When oral therapy is not feasible, and the strength, dosage form and route of administration of the drug reasonably lend the preparation to the treatment of the condition, A-METHAPRED (methylprednisolone sodium succinate) is indicated for intravenous or intramuscular use in the following conditions:
a. Primary or secondary adrenocortical insufficiency (hydrocortisone or cortisone is the drug of choice, synthetic analogs may be used in conjunction with mineralocorticoids where applicable; in infancy, mineralocorticoid supplementation is of particular importance).
b. Acute adrenocortical insufficiency (hydrocortisone or cortisone is the drug of choice; mineralocorticoid supplementation may be necessary, particularly when synthetic analogs are used).
c. Preoperatively and in the event of serious trauma or illness, in patients with known adrenal insufficiency or when adrenocortical reserve is doubtful.
d. Shock unresponsive to conventional therapy if adrenocortical insufficiency exists or is suspected.
e. Congenital adrenal hyperplasia.
f. Hypercalcemia associated with cancer.
g. Nonsuppurative thyroiditis.
Rheumatic disorders — As adjunctive therapy for short-term administration (to tide the patient over an acute episode or exacerbation) in:
a. Post-traumatic osteoarthritis.
b. Synovitis of osteoarthritis.
c. Rheumatoid arthritis, including juvenile rheumatoid arthritis (selected cases may require low-dose maintenance therapy).
d. Acute and subacute bursitis.
f. Acute nonspecific tenosynovitis.
g. Acute gouty arthritis.
h. Psoriatic arthritis.
i. Ankylosing spondylitis.
Collagen diseases — During an exacerbation or as maintenance therapy in selected cases of:
a. Systemic lupus erythematosus.
b. Systemic dermatomyositis (polymyositis).
c. Acute rheumatic carditis.
b. Severe erythema multiforme (Stevens-Johnson syndrome).
c. Exfoliative dermatitis.
d. Bullous dermatitis herpetiformis.
e. Severe seborrheic dermatitis.
f. Severe psoriasis.
g. Mycosis fungoides.
Allergic states — Control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment in:
a. Bronchial asthma.
b. Contact dermatitis.
c. Atopic dermatitis.
d. Serum sickness.
e. Seasonal or perennial allergic rhinitis.
f. Drug hypersensitivity reactions.
g. Urticarial transfusion reactions.
h. Acute noninfectious laryngeal edema (epinephrine is the drug of first choice).
Ophthalmic diseases — Severe acute and chronic allergic and inflammatory processes involving the eye, such as:
a. Herpes zoster ophthalmicus.
b. Iritis iridocyclitis.
d. Diffuse posterior uveitis and choroiditis.
e. Optic neuritis.
f. Sympathetic ophthalmia.
g. Anterior segment inflammation.
h. Allergic conjunctivitis.
i. Allergic corneal marginal ulcers.
Gastrointestinal diseases — To tide the patient over a critical period of disease in:
a. Ulcerative colitis — (Systemic therapy).
b. Regional enteritis — (Systemic therapy).
a. Symptomatic sarcoidosis.
c. Fulminating or disseminated pulmonary tuberculosis when concurrently accompanied by appropriate antituberculous chemotherapy.
d. Loeffler’s syndrome not manageable by other means.
e. Aspiration pneumonitis.
a. Acquired (autoimmune) hemolytic anemia.
b. Idiopathic thrombocytopenic purpura in adults (IV only; IM administration is contraindicated).
c. Secondary thrombocytopenia in adults.
d. Erythroblastopenia (RBC anemia).
e. Congenital (erythroid) hypoplastic anemia.
Neoplastic diseases — For palliative management of:
a. Leukemias and lymphomas in adults.
b. Acute leukemia of childhood.
Edematous state — To induce diuresis or remission of proteinuria in the nephrotic syndrome, without uremia, of the idiopathic type or that due to lupus erythematosus.
a. Acute exacerbations of multiple sclerosis.
a. Tuberculous meningitis with subarachnoid block or impending block when used concurrently with appropriate antituberculous chemotherapy.
b. Trichinosis with neurologic and myocardial involvement.