Medical

Doctors
Hospitals
Terminology

Home

Drugs (Medrol Enpak)*

Description

Adrenocorticoids (a-dree-noe-KOR-ti-koids) (cortisone-like medicines) are used to provide relief for inflamed areas of the body. They lessen swelling, redness, itching, and allergic reactions. They are often used as part of the treatment for a number of different diseases, such as severe allergies or skin problems, asthma, or arthritis. Adrenocorticoids may also be used for other conditions as determined by your doctor.

Your body naturally produces certain cortisone-like hormones that are necessary to maintain good health. If your body does not produce enough, your doctor may have prescribed this medicine to help make up the difference.

Corticotropin is not an adrenocorticoid. It is a hormone that occurs naturally in the body. Corticotropin is known as an adrenocorticotropic hormone, which means it causes the adrenal glands to produce cortisone-like hormones. Corticotropin is used as a test to determine whether your adrenal glands are producing enough hormones. Also, it is sometimes used instead of adrenocorticoids to treat many of the same medical problems.

Adrenocorticoids and corticotropin are very strong medicines. In addition to their helpful effects in treating your medical problem, they have side effects that can be very serious. If your adrenal glands are not producing enough cortisone-like hormones, taking this medicine is not likely to cause problems unless you take too much of it. If you are taking this medicine to treat another medical problem, be sure that you discuss the risks and benefits of this medicine with your doctor.

These medicines are available only with your doctor's prescription, in the following dosage forms:

Oral
Betamethasone
• Syrup (U.S.)
• Tablets (U.S. and Canada)
• Effervescent tablets (Canada)
• Extended-release tablets (Canada)
Cortisone
• Tablets (U.S. and Canada)
Dexamethasone
• Elixir (U.S.)
• Oral solution (U.S.)
• Tablets (U.S. and Canada)
Hydrocortisone
• Oral suspension (U.S.)
• Tablets (U.S. and Canada)
Methylprednisolone
• Tablets (U.S. and Canada)
Paramethasone
• Tablets (U.S.)
Prednisolone
• Oral solution (U.S.)
• Syrup (U.S.)
• Tablets (U.S.)
Prednisone
• Oral solution (U.S.)
• Syrup (U.S.)
• Tablets (U.S. and Canada)
Triamcinolone
• Syrup (U.S. and Canada)
• Tablets (U.S. and Canada)

Parenteral
Betamethasone
• Injection (U.S. and Canada)
Corticotropin
• Injection (U.S. and Canada)
Cortisone
• Injection (U.S. and Canada)
Dexamethasone
• Injection (U.S. and Canada)
Hydrocortisone
• Injection (U.S. and Canada)
Methylprednisolone
• Injection (U.S. and Canada)
Prednisolone
• Injection (U.S.)
Triamcinolone
• Injection (U.S. and Canada)

Rectal
Betamethasone
• Enema (Canada)
Hydrocortisone
• Aerosol foam (U.S. and Canada)
• Enema (U.S. and Canada)
Methylprednisolone
• Enema (U.S.)

It is very important that you read and understand the following information. If any of it causes you special concern, check with your doctor. Also, if you have any questions or if you want more information about this medicine or your medical problem, ask your doctor, nurse, or pharmacist.

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For adrenocorticoids and corticotropin, the following should be considered:

Allergies -- Tell your doctor if you have ever had any unusual or allergic reaction to adrenocorticoids or corticotropin. Also tell your doctor and pharmacist if you are allergic to any other substances, such as foods, preservatives, or dyes.

Diet -- If you will be using this medicine for a long time, your doctor may want you to:
• Follow a low-salt diet and/or a potassium-rich diet.
• Watch your calories to prevent weight gain.
• Add extra protein to your diet. Make certain your doctor and pharmacist know if you are already on any special diet, such as a low-sodium or low-sugar diet.

Pregnancy -- Studies on birth defects with adrenocorticoids or with corticotropin have not been done in humans. However, too much use of adrenocorticoids during pregnancy may cause the baby to have problems after birth, such as slower growth. Also, studies in animals have shown that adrenocorticoids cause birth defects and that corticotropin may cause other unwanted effects in the fetus.

