介绍

合成糖皮质激素；最小的盐皮质激素活性。 ^{B C d}

醋酸甲泼尼龙的用途

多种疾病和病症的治疗，主要是作为一种消炎和免疫抑制剂使用糖皮质激素，以及在各种疾病的姑息治疗中其对血液和淋巴系统的作用。 ^çd

通常，由于最小的盐皮质激素活性，不足以单独治疗肾上腺皮质功能不全。 ^C

肾上腺皮质功能不全

皮质类固醇以生理剂量给药，以替代肾上腺皮质功能不全患者体内缺乏的内源激素。^一个C

由于盐皮质激素和糖皮质激素的产生均缺乏肾上腺皮质功能不全，因此氢化可的松或可的松（与大量食盐结合使用）通常是替代疗法的首选皮质类固醇。^{一个C d米}

如果使用甲基泼尼松龙，也必须给予盐皮质激素（氟可的松），尤其是在婴儿中。^{一个C d}

在怀疑或已知的肾上腺功能不全的情况下，可以在术前或对常规疗法无反应的严重外伤，疾病或休克期间使用肠胃外疗法。 ^dÈ米

在对常规疗法无反应的休克中，静脉注射疗法与其他休克疗法相结合是必不可少的。氢化可的松是优选的，但是合成的糖皮质激素如甲基泼尼松龙可以被取代。 ^çé

肾上腺综合症

终生糖皮质激素治疗先天性肾上腺皮质综合征。^一个C

在失盐形式中，可可松或氢化可的松与大量食盐结合使用是优选的。至少在5至7岁的年龄可能需要盐皮质激素。 ^C

糖皮质激素，通常单独使用，可在儿童早期进行长期治疗。 ^C

在高血压形式中，首选具有最小盐皮质激素活性的“短效”糖皮质激素（例如甲基泼尼松龙，泼尼松）； ^c避免使用长效糖皮质激素（例如地塞米松），因为这会导致药物过量和生长迟缓。 ^C

高钙血症

与恶性肿瘤相关的高钙血症的治疗。^{一个C d米}

通常可改善与多发性骨髓瘤的骨受累相关的高钙血症。 ^C

绝经后妇女与乳腺癌相关的高钙血症最有效的长期治疗。 ^C

其他恶性肿瘤的疗效也不同。 ^C

与结节病相关的高钙血症的治疗†。 ^C

与维生素D中毒相关的高钙血症的治疗†。 ^C

不能有效高钙血症引起的甲状旁腺功能亢进†。 ^C

甲状腺炎

肉芽肿性（亚急性，非化脓性）甲状腺炎的治疗。^{一个C d米}

抗炎作用可缓解发烧，急性甲状腺疼痛和肿胀。 ^C

可能减轻内分泌性眼球突出症（甲状腺眼病）的眼眶水肿。 ^C

通常保留用于对水杨酸盐和甲状腺激素无反应的重症患者的姑息治疗。 ^C

风湿病和胶原蛋白疾病

风湿性疾病的急性发作或加重和全身并发症的短期姑息治疗（例如，类风湿性关节炎，青少年关节炎，银屑病关节炎，急性痛风性关节炎，创伤后骨关节炎，骨关节炎的滑膜炎，上尖锐湿疣，急性非特异性腱鞘炎，强直性腱鞘炎，甲过少†，风湿热†[特别是心脏病]以及胶原蛋白疾病（例如急性风湿性心脏病，系统性红斑狼疮，皮肌炎†[多发性肌炎]，结节性多发性动脉炎†，血管炎†）难以采取较为保守的措施。^{一个C d升米}

缓解炎症并抑制症状，但不抑制疾病进展。 ^C

很少用于维持治疗。 ^C

当已证明更保守的疗法无效时，可将其用作维持治疗（例如，在类风湿性关节炎，急性痛风性关节炎，系统性红斑狼疮，急性风湿性心脏病）中作为总治疗计划的一部分。 ^{a b c d}

如果用于维护，糖皮质激素的撤药极其困难。复发和复发通常伴随停药而发生。 ^C

局部注射最初可为风湿性疾病（例如类风湿性关节炎）的关节表现提供戏剧性的缓解，该风湿性疾病仅累及几个持续性发炎的关节，或者可减轻肌腱或法氏囊的炎症。 ^c停药后炎症易于复发，有时甚至更严重。 ^C

局部注射用于处理腱膜或肌腱（神经节）的囊性肿瘤。 ^d

局部注射可通过促进关节的运动来防止无效，否则关节可能会变得不动。 ^C

控制风湿性心脏病的急性表现比水杨酸盐更快，并且可能挽救生命；不能预防瓣膜损伤，长期治疗不优于水杨酸酯。 ^C

辅助治疗韦格纳肉芽肿病的严重全身性并发症†，但细胞毒性疗法是首选治疗方法。 ^C

皮肌炎和多发性肌炎，结节性多发性动脉炎，复发性多发性软骨炎，多发性肌痛和巨细胞（颞）动脉炎或混合性结缔组织病综合症患者的主要治疗方法是控制症状并预防严重且经常危及生命的并发症†。^一个C高剂量可能需要用于急性的情况;在获得反应后，药物必须经常以低剂量长期服用。 ^C

与恶性肿瘤和儿童期皮肌炎相关的多发性肌炎†可能反应不良。 ^C

很少见于银屑病关节炎，弥漫性硬皮病†（进行性全身性硬化症），急性和亚急性滑囊炎或骨关节炎†；风险大于收益。^{一个C d米}

在骨关节炎中，进行关节内注射可能是有益的，但应限制数量，因为可能会发生关节损伤。 ^çd

皮肤病

天疱疮和天疱疮†，疱疹样大疱性皮炎，严重的多形性红斑（Stevens-Johnson综合征），剥脱性皮炎，不可控制的湿疹†，皮肤结节病†，真菌病真菌病，扁平苔藓，重度单纯性扁平苔藓（神经皮炎，神经皮炎）脂溢性皮炎。^{一个C dë}

通常保留用于对保守疗法无反应的急性加重。 ^C

在寻常性天疱疮和天疱疮中，尽早开始全身性糖皮质激素治疗可挽救生命，并且可能需要高剂量或大剂量。 ^C

对于控制严重或无能力的过敏性疾病（例如接触性皮炎，特应性皮炎），这些方法在常规治疗的适当试验中难以解决。^{一个d电子网米}

慢性皮肤疾病很少是全身性糖皮质激素的适应症。 ^C

病灶内或sublesional注射偶尔表示用于局部慢性皮肤病，瘢痕瘤，银屑病斑块，斑秃，盘状红斑狼疮，渐进性坏死糖尿病脂，环状肉芽肿^d米反应迟钝的局部治疗。 ^C

很少用于牛皮癣†； ^c如果使用该药，则在停药或降低剂量时可能会加剧病情。 ^C

很少系统地指出脱发（区域性，总性或通用性）。 ^c可能会刺激头发生长，但停药后又会掉发。 ^C

过敏状况

用于控制严重或无能力的变态反应性疾病，而对于常规治疗和急性表现的控制而言，这些实验难以控制，包括过敏性和类过敏反应†，血管性水肿†，急性非感染性喉水肿，血清病，旋毛虫病的过敏症状†，哮喘，荨麻疹输血反应，药物过敏反应和严重的季节性或常年性鼻炎。^{一个C d电子网米}

全身治疗通常保留用于急性疾病和严重加重。 ^C

对于急性疾病，通常以高剂量和其他疗法（例如抗组胺药，拟交感神经药）一起使用。 ^C

当对更保守的治疗无反应的残疾状况以及长期糖皮质激素治疗的风险被证明是合理的时，应保留长期的慢性过敏性疾病治疗。 ^C

眼部疾病

抑制多种变应性和非化脓性眼部炎症。 ^C

减少眼外伤疤痕†。 ^C

用于治疗涉及眼睛和附件的严重急性和慢性过敏和炎症过程（例如，过敏性结膜炎，角膜炎，角膜过敏性角膜溃疡，眼带状疱疹，虹膜炎和虹膜睫状体炎，脉络膜视网膜炎，弥漫性后葡萄膜炎和脉络膜炎，前节炎症，视神经炎，交感性眼炎，颞动脉炎）。^{一个C d电子网米}

急性视神经炎的最佳治疗方法是先进行大剂量静脉IV治疗，然后进行慢性口服治疗。有助于恢复视力并减慢临床上明确的多发性硬化的进程。

用局部（对眼睛）皮质类固醇激素治疗不太严重的眼睛过敏性和炎性过敏性疾病。 ^G

局部应用糖皮质激素治疗大多数眼前部炎症与全身类固醇激素一样有效。 ^C

在前眼部疾病的顽固病例中以及在涉及更深的眼部结构时全身性地使用。 ^C

哮喘

辅助治疗中度至重度哮喘发作并维持持续性哮喘。 ^{C G}

全身（口服或静脉注射）治疗中度至重度哮喘急性发作（通常首选口服泼尼松）；加快气流阻塞的解决速度并降低复发率。 ^G

因为影响延迟发作，不进行抢救单独使用。 ^C

早期全身糖皮质激素治疗对婴儿和儿童的哮喘发作特别重要。 ^G

在医院治疗急性哮喘急性发作时，如果对口服吸入疗法的反应不是立即的，如果在住院前使用口服皮质类固醇作为自我药物治疗，或者发作严重，则可能给予全身性辅助糖皮质激素治疗。 ^C

对于严重的持续性哮喘，一旦实现初步控制，由于维持糖皮质激素的全身作用较小，因此高剂量的吸入糖皮质激素优于口服糖皮质激素来维持。

低剂量口服吸入激素维持治疗成人和儿童轻度持续性哮喘^C（首选的治疗方法，即，哮喘患者日间症状超过每周两次但小于每日一次，和哮喘的夜间症状更加每两倍月）。 ^b

口服作为一种辅助治疗其他所有的速度分辨率，但哮喘的急性发作温和时响应短效吸入β激动剂₂不及时或1小时后或那些谁拥有严重恶化的历史持续。 ^C

具有最小盐皮质激素活性和相对短的半衰期的口服糖皮质激素（例如，泼尼松，泼尼松龙，甲基泼尼松龙）是优选的。

慢性阻塞性肺病

对于严重加重COPD†的患者，可以在现有疗法中添加短期（例如1-2周）的口服糖皮质激素疗程。

稳定COPD的作用远不如哮喘严重，而且糖皮质激素在稳定COPD管理中的作用仅限于非常具体的适应症。

臀部

儿科患者的croup辅助治疗。 ^G

减少喉粘膜水肿。 ^G

减少了住院需求，缩短了住院时间，并减少了后续干预措施（例如肾上腺素）的需求。 ^G

结节病

有症状结节病的处理。^{一个C d电子网米}

全身性糖皮质激素适用于高钙血症；眼部，中枢神经系统，腺体，心肌或严重的肺部受累；或病灶内注射糖皮质激素无反应的严重皮肤损伤。 ^C

晚期肺结核和肺外结核

使用有效的抗分枝杆菌药物（例如，链霉素，异烟肼）作为辅助疗法，以抑制与宿主对细菌的炎症反应（结核分枝杆菌）有关的表现，并减轻严重的肺或肺外结核的并发症。^一个米

糖皮质激素辅助治疗可以增强晚期肺结核疾病表现（例如临床和影像学异常）的短期缓解，还可以降低与某些形式的肺外疾病（例如脑膜炎，心包炎）相关的死亡率。

在中度至重度结核性脑膜炎中，全身性辅助糖皮质激素可减少后遗症（例如智力障碍）和/或提高生存率；用于伴有蛛网膜下腔阻滞或即将发生的阻滞的结核性脑膜炎，并进行适当的抗结核化学疗法。^{一个d电子网米}

急性结核性心包炎的全身辅助糖皮质激素治疗可迅速减少心包积液的大小和引流程序的需要，并降低死亡率（可能通过控制血流动力学威胁性积液）。

加快了结核性胸膜炎引起的疼痛，呼吸困难和发烧的消退。 ^C

脂性肺炎

促进肺部病变的分解或溶解，消除脂质性肺炎中的痰液脂质。 ^C

吉氏肺孢子虫肺炎

全身性辅助糖皮质激素可降低AIDS†中至重度肺原虫肺炎（以前称为卡氏肺孢子虫）肺炎时氧合作用恶化，呼吸衰竭和/或死亡的可能性。

防止与抗肺囊肿治疗相关的早期氧合作用恶化；在中度至重度肺囊肿性肺炎中尽早开始辅助糖皮质激素治疗。

尚不清楚轻度肺气肿性肺炎（动脉氧压> 70 mm Hg或室内空气中动脉-肺泡梯度<35 mm Hg）的患者在糖皮质激素辅助治疗中是否具有临床重要意义。

通常优选口服泼尼松或肠胃外甲基泼尼松龙。

洛夫勒氏综合症

对症状缓解的症状Loeffler综合征的急性表现无法通过其他方式控制。 ^{A F}

铍病

缓解铍病的急性表现。^一d女男

吸入性肺炎

吸入性肺炎急性表现的症状缓解。^一d˚F

炭疽病

辅助治疗炭疽病的抗感染疗法，以改善与炭疽芽孢杆菌感染相关的毒素介导作用。

对于皮肤炭疽病†，如果有全身性感染或颈部和胸部区域广泛水肿的迹象，则炭疽性脑膜炎†和吸入性炭疽病†是由于在生物战或生物恐怖主义的情况下接触炭疽孢子而发生的，如果出现广泛水肿，呼吸困难或脑膜炎。

