同: Depo-Medrol, Medrol, Solu- Medrol

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/04/12 14:31:46」(JST)

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Methylprednisolone is a synthetic glucocorticoid or corticosteroid drug. It is marketed in the USA and Canada under the brand names Medrol and Solu-Medrol.^[1] It is also available as a generic drug.

It is a variant of prednisolone, methylated at carbon 6 of the B ring.

Uses

Like most adrenocortical steroids, methylprednisolone is typically used for its anti-inflammatory effects. However, glucocorticoids have a wide range of effects, including changes to metabolism and immune responses. The list of medical conditions for which methylprednisolone is prescribed is rather long, and is similar to other corticosteroids such as prednisolone. Common uses include arthritis therapy and short-term treatment of bronchial inflammation or acute bronchitis due to various respiratory diseases. It is used both in the treatment of acute periods and long-term management of autoimmune diseases, most notably systemic lupus erythematosus. It is also used as a treatment for multiple sclerosis.

Methylprednisolone is also prescribed for nonpenetrating spinal cord injuries. It has been shown that a dose of 30 mg/kg IV followed by IV drip at 5.4 mg/kg/hr for 23 hours improves sensory and motor recovery if given within eight hours of the injury.^{[citation needed]}

It is also used for vestibular neuritis.^[2]

Side effects

Long-term use of methylprednisolone, as with all corticosteroids, can be associated with hyperglycemia, decreased resistance to infection, swelling of face, weight gain, glaucoma, osteoporosis and psychosis, especially when used at high dosage.^[3] The most serious side effect occurs after the adrenal glands cease natural production of cortisol, which methylprednisolone will replace. Abrupt cessation of the drug after this occurs can result in a condition known as Addisonian crisis, which can be fatal. To prevent this, the drug is usually prescribed with a tapering dosage, including a pre-dosed "dose pack" detailing a specific number of pills to take at designated times over a several-day period. Pharmacists sometimes advise that this drug can cause sleeplessness and "down" moods.

Individuals on methylprednisolone therapy should assiduously avoid exposure to measles and chicken pox as contracting these viral infections while on high dose corticosteroids can result in a potentially fatal viral course. Any accidental exposure to these viral infections by individuals uncertain of their immunity to chicken pox or measles should be reported immediately as prophylactic immunoglobulin therapy may be administered. Additionally, the administration of live, attenuated vaccines is contraindicated for individuals taking immunosuppressive doses of methylprednisolone. The exception to this rule is patients receiving complete corticosteroid replacement therapy, e.g., for Addison's disease, who may follow standard immunization protocols.^[4]

Additional images

4mg Methylprednisolone tablets by Sandoz

References

^ Methylprednisolone - Compound Summary PubChem
^ Strupp M, Zingler VC, Arbusow V, Niklas D, Maag KP, Dieterich M, Bense S, Theil D, Jahn K, Brandt T (July 2004). "Methylprednisolone, valacyclovir, or the combination for vestibular neuritis" (PDF). N. Engl. J. Med. 351 (4): 354–61. doi:10.1056/NEJMoa033280. PMID 15269315.
^ "SOLU-MEDROL (methylprednisolone sodium succinate) injection, powder, for solution". National Institutes of Health. Retrieved 24 August 2012.
^ "SOLU-MEDROL (methylprednisolone sodium succinate) injection, powder, for solution". National Institutes of Health. Retrieved 24 August 2012.

External links

Medrol Prescribing Information Pfizer
U.S. National Library of Medicine: Drug Information Portal - Methylprednisolone
"methylprednisolone" at medicinenet.com

UpToDate Contents

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English Journal

The liver protective effect of methylprednisolone on a new experimental acute-on-chronic liver failure model in rats.

Hu C1, Shen S2, Zhang A1, Ren B1, Lin F1.
Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver.Dig Liver Dis.2014 Oct;46(10):928-35. doi: 10.1016/j.dld.2014.06.008. Epub 2014 Jul 10.
BACKGROUND: Acute-on-chronic liver failure is a severe, life-threatening entity and the comprehension of this disease is incomplete. Currently, a reasonable surgical model of acute-on-chronic liver failure is still lacking. The aim of this study was to establish a new model of acute-on-chronic liver
PMID 25022338

A case of membranous nephropathy and myeloperoxidase anti-neutrophil cytoplasmic antibody-associated glomerulonephritis.

Hu ZJ, Niu K, Liu B, Shi YN.
Experimental and therapeutic medicine.Exp Ther Med.2014 Oct;8(4):1170-1172. Epub 2014 Jul 17.
Membranous nephropathy (MN) may be a primary disease or secondary to autoimmune conditions such as systemic lupus erythematosus, infection (for example, with hepatitis B or C virus), cancer or drugs. In primary MN, crescents are rarely observed. Therefore, the presence of crescents suggests another
PMID 25187818

Marked improvement of anti-N-methyl-D-aspartate receptor encephalitis by large-dose methylprednisolone and plasmapheresis therapy combined with 18F-fluorodeoxyglucose positron emission tomography imaging: A case report.