Breast-feeding -- Adrenocorticoids pass into breast milk and may cause problems with growth or other unwanted effects in nursing babies. Depending on the amount of medicine you are taking every day, it may be necessary for you to take another medicine or to stop breast-feeding during treatment. Corticotropin has not been shown to cause problems in nursing babies.

Age Groups

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For adrenocorticoids and corticotropin, the following should be considered:

Children -- Adrenocorticoids or corticotropin may slow or stop growth in children and in growing teenagers, especially when they are used for a long time. Before this medicine is given to children or teenagers, you should discuss its use with your child's doctor and then carefully follow the doctor's instructions.

Older adults -- Older patients may be more likely to develop high blood pressure or bone disease from adrenocorticoids. Women are especially at risk of developing bone disease.

Other Therapy

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For adrenocorticoids and corticotropin, the following should be considered:

Other medicines -- Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking adrenocorticoids or corticotropin, it is especially important that your doctor and pharmacist know if you are taking any of the following:

• Aminoglutethimide or
• Antacids (in large amounts) or
• Barbiturates, except butalbital, or
• Carbamazepine (e.g., Tegretol) or
• Griseofulvin (e.g., Fulvicin) or
• Mitotane (e.g., Lysodren) or
• Phenylbutazone (e.g., Butazolidin) or
• Phenytoin (e.g., Dilantin) or
• Primidone (e.g., Mysoline) or
• Rifampin (e.g., Rifadin) -- Use of these medicines may make corticotropin or certain adrenocorticoids less effective
• Amphotericin B by injection (e.g., Fungizone) -- Adrenocorticoids and this medicine decrease the amount of potassium in the blood. Serious side effects could occur if the level of potassium gets too low
• Antidiabetics, oral (diabetes medicine taken by mouth) or
• Insulin -- Adrenocorticoids may increase blood glucose (sugar) levels
• Digitalis glycosides (heart medicine) -- Adrenocorticoids decrease the amount of potassium in the blood. Digitalis can cause an irregular heartbeat or other problems more commonly if the blood potassium gets too low
• Diuretics (water pills) or
• Medicine containing potassium -- Using adrenocorticoids with diuretics may cause the diuretic to be less effective. Also, adrenocorticoids may increase the risk of low blood potassium, which is also a problem with certain diuretics. Potassium supplements or a different type of diuretic is used in treating high blood pressure in those people who have problems keeping their blood potassium at a normal level. Adrenocorticoids may make these medicines less able to do this
• Immunizations (vaccinations) -- While you are being treated with this medicine, and even after you stop taking it, do not have any immunizations without your doctor's approval. Also, other people living in your home should not receive oral polio vaccine, since there is a chance they could pass the polio virus on to you. In addition, you should avoid close contact with other people at school or work who have recently taken oral polio vaccine
• Skin test injections -- Adrenocorticoids may cause false results in skin tests
• Sodium-containing medicine -- Adrenocorticoids and corticotropin cause the body to retain (keep) more salt and water. Too much sodium may cause high blood sodium, high blood pressure, and excess body water

Other medical problems -- The presence of other medical problems may affect the use of adrenocorticoids and corticotropin. Make sure you tell your doctor if you have any other medical problems, especially:

• Bone disease -- These medicines may worsen bone disease because they cause the body to lose more calcium
• Colitis or
• Diverticulitis or
• Stomach ulcer or other stomach or intestine problems -- These medicines may cover up symptoms of a worsening stomach or intestinal condition. A patient would not know if his/her condition was getting worse and would not get medical help when needed
• Diabetes mellitus (sugar diabetes) -- Adrenocorticoids may cause a loss of control of diabetes by increasing blood glucose (sugar)
• Fungus infection or any other infection or
• Herpes simplex infection of the eye or
• Infection at the place of treatment or
• Recent surgery or serious injury or
• Tuberculosis (active TB, nonactive TB, or past history of) -- These medicines can cause slower healing, worsen existing infections, or cause new infections
• Glaucoma -- Adrenocorticoids may cause the pressure within the eye to increase
• Heart disease or
• High blood pressure or
• Kidney disease (especially if you are receiving dialysis) or
• Kidney stones -- These medicines cause the body to retain (keep) more salt and water. These conditions may be made worse by this extra body water
• High cholesterol levels -- Adrenocorticoids may increase blood cholesterol levels
• Liver disease or
• Overactive thyroid or
• Underactive thyroid -- With these conditions, the body may not eliminate the adrenocorticoid at the usual rate, which may change the medicine's effect
• Myasthenia gravis -- When these medicines are first started, muscle weakness may occur. Your doctor may want to take special precautions because this could cause problems with breathing
• Systemic lupus erythematosus (SLE) -- This condition may cause certain side effects of adrenocorticoids to occur more easily

