Brand
Name:
Depo-Medrol (U.S. and Canada)
Generic Available: Yes (U.S. and Canada)
Description: Methylprednisolone is one of a group of corticosteroids
(cortisone-like medications) that are used to relieve inflammation in different
parts of the body. Corticosteroids are used in MS for the management of acute
exacerbations because they have the capacity to close the damaged blood-brain
barrier and reduce inflammation in the central nervous system. Although
methylprednisolone is among the most commonly used corticosteroids in MS, it is
only one of several possibilities. Other commonly used corticosteroids include
dexamethazone, prednisone, betamethasone, and prednisolone. The following
information pertains to all of the various corticosteroids.
Proper
Usage
Most
neurologists treating MS believe that high-dose corticosteroids given
intravenously are the most effective treatment for an exacerbation, although the
exact protocol for the drug’s use may differ somewhat from one treating
physician to another. Patients generally receive a four-day course of treatment
(either in the hospital or as an outpatient), with doses of the medication
spread throughout the day. This high-dose, intravenous steroid treatment is then
typically followed by a gradually tapering dose of an oral corticosteroid (see
Prednisone).
Precautions
Since
corticosteroids can stimulate the appetite and increase water retention, it is
advisable to follow a low-salt and/or potassium-rich diet and watch your caloric
intake. Your physician will make specific dietary recommendations for you.
Corticosteroids can lower your resistance to infection and make any infection
that you get more difficult to treat. Contact your physician if you notice any
sign of infection, such as sore throat, fever, coughing, or sneezing.
Avoid close contact with anyone who has chicken pox or measles. Tell your
physician right away if you think you have been exposed to either of these
illnesses. Do not have any immunizations after you stop taking this medication
until you have consulted your physician. People living in your home should not
have the oral polio vaccine while you are being treated with corticosteroids
since they might pass the polio virus on to you.
Corticosteroids may affect the blood sugar levels of diabetic patients. If you
notice a change in your blood or urine sugar tests, be sure to speak to your
physician.
The risk of birth defects for women taking corticosteroids is not known. Overuse
of corticosteroids during pregnancy may slow the growth of the infant after
birth. Animal studies have demonstrated that corticosteroids cause birth
defects.
Corticosteroids pass into breast milk and may slow the infant’s growth. If you
are nursing or plan to nurse, be sure to discuss this with your physician. It
may be necessary for you to stop nursing while taking this medication.
Corticosteroids may produce mood changes and/or mood swings of varying
intensity. These mood alterations can vary from relatively mild to extremely
intense, and can vary in a single individual from one course of treatment to
another. Neither the patient nor the physician can predict with any certainty
whether the corticosteroids are likely to precipitate these mood alterations. If
you have a history of mood disorders (depression or bipolar disorder, for
example), be sure to share this information with your physician. If you begin to
experience mood changes or swings that feel unmanageable, contact your physician
so that a decision can be made about whether or not you need an additional
medication to help you until the mood alterations subside.
Possible
Side Effects
Side
effects that may go away as your body adjusts to the medication and do not
require medical attention unless they continue or are bothersome: increased
appetite; indigestion; nervousness or restlessness; trouble sleeping; headache;
increased sweating; unusual increase in hair growth on body or face.
Less common side effects that should be reported as soon as possible to your
physician: severe mood changes or mood swings; decreased or blurred vision*;
frequent urination*.
Additional side effects that can result from the prolonged use of
corticosteroids and should be reported to your physician: acne or other skin
problems; swelling of the face; swelling of the feet or lower legs; rapid weight
gain; pain in the hips or other joints (caused by bone cell degeneration);
bloody or black, tarry stools; elevated blood pressure; markedly increased
thirst (with increased urination indicative of diabetes mellitus); menstrual
irregularities; unusual bruising of the skin; thick, shiny skin; hair loss;
muscle cramps or pain. Once you stop this medication after taking it for a long
period of time, it may take several months for your body to readjust.
*
Since it may be difficult to distinguish between certain common symptoms of MS
and some side effects of methylprednisolone, be sure to consult your health care
professional if an abrupt change of this type occurs.
Prednisone
(pred-ni-sone)
Brand
Name:
Deltasone (U.S. and Canada)
Generic Available: Yes (U.S. and Canada)
Description: Prednisone is one of a group of corticosteroids (cortisone-like
medicines) that are used to relieve inflammation in different parts of the body.