血液学疾病

应对获得性（自身免疫性）溶血性贫血，纯红细胞发育不良，特发性血小板减少性紫癜（ITP），继发性血小板减少症，红细胞减少症或先天性（红系）发育不良性贫血。^{一个d电子网米}

高剂量甚至大剂量可以减少出血倾向并使血液计数正常化。不影响血液疾病的病程或病程。 ^C

糖皮质激素，免疫球蛋白IV（IGIV）或脾切除术是中重度ITP的一线治疗方法，具体取决于所涉及的出血程度。

可能不会影响或预防过敏性紫癜的肾脏并发症。 ^C

在儿童再生障碍性贫血中有效性的证据不足，但被广泛使用。 ^C

休克

尽管IV糖皮质激素可能在肾上腺皮质功能不全继发的休克中挽救生命（参见使用中的肾上腺皮质功能不全），但该药物在治疗其他原因引起的休克中的价值还是有争议的。 ^C

休克的治疗应基于对原发原因和继发异常的特殊治疗，如果使用糖皮质激素，应仅将其视为辅助支持治疗。 ^C

败血性休克的辅助治疗的价值†尤其引起争议。关于在脓毒性休克中高剂量方案对发病率和死亡率影响的有争议的证据。在一项临床研究中，甲基强的松龙在败血症综合征和败血性休克的治疗中无效，并且可能增加某些患者（即_Scr升高的患者或治疗后发生继发感染的患者）的死亡风险。 ^Ë

心包炎

减轻心包炎的疼痛，发烧和发炎†，包括与MI有关的心包炎。 ^C

糖皮质激素可提供有效的症状缓解，但阿司匹林考虑到更多的证据证明获益，因此考虑治疗心梗后心包炎。

区分心包炎和局部缺血引起的疼痛很重要，因为治疗方法会有所不同。

考虑一下由于糖皮质激素的使用可能是心脏破裂的危险因素，因此可能导致心脏破裂。

糖皮质激素可能会导致瘢痕变薄和心肌破裂。

结核性心包炎的处理。 （请参阅使用中的晚期肺结核和肺外结核。）

胃肠疾病

溃疡性结肠炎，局部肠炎（克罗恩病）和乳糜泻的急性加重和全身并发症的短期姑息治疗。^{一个C d电子网米}

如果即将穿孔，脓肿，或其它化脓性感染的概率，请勿使用。 ^Ë

很少用于慢性胃肠道疾病（例如溃疡性结肠炎，腹腔疾病）的维持治疗，因为它不能预防复发，长期服用可能产生严重的不良反应。 ^C

有时，低剂量与其他支持疗法联合使用可能会导致对慢性病指示的常规疗法无反应的疾病。 ^C

轻度至中度活动和中度至重度活动克罗恩病的处理。

胃肠外糖皮质激素推荐用于重症克罗恩病患者。一旦患者对肠胃外治疗有反应，就应逐渐改用口服糖皮质激素的等效治疗方案。

一些专家指出，由于不良反应的发生率很高，因此不应将糖皮质激素用于中度至中度活动的克罗恩病的治疗，应将其用于中度至重度活动的患者。

糖皮质激素不应用于慢性胃肠道疾病（例如溃疡性结肠炎，克罗恩病）的维持治疗，因为它们通常不能预防复发，并且长期服用可能会产生严重的不良反应。^一个C

糖皮质激素已被用于小儿患者的中度至重度活动性克罗恩病以及轻度食道或胃十二指肠克罗恩病的治疗。

肿瘤疾病

在姑息治疗淋巴系统肿瘤（例如成人的白血病和淋巴瘤以及儿童的急性白血病）中单独或作为各种化疗方案的组成部分。^{一个d电子网米}

乳腺癌的治疗†;单独使用糖皮质激素的效果不如其他药物（例如，细胞毒性药物，激素，抗雌激素药）有效，应保留用于无反应的疾病。 ^C

糖皮质激素单独使用或作为各种联合化疗方案的一部分用于姑息治疗晚期，有症状（即疼痛）的激素难治性前列腺癌†。

癌症化疗引起的恶心和呕吐

预防与呕吐癌化学疗法相关的恶心和呕吐†。

脑水肿

减少与脑瘤和神经外科手术有关的脑水肿。 ^Çd米

与假性肿瘤相关的脑水肿也可能有益，但是糖皮质激素的疗效尚有争议，尚待确定。 ^C

脑脓肿引起的水肿反应不如脑瘤引起的水肿。 ^C

脑水肿的药理管理不能替代仔细的神经外科评估和确定的管理，例如神经外科手术或其他特定疗法。 ^Çd˚F

头部受伤

头部受伤患者尚未建立糖皮质激素治疗的疗效；这样的治疗可能是有害的，并且与死亡风险的显着增加有关。头部外伤患者不建议使用这种药物来改善结局或降低颅内压。

脑疟疾

糖皮质激素是不是有效的，可以引起恶性疟原虫脑型疟疾的管理不利影响;不推荐使用此条件。 ^C

急性脊髓损伤

一些证据表明，大剂量静脉使用糖皮质激素（即甲基强的松龙）可以改善急性脊髓损伤患者的运动和感觉功能，†在损伤后立即开始治疗（8小时内）。尚不清楚通过这种疗法改善神经功能是否会常规导致残疾的特定改善。

腰背疼痛

已硬膜外使用†（单独使用或与局部麻醉药和/或阿片类镇痛药联合使用）以缓解腰痛†。

尽管仍存在争议，并且缺乏有效的令人信服的证据，但大多数专家认为，这种疗法可短期缓解患有腰背痛和与椎间盘疾病或疝或椎管狭窄相关的神经根病的患者的急性，亚急性或慢性放射性疼痛当较为保守的疗法（例如，休息，止痛药，物理疗法）失败时，则可避免手术。 （请参阅“小心情况下的神经系统效果”。）

有限的证据表明，虽然小关节注射可能对某些小关节病患者有用，但治疗性小关节†和椎间盘内糖皮质激素注射†对下腰痛的治疗效果不佳。在触发点注射中包括糖皮质激素似乎没有益处。

当脊柱疼痛的主要来源是the关节时，使用透视引导下进行的joint关节注射可以在某些患者中暂时缓解疼痛。

曾经使用过口服糖皮质激素†；但是，它们似乎并不有效，并且缺乏支持这种使用的证据。

细菌性脑膜炎

动物方面的有限数据表明，在逆转某些与细菌性脑膜炎相关的脑脊液异常（例如颅内高压，乳酸浓度升高）方面，地塞米松可能优于甲基强的松龙，并且经验不足以推荐除地塞米松以外的糖皮质激素用于细菌性脑膜炎的辅助治疗†。

地塞米松短期静脉辅助治疗是首选。

多发性硬化症

糖皮质激素是治疗多发性硬化症急性发作的首选药物† ^{a d m} ，由于起效更快，作用更一致且不良反应更少，因此已替代了促肾上腺皮质激素。

抗炎和免疫调节作用可通过恢复血脑屏障，减少水肿并可能改善轴突传导来加速神经系统恢复。

缩短复发时间并加速恢复；总体恢复程度提高还是长期过程改变尚待确定。

重症肌无力

重症肌无力的处理，通常是在对抗胆碱酯酶疗法反应不足时。

肠胃外用于治疗肌无力危象。

器官移植

大量使用时，应与其他免疫抑制药物同时使用，以防止移植器官排斥。 ^C

免疫抑制药物的继发感染发生率很高；仅限于有使用经验的临床医生。 ^C

旋毛虫病

神经或心肌受累治疗旋毛虫病。^{一个d电子网}

肾病综合征和狼疮性肾炎

无尿毒症的特发性肾病综合征的治疗。^{一个d电子网}

可诱导利尿和蛋白尿的缓解肾病综合征^{一个C d电子网米}继发于红斑狼疮或原发性肾脏疾病，特别是当存在最小肾组织学变化。 ^{b d米}

狼疮性肾炎的治疗。^一dê

腕管综合症

有限数量的患者已使用糖皮质激素（例如甲基强的松龙，倍他米松）局部注射到腕管附近，以缓解腕管综合症的症状（例如疼痛，水肿，感觉不足）。

醋酸甲泼尼龙的剂量和用法

一般

• 给药途径和剂量取决于所治疗的病症和患者的反应。^一种

隔日疗法

• 在大多数情况下，长期口服糖皮质激素治疗的可选用药方案是隔日疗法，其中每隔一个早晨进行一次单剂量（通常每日剂量的两倍）。^一个c本方案提供症状的缓解，同时最小化肾上腺抑制，蛋白质分解代谢，及其他不良影响。^一个C

• 如果首选隔日治疗，则仅使用“短效”糖皮质激素，在单次口服剂量（例如甲基泼尼松龙，泼尼松，泼尼松龙）后，可抑制HPA轴＜1.5天。 ^C

• 有些疾病（例如类风湿性关节炎，溃疡性结肠炎）需要每天进行糖皮质激素治疗，因为基础疾病的症状无法通过隔日治疗来控制。 ^C

中止治疗

• 突然停药后，会出现由嗜睡，发烧和肌痛组成的类固醇戒断综合征。 ^c症状常常在没有肾上腺功能不全的证据的情况下发生（而血浆糖皮质激素浓度仍然很高，但迅速下降）。 ^C

• 如果在紧急情况下仅短时间（几天）使用，可能会迅速减少和停药。 ^C

• 长期服用药物剂量的治疗后，逐渐逐渐退出全身糖皮质激素，直到HPA轴功能恢复。 ^{c d e m} （请参阅“警告下的肾上腺皮质功能不全”。）

• 从全身性糖皮质激素转移到口服或经鼻吸入皮质类固醇激素治疗时，请谨慎行事。 ^C

• 已经描述了许多缓慢退出或“渐缩”的方法。 ^C

• 在一种建议的方案中，每3-7天减少2-4 mg，直到达到生理剂量（4 mg）。 ^C

• 其他建议指出，减量通常不应每1-2周超过2 mg。 ^C

• 当达到生理剂量时，可以用单次20毫克口服早晨剂量的氢化可的松代替患者所接受的任何糖皮质激素。 ^c 2–4周后，每周可将氢化可的松的剂量降低2.5 mg，直到每天一次的早晨剂量达到10 mg。 ^C

• 对于某些急性过敏性疾病（例如接触性皮炎，如常春藤）或慢性过敏性疾病的急性加重，可短期（例如连续6天）给予糖皮质激素。 ^c在治疗的第一天开始服用高剂量的药物，然后在几天内逐渐减少剂量以退出治疗。 ^C

行政

口服，静脉注射或输注，或IM注射。^{一个d电子网米}

通过关节内，病变内，滑膜内，软组织或硬膜外注射进行局部治疗。 ^Çd米

通常为不能口服或在紧急情况下不能使用药物的患者保留IM或IV疗法。 ^{d e}在最初的紧急时期之后，应考虑使用长效注射皮质类固醇制剂或口服皮质类固醇。 ^b

醋酸甲泼尼龙（多剂量小瓶）中含有苯甲醇；不鞘内给药的，因为这种使用严重不良事件的报告。^米

口头管理

甲基泼尼松龙

以片剂形式口服。^一种

IV管理

有关溶液和药物的兼容性信息，请参见稳定性下的兼容性。

甲基泼尼松龙琥珀酸钠

通过静脉注射或输注给药。 ^Ë

甲基强的松龙琥珀酸钠的重构

通过按压塑料活化剂进行重构，以将制造商提供的稀释剂从2格样品瓶的上部隔室压至装有无菌粉末的下部隔室。 ^e或者，使用抑菌水注射苄醇进行重构。 ^Ë

甲基强的松龙琥珀酸钠的稀释

当通过静脉输注给药时，可以将药物加入氯化钠注射液中的5％葡萄糖，0.9％氯化钠或5％葡萄糖中。 ^Ë

甲基强的松龙琥珀酸钠的给药速率

直接静脉注射：在几分钟内给药。 ^Ë

IM管理

别管理IM为容易出血条件（例如，特发性血小板减少性紫癜[ITP]）。 ^Ë

醋酸甲泼尼龙

通过IM注入进行管理。 ^d米

由于它吸收缓慢，因此在需要短期持续治疗的即时效果时，不建议使用IM。 ^d

市售的单剂量小瓶仅可单次使用。 ^{d m}尽管最初是无菌的，但除非观察到严格的无菌技术，否则多次使用单剂量小瓶可能会造成污染。^米

甲基泼尼松龙琥珀酸钠

通过IM注入进行管理。 ^Ë

IM注射部位吸收迅速。 ^b

关节内，鼻内和软组织给药

醋酸甲泼尼龙

通过关节内，病变内，滑膜内或软组织注射给药。 ^{b d m} （请参阅“小心皮肤病”。）

在服用醋酸甲泼尼龙之前，可用局部麻醉剂（例如盐酸普鲁卡因）浸润关节周围的组织。 ^{b d}

检查关节液以排除败血症，避免注射到感染部位；如果明显存在关节败血症，请采取适当的抗菌治疗。 ^{c d m}败血性关节炎的症状包括局部肿胀，关节运动进一步受限，发烧或不适。 ^{c d m}请勿在不稳定的关节中注射糖皮质激素，并警告患者不要过度使用尽管症状有所改善但炎症过程仍活跃的关节。 ^C

硬膜外给药†

长效注射混悬剂已通过硬膜外注射给药，尽管使用保存制剂进行硬膜外注射的安全性存在争议，制造商不建议对这些制剂进行硬膜外给药。 ^c有限的证据表明，糖皮质激素悬液中的大颗粒可能会在无意间进行动脉内注射后引起栓塞性血管闭塞。 （请参阅“小心情况下的神经系统效果”。）

在进入椎间孔之前，先将神经根穿过的部位注入硬膜外腔。

硬膜外注射可以通过尾，椎间或经椎间孔途径进行。经孔方式需要最小的注射量，并且似乎是最具体且可能是最有效的途径。

Because of the potential for complications related to improper needle placement or drug administration, many experts state that epidural injections should be performed by an experienced clinician using fluoroscopic guidance and contrast control to ensure that the needle is correctly positioned and that the injection is not performed intravascularly, intrathecally, or into tissues other than the epidural space. However, serious adverse neurologic effects have been reported even with fluoroscopic guidance. ^{1000 1001 1002 1003} (See Nervous System Effects under Cautions.)