Before you begin using any new medicine (prescription or nonprescription) or if you develop any new medical problem while you are using this medicine, check with your doctor, nurse, or pharmacist.

Proper Use of This Medicine

For patients taking this medicine by mouth:

• Take this medicine with food to help prevent stomach upset. If stomach upset, burning, or pain continues, check with your doctor.
• Stomach problems may be more likely to occur if you drink alcoholic beverages while being treated with this medicine. You should not drink alcoholic beverages while taking this medicine, unless you have first checked with your doctor.

For patients using this medicine rectally:

• This medicine usually comes with patient directions. Read them carefully before using this medicine.
• For patients using hydrocortisone enema:

-- Each bottle contains a single dose. Use it all, unless otherwise directed by your doctor.
-- For best results, use this medicine right after a bowel movement. Lie down on your left side when giving the enema.
-- Insert the rectal tip of the enema applicator gently to prevent damage to the rectal wall.
-- Stay on your left side for at least 30 minutes after the enema is given so the medicine can work. If you can, keep the medicine inside the rectum all night.

• For patients using hydrocortisone acetate rectal aerosol foam:

-- This medicine is used with a special applicator. Do not insert any part of the aerosol container into the rectum.

• For patients using methylprednisolone acetate for enema:

-- Each bottle contains a single dose. Use it all, unless otherwise directed by your doctor.
-- Insert the rectal tip of the enema applicator gently to prevent damage to the rectal wall.
-- If you have been directed to use this enema slowly (not all at once), shake the bottle once in a while while you are giving the enema.
-- Save your applicator. Refill units of this medicine may be available at a lower cost.

Use this medicine only as directed by your doctor. Do not use more or less of it, do not use it more often, and do not use it for a longer time than your doctor ordered. To do so may increase the chance of side effects.

Storage -- To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store tablets in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Keep the liquid dosage forms of this medicine, including enemas, and hydrocortisone rectal aerosol foam from freezing.
• Do not puncture, break, or burn the hydrocortisone rectal aerosol foam container, even when it is empty.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

Dosing

Missed dose -- If you miss a dose of this medicine and your dosing schedule is:

• One dose every other day -- Take the missed dose as soon as possible if you remember it the same morning, then go back to your regular dosing schedule. If you do not remember the missed dose until later, wait and take it the following morning. Then skip a day and start your regular dosing schedule again.
• One dose a day -- Take the missed dose as soon as possible, then go back to your regular dosing schedule. If you do not remember until the next day, skip the missed dose and do not double the next one.
• Several doses a day -- Take the missed dose as soon as possible, then go back to your regular dosing schedule. If you do not remember until your next dose is due, double the next dose.

If you have any questions about this, check with your doctor, nurse, or pharmacist.

Precautions While Using This Medicine

Your doctor should check your progress at regular visits. Also, your progress may have to be checked after you have stopped using this medicine, since some of the effects may continue.

Do not stop using this medicine without first checking with your doctor. Your doctor may want you to reduce gradually the amount you are using before stopping completely.

Check with your doctor if your condition reappears or worsens after the dose has been reduced or treatment with this medicine is stopped.

If you will be using adrenocorticoids or corticotropin for a long time:

• Your doctor may want you to follow a low-salt diet and/or a potassium-rich diet.
• Your doctor may want you to watch your calories to prevent weight gain.
• Your doctor may want you to add extra protein to your diet.
• Your doctor may want you to have your eyes examined by an ophthalmologist (eye doctor) before and also sometime later during treatment.
• Your doctor may want you to carry a medical identification card stating that you are using this medicine.