Chen B1, Wang Y1, Geng Y1, Huang Y1, Guo S1, Mao X2.
Experimental and therapeutic medicine.Exp Ther Med.2014 Oct;8(4):1167-1169. Epub 2014 Jul 16.
Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis, a recently defined and frequently misdiagnosed disease characterized by psychiatric symptoms, seizures, movement disorders and autonomic dysfunction, has been observed predominantly in young females with ovarian teratoma. Conventional ima
PMID 25187817

Japanese Journal

Chronic Graft-versus-Host Disease: Disease Biology and Novel Therapeutic Strategies

Nishimori Hisakazu,Maeda Yoshinobu,Tanimoto Mitsune
Acta Medica Okayama 67(1), 1-8, 2013-02-00
… Standard treatment is 1-2mg/kg/day of prednisone or an equivalent dose of methylprednisolone, with continued administration of a calcineurin inhibitor for steroid sparing. …
NAID 120005232331

脊髄長大病変を有し抗アクアポリン-4抗体陰性の小児多発性硬化症の一例

鈴木恵子,富沢尚子,新井麻子,上田哲,梅津亮二,杉原茂孝
東京女子医科大学雑誌 83(E1), E331-E335, 2013-01-31
抗アクアポリン-4 (aquaporin-4: AQP4) 抗体は,視神経脊髄炎(neuromyelitis optica;NMO),および日本人において臨床像がNMOと一致し,3椎体以上の脊髄長大病変(long spinal cord lesion;LSCL)を持つ,視神経脊髄型の多発性硬化症(multiple sclerosis;MS)に対する診断マーカーとして注目されている.症例は15歳の女 …
NAID 110009559427

経過良好な、マイコプラズマ感染症関連Opsoclonus-Myoclonus症候群の1例

河野香,伊藤康,石塚喜世伸,西川愛子,佐原真澄,平野嘉子,石垣景子,舟塚真,高橋幸利,大澤眞木子
東京女子医科大学雑誌 83(E1), E336-E341, 2013-01-31
Opsoclonus-myoclonus syndrome(OMS)は,左右共同性の不規則で多方向性の異常眼球運動,顔面,頭部,体幹などに出現するmyoclonus,小脳失調を特徴とする症候群である.小児において,腫瘍,感染,予防接種などが誘因となり,半数に神経芽細胞腫を合併する.症例は4歳9ヵ月の女児.生後11ヵ月時にマイコプラズマ感染を契機にOMSを発症した.血清マイコプラズマ抗体価(PA法) …
NAID 110009559410

Related Pictures

★リンクテーブル★

リンク元	「メチルプレドニゾロン」
拡張検索	「methylprednisolone aceponate」「methylprednisolone hemisuccinate」「methylprednisolone succinate」「6α-methylprednisolone」

「メチルプレドニゾロン」

Methylprednisolone
Systematic (IUPAC) name
	(1S,2R,8S,10S,11S,14R,15S,17S)-14,17-dihydroxy-14-(2-hydroxyacetyl)-2,8,15-trimethyltetracyclo[8.7.0.02,7.011,15]heptadeca-3,6-dien-5-one
Clinical data
Trade names	Medrol, Meprolone
AHFS/Drugs.com	monograph
MedlinePlus	a682795
Licence data	US FDA:link
Pregnancy cat.	A (AU) C (US)
Legal status	POM (UK) ℞-only (US)
Routes	IV, IM, IV Infusion, Oral, Rectal, Topical
Pharmacokinetic data
Protein binding	78%
Metabolism	liver primarily, kidney, tissues; CYP450: 3A4 substrate
Half-life	urine; Half-life: 18-26h (biological)
Identifiers
CAS number	83-43-2
ATC code	D07AA01 D07AC14, D10AA02, H02AB04
PubChem	CID 6741
DrugBank	DB00959
ChemSpider	6485
UNII	X4W7ZR7023
KEGG	D00407
ChEBI	CHEBI:6888
ChEMBL	CHEMBL650
Synonyms	(6α, 11β)-11,17,21-trihydroxy-6-methyl-pregna-1,4-diene-3,20-dione
Chemical data
Formula	C22H30O5
Mol. mass	374.471 g/mol
	SMILES O=C\1\C=C/[C@]4(/C(=C/1)[C@@H](C)C[C@@H]2[C@@H]4[C@@H](O)C[C@@]3([C@@](O)(C(=O)CO)CC[C@@H]23)C)C;
	InChI InChI=1S/C22H30O5/c1-12-8-14-15-5-7-22(27,18(26)11-23)21(15,3)10-17(25)19(14)20(2)6-4-13(24)9-16(12)20/h4,6,9,12,14-15,17,19,23,25,27H,5,7-8,10-11H2,1-3H3/t12-,14-,15-,17-,19+,20-,21-,22-/m0/s1 ; Key:VHRSUDSXCMQTMA-PJHHCJLFSA-N ;
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