Optimal technique, dosage, timing of initial injection, injection frequency, and maximum number of injections remain to be established.

剂量

Available as methylprednisolone, methylprednisolone acetate, and methylprednisolone sodium succinate. ^{a b d e m} Dosage of methylprednisolone sodium succinate or methylprednisolone acetate is expressed in terms of methylprednisolone or methylprednisolone acetate, respectively. ^{d e m}

After a satisfactory response is obtained, decrease dosage in small decrements to the lowest level that maintains an adequate clinical response, and discontinue the drug as soon as possible. ^{a b e}

Monitor patients continually for signs that indicate dosage adjustment is necessary, such as remissions or exacerbations of the disease and stress (surgery, infection, trauma). ^b

High dosages may be required for acute situations of certain rheumatic disorders and collagen diseases; after a response has been obtained, drug often must be continued for long periods at low dosage. ^C

High or massive dosages may be required in the treatment of pemphigus, exfoliative dermatitis, bullous dermatitis herpetiformis, severe erythema multiforme, or mycosis fungoides. ^c Early initiation of systemic glucocorticoid therapy may be life-saving in pemphigus vulgaris. ^c Reduce dosage gradually to the lowest effective level, but discontinuance may not be possible. ^{c d m}

Massive dosages may be required for treatment of shock. ^b

Increase dosage of rapidly acting corticosteroids in patients subjected to any unusual stress before, during, and after the stressful situation. ^{a d e m}

Pediatric Patients

Base pediatric dosage on severity of the disease and patient response rather than on strict adherence to dosage indicated by age, body weight, or body surface area. ^bé

常用剂量

Oral

0.117–1.66 mg/kg daily or 3.3–50 mg/m ² daily, administered in 3 or 4 divided doses. ^b

即时通讯

Methylprednisolone sodium succinate: 0.03–0.2 mg/kg or 1–6.25 mg/m ² IM 1–2 times daily has been used. ^b

哮喘

Oral

To gain prompt control of asthma in infants and children ≤4 years of age with very poorly controlled, moderate-to-severe asthma (ie, >3 exacerbations per year requiring oral corticosteroids) and in children 5–11 years of age with asthma of comparable control and severity (ie, ≥2 exacerbations per year requiring oral corticosteroids): Methylprednisolone 1–2 mg/kg daily (maximum 60 mg daily) may be added to existing asthma therapy.

In children ≤11 years of age undergoing emergency department treatment for moderate-to-severe acute asthma exacerbations not controlled with an inhaled β ₂ -adrenergic agonist: May add methylprednisolone 1–2 mg/kg daily in 2 divided doses (maximum 60 mg daily). Continue treatment until patient achieves a PEF of 70% of predicted or personal best.

Allergic Conditions

即时通讯

Methylprednisolone acetate: For control of severe or incapacitating allergic conditions (eg, bronchial asthma, seasonal or perennial allergic rhinitis) intractable to adequate trials of conventional therapy, initially, 1–2 mg/kg.

To gain prompt control of asthma in infants and children ≤4 years of age or children ≥5 years of age with very poorly-controlled, moderate-to-severe asthma (as an alternative to a short course of an oral corticosteroid) who are vomiting or noncompliant with oral corticosteroid therapy: 7.5 mg/kg or 240 mg as a single dose of methylprednisolone acetate, respectively. Relief of asthma symptoms should occur within 6–48 hours and persist for several days to 2 weeks. ^d

Relief of coryzal symptoms of allergic rhinitis should occur within 6 hours and persist for several days to 3 weeks. ^d

IV

Methylprednisolone sodium succinate: For control of severe or incapacitating allergic conditions (eg, bronchial asthma) intractable to adequate trials of conventional therapy, initially, 1–2 mg/kg.

Croup†

IV

Methylprednisolone sodium succinate: Initially, 1–2 mg/kg.

Pneumocystis jiroveci Pneumonia†

IV

Methylprednisolone sodium succinate in children >13 years of age with AIDS† and moderate to severe Pneumocystis jiroveci pneumonia: 30 mg twice daily for 5 days, followed by 30 mg once daily for 5 days, and then 15 mg once daily for 11 days (or until completion of the anti-infective regimen). Initiate within 24–72 hours of initial antipneumocystis therapy.

Acute Spinal Cord Injury†

IV

Methylprednisolone sodium succinate: 30 mg/kg IV (administered over 15 minutes), followed after 45 minutes by a continuous IV infusion of 5.4 mg/kg per hour for 23 hours.

Lupus Nephritis†

IV

Methylprednisolone sodium succinate: 30 mg/kg IV every other day for 6 doses. ^b

大人

常用剂量

Oral

Initially, 2–60 mg daily, depending on disease being treated, and is usually divided into 4 doses. ^b

IV或IM

Methylprednisolone sodium succinate: Usually, 10–250 mg; may repeat up to 6 times daily. ^b

IV then IV or IM

Methylprednisolone sodium succinate: For high-dose therapy, administer 30 mg/kg over at least 30 minutes. ^e May repeat every 4–6 hours for 48 hours. ^e Continue high-dose therapy only until the condition stabilizes, usually ≤48–72 hours. ^Ë

For other conditions, 10–40 mg over several minutes. ^e Administer subsequent doses IV or IM depending on response and clinical condition. ^Ë

即时通讯

Methylprednisolone acetate: 10–80 mg. ^b

Methylprednisolone acetate for maintenance of patients with rheumatoid arthritis: 40–120 mg weekly.

When methylprednisolone acetate suspension is given as a temporary substitute for oral therapy, dose of the suspension should be equal to the total daily oral dose of methylprednisolone; administer IM once daily. ^{d m} If a prolonged effect is desired, may administer an IM dose of methylprednisolone acetate equal to 7 times the daily oral dose of methylprednisolone once weekly. ^{d m}

Intraarticular, Intrasynovial, Intralesional, or Soft-tissue Injection

Varies depending on location, size, and degree of inflammation. ^{b d m} In chronic cases, repeat injections at intervals ranging from 1–5 weeks or more, depending on degree of relief resulting from initial injection. ^{d m}

Large Joints (eg, knee): 20–80 mg of methylprednisolone acetate. ^{d m}

Smaller Joints: 4–40 mg of methylprednisolone acetate repeated. ^{d m}

Bursae, Ganglia, Tendinitis, Epicondylitis: 4–30 mg of methylprednisolone acetate; repeat if necessary for recurrent or chronic conditions. ^{d m}

Soft Tissue: 4–30 mg of methylprednisolone acetate for soft tissue infiltration; repeat if necessary for recurrent or chronic conditions. ^d .

哮喘

Oral

In adults and adolescents with very poorly controlled, moderate-to-severe asthma (ie, ≥2 exacerbations per year requiring oral corticosteroids): May add methylprednisolone 40–60 mg daily as a single dose or in 2 divided doses to low-to-high maintenance dosages of the inhaled corticosteroid and a long-acting inhaled β ₂ -agonist bronchodilator. Continue with a short course (usually 3–10 days) of oral corticosteroid therapy until patient achieves a PEF of 80% of his or her personal best and until symptoms resolve. May need a longer duration of treatment in some patients. There is no evidence that tapering the dosage after improvement will prevent a relapse.

In adults and adolescents with severe asthma who are inadequately controlled with a high-dose inhaled corticosteroid, intermittent oral corticosteroid therapy, and a long-acting inhaled β ₂ -agonist bronchodilator (based on consensus and clinical experience): May use methylprednisolone 7.5–60 mg daily in the morning or every other day. May consider a short course (2 weeks) of oral corticosteroids to confirm clinical response prior to implementing long-term therapy with these agents. Once long-term oral corticosteroid therapy is initiated, use the lowest possible effective dosage (ie, alternate-day or once-daily administration); monitor the patient carefully for adverse effects. Once asthma is well controlled, make repeated attempts to reduce the oral corticosteroid dosage.

In adults and adolescents undergoing emergency department treatment for moderate-to-severe acute asthma exacerbations not controlled with an inhaled β ₂ -adrenergic agonist: May add methylprednisolone 40–80 mg daily as a single dose or in 2 divided doses to an inhaled β ₂ -adrenergic agonist. Continue treatment until patient achieves a PEF of 70% of predicted or personal best.

皮肤病

Intralesional Injection

Methylprednisolone acetate: 20–60 mg into the lesion. ^d For large lesions, it may be necessary to administer 20–40 mg doses by repeated local injections spaced across the affected area. ^d Usually, 1–4 injections are employed, with interval between injections varying with the type of lesion treated and the duration of improvement observed with each injection. ^d

即时通讯

Methylprednisolone acetate: In patients with dermatologic lesions, usually, 40–120 mg of methylprednisolone acetate once weekly for 1–4 weeks. ^d

Methylprednisolone acetate: In seborrheic dermatitis, 80 mg weekly may be adequate to control the condition. ^{d m}

Adrenogenital Syndrome

即时通讯

Methylprednisolone acetate: 40 mg every 2 weeks. ^{d m}

Allergic Conditions

Oral

For certain conditions (eg, contact dermatitis, including poison ivy), 24 mg (6 tablets) for the first day, which is then tapered by 4 mg daily until 21 tablets have been administered. (See Tapered Dosage Schedule table.) ^b

Some clinicians suggest tapering the dosage of the drug over 12 days may be associated with a lower incidence of flare-up of the dermatitis than that associated with 6-day therapy. ^b

即时通讯

Methylprednisolone acetate: In acute severe dermatitis due to poison ivy, 80–120 mg as a single dose. ^{d m} In chronic contact dermatitis, repeated injections at 5- to 10-day intervals may be necessary. ^d

Methylprednisolone acetate: For control of severe or incapacitating allergic conditions (eg, bronchial asthma, seasonal or perennial allergic rhinitis) intractable to adequate trials of conventional therapy, 80–120 mg. ^{d m} Relief of coryzal symptoms of allergic rhinitis should occur within 6 hours and persist for several days to 3 weeks.

To gain prompt control of asthma in patients with very poorly controlled, moderate-to-severe asthma (as an alternative to a short course of an oral corticosteroid) who are vomiting or noncompliant with oral corticosteroid therapy: 240 mg of methylprednisolone acetate as a single dose. Relief of asthma symptoms should occur within 6–48 hours and persist for several days to 2 weeks. ^{d m}

Acute Exacerbations of Multiple Sclerosis

IV

For moderate to severe relapses, 1 g daily for 3–5 days, followed by 60 mg of oral prednisone daily, tapering the dosage over 12 days.

Alternatively, 1 g or 15 mg/kg of IV methylprednisolone tapered over 15 days to 1 mg/kg, followed by oral prednisone or prednisolone in gradually decreasing dosages over several weeks to months. ^C

Oral

160 mg daily for 1 week, followed by 64 mg every other day for a month. ^{a d e f}

Pneumocystis jiroveci Pneumonia

IV

In adults with AIDS† and moderate to severe Pneumocystis jiroveci pneumonia, 30 mg twice daily for 5 days, followed by 30 mg once daily for 5 days, and then 15 mg once daily for 11 days (or until completion of the anti-infective regimen). Initiate within 24–72 hours of initial antipneumocystis therapy.

休克

IV

Life-threatening shock: massive doses of methylprednisolone as the sodium succinate such as 30 mg/kg by direct IV injection (over 3–15 minutes) initially and repeated every 4–6 hours if needed or 100–250 mg by direct IV injection (over 3–15 minutes) initially and repeated at 2- to 6-hour intervals as required. ^b

Alternatively, following the initial dose by direct IV injection, additional doses of 30 mg/kg may be administered by slow continuous IV infusion every 12 hours for 24–48 hours. ^b

Continue high-dose therapy only until the patient's condition has stabilized and usually not beyond 48–72 hours. ^b

Acute Spinal Cord Injury†

IV

Methylprednisolone sodium succinate: Initially, 30 mg/kg of methylprednisolone by rapid IV injection over 15 minutes, followed in 45 minutes by IV infusion of 5.4 mg/kg per hour for 23 hours (total dose administered over 24 hours), has been recommended.

Lupus Nephritis†

IV

Methylprednisolone sodium succinate: 1 g IV (over a 1-hour period) daily for 3 consecutive days (“pulse” therapy). ^b

“Pulse” therapy has been followed by long-term oral prednisone or prednisolone therapy (0.5–1 mg/kg per day).

Optic Neuritis†

IV

1 g daily for 3 days followed by oral prednisone 1 mg/kg daily for 11 days has been used.

