Depo Medrone Injection

Connective tissue disorders: systemic lupus erythematosus (rash with fever, arthritis, inflammation of blood vessels, kidney problems and problems affecting the brain).
Stevens-Johnson syndrome (severe erythema multiforme) - a rash with circular red patches and blisters; blisters in the mouth, nose, genitals and anal canal (back passage); sticky, itchy eyes, often with ulcers on them; high temperature with joint and muscle pains; kidney failure (passing very little urine or too much urine); arthritis; diarrhoea; pneumonia (cough, fever, breathlessness, coughing up sputum).
Angioneurotic oedema and allergic reactions to medicines causing fainting, difficulty in breathing, fast pulse, pale or bluish skin, and swelling of the eyelids, lips, tongue and/or throat.
Bronchial asthma with inflammation of the lungs and airways.
Severe forms of hayfever and other allergies.

Crohn's disease: inflammation of the gut.

Ulcerative colitis: inflammation of the lower bowel which causes diarrhoea, and often blood in your bowel movements.
Inflammation caused by breathing in the contents of the stomach (vomit) into the lungs.
Tuberculosis (TB) which is progressing quickly or has spread to other areas (used with anti-TB medicines).

Other conditions:

• TB affecting the meninges (covering of the brain). Depo-Medrone will be used with anti-TB medicines in this case.
• Problems affecting certain parts of your body that can be helped by Depo-Medrone:
• Rheumatoid arthritis with inflammation localized in one or two joints.
• Osteo-arthritis where there is inflammation in just one or two joints.
• Inflammation of the covering of the tendons (synovium), with the exception of the Achilles tendon.
• Inflammation of the areas where the tendon is attached to bone such as in tennis elbow.
• Plantar fasciitis (inflammation of the tissues of the sole of the foot).
• Inflammation of fluid-filled cushions (bursae) around tendons and joints.
• Patchy baldness (alopecia areata).
• Keloids (overgrowth of scar tissue at the site of a previous wound).
• Lichen planus (small, purplish raised spots, often itchy).
• Lichen simplex (usually single, raised thickened patch of skin).
• Discoid lupus (round-shaped patches, usually on the face).
• Granuloma annulare (circular warty growths which may grow to be quite large).
• Your doctor may use Depo-Medrone to treat conditions other than those listed above. If you are unsure why you have been given your injection, ask your doctor.

How does it work?

Depo-Medrone belongs to a group of medicines called corticosteroids or steroids. Corticosteroids are hormones that are made naturally by your adrenal glands, which sit on top of your kidneys. They help your body to cope with inflammation, allergic reactions and other stresses. Your medicine is a synthetic corticosteroid, similar to the natural hormone, and works in the same way. Your medicine has two main actions. First, it cuts down inflammation (pain, swelling, redness and heat) in your body. Its other action is to reduce the activity of the immune system. This is useful, for example, in conditions where the immune system attacks the patient's own body (an auto-immune reaction), causing damage, or when it exerts an excessive reaction to a substance with which the patient comes in contact (e.g. allergy). It is not an 'anabolic steroid' that some bodybuilders misuse.

When and how do I take it?

Your medicine can be injected into different parts of your body such as:
Into muscle to treat generalized problems.
Or, to treat local problems:

• into muscle tendons
• into or around joints
• into inflamed areas in soft tissue or the skin.

Depo-Medrone must not be injected into a vein, into the area around the spine, into the nose, into the eye, into the Achilles tendon, into the deltoid (shoulder) muscle, into an unstable joint or into a previously infected joint. Your medicine is given as an injection. It should not be mixed with any other liquid. It has a long acting ('depot') effect and may work in your body for several weeks.

Whats the dose?

The amount you are given will depend on the condition you have and how severe it is. Your doctor will try to use the lowest dose possible to get a good result.

Could it interact with other tablets?

Methylprednisolone acetate may interact with some medicines and cause problems. Tell your doctor if you are taking other medicines before you are given Depo-Medrone. This includes medicines that you buy yourself. Make sure you tell your doctor if you think you are taking any of these medicines:

Cyclosporin. This is a medicine called an 'immunosuppressant' which is used to suppress the immune system in patients who have severe rheumatoid arthritis, severe psoriasis or who have had an organ or bone marrow transplant. Levels of cyclosporin and methylprednisolone acetate may get too high; this can cause convulsions (fits) and make all the side-effects listed (see later) more likely to occur.
Drugs that speed up the way the liver breaks down medicines can reduce the effects of your medicine - these include rifampicin and rifabutin (for the treatment of TB and other infections caused by similar bacteria), carbamazepine, phenobarbitone, phenytoin and primidone (for epilepsy), and aminoglutethimide (for cancer). If you are taking one of these medicines, you may need a different dose of Depo-Medrone.
Erythromycin or ketoconazole for bacterial or fungal infections, respectively, may stop the breakdown of your medicine by the liver, increasing its levels and making all the side-effects listed (see later) more likely to occur.
Anticholinesterases for myasthenia gravis (when some or all of your muscles are affected by weakness, or they tire easily) may be less effective if taken with methylprednisolone acetate.
If you are being treated for diabetes (high blood sugar), high blood pressure (may cause headaches and dizziness) or water retention (oedema), your injection may make your treatment less effective. This means that your doctor may need to adjust the dose of these other medicines.
Some medicines including acetazolamide (for glaucoma and epilepsy), some water tablets (loop diuretics and thiazide diuretics for water retention), carbenoxolone (for heartburn) and digoxin (for heart failure) may make you lose potassium from your body. If taken with Depo-Medrone, this can cause you to lose even more potassium, which may cause increased passing of urine, thirst, muscle weakness, low blood pressure (causing dizziness), and rarely drowsiness, confusion and coma.
Anticoagulants (blood-thinning medicines): if you are taking warfarin, acenocoumarol or phenindione, methylprednisolone acetate may increase their effect so you might need more frequent blood tests to check that you are not receiving too much anticoagulant, which would cause increased or sudden bleeding.
Methylprednisolone acetate may decrease the effects of some neuromuscular blocking agents such as pancuronium (medicines used to paralyse the muscles during operations), so make sure you tell your doctor and anaesthetist before you have an operation that you are being given Depo-Medrone.
Methylprednisolone acetate speeds up the loss of aspirin and similar medicines (called salicylates) from your body. If your medicine is stopped, aspirin levels may rise suddenly and cause side-effects, such as ringing in the ears. If you have hypothrombinaemia (a tendency to bleed), your doctor will be more careful about giving you steroids with aspirin, salicylates or non-steroidal anti-inflammatory drugs.