Tell the doctor in charge that you are using this medicine:

• Before having skin tests.
• Before having any kind of surgery (including dental surgery) or emergency treatment.
• If you get a serious infection or injury.

While you are being treated with this medicine, and after you stop taking it, do not have any immunizations without your doctor's approval. Also, other people living in your home should not receive oral polio vaccine, since there is a chance they could pass the polio virus on to you. In addition, you should avoid close contact with other people at school or work who have recently taken oral polio vaccine.

For diabetic patients:
• This medicine may affect blood sugar levels. If you notice a change in the results of your blood or urine sugar tests or if you have any questions, check with your doctor.

For patients having this medicine injected into their joints:

• If this medicine is injected into one of your joints, you should be careful not to put too much stress or strain on that joint for a while, even if it begins to feel better. Make sure your doctor has told you how much you are allowed to move this joint while it is healing.
• If redness or swelling occurs at the place of injection, and continues or gets worse, check with your doctor.

For patients using this medicine rectally:

• Check with your doctor if you notice rectal bleeding, pain, burning, itching, blistering, or any other sign of irritation not present before you started using this medicine, or if signs of infection occur.

Side Effects of This Medicine

Adrenocorticoids or corticotropin may lower your resistance to infections. Also, any infection you get may be harder to treat. Always check with your doctor as soon as possible if you notice any signs of a possible infection, such as sore throat, fever, sneezing, or coughing.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. When this medicine is used for short periods of time, side effects usually are rare. However, check with your doctor as soon as possible if any of the following side effects occur:

Less common
Decreased or blurred vision; frequent urination; increased thirst; rectal bleeding, blistering, burning, itching, or pain not present before use of this medicine (when used rectally)

Rare
Blindness (sudden, when injected in the head or neck area); confusion; excitement; false sense of well-being; hallucinations (seeing, hearing, or feeling things that are not there); mental depression; mood swings (sudden and wide); mistaken feelings of self-importance or being mistreated; redness, swelling, pain, or other sign of allergy or infection at place of injection; restlessness

Additional side effects may occur if you take this medicine for a long time. Check with your doctor if any of the following side effects occur:

Abdominal or stomach pain or burning (continuing); acne or other skin problems; bloody or black, tarry stools; filling or rounding out of the face; irregular heartbeat; menstrual problems; muscle cramps or pain; muscle weakness; nausea; pain in back, hips, ribs, arms, shoulders, or legs; pitting, scarring, or depression of skin at place of injection; reddish purple lines on arms, face, legs, trunk, or groin; swelling of feet or lower legs; thin, shiny skin; unusual bruising; unusual tiredness or weakness; vomiting; weight gain (rapid); wounds that will not heal

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

More common
Increased appetite; indigestion; loss of appetite (for triamcinolone only); nervousness or restlessness; trouble in sleeping

Less common or rare
Darkening or lightening of skin color; dizziness; flushing of face or cheeks (after injection into the nose); headache; increased joint pain (after injection into a joint); increased sweating; lightheadedness; nosebleeds (after injection into the nose); unusual increase in hair growth on body or face

After you stop using this medicine, your body may need time to adjust. The length of time this takes depends on the amount of medicine you were using and how long you used it. If you have taken large doses of this medicine for a long time, your body may need one year to adjust. During this time, check with your doctor immediately if any of the following side effects occur:

Abdominal, stomach, or back pain; dizziness; fainting; fever; loss of appetite (continuing); muscle or joint pain; nausea; reappearance of disease symptoms; shortness of breath; unexplained headaches (frequent or continuing); unusual tiredness or weakness; vomiting; weight loss (rapid)

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

*This information is reproduced from the Mayo Clinic Family Pharmacist v 2.0
Copyright 1994-1995 IVI Publishing Inc.

This information may not be complete and/or up to date.  Please do not use this as any sort of authoritative text for this drug.  Please consult with a physician before taking this or any drug.  This is presented only for reference usage within this site.