Cautions for Methylprednisolone Acetate

禁忌症

• Known hypersensitivity to methylprednisolone, any ingredient in the respective formulation, or any other corticosteroid. ^{d m}

• IM administration in patients with idiopathic thrombocytopenic purpura. ^m

• Systemic fungal infections, ^{a d m} except when administered as an intra-articular injection for localized joint conditions. ^{d m}

• Concurrent administration of live or live, attenuated vaccines in patients receiving immunosuppressive doses of corticosteroids. ^{a d e m} (See Specific Drugs under Interactions.)

• Intrathecal administration of methylprednisolone acetate. ^{d m}

• Methylprednisolone sodium succinate injection preparations containing benzyl alcohol in premature neonates. ^{e m}

• Methylprednisolone acetate injection preparations (in multiple-dose vials) containing benzyl alcohol in premature infants. ^m

• Epidural administration in patients with local or systemic infection; individuals with bleeding disorders or receiving concurrent anticoagulant therapy (eg, warfarin, heparin, antiplatelet agents); patients with known hypersensitivity to local anesthetic agents, contrast agents, or glucocorticoids; and patients who experienced complications with prior glucocorticoid injections.

警告/注意事项

警告事项

神经系统的影响

May precipitate mental disturbances ranging from euphoria, insomnia, mood swings, depression and anxiety, and personality changes to frank psychoses. ^{a d e m} Use may aggravate emotional instability or psychotic tendencies. ^{a d e m}

Use with caution in patients with myasthenia gravis.^一种

Aseptic meningitis, arachnoiditis, exacerbation of pain, spinal cord trauma, subdural injection, intracranial air injection, increased intracranial pressure, nerve injury, seizures, bladder or bowel dysfunction, paraparesis or paralysis, sensory disturbances, and brain damage reported following epidural and/or intrathecal glucocorticoid injection. Unclear whether these effects involved improper needle placement or were related to administration of the drug and/or preservatives.

Serious, potentially permanent, and sometimes fatal adverse neurologic events (eg, spinal cord infarction, paraplegia, quadriplegia, cortical blindness, stroke, seizures, nerve injury, brain edema) reported rarely, often within minutes to 48 hours following epidural glucocorticoid injection given either with or without fluoroscopic guidance. ^{1000 1001 1002 1003}

FDA states efficacy and safety of epidural glucocorticoid administration not established; not FDA-labeled for this use. ^{1000 1001} (See Advice to Patients.)

Results from a multicenter, randomized, placebo controlled study with methylprednisolone hemisuccinate (an IV corticosteroid) showed an increase in early (at 2 weeks) and late (at 6 months) mortality in patients with cranial trauma who were determined not to have other clear indications for corticosteroid treatment. ^{d m} Do not use high doses of systemic corticosteroids, including methylprednisolone acetate (Depo-Medrol ), for treatment of traumatic brain injury. ^{d m}

Adrenocortical Insufficiency

When given in supraphysiologic doses for prolonged periods, glucocorticoids may cause decreased secretion of endogenous corticosteroids by suppressing pituitary release of corticotropin (secondary adrenocortical insufficiency). ^C

The degree and duration of adrenocortical insufficiency is highly variable among patients and depends on the dose, frequency and time of administration, and duration of glucocorticoid therapy. ^C

Acute adrenal insufficiency (even death) may occur if the drugs are withdrawn abruptly or if patients are transferred from systemic glucocorticoid therapy to local (eg, inhalation) therapy. ^C

Withdraw methylprednisolone very gradually following long-term therapy with pharmacologic dosages. ^{c d e m} (See Discontinuance of Therapy under Dosage and Administration.)

Adrenal suppression may persist up to 12 months in patients who receive large dosages for prolonged periods. ^C

Until recovery occurs, signs and symptoms of adrenal insufficiency may develop if subjected to stress (eg, infection, surgery, trauma) and replacement therapy may be required. ^{c d e f m} Since mineralocorticoid secretion may be impaired, sodium chloride and/or a mineralocorticoid should also be administered. ^{c e f m}

If the disease flares up during withdrawal, dosage may need to be increased and followed by a more gradual withdrawal. ^C

Immunosuppression

Increased susceptibility to infections secondary to glucocorticoid-induced immunosuppression. ^{d e m} Certain infections (eg, varicella [chickenpox], measles) can have a more serious or even fatal outcome in such patients. ^{d e m} (See Increased Susceptibility to Infection under Warnings.)

Administration of live virus vaccines, including smallpox, is contraindicated in patients receiving immunosuppressive dosages of glucocorticoids. ^{a d e m} If inactivated viral or bacterial vaccines are administered to such patients, the expected serum antibody response may not be obtained. ^e May undertake indicated immunization procedures in patients receiving glucocorticoids as replacement therapy (eg, Addison's disease). ^{a d e f m}

Increased Susceptibility to Infection

Glucocorticoids, especially in large doses, increase susceptibility to and mask symptoms of infection. ^{a d e f m f}

Infections with any pathogen, including viral, bacterial, fungal, protozoan, or helminthic infections in any organ system, may be associated with glucocorticoids alone or in combination with other immunosuppressive agents. ^{a d e m}

Infections may be mild, but they can be severe or fatal, and localized infections may disseminate. ^{a d e m}

Do not inject methylprednisolone acetate intra-articularly, bursally, or into a tendon for local effect in patients with acute infection. ^{d m}

Do not use, except in life-threatening situations, in patients with viral infections or bacterial infections not controlled by anti-infectives. ^C

Some infections (eg, varicella [chickenpox], measles) can have a more serious or even fatal outcome, particularly in children. ^{d m}

Children and any adult who are not likely to have been exposed to varicella or measles should avoid exposure to these infections while receiving glucocorticoids. ^{d m}

If exposure to varicella or measles occurs in susceptible patients, treat appropriately (eg, VZIG, IG, acyclovir). ^{a d e m}

Fatal outcome (eg, in those developing hemorrhagic varicella) may not always be avoided even if appropriate therapy is initiated aggressively.

Immunosuppression may result in activation of latent infection or exacerbation of intercurrent infections (eg, those caused by Candida , Mycobacterium , Toxoplasma , Strongyloides , Pneumocystis , Cryptococcus , Nocardia , Ameba ). ^m

Use with great care in patients with known or suspected Strongyloides (threadworm) infection. ^e Immunosuppression may lead to Strongyloides hyperinfection and dissemination with widespread larval migration, often accompanied by severe enterocolitis and potentially fatal gram-negative septicemia. ^{a d e m}

Corticosteroids may exacerbate fungal infections and should not be used in the presence of such infections, ^{a d e f m} unless they are needed to control drug reactions. ^{d m}

Not effective and can have detrimental effects in the management of cerebral malaria. ^{c d m} Do not use corticosteroids in cerebral malaria. ^{d m}

Can reactivate tuberculosis. ^{a d e f m} Include chemoprophylaxis in patients with a history of active tuberculosis undergoing prolonged glucocorticoid therapy. ^{a c d m} Observe closely for evidence of reactivation. ^d Restrict use in active tuberculosis to those with fulminating or disseminated tuberculosis in which glucocorticoids are used in conjunction with appropriate chemoprophylaxis. ^{a d e m c d m}

Can reactivate latent amebiasis. ^c Exclude possible amebiasis in any patient who has been in the tropics or who has unexplained diarrhea prior to initiating therapy. ^{c d m}

Rarely, epidural abscess reported following epidural glucocorticoid injection; infectious complications (eg, bacterial meningitis) also reported.

肌肉骨骼效应

Muscle wasting, muscle pain or weakness, delayed wound healing, and atrophy of the protein matrix of the bone resulting in osteoporosis, vertebral compression fractures, aseptic necrosis of femoral or humeral heads, or pathologic fractures of long bones are manifestations of protein catabolism that may occur during prolonged therapy with glucocorticoids. ^c These adverse effects may be especially serious in geriatric or debilitated patients. ^c A high protein diet may help to prevent adverse effects associated with protein catabolism. ^C

An acute, generalized myopathy can occur with the use of high doses of glucocorticoids, particularly in patients with disorders of neuromuscular transmission (eg, myasthenia gravis) or in patients receiving concomitant therapy with neuromuscular blocking agents (eg, pancuronium). ^{d e m}

Tendon rupture, particularly of the Achilles tendon.

Osteoporosis and related fractures are one of the most serious adverse effects of long-term glucocorticoid therapy.

To minimize the risk of glucocorticoid-induced bone loss, the smallest possible effective dosage and duration should be used. Topical and inhaled preparations should be used whenever possible.

Before initiating glucocorticoid therapy in postmenopausal women, consider that they are especially prone to osteoporosis. ^C

Withdraw glucocorticoids if osteoporosis develops, unless their use is life-saving. ^C

Glucocorticoid-induced bone loss can be both prevented and treated. Baseline measurement of bone mass density (BMD) at the lumbar spine and/or hip should be obtained when initiating long-term (eg, exceeding 6 months) glucocorticoid therapy and appropriate preventive therapy should be initiated. Longitudinal measurements may be repeated as often as every 6 months to detect possible bone loss. Less frequent (eg, annually) follow-up probably is sufficient in patients who are receiving therapy to prevent bone loss.

Skeletal wasting is most rapid during the initial 6 months of therapy, and trabecular bone is affected to a greater degree than is cortical bone.

Calcium and vitamin D supplementation, bisphosphonate (eg, alendronate, risedronate), and a weight-bearing exercise program that maintains muscle mass are suitable first-line therapies aimed at reducing the risk of adverse bone effects.

Calcitonin may be considered as second-line therapy for patients who refuse or do not tolerate bisphosphonate therapy or in whom the drugs are contraindicated.

Fluid and Electrolyte Disturbances

Sodium retention with resultant edema, potassium loss, hypokalemic alkalosis, and elevation of BP may occur with average and large doses of corticosteroids. ^{a d e m} These effects are less frequent with synthetic glucocorticoids tha

对于消费者

适用于甲泼尼龙：口服片剂

其他剂型：

• 溶液注射粉，注射溶液，注射悬浮液

需要立即就医的副作用

除了其所需的作用外，甲基泼尼松龙还可能引起一些不良作用。尽管并非所有这些副作用都可能发生，但如果确实发生了，则可能需要医疗护理。

服用甲基泼尼松龙时，如果有下列任何副作用，请立即咨询医生：

发病率未知

• 黑色柏油凳
• 失明
• 腹胀
• 血腥呕吐
• 模糊的视野
• 骨痛
• 视力改变
• 胸痛
• 发冷
• 混乱
• 便秘
• 咳嗽
• 黑尿
• 皮肤变黑
• 高度降低
• 尿量减少
• 运动范围减小
• 视力下降
• 腹泻
• 吞咽困难
• 颈静脉扩张
• 头晕或头晕
• 口干
• 极度疲劳或虚弱
• 眼痛
• 眼泪
• 眼球从眼窝凸出
• 晕倒
• 自我或周围环境不断运动的感觉
• 发热
• 潮红，皮肤干燥
• 水果味的气味
• 饱胀或肿胀的感觉
• 头痛
• 胃灼热
• 荨麻疹，瘙痒，皮疹
• 伤口愈合不良
• 饥饿加剧
• 口渴
• 排尿增加
• 消化不良
• 不规则的呼吸
• 心律不齐
• 关节痛
• 跛行
• 食欲不振
• 意识丧失
• 下背部或侧面疼痛
• 精神抑郁
• 情绪变化
• 肌肉疼痛，抽筋或无力
• 恶心
• 紧张
• 嘈杂，呼吸嘶哑
• 手，脚或嘴唇麻木或刺痛
• 背部，肋骨，手臂或腿部疼痛
• 喉咙疼痛或灼痛
• 手臂或腿部疼痛或肿胀，无任何伤害
• 排尿困难或困难
• 关节疼痛，肿胀
• 胃部，侧面或腹部疼痛，可能放射到背部
• 敲打耳朵
• 胃压力
• 眼睑或眼睛，面部，嘴唇或舌头周围浮肿或肿胀
• 癫痫发作
• 旋转感
• 严重或持续的胃痛
• 儿童生长缓慢
• 缓慢或快速的心跳
• 嘴唇，舌头或口腔内的疮，溃疡或白斑
• 面部，手指，脚，腹部或腹部或小腿肿胀
• 撕裂
• 胸闷
• 呼吸困难
• 休息时呼吸困难
• 无法解释的体重减轻
• 异常疲倦或虚弱
• 呕吐
• 呕吐物看起来像咖啡渣的呕吐
• 眼睛或皮肤发黄

不需要立即就医的副作用

可能会发生甲基泼尼松龙的某些副作用，这些副作用通常不需要医疗。随着身体对药物的适应，这些副作用可能会在治疗期间消失。另外，您的医疗保健专业人员可能会告诉您一些预防或减少这些副作用的方法。

请咨询您的医疗保健专业人员，是否持续存在以下不良反应或令人讨厌，或者是否对这些副作用有任何疑问：

发病率未知

• 脂肪沉积在面部，颈部和躯干上
• 粉刺
• 瘀血
• 干燥头皮
• 出汗增加
• 皮肤大而扁平的蓝色或紫色斑点
• 淡化正常肤色
• 月经变化
• 手臂，脸部，腿部，躯干或腹股沟上的红紫色线条
• 脸红
• 皮肤上的小，红色或紫色斑点
• 胃部肿胀
• 薄而脆弱的皮肤
• 头皮头发稀疏

对于医疗保健专业人员

适用于甲泼尼龙：复方散剂，注射剂，散剂，口服片剂

一般

最常见的副作用包括体液retention留，葡萄糖耐量改变，血压升高，行为和情绪变化，食欲增加和体重增加。发病率通常与剂量，给药时间和治疗时间有关。 ^[参考]