Herbal products should also only be taken after talking with your doctor.

What are the possible risks or side-effects?

As with any medicine, Depo-Medrone can have side-effects (unwanted effects). Your doctor will carefully weigh up the risk of side-effects against the benefits of treatment before giving you your injection. You are more likely to get side-effects if you are given a high dose for a long time. Doctors try to use the lowest dose to relieve your symptoms and it is usually given for only a short time. This means that the risk of developing a serious side-effect is low. If you are worried, ask your doctor to explain the chance of you having a side-effect with your medicine.
If you are elderly, side-effects may be more serious. Your doctor will keep a close eye on you; if you notice any side-effects, let your doctor know straight away.

Tell your doctor straight away if you notice any of these problems, or if you think you are at increased risk of infection (e.g. you have been in contact with someone who has an infection):

• An allergic reaction such as skin rash, swelling of the face or wheezing.
• Irregular or very fast or slow pulse, faintness.
• Muscle cramps or spasms.
• Pseudotumour cerebri in children (raised pressure within the skull, indicated by headaches with vomiting, listlessness and drowsiness); this usually occurs after treatment is stopped.
• Nausea, vomiting, giddiness (vertigo).
• Burst or bleeding ulcers (indicated by stomach pain - especially if it seems to spread to your back, bleeding from the back passage, black stools or vomiting with blood in the vomit).
• Acute pancreatitis (abdominal pain, possibly accompanied by vomiting and shock, i.e. low blood pressure with decreased output of urine and often loss of consciousness).
• With a joint injection only: pain, fever, local swelling, less joint movement than before and generally feeling unwell (this could mean that your joint became infected when the injection was given); Charcot-arthropathy (very bad arthritis with unstable joints that may click or give way; this is more likely to occur after repeated injections). If your doctor confirms that you have an infection, you will need treatment with antibiotics.
• A worsening of schizophrenia, mania, depression and paranoia.
• A worsening of seizures or fits.
• A worsening of sight.
• Thrombosis (a blood clot in a vein in your leg, symptoms of which are a swollen, red, hot tender muscle).
• Thrombo-embolism (a blood clot which may go to the lung, symptoms of which are sudden chest pain and coughing up blood).
• Heart failure - problems with the pumping of your heart indicated by swollen ankles, chest pain, difficulty in breathing and palpitations or irregular beating of the heart, irregular or very fast or slow pulse; hypertension (high blood pressure, indicated by headaches, or generally feeling unwell).

Tell your doctor if you experience any of the following:

• Effects on your digestive system
• swollen abdomen.
• Ulcers or thrush in the gullet (discomfort on swallowing).
• Indigestion.
• Bloating.
• The amount of certain enzymes (chemicals that help the body digest drugs and other substances - called alanine transaminase, aspartate transaminase and alkaline phosphatase) in your body may be raised after treatment with a corticosteroid, but the change is usually small and the enzyme levels return to normal after your medicine has cleared from your system. You will not notice any symptoms if this happens, but it will show if you have a blood test. It is important if you are to have a blood test that you tell the doctor or nurse that you have been given treatment with Depo-Medrone.
• Effects on your muscles and bones
• Muscle weakness or wasting.
• Osteoporosis (brittle bones - bones that break easily).
• Broken bones or fractures.
• Breakdown of bone due to poor circulation of blood (pain in the hip).
• Aseptic necrosis (joint inflammation in the knee and groin).
• Torn muscle tendons (pain and/or swelling).

Can I drink alcohol while taking it?

• There are no known interactions between alcohol and Depo-Medrone.
• Always ask you doctor or pharmacist however as other medications you are taking may have a bearing on this.

What if I’m pregnant/breastfeeding?

You should only take this medicine during pregnancy or while breast feeding if your doctor thinks that you need it.

If you have any more questions please ask your Pharmacist.

Remember to keep all medicines out of reach of children
Please Note: We have made every effort to ensure that the content of this information sheet is correct at time of publish, but remember that information about drugs may change. This sheet does not list all the uses and side-effects associated with this drug. For full details please see the drug information leaflet which comes with your medicine. Your doctor will assess your medical circumstances and draw your attention to any information or side-effects which may be relevant in your particular case.

References:

http://www.netdoctor.co.uk/medicines/aches-and-pains/a6529/depo-medrone-injection-methylprednisolone/

http://www.netdoctor.co.uk/medicines/aches-and-pains/a6529/depo-medrone-injection-methylprednisolone/

http://www.drugs.com/uk/depo-medrone-injection-40-mg-ml-leaflet.html

http://www.mhra.gov.uk/home/groups/spcpil/documents/spcpil/con1404457495320.pdf