Depo-Medrol (Methylprednisolone)

DEPO-MEDROL is to be given to you as an injection to the joint (intra-articular or intra-synovial injection), or into a muscle (intramuscular injection) by your health care provider. The dose of DEPO-MEDROL will depend on your condition and how severe it is.

When your condition has improved, your dose will be reduced gradually.

DEPO-MEDROL should not be stopped abruptly.

Overdose:

In case of drug overdose, contact a health care practitioner, hospital emergency department or regional Poison Control Centre immediately, even if there are no symptoms.

DEPO-MEDROL may hide symptoms of infections, may cause latent infections to become active, and may induce infections by normally inoffensive organisms due to lowered body resistance.

Potential side effects with DEPO-MEDROL include:

Allergic Reactions:

• anaphylaxis (a severe, life-threatening allergic reaction)
• cardiac arrest
• bronchospasm (narrowing of the airway)

Cardiovascular:

• heart failure
• heart attack
• arrhythmia (irregular heartbeat)
• high and low blood pressure
• blood clots
• thrombophlebitis (vein inflammation)

Dermatologic:

• thin fragile skin
• impaired wound healing
• swelling
• ecchymosis (spots caused by ruptured blood vessels)
• petechiae (reddish spot containing blood that appears in skin)
• stretch marks
• dry, scaly skin
• rash
• redness
• itching
• acne
• increased sweating
• injection site reaction
• lightening or darkening of an area of skin
• abscess
• suppressed reaction to skin tests
• thinning hair

Endocrine and Metabolism:

• development of Cushingoid state (abnormal bodily condition caused by excess corticosteroids)
• moon face (enlargement of chin and forehead)
• weight gain
• abnormal fat deposits
• suppression of pituitary-adrenal axis (a condition that could lead to disabling the body’s responses to physiological stress such as severe infections or trauma)
• suppression of growth in children
• abnormal hair growth
• new symptoms of diabetes

Gastrointestinal:

• stomach ulcer
• stomach bleeding
• inflammation of the pancreas and esophagus
• perforation of the bowel
• nausea
• vomiting or altered sense of taste (with rapid administration of large doses)
• abdominal pain
• bloating
• diarrhea
• indigestion
• bowel/bladder dysfunction
• increased appetite
• peritonitis

Hematology:

• above normal white blood cell count
• above normal cholesterol or triglycerides

Hepatic:

• enlarged liver

Musculoskeletal:

• loss of muscle mass
• muscle weakness
• muscle pain
• malaise (feeling of general discomfort or uneasiness)
• osteoporosis
• pathological fractures
• vertebral compression fractures
• tendon rupture, (particularly of the Achilles tendon)
• Charcot joint disease (neuropathic arthropathy)
• pain and inflammation of the tissues surrounding the injection site
• joint pain

Neurologic:

• seizures
• headache
• vertigo
• pain and tenderness
• impaired sensation, strength, and reflexes
• sensation of tingling, tickling, prickling, or burning of a person's skin
• amnesia
• dizziness

Ophthalmologic:

• cataracts
• increased intraocular pressure
• glaucoma
• bulging of the eye
• blindness

Psychiatric:

• depression
• emotional instability
• euphoria (intense feelings of well-being, elation, happiness, excitement and joy)
• insomnia
• mood swings
• personality changes
• thoughts of suicide
• delusion
• hallucination
• confusion
• schizophrenia
• anxiety

Sexual Function/Reproduction:

• menstrual irregularities
• increased or decreased motility and number of sperm

Other:

• hiccups, fatigue, irritability, swelling

DEPO-MEDROL with preservative benzyl alcohol is not recommended for injection into the joint (intra-synovial or intra-articular injection).

Before taking DEPO-MEDROL, talk to your doctor if you have:

• an infection (such as herpes simplex, chicken pox, tuberculosis, threadworm);
• recently had myocardial infarction (heart attack);
• thromboembolic disorders (bleeding or blood clotting problems);
• brittle bone (osteoporosis);
• high blood pressure;
• water retention (oedema);
• seizures (fits);
• thyroid problems;
• muscle pain or weakness (such as myasthenia gravis);
• skin cancer (Kaposi's sarcoma);
• heart problems such as heart failure;
• certain eye diseases such as glaucoma, cataracts; herpes infection;
• kidney disease;
• liver disease such as cirrhosis;
• certain mental or mood conditions (such as depression);
• stomach or gut problems (ulcer, ulcerative colitis);
• low potassium or calcium;
• Cushing's disease (caused by an excess of cortisol hormone);
• weak immune response;
• high blood sugar.

Before you have any operation, tell your doctor, dentist or anesthetist that you are taking DEPO-MEDROL.

Pregnancy and breast feeding:

You must tell your doctor if you are pregnant, think you might be pregnant or are trying to become pregnant as this medicine could slow the baby's growth.

You should also tell your doctor if you are breast feeding as small amounts of corticosteroid medicines may get into breast milk.

Children:

Corticosteroids can affect growth in children.

DEPO-MEDROL with preservative benzyl alcohol is not recommended to be used in infants since benzyl alcohol has been reported to cause “gasping syndrome” that may result in death.

Before taking DEPO-MEDROL talk to your doctor about all your other medications, including those you bought without prescription, herbal or natural products. The following may interact with DEPO-MEDROL:

• drugs to treat glaucoma and epilepsy such as acetazolamide
• drugs to prevent or alleviate nausea and vomiting such as aprepitant or fosaprepitant
• drugs to treat cancer such as aminoglutethimide or cyclophosphamide
• drugs to “thin” the blood; anticoagulants such as acenocoumarol, phenindione and warfarin
• drugs to treat myasthenia gravis (a muscle condition) such as distigmine and neostigmine
• antibiotics and antifungals (such as ketoconazole, itraconazole, amphotericin B, erythromycin, clarithromycin, troleandomycin, rifampicin and rifabutin)
• aspirin and non-steroidal anti-inflammatory medicines (also called NSAIDs) such as ibuprofen
• drugs to treat epilepsy such as barbiturates, carbamazepine, phenytoin and primidone
• drugs for heartburn and acid indigestion such as cimetidine
• cyclosporine
• drugs for heart problems or high blood pressure such as calcium channel blockers, digoxin and diltiazem
• water pills (diuretics)
• hormone replacement therapy or hormonal oral contraceptives
• drugs to treat HIV infections such as indinavir or ritonavir
• pancuronium or vecuronium—or other medicines called neuromuscular blocking agents which are used in some surgical procedures
• tacrolimus—used following an organ transplant to prevent rejection of the organ
• vaccines—tell your doctor or nurse if you have recently had, or are about to have any vaccination.
• drugs to treat diabetes
• drugs to treat tuberculosis
• drugs to treat high cholesterol (cholestyramine)
• aromatase inhibitors (drugs to treat breast or ovarian cancer)
• immunosuppressants (drugs that suppress or reduce the strength of the body's immune system

Do not drink grapefruit juice while taking DEPO-MEDROL.

Driving and Using Machines:

DEPO-MEDROL may cause dizziness, vertigo, vision problems and fatigue. If you experience these side effects you should not drive or operate machinery.