过敏症

未报告频率：过敏或超敏反应;过敏反应，过敏反应，血管性水肿，支气管痉挛^[参考]

一项欧洲评论描述了对接受含有牛源乳糖的可注射甲基强的松龙产品的牛奶蛋白过敏的患者的过敏反应案例，包括支气管痉挛和过敏反应。在大多数情况下，患者不到12岁，患有儿童哮喘。在某些情况下，该反应被误认为是缺乏疗效，并在患者病情恶化的情况下给予了更多剂量。欧盟已建议含乳糖甲泼尼龙产品可重新在2019年以去除牛奶中的蛋白质的任何痕迹^[参考]

心血管的

未报告频率：心动过缓，心脏骤停，心律不齐，心脏扩大，循环衰竭，充血性心力衰竭，脂肪栓塞，高血压，近期心肌梗死后心肌破裂，晕厥，心动过速，血栓栓塞，血栓形成水肿，低血压^[参考]

内分泌

未报告的频率：类丘疹状态，多毛症，继发性肾上腺皮质和垂体无反应（特别是在压力时期，如在外伤，手术或疾病中），月球面^[参考]

胃肠道

未报告频率：腹胀，恶心，胰腺炎，消化性溃疡，小肠和大肠穿孔，溃疡性食管炎，胃出血，呕吐，腹痛，腹泻，消化不良，恶心^[参考]

肝的

糖皮质激素治疗后观察到可逆转氨酶升高（AST，ALT）。这些变化通常很小，并且与任何临床综合征无关。据报道，高剂量的周期性脉冲IV治疗可导致中毒性肝炎，发病已持续数周或更长时间。据报解决方案已停产；然而，据报道再次发生具有挑战性。 ^[参考]

未报告频率：肝肿大，肝酶升高，中毒性肝炎^[参考]

新陈代谢

未报告频率：糖耐量和葡萄糖耐量降低，潜在的糖尿病表现，低血钾性碱中毒，钾丢失，钠retention留，食欲增加，蛋白质分解代谢，体重增加，代谢性酸中毒，血脂异常，脂肪瘤病所致的负氮平衡^[参考]

肌肉骨骼

未报告频率：儿科患者生长受到抑制，股骨头和肱骨头无菌坏死，钙化，夏氏样萎缩，肌肉质量下降，肌肉无力，骨质疏松症，长骨病理性骨折，注射后耀斑，类固醇肌病，肌腱断裂，尤其是跟腱，椎骨压缩性骨折，肌痛，肌肉萎缩，骨坏死，神经性关节痛，发育迟缓^[参考]

血液学

未报告频率：白细胞增多症^[参考]

免疫学的

未报告频率：机会感染^[参考]

眼科

未报告频率：眼球突出症，青光眼，眼内压增高，后囊后白内障，失明，脉络膜视网膜病变^[参考]

皮质类固醇注射至头皮，扁桃体水管，蝶ala神经节有失明的报道。 ^[参考]

精神科

未报告的频率：抑郁，情绪不稳定，欣快，失眠，情绪波动，性格改变，精神障碍，精神错乱，焦虑，异常行为，易怒^[参考]

皮肤科

未报告频率：痤疮，过敏性皮炎，皮肤和皮下萎缩，鳞屑干燥，瘀斑，瘀斑，红斑，色素沉着，色素沉着，伤口愈合受损，出汗，皮疹，无菌脓肿，条纹，对皮肤检查的反应受到抑制，皮肤脆弱皮肤，头皮稀疏，荨麻疹，肥大症，血管性水肿，皮肤萎缩，多汗症，瘙痒^[参考]

本地

未报告频率：注射部位感染，注射部位反应^[参考]

神经系统

未报告的频率：抽搐，头痛，颅内压增高伴乳头水肿（假性脑瘤），通常在停药，神经炎，神经病，感觉异常，健忘症，头昏眼花^[参考]

其他

未报告频率：眩晕，异常脂肪沉积，不适，脓肿，愈合不良，疲劳^[参考]

肿瘤的

未报告频率：卡波济肉瘤^[参考]

呼吸道

未报告频率：肺水肿，肺栓塞，打h ^[参考]

泌尿生殖

未报告频率：月经不调，运动或增加或减少精子数量，尿钙增加，糖尿^[参考]

某些副作用可能没有报道。您可以将其报告给FDA。

过敏性鼻炎的常规成人剂量

醋酸盐悬浮液：
80至120 mg IM

评论：
-症状缓解可能在6小时内发生，并持续数天至3周。

使用：用于缓解过敏性鼻炎（花粉症）的症状。

通常的成人脱发剂量

剂量应根据疾病和患者反应而个性化

系统作用：
口服：
初始剂量：每天口服4至48毫克或分次服用
-调整或维持初始剂量，直至获得满意的反应；然后，以适当的间隔逐渐减小，逐渐降低至维持适当临床反应的最低剂量

或者，甲基泼尼松龙Dosepak（R） ：
第1天：口服24毫克（早餐前8毫克；午餐后4毫克；晚餐后4毫克；就寝时间8毫克）
第2天：口服20毫克（早餐前4毫克；午餐后4毫克；晚餐后4毫克；就寝时间8毫克）
第3天：口服16毫克（早餐前4毫克；午餐后4毫克；晚餐后4毫克；就寝时间4毫克）
第4天：口服12毫克（早餐前4毫克；午餐后4毫克；就寝时间4毫克）
第5天：口服8毫克（早餐前4毫克；就寝时间4毫克）
第6天：口服4毫克（早餐前4毫克）

肠胃外：
醋酸盐悬浮液：
初始剂量：每周一次40至120 mg IM，持续1至4周
-为缓解常春藤引起的急性重症皮炎：IM 80至120 mg；缓解可能会在8到12个小时内发生
-为缓解慢性接触性皮炎：每5至10天IM 80至120 mg
-缓解脂溢性皮炎：每周80毫克，以控制病情

评论：
-最大活动时给予外源性皮质类固醇抑制肾上腺皮质激素的活动最少；给药时应考虑最大肾上腺皮质活动时间（2 AM至8 AM）。
-需要长期治疗的患者可以考虑采用替代疗法；如果发生急性发作，可能有必要恢复到每日完全抑制剂量。

局部效果：
皮内注射：将醋酸酯混悬液注射到病变部位：
初始剂量：注入病灶20至60 mg；对于较大的病灶，应使用1至4次注射，每次20至40 mg，以分配剂量。
-两次注射之间的间隔随病变类型和初次注射产生的改善持续时间而变化。

评论：
-为了使皮肤和皮下萎缩的发生率降至最低，应尽可能进行多次注射。

用途：用于皮肤病的全身治疗；病灶内注射可用于局部治疗斑秃，盘状红斑狼疮，瘢痕loid，扁平苔藓，慢性扁平苔藓（神经性皮炎），银屑病斑块，坏死性脂肪样脂溢性糖尿病，局部增生，浸润性，肉芽肿性环形炎性病变。
-腹腔内注射还可用于治疗腱膜或肌腱（神经节）的囊性肿瘤。

皮肤病通常的成人剂量

剂量应根据疾病和患者反应而个性化

系统作用：
口服：
初始剂量：每天口服4至48毫克或分次服用
-调整或维持初始剂量，直至获得满意的反应；然后，以适当的间隔逐渐减小，逐渐降低至维持适当临床反应的最低剂量

或者，甲基泼尼松龙Dosepak（R） ：
第1天：口服24毫克（早餐前8毫克；午餐后4毫克；晚餐后4毫克；就寝时间8毫克）
第2天：口服20毫克（早餐前4毫克；午餐后4毫克；晚餐后4毫克；就寝时间8毫克）
第3天：口服16毫克（早餐前4毫克；午餐后4毫克；晚餐后4毫克；就寝时间4毫克）
第4天：口服12毫克（早餐前4毫克；午餐后4毫克；就寝时间4毫克）
第5天：口服8毫克（早餐前4毫克；就寝时间4毫克）
第6天：口服4毫克（早餐前4毫克）

肠胃外：
醋酸盐悬浮液：
初始剂量：每周一次40至120 mg IM，持续1至4周
-为缓解常春藤引起的急性重症皮炎：IM 80至120 mg；缓解可能会在8到12个小时内发生
-为缓解慢性接触性皮炎：每5至10天IM 80至120 mg
-缓解脂溢性皮炎：每周80毫克，以控制病情

评论：
-最大活动时给予外源性皮质类固醇抑制肾上腺皮质激素的活动最少；给药时应考虑最大肾上腺皮质活动时间（2 AM至8 AM）。
-需要长期治疗的患者可以考虑采用替代疗法；如果发生急性发作，可能有必要恢复到每日完全抑制剂量。

局部效果：
皮内注射：将醋酸酯混悬液注射到病变部位：
初始剂量：注入病灶20至60 mg；对于较大的病灶，应使用1至4次注射，每次20至40 mg，以分配剂量。
-两次注射之间的间隔随病变类型和初次注射产生的改善持续时间而变化。

评论：
-为了使皮肤和皮下萎缩的发生率降至最低，应尽可能进行多次注射。

用途：用于皮肤病的全身治疗；病灶内注射可用于局部治疗斑秃，盘状红斑狼疮，瘢痕loid，扁平苔藓，慢性扁平苔藓（神经性皮炎），牛皮癣斑块，坏死性脂肪样脂溢性糖尿病，局部增生性，浸润性，肉芽肿性环形炎性病变。
-腹腔内注射还可用于治疗腱膜或肌腱（神经节）的囊性肿瘤。

地衣单纯性慢性的通常成人剂量

剂量应根据疾病和患者反应进行个性化

系统作用：
口服：
初始剂量：每天口服4至48毫克或分次服用
-调整或维持初始剂量，直至获得满意的反应；然后，以适当的间隔逐渐减小，逐渐降低至维持适当临床反应的最低剂量

或者，甲基泼尼松龙Dosepak（R） ：
第一天：口服24毫克（早餐前8毫克；午餐后4毫克；晚餐后4毫克；就寝时间8毫克）
第2天：口服20毫克（早餐前4毫克；午餐后4毫克；晚餐后4毫克；就寝时间8毫克）
第3天：口服16毫克（早餐前4毫克；午餐后4毫克；晚餐后4毫克；就寝时间4毫克）
第4天：口服12毫克（早餐前4毫克；午餐后4毫克；就寝时间4毫克）
第5天：口服8毫克（早餐前4毫克；就寝时间4毫克）
第6天：口服4毫克（早餐前4毫克）

肠胃外：
醋酸盐悬浮液：
初始剂量：每周一次40至120 mg IM，持续1至4周
-为缓解常春藤引起的急性重症皮炎：IM 80至120 mg；缓解可能会在8到12个小时内发生
-为缓解慢性接触性皮炎：每5至10天IM 80至120 mg
-缓解脂溢性皮炎：每周80毫克，以控制病情

评论：
-在最大活动时给予外源性皮质类固醇抑制肾上腺皮质激素的活动最少；给药时应考虑最大肾上腺皮质活动时间（2 AM至8 AM）。
-需要长期治疗的患者可以考虑采用替代疗法；如果发生急性发作，可能有必要恢复到每日完全抑制剂量。

局部效果：
皮内注射：将醋酸酯混悬液注射到病变部位：
初始剂量：注入病灶20至60 mg；对于较大的病灶，应使用1至4次注射，每次20至40 mg，以分配剂量。
-两次注射之间的间隔随病变类型和初次注射产生的改善持续时间而变化。

评论：
-为了使皮肤和皮下萎缩的发生率降至最低，应尽可能进行多次注射。

用途：用于皮肤病的全身治疗；病灶内注射可用于局部治疗斑秃，盘状红斑狼疮，瘢痕loid，扁平苔藓，慢性扁平苔藓（神经性皮炎），银屑病斑块，坏死性脂肪样脂溢性糖尿病，局部增生，浸润性，肉芽肿性环形炎性病变。
-腹腔内注射还可用于治疗腱膜或肌腱（神经节）的囊性肿瘤。

牛皮癣的成人剂量

剂量应根据疾病和患者反应而个性化

系统作用：
口服：
初始剂量：每天口服4至48毫克或分次服用
-调整或维持初始剂量，直至获得满意的反应；然后，以适当的间隔逐渐减小，逐渐降低至维持适当临床反应的最低剂量

或者，甲基泼尼松龙Dosepak（R） ：
第1天：口服24毫克（早餐前8毫克；午餐后4毫克；晚餐后4毫克；就寝时间8毫克）
第2天：口服20毫克（早餐前4毫克；午餐后4毫克；晚餐后4毫克；就寝时间8毫克）
第3天：口服16毫克（早餐前4毫克；午餐后4毫克；晚餐后4毫克；就寝时间4毫克）
第4天：口服12毫克（早餐前4毫克；午餐后4毫克；就寝时间4毫克）
第5天：口服8毫克（早餐前4毫克；就寝时间4毫克）
第6天：口服4毫克（早餐前4毫克）

肠胃外：
醋酸盐悬浮液：
初始剂量：每周一次40至120 mg IM，持续1至4周
-为缓解常春藤引起的急性重症皮炎：IM 80至120 mg；缓解可能会在8到12个小时内发生
-为缓解慢性接触性皮炎：每5至10天IM 80至120 mg
-缓解脂溢性皮炎：每周80毫克，以控制病情

评论：
-最大活动时给予外源性皮质类固醇抑制肾上腺皮质激素的活动最少；给药时应考虑最大肾上腺皮质活动时间（2 AM至8 AM）。
-需要长期治疗的患者可以考虑采用替代疗法；如果发生急性发作，可能有必要恢复到每日完全抑制剂量。

