Friday, September 13, 2013

Depo-Medrol (rest of pamphlet)

Depo-Medrol rest of pamphlet
Knees 
Ankles 
Shsslders
Elbsws 
Wdsts

Rarely. anaphylactoid reactions hana been reported following injection of methyiprednisolone acetate. Physicians osing
2. BursitIs. The area around the Injection site is prepared in a sterita way asd wheel at the site made with t percent
Deps-Medrsl shsuld be prepared ts deal with this possibility
procaine hpdrochlorid solution. A 20 ts 24 gauge needte affached to a dry sydnge is inserted into the bums and the fluid
Sisce spsntanesus remission of some diseases, ssch as rhesmstsid arthdtis, map occur dsring pregnancp, enery effsrt should be made to anoid hormone treatment in pregnancy.
aspirated. The needle is left In place after injection, the needle Is withdraws and a small dressing applied. 3.Mlscellaecetoue: Gangllos, Tosdisitle, Epfcondylltle. In the treatment of conditions such as tendinitn or
Long-term adrenocorticold therapy may cooke a rine in hyperacidity or peptic ulcer, therefore, as a prophylactic measure,
tanosynositin, care should be taken, tollowing application of a nuitable antiseptic to the oeedying nibs, to inject the
an ulcer regimen and the administration of as antacid are highly tecommended. X-rayo nhoeld be taken In peptic olcer
aunpennion into the tendon sheath rather than into the substance of tendon. Tan tendon may be readily palpated when
patients complaining of gastric distress, and, whether or not changes are nnted, an olcer regimen in recommended,
placed on a stretch. When treating conditions such as epicondolitis, the area of greatest tendemeso uhoold be outlined
gince methyipradninolone causes less salt and water refention than other glococorticoids, patients should observed closely
carefully and the suspension infiltrated into the area. For ganglia of the tendon sheathn, the suspension is injected directly
for denelopment of undesirable hormonal effects that are lens obvious indications of steroid touicity than udema and
into the cyst In many canes, o single injection causes a marked decreuse In the size of the cystic tumor and mop effect
hypertension doe to salt and water retention,
disappearance. The unaal ntertle precautions should be observed, of course, with each injection. The dose in the
Continued supemision of the patient after cessation of Depo-Medrol therapy is essential, ainca there map be a sudden
treatment of the various conditions of the tendinoun of baroal structures listed abuse norien with the condition being treated
reappearance of severe manifestations of the disease for which the patient wan treofad.
and ranges from 4 to 30mg. In recorrent or chronic cnndifionn, repeated injections may be necessary.
Adverse Reactions: Adverse reactions associated with uae cf corficoida, include Coshings’n syndrome, moon fades, napraclavicular fat pads.
4. fejectione for Locaf Effect In Dermafofogfc Conditions. Following cleansing with an apprvpdate nach an 70% 
alcohol, 20 to 60 mg of the nonpennion in injected info the lesion, It may be necessary to distribute dones ranging from 20 
to mg be repeated local Injections in the cans of large lenionn. Care nhoald be taken to avoid injection of sufficient mat eriol
hirnotism, sfriae arid acae; ralatine adrenocartical insufficiency particularly In time of stress due to trauma. surgery, or
to cause blanching since this may be followed by a small slough. One to tour Injactions are usually employed, the intervals
severe illness; protein catabolism wth negative nitrogen balance; electrolyte imbalance; alterahon of glucose metabolism
between injections sewing with the type of lesion being treated and the duration of impomement produced by the infial
with aggravation of diabetes mellitos including hyperglycemia and glyc000da; onteoporonin revnmible only with difficulty;
injection.
