which increases the risk of side effects. To avoid interactions, you should not eat grapefruit at least 4 hours before and 4 hours after taking the drug.

Which drugs should never be combined with each other? Check: Dangerous interactions

Metypred, pregnancy and breastfeeding

The use of any medications or dietary supplements during pregnancy requires consultation with the attending physician. If you are pregnant or breastfeeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking Metypred.

The active substance in the drug, methylprednisolone, crosses the placenta and is excreted into breast milk. In pregnant women, the use of the preparation is limited only to cases when the doctor deems it absolutely necessary.

Breastfeeding is also not recommended during prolonged systemic corticosteroid use.

What is worth knowing about proper supplementation during pregnancy? Check: Conscious choices. Diet and supplementation in pregnancy

Metypred – price

The price of the drug Metypred may differ depending on the city in which the preparation will be purchased or the pharmacy chosen by the patient. The price of the product also depends on the content of the active substance in the drug.

A package containing 30 tablets with 16 mg of active substance costs about PLN 30-35. This drug is reimbursable and can be dispensed free of charge in the indicated cases.

A package containing 30 tablets with 4 mg of active substance costs about PLN 10. And as in the above description, the drug can be dispensed free of charge in the indicated cases.

How much money does the average Pole spend on treatment? Check: The Pole is not expected to see a doctor

Metypred – replacements

Products that have the same international name and exist in the same form do not have to be substitutes, because the use of a given drug is determined by the content of the active substance, i.e. the dose of the drug.

It should be remembered that even when the dose of the active substance is similar, the patient may not always use the substitute, because he may be allergic to any of the other excipients of the drug.

Therefore, before using a substitute for Metypred, read the package leaflet or consult your doctor or pharmacist.

The preparations containing the same active substance as Metypred and showing similar properties include:

1. Medrol in tablets – a drug produced by the Pfizer concern. Available packages contain 50 or 30 tablets;
2. Meprelon in powder and solvent for solution for injection and infusion – a drug manufactured by the Sun-Farm concern. It is available in four different packages with different active ingredient content;
3. Meprelon in tablets – a drug produced by the Sun-Farm concern. The available packages contain 30 tablets with different content of the active substance;
4. Solu-Medrol in powder and solvent for solution for injection and infusion – a drug manufactured by the Pfizer concern. It is available in five different packages with different active ingredient content.

When is it worth asking the pharmacy about drug substitutes? Check: Swap when you can