局部效果：
皮内注射：将醋酸酯混悬液注射到病变部位：
初始剂量：注入病灶20至60 mg；对于较大的病灶，应使用1至4次注射，每次20至40 mg，以分配剂量。
-两次注射之间的间隔随病变类型和初次注射产生的改善持续时间而变化。

评论：
-为了使皮肤和皮下萎缩的发生率降至最低，应尽可能进行多次注射。

用途：用于皮肤病的全身治疗；病灶内注射可用于局部治疗斑秃，盘状红斑狼疮，瘢痕loid，扁平苔藓，慢性扁平苔藓（神经性皮炎），牛皮癣斑块，坏死性脂肪样脂溢性糖尿病，局部增生性，浸润性，肉芽肿性环形炎性病变。
-腹腔内注射还可用于治疗腱膜或肌腱（神经节）的囊性肿瘤。

成人皮肤病的常用剂量

剂量应根据疾病和患者反应而个性化

系统作用：
口服：
初始剂量：每天口服4至48毫克或分次服用
-调整或维持初始剂量，直至获得满意的反应；然后，以适当的间隔逐渐减小，逐渐降低至维持适当临床反应的最低剂量

或者，甲基泼尼松龙Dosepak（R） ：
第1天：口服24毫克（早餐前8毫克；午餐后4毫克；晚餐后4毫克；就寝时间8毫克）
第2天：口服20毫克（早餐前4毫克；午餐后4毫克；晚餐后4毫克；就寝时间8毫克）
第3天：口服16毫克（早餐前4毫克；午餐后4毫克；晚餐后4毫克；就寝时间4毫克）
第4天：口服12毫克（早餐前4毫克；午餐后4毫克；就寝时间4毫克）
第5天：口服8毫克（早餐前4毫克；就寝时间4毫克）
第6天：口服4毫克（早餐前4毫克）

肠胃外：
醋酸盐悬浮液：
初始剂量：每周一次40至120 mg IM，持续1至4周
-为缓解常春藤引起的急性重症皮炎：IM 80至120 mg；缓解可能会在8到12个小时内发生
-为缓解慢性接触性皮炎：每5至10天IM 80至120 mg
-缓解脂溢性皮炎：每周80毫克，以控制病情

评论：
-最大活动时给予外源性皮质类固醇抑制肾上腺皮质激素的活动最少；给药时应考虑最大肾上腺皮质活动时间（2 AM至8 AM）。
-需要长期治疗的患者可以考虑采用替代疗法；如果发生急性发作，可能有必要恢复到每日完全抑制剂量。

局部效果：
皮内注射：将醋酸酯混悬液注射到病变部位：
初始剂量：注入病灶20至60 mg；对于较大的病灶，应使用1至4次注射，每次20至40 mg，以分配剂量。
-两次注射之间的间隔随病变类型和初次注射产生的改善持续时间而变化。

评论：
-为了使皮肤和皮下萎缩的发生率降至最低，应尽可能进行多次注射。

用途：用于皮肤病的全身治疗；病灶内注射可用于局部治疗斑秃，盘状红斑狼疮，瘢痕loid，扁平苔藓，慢性扁平苔藓（神经性皮炎），银屑病斑块，坏死性脂肪样脂溢性糖尿病，局部增生，浸润性，肉芽肿性环形炎性病变。
-腹腔内注射还可用于治疗腱膜或肌腱（神经节）的囊性肿瘤。

环状肉芽肿的常规成人剂量

剂量应根据疾病和患者反应而个性化

系统作用：
口服：
初始剂量：每天口服4至48毫克或分次服用
-调整或维持初始剂量，直至获得满意的反应；然后，以适当的间隔逐渐减小，逐渐降低至维持适当临床反应的最低剂量

或者，甲基泼尼松龙Dosepak（R） ：
第1天：口服24毫克（早餐前8毫克；午餐后4毫克；晚餐后4毫克；就寝时间8毫克）
第2天：口服20毫克（早餐前4毫克；午餐后4毫克；晚餐后4毫克；就寝时间8毫克）
第3天：口服16毫克（早餐前4毫克；午餐后4毫克；晚餐后4毫克；就寝时间4毫克）
第4天：口服12毫克（早餐前4毫克；午餐后4毫克；就寝时间4毫克）
第5天：口服8毫克（早餐前4毫克；就寝时间4毫克）
第6天：口服4毫克（早餐前4毫克）

肠胃外：
醋酸盐悬浮液：
初始剂量：每周一次40至120 mg IM，持续1至4周
-为缓解常春藤引起的急性重症皮炎：IM 80至120 mg；缓解可能会在8到12个小时内发生
-为缓解慢性接触性皮炎：每5至10天IM 80至120 mg
-缓解脂溢性皮炎：每周80毫克，以控制病情

评论：
-最大活动时给予外源性皮质类固醇抑制肾上腺皮质激素的活动最少；给药时应考虑最大肾上腺皮质活动时间（2 AM至8 AM）。
-需要长期治疗的患者可以考虑采用替代疗法；如果发生急性发作，可能有必要恢复到每日完全抑制剂量。

局部效果：
皮内注射：将醋酸酯混悬液注射到病变部位：
初始剂量：注入病灶20至60 mg；对于较大的病灶，应使用1至4次注射，每次20至40 mg，以分配剂量。
-两次注射之间的间隔随病变类型和初次注射产生的改善持续时间而变化。

评论：
-为了使皮肤和皮下萎缩的发生率降至最低，应尽可能进行多次注射。

用途：用于皮肤病的全身治疗；病灶内注射可用于局部治疗斑秃，盘状红斑狼疮，瘢痕loid，扁平苔藓，慢性扁平苔藓（神经性皮炎），银屑病斑块，坏死性脂肪样脂溢性糖尿病，局部增生，浸润性，肉芽肿性环形炎性病变。
-腹腔内注射还可用于治疗腱膜或肌腱（神经节）的囊性肿瘤。

扁平苔藓的成人剂量

剂量应根据疾病和患者反应而个性化

系统作用：
口服：
初始剂量：每天口服4至48毫克或分次服用
-调整或维持初始剂量，直至获得满意的反应；然后，以适当的间隔逐渐减小，逐渐降低至维持适当临床反应的最低剂量

或者，甲基泼尼松龙Dosepak（R） ：
第一天：口服24毫克（早餐前8毫克；午餐后4毫克；晚餐后4毫克；就寝时间8毫克）
第2天：口服20毫克（早餐前4毫克；午餐后4毫克；晚餐后4毫克；就寝时间8毫克）
第3天：口服16毫克（早餐前4毫克；午餐后4毫克；晚餐后4毫克；就寝时间4毫克）
第4天：口服12毫克（早餐前4毫克；午餐后4毫克；就寝时间4毫克）
第5天：口服8毫克（早餐前4毫克；就寝时间4毫克）
第6天：口服4毫克（早餐前4毫克）

肠胃外：
醋酸盐悬浮液：
初始剂量：每周一次40至120 mg IM，持续1至4周
-为缓解常春藤引起的急性重症皮炎：IM 80至120 mg；缓解可能会在8到12个小时内发生
-为缓解慢性接触性皮炎：每5至10天IM 80至120 mg
-缓解脂溢性皮炎：每周80毫克，以控制病情

评论：
-在最大活动时给予外源性皮质类固醇抑制肾上腺皮质激素的活动最少；给药时应考虑最大肾上腺皮质活动时间（2 AM至8 AM）。
-需要长期治疗的患者可以考虑采用替代疗法；如果发生急性发作，可能有必要恢复到每日完全抑制剂量。

局部效果：
皮内注射：将醋酸酯混悬液注射到病变部位：
初始剂量：注入病灶20至60 mg；对于较大的病灶，应使用1至4次注射，每次20至40 mg，以分配剂量。
-两次注射之间的间隔随病变类型和初次注射产生的改善持续时间而变化。

评论：
-为了使皮肤和皮下萎缩的发生率降至最低，应尽可能进行多次注射。

用途：用于皮肤病的全身治疗；病灶内注射可用于局部治疗斑秃，盘状红斑狼疮，瘢痕loid，扁平苔藓，慢性扁平苔藓（神经性皮炎），银屑病斑块，坏死性脂肪样脂溢性糖尿病，局部增生，浸润性，肉芽肿性环形炎性病变。
-腹腔内注射还可用于治疗腱膜或肌腱（神经节）的囊性肿瘤。

瘢痕loid的成人剂量

剂量应根据疾病和患者反应而个性化

系统作用：
口服：
初始剂量：每天口服4至48毫克或分次服用
-调整或维持初始剂量，直至获得满意的反应；然后，以适当的间隔逐渐减小，逐渐降低至维持适当临床反应的最低剂量

或者，甲基泼尼松龙Dosepak（R） ：
第一天：口服24毫克（早餐前8毫克；午餐后4毫克；晚餐后4毫克；就寝时间8毫克）
第2天：口服20毫克（早餐前4毫克；午餐后4毫克；晚餐后4毫克；就寝时间8毫克）
第3天：口服16毫克（早餐前4毫克；午餐后4毫克；晚餐后4毫克；就寝时间4毫克）
第4天：口服12毫克（早餐前4毫克；午餐后4毫克；就寝时间4毫克）
第5天：口服8毫克（早餐前4毫克；就寝时间4毫克）
第6天：口服4毫克（早餐前4毫克）

肠胃外：
醋酸盐悬浮液：
初始剂量：每周一次40至120 mg IM，持续1至4周
-为缓解常春藤引起的急性重症皮炎：IM 80至120 mg；缓解可能会在8到12个小时内发生
-为缓解慢性接触性皮炎：每5至10天IM 80至120 mg
-缓解脂溢性皮炎：每周80毫克，以控制病情

评论：
-在最大活动时给予外源性皮质类固醇抑制肾上腺皮质激素的活动最少；给药时应考虑最大肾上腺皮质活动时间（2 AM至8 AM）。
-需要长期治疗的患者可以考虑采用替代疗法；如果发生急性发作，可能有必要恢复到每日完全抑制剂量。

局部效果：
皮内注射：将醋酸酯混悬液注射到病变部位：
初始剂量：注入病灶20至60 mg；对于较大的病灶，应使用1至4次注射，每次20至40 mg，以分配剂量。
-两次注射之间的间隔随病变类型和初次注射产生的改善持续时间而变化。

评论：
-为了使皮肤和皮下萎缩的发生率降至最低，应尽可能进行多次注射。

用途：用于皮肤病的全身治疗；病灶内注射可用于局部治疗斑秃，盘状红斑狼疮，瘢痕loid，扁平苔藓，慢性扁平苔藓（神经性皮炎），银屑病斑块，坏死性脂肪样脂溢性糖尿病，局部增生，浸润性，肉芽肿性环形炎性病变。
-腹腔内注射还可用于治疗腱膜或肌腱（神经节）的囊性肿瘤。

类风湿关节炎的成人剂量

系统作用：
口服：
初始剂量：每天口服4至48毫克或分次服用
-调整或维持初始剂量，直至获得满意的反应；然后，以适当的间隔逐渐减小，逐渐降低至维持适当临床反应的最低剂量

肠胃外：醋酸盐悬浮液：提供长期的全身作用
维持剂量：每周一次40至120 mg IM

评论：
-最大活动时给予外源性皮质类固醇抑制肾上腺皮质激素的活动最少；给药时应考虑最大肾上腺皮质活动时间（2 AM至8 AM）。
-需要长期治疗的患者可以考虑采用替代疗法；如果发生急性发作，可能有必要恢复到每日完全抑制剂量。

局部效果：
关节腔内注射：醋酸盐悬浮液：
一般指导：实际剂量可能根据病情的严重性而有所不同
-大关节（膝盖，角度，肩膀）：通过关节内注射20至80 mg
-中关节（肘部，腕部）：通过关节内注射10至40 mg
-小关节（掌指，指间，胸锁，肩锁）：通过关节内注射4至10 mg
可以每1-5周或更长时间重复注射一次，具体取决于从原始注射中获得的缓解程度。

用途：用于治疗类风湿关节炎；短期关节内给药可用于治疗急性发作或加重病情的患者

肾上腺综合症的常规成人剂量

醋酸盐悬浮液：
初始剂量：每2周IM 40 mg
维护：根据个别患者的需要调整剂量

用途：用于治疗肾上腺生殖器综合症。

急性痛风的常规成人剂量

剂量应根据疾病和患者反应而个性化：

口服：
-初始剂量：每天口服4至48毫克或分次服用

或者，甲基泼尼松龙Dosepak（R） ：
第1天：口服24毫克（早餐前8毫克；午餐后4毫克；晚餐后4毫克；就寝时间8毫克）
第2天：口服20毫克（早餐前4毫克；午餐后4毫克；晚餐后4毫克；就寝时间8毫克）
第3天：口服16毫克（早餐前4毫克；午餐后4毫克；晚餐后4毫克；就寝时间4毫克）
第4天：口服12毫克（早餐前4毫克；午餐后4毫克；就寝时间4毫克）
第5天：口服8毫克（早餐前4毫克；就寝时间4毫克）
第6天：口服4毫克（早餐前4毫克）

肠胃外：
琥珀酸钠（IV或IM）;在紧急情况下，首选静脉注射
-高剂量治疗：每4至6小时至少30分钟静脉输注30 mg / kg，直至病情稳定，通常不超过48至72小时；在最初的紧急时期后，应考虑使用长效注射剂或口服制剂
-或者，当口服治疗不可行时，IM或IV给药可以代替。