spontaneous fracturen; aseptic necrosis of the hip and humerus; activation and complication of peptic olcar Including perforation and hemorrhage; aggravation or masking of Infection increased blood prannora; convulsions; potechiae and pmpura; menstrual irregularities including amenorrhea, opnfflng or prolonged bleeding; insomnia; psychic disturbances especially abnormal euphoria., namousneno; posterior sobcanular cataracts occasionally requiring ectrocticn; Increaned
6. teatitlatlon for tenet Effect a patfenta wffh Utcaratins Cotffe. A dose of 40 mg administered as a retention enema 
or by continuous drip three to seven times a week for two or more weeks han been shown to be a useful adjonct in the 
treatment of tome patients with ulcerative colitis, Many patients can be controlled with 40mg adminntered in from f to 10 
ounces of water depending apon tha degree of involvement of the inflamed clonic macvan. Other accepted therapeutic
intraocslar tennion; increased intracranial presnure with papilledema jyneadofumor cerebrij; pancreshlin. necrotizing
measures should, of coame, be instituted.
angitis; thinning of scalp hair; suppression of growth In children: facial arythema; allergic reactions involving the shin;
B. Admfolsfratton for systemIc Effect:
ulcerative enophagmu; sweating; vertigo;weaknesn; myopathy; headache; eaophthalmoo. Subcotvnaous and cutaneous
The intramuscular dosage will vary with the condition being treated, When employed es a femporory oubstitste for oral
atrophy, pontivjncrion flare, sterile abscess, hyper- and hypopigmentation have bean associated with injected
therapy, a single injection during each 24 boom period of a dose of the nuopension equal to the total done of
carticoidn,When adverse react ions occur, they are anoally reversible and disappear when the hormone is discontinued,
)methylprednisolone) In usually sufficient When a prolonged affect In desired, the weakly done may be calculated by
Dosage and Administration: A. Admlnletretion for Locef Effect 
Therapy with Oepo-Medrol jmethylpredoiuulone acetate) dues not obviate the veed tot the conventional measures uoaety employed. Although this method of treatment will, ameliorate symptoms. Iris iv no nente score asd the hormone has no effect on the cause of the inflammation. 
1. Rheumatoid end Oetmmrtfsdtta. The dose for inlra-articular administration depends upon the nize of the 1nint and vanes wdh the seventy of the condition in the individual patient. In chronic cases, ln1ections may be repeated at intervals ranging from one to Ova or more weekn depending upon the degree of relic obtained from the initial injection. The doses in the following table are givev as a general guide:
multiplying the daily oral dose by 7 and given as a oingle intramuscolar injection. 
Onoage must be lndiddualized according to the nenerity of the disease and response of the patient. For infants and children, the recommended donsge will have to be radoced, but dosage should be govemed by the severity of the condition rather than by strict adherence to the rafts indicated by age or body weight. 
Hormone therapy is an ajanct to and not a replacemast for, conventional therapy. 005age must be decreased or dincanhnoed gradoally when the drag hat been adminisfered tsr more than a few days. The neverity, prognosis and aopected duration of the disease and the reaction of the patient to medication are primary factors in determining dosage. If period of spontanecan remission occurs in a chronic condition, treatment should be discontinued. Roatine laboratory studies, nach so urinalysis, tow-hours pvofprandivt blood sager, determinofion of blood pmsnare and body weight, and a chest X-ray nhoold be made at mgular intemain dsring prolonged therapy. Upper 01 X-rays are desirable in patients with
fffae at JoInt Eaempfee Range of Dosage
Sn ulcer history of significant dynpeyaia.
Large 
20 to ff0 mg
In patienta with fhe edreaogenlfef syndrome, a single intramascalar injection of 40 mg avery two weeks may be adequate. For maintenance of patients with rheametofd erthrftls, the weekly lntrsmoncalar dose wilt nsry from 40 to 120 mg. The osual dosage for patients with dermetofogfc leaf one benefited by systemic corticoid therapy is 40 to 120 mg
Medium 
101040mg 
Small Mefocarpophalangeal 
interphalangeal 
Strenociavicalar 4 to 10 mg 
Acromiociavicalar
Oepo-Medrol jmethylpredniaolone acetate) Ouapenaioo administered intramuscularly at weakly intervals for one to four weeks, In acute nenere dermatif In due to poinon by relief may renoir within 6 to 12 hours following intramuscular administration of a single dose of ff0 to 120mg. In chronic contact dermatitis repeated injections al ft to 10 dayn intemain may be necessary in seborrfielc dermatitis, a weakly done of ff0 mg may be adequate Is control the condition, Following 
intramuscular administration of ff0 to 120 mg to anthmaf ic patients, relief may result within 6 to 46 hours and persist for several days to two weeks. fflmllady In patienta with allergic rhinitin jhay feverj an intramuscular dose of SOft 120mg may be followed by relief of coryzal symptoms within six boom persisting for several dayn to three weeks, After initial therapy
Procedurerit in recommended that the anatomy of the loint involved be reviewed before affempting infra-articolar in1ection, 
In order to obtain the full antiinnflammatory affect if in important that the inejction be made into the nynovial space. 