Corticosteroids are used in MS for the management of acute exacerbations because
they have the capacity to close the damaged blood-brain barrier and reduce
inflammation in the central nervous system. Although prednisone is among the
most commonly used corticosteroids in MS, it is only one of several different
possibilities. Other commonly used corticosteroids include dexamethasone;
prednisone; betamethasone; and prednisolone. The following information pertains
to all of the various corticosteroids.
Proper
Usage
Most
neurologists treating MS believe that high-dose corticosteroids given
intravenously are the most effective treatment for an MS exacerbation, although
the exact protocol for the drug’s use may differ somewhat from one treating
physician to another. Patients generally receive a four-day course of treatment
(either in the hospital or as an out-patient), with doses of the medication
spread throughout the day (see Methylprednisolone). The high-dose, intravenous
dose is typically followed by a gradually tapering dose of an oral
corticosteroid (usually ranging in length from ten days to five or six weeks).
Prednisone is commonly used for this oral taper. Oral prednisone may also be
used instead of the high-dose, intravenous treatment if the intravenous
treatment is not desired or is medically contraindicated.
Precautions
This
medication can cause indigestion and stomach discomfort. Always take it with a
meal and/or a glass of milk. Your physician may prescribe an antacid for you to
take with this medication.
Take this medication exactly as prescribed by your physician. Do not stop taking
it abruptly; your physician will give you a schedule that gradually tapers the
dose before you stop it completely.
Since corticosteroids can stimulate the appetite and increase water retention,
it is advisable to follow a low-salt and/or a potassium-rich diet and watch your
caloric intake.
Corticosteroids can lower your resistance to infection and make any infection
that you get more difficult to treat. Contact your physician if you notice any
sign of infection, such as sore throat, fever, coughing, or sneezing.
Avoid close contact with anyone who has chicken pox or measles. Tell your
physician immediately if you think you have been exposed to either of these
illnesses. Do not have any immunizations after you stop taking this medication
until you have consulted your physician. People living in your home should not
have the oral polio vaccine while you are being treated with corticosteroids
since they might pass the polio virus on to you.
Corticosteroids may affect the blood sugar levels of diabetic patients. If you
notice a change in your blood or urine sugar tests, be sure to discuss it with
your physician.
The risk of birth defects in women taking corticosteroids during pregnancy has
not been studied. Overuse of corticosteroids during pregnancy may slow the
growth of the infant after birth. Animal studies have demonstrated that
corticosteroids cause birth defects.
Corticosteroids pass into breast milk and may slow the infant’s growth. If you
are nursing or plan to nurse, be sure to discuss this with your physician. It
may be necessary for you to stop nursing while taking this medication.
Corticosteroids can produce mood changes and/or mood swings of varying
intensity. These mood alterations can vary from relatively mild to extremely
intense, and can vary in a single individual from one course of treatment to
another. Neither the patient nor the physician can predict with any certainty
whether the corticosteroids are likely to precipitate these mood alterations. If
you have a history of mood disorders (depression or bipolar disorder, for
example), be sure to share this information with your physician. If you begin to
experience unmanageable mood changes or swings while taking corticosteroids,
contact your physician so that a decision can be made whether or not you need an
additional medication to help you until the mood alterations subside.
Possible
Side Effects
Side
effects that may go away as your body adjusts to the medication and do not
require medical attention unless they continue or are bothersome: increased
appetite; indigestion; nervousness or restlessness; trouble sleeping; headache;
increased sweating; unusual increase in hair growth on body or face.
Less common side effects that should be reported as soon as possible to your
physician: severe mood changes or mood swings; decreased or blurred vision*;
frequent urination*.
Additional side effects that can result from the prolonged use of
corticosteroids and should be reported to your physician: acne or other skin
problems; swelling of the face; swelling of the feet or lower legs; rapid weight
gain; pain in the hips or other joints (caused by bone cell degeneration);
bloody or black, tarry stools; elevated blood pressure; markedly increased
thirst (with increased urination indicative of diabetes mellitus); menstrual
irregularities; unusual bruising of the skin; thin, shiny skin; hair loss;
muscle cramps or pain. Once you stop this medication after taking it for a long
period of time, it may take several months for your body to readjust.
* Since it may be difficult to distinguish between certain common symptoms of MS
and some side effects of prednisone, be sure to consult your health care
professional if an abrupt change of this type occurs.
NMSS Information Resource Center and Library. Compendium of Multiple Sclerosis
Information (CMSI). Reprinted with permission from Rosalind C. Kalb (ed.),
Multiple Sclerosis: The Questions You Have: The Answers You Need. New York:
Demos Vermande, 1996.
|