醋酸盐悬浮液（仅限IM）：为了延长全身作用：
初始剂量：4至120 mg IM；可以重复剂量，具体取决于从原始注射获得的缓解程度。
-或者，当口服治疗不可行时，IM给药可以代替；通常在每24小时内一次等于每日口服总剂量的IM注射就足够了；当需要延长效果时，每周一次可作为单次IM注射给药。

维持剂量：调整或维持初始剂量，直到获得满意的反应为止；然后，以适当的间隔逐渐减小，逐渐降低至维持适当临床反应的最低剂量。

评论：
-在压倒性的，急性的，危及生命的情况下，超出正常剂量的剂量可能是合理的。
-最大活动时给予外源性皮质类固醇抑制肾上腺皮质激素的活动最少；给药时应考虑最大肾上腺皮质活动时间（2 AM至8 AM）。
-需要长期治疗的患者可以考虑采用替代疗法；如果发生急性发作，可能有必要恢复到每日完全抑制剂量。

局部影响：仅醋酸盐悬浮液：

关节内给药：
一般指导：实际剂量可能根据病情的严重性而有所不同
-大关节（膝盖，角度，肩膀）：通过关节内注射20至80 mg
-中关节（肘，腕）：通过关节内注射10至40 mg
-小关节（掌指，指间，胸锁，肩锁）：通过关节内注射4至10 mg
可以每1-5周或更长时间重复注射一次，具体取决于从原始注射中获得的缓解程度。

软组织管理：
-对于腱或法氏囊结构的情况：4至30毫克
-对于复发或慢性病，可能需要重复注射。
-有关具体管理说明，可咨询产品信息

用途：
-在适当的皮质类固醇疗法（例如某些过敏状态的治疗）中作为抗炎药或免疫抑制剂；神经系统，肿瘤或肾脏疾病；内分泌，风湿或血液疾病；胶原蛋白，皮肤病，眼科，呼吸道或胃肠道疾病；与器官移植有关的特定感染性疾病或状况。
-关节内或软组织给药可用作辅助治疗，以治疗急性痛风性关节炎，急性/亚急性滑囊炎，急性非特异性腱鞘炎，上con炎或骨关节炎滑膜炎的急性发作或加重患者。

成年人过敏反应的常用剂量

剂量应根据疾病和患者反应而个性化：

口服：
-初始剂量：每天口服4至48毫克或分次服用

或者，甲基泼尼松龙Dosepak（R） ：
第1天：口服24毫克（早餐前8毫克；午餐后4毫克；晚餐后4毫克；就寝时间8毫克）
第2天：口服20毫克（早餐前4毫克；午餐后4毫克；晚餐后4毫克；就寝时间8毫克）
第3天：口服16毫克（早餐前4毫克；午餐后4毫克；晚餐后4毫克；就寝时间4毫克）
第4天：口服12毫克（早餐前4毫克；午餐后4毫克；就寝时间4毫克）
第5天：口服8毫克（早餐前4毫克；就寝时间4毫克）
第6天：口服4毫克（早餐前4毫克）

肠胃外：
琥珀酸钠（IV或IM）;在紧急情况下，首选静脉注射
-高剂量治疗：每4至6小时至少30分钟静脉输注30 mg / kg，直至病情稳定，通常不超过48至72小时；在最初的紧急时期后，应考虑使用长效注射剂或口服制剂
-或者，当口服治疗不可行时，IM或IV给药可以代替。

醋酸盐悬浮液（仅限IM）：为了延长全身作用：
初始剂量：4至120 mg IM；可以重复剂量，具体取决于从原始注射获得的缓解程度。
-或者，当口服治疗不可行时，IM给药可以代替；通常在每24小时内一次等于每日口服总剂量的IM注射就足够了；当需要延长效果时，每周一次可作为单次IM注射给药。

维持剂量：调整或维持初始剂量，直到获得满意的反应为止；然后，以适当的间隔以小幅度逐渐减小至维持适当临床反应的最低剂量。

评论：
-在压倒性的，急性的，危及生命的情况下，超出正常剂量的剂量可能是合理的。
-最大活动时给予外源性皮质类固醇抑制肾上腺皮质激素的活动最少；给药时应考虑最大肾上腺皮质活动时间（2 AM至8 AM）。
-需要长期治疗的患者可以考虑采用替代疗法；如果发生急性发作，可能有必要恢复到每日完全抑制剂量。

局部影响：仅醋酸盐悬浮液：

关节内给药：
一般指导：实际剂量可能根据病情的严重性而有所不同
-大关节（膝盖，角度，肩膀）：通过关节内注射20至80 mg
-中关节（肘，腕）：通过关节内注射10至40 mg
-小关节（掌指，指间，胸锁，肩锁）：通过关节内注射4至10 mg
可以每1-5周或更长时间重复注射一次，具体取决于从原始注射中获得的缓解程度。

软组织管理：
-对于腱或法氏囊结构的情况：4至30毫克
-对于复发或慢性病，可能需要重复注射。
-有关具体的管理说明，请查阅产品信息

用途：
-在适当的皮质类固醇疗法（例如某些过敏状态的治疗）中作为抗炎药或免疫抑制剂；神经系统，肿瘤或肾脏疾病；内分泌，风湿或血液疾病；胶原蛋白，皮肤病，眼科，呼吸道或胃肠道疾病；与器官移植有关的特定感染性疾病或状况。
-关节内或软组织给药可用作辅助治疗，以治疗急性痛风性关节炎，急性/亚急性滑囊炎，急性非特异性腱鞘炎，上con炎或骨关节炎滑膜炎的急性发作或加重患者。

成年人滑囊炎的常用剂量

剂量应根据疾病和患者反应而个性化：

口服：
-初始剂量：每天口服4至48毫克或分次服用

或者，甲基泼尼松龙Dosepak（R） ：
第1天：口服24毫克（早餐前8毫克；午餐后4毫克；晚餐后4毫克；就寝时间8毫克）
第2天：口服20毫克（早餐前4毫克；午餐后4毫克；晚餐后4毫克；就寝时间8毫克）
第3天：口服16毫克（早餐前4毫克；午餐后4毫克；晚餐后4毫克；就寝时间4毫克）
第4天：口服12毫克（早餐前4毫克；午餐后4毫克；就寝时间4毫克）
第5天：口服8毫克（早餐前4毫克；就寝时间4毫克）
第6天：口服4毫克（早餐前4毫克）

肠胃外：
琥珀酸钠（IV或IM）;在紧急情况下，首选静脉注射
-高剂量治疗：每4至6小时至少30分钟静脉输注30 mg / kg，直至病情稳定，通常不超过48至72小时；在最初的紧急时期后，应考虑使用长效注射剂或口服制剂
-或者，当口服治疗不可行时，IM或IV给药可以代替。

醋酸盐悬浮液（仅限IM）：为了延长全身作用：
初始剂量：4至120 mg IM；可以重复剂量，具体取决于从原始注射获得的缓解程度。
-或者，当口服治疗不可行时，IM给药可以代替； a single IM injection during each 24-hour period equal to the total daily oral dose is usually sufficient; when a prolonged effect is desired a weekly dose may be given as a single IM injection.

MAINTENANCE DOSING: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response.

评论：
-Doses exceeding usual doses may be justified in overwhelming, acute, life-threatening situations.
-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.
-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

LOCAL Effects: Acetate suspension only:

INTRA-ARTICULAR Administration:
General guidance: Actual doses may vary with severity of condition
-Large joints (knee, angles, shoulders): 20 to 80 mg via intra-articular injection
-Medium joints (elbows, wrists): 10 to 40 mg via intra-articular injection
-Small joints (metacarpophalangeal, interphalangeal, sternoclavicular, acromioclavicular): 4 to 10 mg via intra-articular injection
Injections may be repeated every 1 to 5 or more weeks, depending upon the degree of relief obtained from the original injection.

SOFT TISSUE Administration:
-For conditions of the tendinous or bursal structures: 4 to 30 mg
-Repeat injections may be needed for recurrent or chronic conditions.
-Product Information may be consulted for specific administration instructions

用途：
-As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.
-Intra-articular or soft tissue administration may be used as adjunctive therapy to tide patients over an acute episode or exacerbation of acute gouty arthritis, acute/subacute bursitis, acute nonspecific tenosynovitis, epicondylitis, or synovitis of osteoarthritis.

肾病综合征通常的成人剂量

Dosing should be individualized based on disease and patient response:

口服：
-Initial dose: 4 to 48 mg orally once a day or in divided doses

Alternatively, methylprednisolone Dosepak(R) :
Day 1: 24 mg orally (8 mg before breakfast; 4 mg after lunch; 4 mg after dinner; 8 mg at bedtime)
Day 2: 20 mg orally (4 mg before breakfast; 4 mg after lunch; 4 mg after dinner; 8 mg at bedtime)
Day 3: 16 mg orally (4 mg before breakfast; 4 mg after lunch; 4 mg after dinner; 4 mg at bedtime)
Day 4: 12 mg orally (4 mg before breakfast; 4 mg after lunch; 4 mg at bedtime)
Day 5: 8 mg orally (4 mg before breakfast; 4 mg at bedtime)
Day 6: 4 mg orally (4 mg before breakfast)

肠胃外：
Sodium succinate (IV or IM); in emergency situations, IV is preferred
-High dose therapy: 30 mg/kg IV over at least 30 minutes every 4 to 6 hours until condition has stabilized, generally no more than 48 to 72 hours; after initial emergency period, a longer-acting injectable or oral preparation should be considered
-Alternatively, when oral therapy is not feasible, IM or IV administration may be substituted.

Acetate suspension (IM only): For prolonged systemic effect:
Initial dose: 4 to 120 mg IM; may repeat dose depending upon the degree of relief obtained from original injection.
-Alternatively, when oral therapy is not feasible, IM administration may be substituted; a single IM injection during each 24-hour period equal to the total daily oral dose is usually sufficient; when a prolonged effect is desired a weekly dose may be given as a single IM injection.

MAINTENANCE DOSING: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response.

评论：
-Doses exceeding usual doses may be justified in overwhelming, acute, life-threatening situations.
-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.
-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

LOCAL Effects: Acetate suspension only:

INTRA-ARTICULAR Administration:
General guidance: Actual doses may vary with severity of condition
-Large joints (knee, angles, shoulders): 20 to 80 mg via intra-articular injection
-Medium joints (elbows, wrists): 10 to 40 mg via intra-articular injection
-Small joints (metacarpophalangeal, interphalangeal, sternoclavicular, acromioclavicular): 4 to 10 mg via intra-articular injection
Injections may be repeated every 1 to 5 or more weeks, depending upon the degree of relief obtained from the original injection.

SOFT TISSUE Administration:
-For conditions of the tendinous or bursal structures: 4 to 30 mg
-Repeat injections may be needed for recurrent or chronic conditions.
-Product Information may be consulted for specific administration instructions

用途：
-As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.
-Intra-articular or soft tissue administration may be used as adjunctive therapy to tide patients over an acute episode or exacerbation of acute gouty arthritis, acute/subacute bursitis, acute nonspecific tenosynovitis, epicondylitis, or synovitis of osteoarthritis.

成人骨关节炎的常用剂量

Dosing should be individualized based on disease and patient response:

口服：
-Initial dose: 4 to 48 mg orally once a day or in divided doses

Alternatively, methylprednisolone Dosepak(R) :
Day 1: 24 mg orally (8 mg before breakfast; 4 mg after lunch; 4 mg after dinner; 8 mg at bedtime)
Day 2: 20 mg orally (4 mg before breakfast; 4 mg after lunch; 4 mg after dinner; 8 mg at bedtime)
Day 3: 16 mg orally (4 mg before breakfast; 4 mg after lunch; 4 mg after dinner; 4 mg at bedtime)
Day 4: 12 mg orally (4 mg before breakfast; 4 mg after lunch; 4 mg at bedtime)
Day 5: 8 mg orally (4 mg before breakfast; 4 mg at bedtime)
Day 6: 4 mg orally (4 mg before breakfast)

肠胃外：
Sodium succinate (IV or IM); in emergency situations, IV is preferred
-High dose therapy: 30 mg/kg IV over at least 30 minutes every 4 to 6 hours until condition has stabilized, generally no more than 48 to 72 hours; after initial emergency period, a longer-acting injectable or oral preparation should be considered
-Alternatively, when oral therapy is not feasible, IM or IV administration may be substituted.

Acetate suspension (IM only): For prolonged systemic effect:
Initial dose: 4 to 120 mg IM; may repeat dose depending upon the degree of relief obtained from original injection.
-Alternatively, when oral therapy is not feasible, IM administration may be substituted; a single IM injection during each 24-hour period equal to the total daily oral dose is usually sufficient; when a prolonged effect is desired a weekly dose may be given as a single IM injection.

MAINTENANCE DOSING: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response.

评论：
-Doses exceeding usual doses may be justified in overwhelming, acute, life-threatening situations.
-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.
-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

LOCAL Effects: Acetate suspension only:

INTRA-ARTICULAR Administration:
General guidance: Actual doses may vary with severity of condition
-Large joints (knee, angles, shoulders): 20 to 80 mg via intra-articular injection
-Medium joints (elbows, wrists): 10 to 40 mg via intra-articular injection
-Small joints (metacarpophalangeal, interphalangeal, sternoclavicular, acromioclavicular): 4 to 10 mg via intra-articular injection
Injections may be repeated every 1 to 5 or more weeks, depending upon the degree of relief obtained from the original injection.