Employing the name stenle technique astor a lumbar puncture, a oterile 201024 gaage needle jon a drysynngej is quickly 
inserted into the synovial cavity. Procaine infiltration Is elective. The aspiration of only a few drops of joint flaid proves the 
joint space hat been entered by the needle. The injection site for each joint in determined by that locution where the 
synovial cavity Ia most aaperffcial and mont free of large vessels and nerves. With the needle in place, the aspiroting 
syringe is removed and replaced by a second syringe containing the desired amoant of Oepo-Medrol jmethylprednisolone
with jmethylpredrisolone nodlam naccinataj, children and adutln with demonstrated enophageal boma doe to cauntic ingestion have been managed with 201040mg of Oepo-Medrol every 4ff houra,lt oral therapy in tolerated Medrol tablets in aocal therapeutic doses may be used, Treatment should be continued until healing and re-epitkelialization of the eoophagas am complele janually three to four weeks) If signs of stress are usnociated with the condition being treated, the dasage of the nanpennion should be increased,lf a rapid hormonal effect of masimom intensity In required, the intravenous adminintration of highly soluble Sols-Medrol in indicated 
How supplied:
acetate) Sunyannion. The plunger is then pulled oorsnard slightly to aspirate synonlal flaid and to make sure the needle in
Slerile aqoecus Sunpension Depo-Medrol )methylprednisvlvne acetate) Is available In the following strength:4ff mg ri ml in
still is the synovial space. Aher injection, the joint is moved gently a few times to aid mixing of the nynovial fluid and the
1 ml vial or 2 ml & b ml vial,
suspension.

The site is covered with a small sterile dressing. 
Saitabla sites for intra-adicular injection are the knee, ankle, wrist, elbow, shoulder, phalangeal and hip joinfa. Since difficalcp is not infrequently enccantered in entering the hip joint, precauriova 000ald be taken to avoid any large blood
Manufactured by E.I.P.l.CO. 
EGYPTIAN INT. PHARMACEUTICAL INDUSTRIES 
CO.E. I. P. I. Co.
veasela in the area, Joints not naitable for injection are those that are anatomicaly inaccessible nach an the spinal joInts 
and thone like the sacroiliac joints that are devoid of synovial space. Treatment failurea am most frequnelly the resuff of
ioth OF RAMADAN CITY ,AREA 61 P.O.60X149 TENTH, EGYPT
into the nynovial spaces ore Certain on determined by anpiration of flaid,repeafed injections are usually S lie. Lanai therapy failure to enter the joint space. Liole or no beneffi follows injection into aarroanding flasue. If failureo occur when Injections 
does not alter the underlying disease process, and whenever possible comprehensive Iherapp including physiotherapy and orthopedic correction should be employed. Following intra-athcalar steroid therapy care shoald be taken to avoid ovemsa of joints in which symptomatic banefft han been obfained.Negligence in this maSer may permit an increase In joint deterioration that will more than offset the beneficial affects of the steroid. Unatable joints should not be injected. Repeated intra-articular injection may in some caaen result in lnntahility of the joint X-ray follow-up Is osggested iv selected cases to detect deterioration. 
If a local anesthetic in used prior to injection Dapo-Medrol the anesthetic package insert ahould be read caref ally and all
Under Licence of 
UPJOHN s.a. 
Puurs 
— Belgiu ni I El P I CO I 
W
the pmcautiono observed.
22-03-2004 PMS;BLACKC O.;210X170MM313 000 PAM 000