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This document outlines critical safety information and warnings related to the use of methylprednisolone (Medrol). It is essential to carefully review these details and discuss any concerns with your healthcare provider.

• Infection Risk: Long-term use of methylprednisolone can increase susceptibility to infections or mask infection symptoms, including serious fungal, viral (e.g., chickenpox, measles), and bacterial infections such as tuberculosis (TB). Avoid close contact with individuals with these infections. Inform your provider of any history with TB or parasitic infections, and consult them before receiving vaccinations, especially live vaccines, which may not be safe during treatment with high doses of methylprednisolone. Risks include concurrent use of other immune-weakening medications, prolonged use of methylprednisolone, lack of vaccination against viral illnesses, contact with infected individuals, history of bacterial or viral conditions, and receipt of live vaccines.

• Mood and Behavior Changes: Methylprednisolone can cause mood and behavior alterations. Notify your provider immediately if you experience depression, mood swings, insomnia, anxiety, or hallucinations. Individuals with a history of mental health issues are at higher risk.

• Adrenal Gland Function Reduction: Prolonged use of methylprednisolone may cause adrenal suppression, a condition where your adrenal glands reduce hormone production. Sudden discontinuation can be harmful. Symptoms of withdrawal in adults include fever, joint or muscle pain, and fatigue; in children, symptoms include stunted growth, weight gain, and headaches. Your provider will prescribe the lowest effective dose and may require lab tests to assess adrenal function. Do not stop taking the medication abruptly without consulting your provider. Risks include long-term use and stress from trauma, injury, or infection.

• Heart and Kidney Function Changes: Methylprednisolone may alter fluid and electrolyte balance, potentially causing high blood pressure, swelling, and kidney issues. It may also damage the heart if used after a recent heart attack. Inform your provider of any history of heart failure, heart attack, hypertension, or kidney problems.

• Stomach Issues: The medication increases the risk of stomach damage, including irritation, ulcers, and bleeding, particularly if you have a history of stomach problems or are taking NSAIDs. Avoid alcohol as it may worsen stomach irritation. Seek immediate medical attention for persistent stomach pain or bloody/dark stools. Risks include a history of stomach bleeding or ulcers, ulcerative colitis, concurrent medication use causing stomach issues, and alcohol consumption.

• Bone Health Concerns: Long-term use can reduce calcium absorption, leading to osteoporosis in adults or growth retardation in children. Discuss your risk with your provider if you have had fractures or osteoporosis. Risks include high doses or prolonged use, female gender, history of falls, smoking, and young age.

• Eye Health Risks: Extended use may increase the risk of cataracts, glaucoma, and certain eye infections. Notify your provider of any current or past viral eye infections or if you experience vision changes during treatment. Regular eye exams may be necessary. Risks include cataracts, glaucoma, and a history of herpes eye infection.

• High Blood Sugar: Prolonged use can raise blood sugar levels, potentially leading to diabetes. Report symptoms like confusion, drowsiness, excessive thirst or hunger, frequent urination, flushing, rapid breathing, or fruity-smelling breath. Diabetic patients should monitor blood sugar levels closely. The risk is higher with long-term use.

Contraindications: Do not use methylprednisolone if you currently have a fungal infection or are receiving live vaccines at high doses. Consult your healthcare provider if any of these conditions apply.

When taking this medication, you may experience some common side effects such as nausea, vomiting, heartburn, headaches, dizziness, trouble sleeping, changes in appetite, increased sweating, and pain or redness at the injection site. These effects are generally mild; however, if they persist or worsen, it's important to consult your healthcare provider.

Some other side effects that could occur include swelling, muscle weakness, stomach pain, bloating, increased appetite, weight gain, and dizziness. Additionally, you might notice skin thinning, joint problems, or experience infections. If you encounter any of these, especially if they become severe, reach out to your healthcare provider for advice.

This medication can also result in more serious side effects. These include unusual weight gain, changes in menstrual cycles, bone or joint pain, mood changes such as depression or agitation, muscle weakness, puffy face, slow wound healing, or swelling of the ankles, feet, or hands. Vision problems, fast or irregular heartbeat, symptoms of stomach bleeding, and red or purple spots on the skin are also possible. If you notice seizures, or any signs of a serious allergic reaction like a rash, itching, severe dizziness, or trouble breathing, seek immediate medical attention.

Lastly, this medication may increase blood sugar levels, potentially worsening diabetes, or lower your ability to fight infections. If you have symptoms like increased thirst or urination, or signs of infection such as a persistent sore throat, fever, or white patches in the mouth, contact your healthcare provider promptly.

Methylprednisolone (Medrol) can interact with various medications, and it is essential to inform your doctor and pharmacist about all medications and supplements you are currently taking, including prescription, over-the-counter, vitamins, and herbal products. Below are some important interactions to be aware of:

1. Medications to Avoid:

   • Certain medications should not be used with methylprednisolone, such as Desmopressin and the rotavirus live vaccine.

2. Cautionary Use:

   • Some medications may require caution if used with methylprednisolone. Your doctor might adjust the dosage or frequency when both are prescribed together. These include:
     • Anti-inflammatory drugs like aceclofenac, Celecoxib, Ibuprofen, Naproxen, and Aspirin (especially at higher doses).
     • Medications affecting blood clotting, such as Warfarin and other anticoagulants.
     • Other drugs like aldesleukin, Ritonavir, and Ketoconazole may also interact.

3. Potential Side Effects:

   • Using methylprednisolone with certain medications might increase the risk of side effects. These include:
     • Antiplatelet drugs, NSAIDs, and blood thinners which may increase bleeding risk.
     • Antibiotics and antifungals like Clarithromycin and Erythromycin, as well as Cyclosporine, can affect methylprednisolone's removal from the body, influencing its effectiveness.

Always consult your healthcare provider for detailed guidance and before making any changes to your medication regimen. It’s important to ensure that lab personnel are aware of your methylprednisolone use, as it can affect certain lab results.