SOFT TISSUE Administration:
-For conditions of the tendinous or bursal structures: 4 to 30 mg
-Repeat injections may be needed for recurrent or chronic conditions.
-Product Information may be consulted for specific administration instructions

用途：
-As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.
-Intra-articular or soft tissue administration may be used as adjunctive therapy to tide patients over an acute episode or exacerbation of acute gouty arthritis, acute/subacute bursitis, acute nonspecific tenosynovitis, epicondylitis, or synovitis of osteoarthritis.

Usual Adult Dose for Rejection Prophylaxis

Dosing should be individualized based on disease and patient response:

口服：
-Initial dose: 4 to 48 mg orally once a day or in divided doses

Alternatively, methylprednisolone Dosepak(R) :
Day 1: 24 mg orally (8 mg before breakfast; 4 mg after lunch; 4 mg after dinner; 8 mg at bedtime)
Day 2: 20 mg orally (4 mg before breakfast; 4 mg after lunch; 4 mg after dinner; 8 mg at bedtime)
Day 3: 16 mg orally (4 mg before breakfast; 4 mg after lunch; 4 mg after dinner; 4 mg at bedtime)
Day 4: 12 mg orally (4 mg before breakfast; 4 mg after lunch; 4 mg at bedtime)
Day 5: 8 mg orally (4 mg before breakfast; 4 mg at bedtime)
Day 6: 4 mg orally (4 mg before breakfast)

肠胃外：
Sodium succinate (IV or IM); in emergency situations, IV is preferred
-High dose therapy: 30 mg/kg IV over at least 30 minutes every 4 to 6 hours until condition has stabilized, generally no more than 48 to 72 hours; after initial emergency period, a longer-acting injectable or oral preparation should be considered
-Alternatively, when oral therapy is not feasible, IM or IV administration may be substituted.

Acetate suspension (IM only): For prolonged systemic effect:
Initial dose: 4 to 120 mg IM; may repeat dose depending upon the degree of relief obtained from original injection.
-Alternatively, when oral therapy is not feasible, IM administration may be substituted; a single IM injection during each 24-hour period equal to the total daily oral dose is usually sufficient; when a prolonged effect is desired a weekly dose may be given as a single IM injection.

MAINTENANCE DOSING: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response.

评论：
-Doses exceeding usual doses may be justified in overwhelming, acute, life-threatening situations.
-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.
-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

LOCAL Effects: Acetate suspension only:

INTRA-ARTICULAR Administration:
General guidance: Actual doses may vary with severity of condition
-Large joints (knee, angles, shoulders): 20 to 80 mg via intra-articular injection
-Medium joints (elbows, wrists): 10 to 40 mg via intra-articular injection
-Small joints (metacarpophalangeal, interphalangeal, sternoclavicular, acromioclavicular): 4 to 10 mg via intra-articular injection
Injections may be repeated every 1 to 5 or more weeks, depending upon the degree of relief obtained from the original injection.

SOFT TISSUE Administration:
-For conditions of the tendinous or bursal structures: 4 to 30 mg
-Repeat injections may be needed for recurrent or chronic conditions.
-Product Information may be consulted for specific administration instructions

用途：
-As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.
-Intra-articular or soft tissue administration may be used as adjunctive therapy to tide patients over an acute episode or exacerbation of acute gouty arthritis, acute/subacute bursitis, acute nonspecific tenosynovitis, epicondylitis, or synovitis of osteoarthritis.

Usual Adult Dose for Rejection Reversal

Dosing should be individualized based on disease and patient response:

口服：
-Initial dose: 4 to 48 mg orally once a day or in divided doses

Alternatively, methylprednisolone Dosepak(R) :
Day 1: 24 mg orally (8 mg before breakfast; 4 mg after lunch; 4 mg after dinner; 8 mg at bedtime)
Day 2: 20 mg orally (4 mg before breakfast; 4 mg after lunch; 4 mg after dinner; 8 mg at bedtime)
Day 3: 16 mg orally (4 mg before breakfast; 4 mg after lunch; 4 mg after dinner; 4 mg at bedtime)
Day 4: 12 mg orally (4 mg before breakfast; 4 mg after lunch; 4 mg at bedtime)
Day 5: 8 mg orally (4 mg before breakfast; 4 mg at bedtime)
Day 6: 4 mg orally (4 mg before breakfast)

肠胃外：
Sodium succinate (IV or IM); in emergency situations, IV is preferred
-High dose therapy: 30 mg/kg IV over at least 30 minutes every 4 to 6 hours until condition has stabilized, generally no more than 48 to 72 hours; after initial emergency period, a longer-acting injectable or oral preparation should be considered
-Alternatively, when oral therapy is not feasible, IM or IV administration may be substituted.

Acetate suspension (IM only): For prolonged systemic effect:
Initial dose: 4 to 120 mg IM; may repeat dose depending upon the degree of relief obtained from original injection.
-Alternatively, when oral therapy is not feasible, IM administration may be substituted; a single IM injection during each 24-hour period equal to the total daily oral dose is usually sufficient; when a prolonged effect is desired a weekly dose may be given as a single IM injection.

MAINTENANCE DOSING: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response.

评论：
-Doses exceeding usual doses may be justified in overwhelming, acute, life-threatening situations.
-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.
-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

LOCAL Effects: Acetate suspension only:

INTRA-ARTICULAR Administration:
General guidance: Actual doses may vary with severity of condition
-Large joints (knee, angles, shoulders): 20 to 80 mg via intra-articular injection
-Medium joints (elbows, wrists): 10 to 40 mg via intra-articular injection
-Small joints (metacarpophalangeal, interphalangeal, sternoclavicular, acromioclavicular): 4 to 10 mg via intra-articular injection
Injections may be repeated every 1 to 5 or more weeks, depending upon the degree of relief obtained from the original injection.

SOFT TISSUE Administration:
-For conditions of the tendinous or bursal structures: 4 to 30 mg
-Repeat injections may be needed for recurrent or chronic conditions.
-Product Information may be consulted for specific administration instructions

用途：
-As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.
-Intra-articular or soft tissue administration may be used as adjunctive therapy to tide patients over an acute episode or exacerbation of acute gouty arthritis, acute/subacute bursitis, acute nonspecific tenosynovitis, epicondylitis, or synovitis of osteoarthritis.

常见的成人肌腱炎剂量

Dosing should be individualized based on disease and patient response:

口服：
-Initial dose: 4 to 48 mg orally once a day or in divided doses

Alternatively, methylprednisolone Dosepak(R) :
Day 1: 24 mg orally (8 mg before breakfast; 4 mg after lunch; 4 mg after dinner; 8 mg at bedtime)
Day 2: 20 mg orally (4 mg before breakfast; 4 mg after lunch; 4 mg after dinner; 8 mg at bedtime)
Day 3: 16 mg orally (4 mg before breakfast; 4 mg after lunch; 4 mg after dinner; 4 mg at bedtime)
Day 4: 12 mg orally (4 mg before breakfast; 4 mg after lunch; 4 mg at bedtime)
Day 5: 8 mg orally (4 mg before breakfast; 4 mg at bedtime)
Day 6: 4 mg orally (4 mg before breakfast)

肠胃外：
Sodium succinate (IV or IM); in emergency situations, IV is preferred
-High dose therapy: 30 mg/kg IV over at least 30 minutes every 4 to 6 hours until condition has stabilized, generally no more than 48 to 72 hours; after initial emergency period, a longer-acting injectable or oral preparation should be considered
-Alternatively, when oral therapy is not feasible, IM or IV administration may be substituted.

Acetate suspension (IM only): For prolonged systemic effect:
Initial dose: 4 to 120 mg IM; may repeat dose depending upon the degree of relief obtained from original injection.
-Alternatively, when oral therapy is not feasible, IM administration may be substituted; a single IM injection during each 24-hour period equal to the total daily oral dose is usually sufficient; when a prolonged effect is desired a weekly dose may be given as a single IM injection.

MAINTENANCE DOSING: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response.

评论：
-Doses exceeding usual doses may be justified in overwhelming, acute, life-threatening situations.
-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.
-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

LOCAL Effects: Acetate suspension only:

INTRA-ARTICULAR Administration:
General guidance: Actual doses may vary with severity of condition
-Large joints (knee, angles, shoulders): 20 to 80 mg via intra-articular injection
-Medium joints (elbows, wrists): 10 to 40 mg via intra-articular injection
-Small joints (metacarpophalangeal, interphalangeal, sternoclavicular, acromioclavicular): 4 to 10 mg via intra-articular injection
Injections may be repeated every 1 to 5 or more weeks, depending upon the degree of relief obtained from the original injection.

SOFT TISSUE Administration:
-For conditions of the tendinous or bursal structures: 4 to 30 mg
-Repeat injections may be needed for recurrent or chronic conditions.
-Product Information may be consulted for specific administration instructions

用途：
-As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.
-Intra-articular or soft tissue administration may be used as adjunctive therapy to tide patients over an acute episode or exacerbation of acute gouty arthritis, acute/subacute bursitis, acute nonspecific tenosynovitis, epicondylitis, or synovitis of osteoarthritis.

通常的成人抗炎剂量

Dosing should be individualized based on disease and patient response:

口服：
-Initial dose: 4 to 48 mg orally once a day or in divided doses

Alternatively, methylprednisolone Dosepak(R) :
Day 1: 24 mg orally (8 mg before breakfast; 4 mg after lunch; 4 mg after dinner; 8 mg at bedtime)
Day 2: 20 mg orally (4 mg before breakfast; 4 mg after lunch; 4 mg after dinner; 8 mg at bedtime)
Day 3: 16 mg orally (4 mg before breakfast; 4 mg after lunch; 4 mg after dinner; 4 mg at bedtime)
Day 4: 12 mg orally (4 mg before breakfast; 4 mg after lunch; 4 mg at bedtime)
Day 5: 8 mg orally (4 mg before breakfast; 4 mg at bedtime)
Day 6: 4 mg orally (4 mg before breakfast)

肠胃外：
Sodium succinate (IV or IM); in emergency situations, IV is preferred
-High dose therapy: 30 mg/kg IV over at least 30 minutes every 4 to 6 hours until condition has stabilized, generally no more than 48 to 72 hours; after initial emergency period, a longer-acting injectable or oral preparation should be considered
-Alternatively, when oral therapy is not feasible, IM or IV administration may be substituted.

Acetate suspension (IM only): For prolonged systemic effect:
Initial dose: 4 to 120 mg IM; may repeat dose depending upon the degree of relief obtained from original injection.
-Alternatively, when oral therapy is not feasible, IM administration may be substituted; a single IM injection during each 24-hour period equal to the total daily oral dose is usually sufficient; when a prolonged effect is desired a weekly dose may be given as a single IM injection.

MAINTENANCE DOSING: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response.

评论：
-Doses exceeding usual doses may be justified in overwhelming, acute, life-threatening situations.
-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.
-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

LOCAL Effects: Acetate suspension only:

INTRA-ARTICULAR Administration:
General guidance: Actual doses may vary with severity of condition
-Large joints (knee, angles, shoulders): 20 to 80 mg via intra-articular injection
-Medium joints (elbows, wrists): 10 to 40 mg via intra-articular injection
-Small joints (metacarpophalangeal, interphalangeal, sternoclavicular, acromioclavicular): 4 to 10 mg via intra-articular injection
Injections may be repeated every 1 to 5 or more weeks, depending upon the degree of relief obtained from the original injection.

SOFT TISSUE Administration:
-For conditions of the tendinous or bursal structures: 4 to 30 mg
-Repeat injections may be needed for recurrent or chronic conditions.
-Product Information may be consulted for specific administration instructions

用途：
-As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.
-Intra-articular or soft tissue administration may be used as adjunctive therapy to tide patients over an acute episode or exacerbation of acute gouty arthritis, acute/subacute bursitis, acute nonspecific tenosynovitis, epicondylitis, or synovitis of osteoarthritis.

Usual Adult Dose for Neoplastic Diseases

Dosing should be individualized based on disease and patient response:

口服：
-Initial dose: 4 to 48 mg orally once a day or in divided doses

Alternatively, methylprednisolone Dosepak(R) :
Day 1: 24 mg orally (8 mg before breakfast; 4 mg after lunch; 4 mg after dinner; 8 mg at bedtime)
Day 2: 20 mg orally (4 mg before breakfast; 4 mg after lunch; 4 mg after dinner; 8 mg at bedtime)
Day 3: 16 mg orally (4 mg before breakfast; 4 mg after lunch; 4 mg after dinner; 4 mg at bedtime)
Day 4: 12 mg orally (4 mg before breakfast; 4 mg after lunch; 4 mg at bedtime)
Day 5: 8 mg orally (4 mg before breakfast; 4 mg at bedtime)
Day 6: 4 mg orally (4 mg before breakfast)

肠胃外：
Sodium succinate (IV or IM); in emergency situations, IV is preferred
-High dose therapy: 30 mg/kg IV over at least 30 minutes every 4 to 6 hours until condition has stabilized, generally no more than 48 to 72 hours; after initial emergency period, a longer-acting injectable or oral preparation should be considered
-Alternatively, when oral therapy is not feasible, IM or IV administration may be substituted.

Acetate suspension (IM only): For prolonged systemic effect:
Initial dose: 4 to 120 mg IM; may repeat dose depending upon the degree of relief obtained from original injection.
-Alternatively, when oral therapy is not feasible, IM administration may be substituted; a single IM injection during each 24-hour period equal to the total daily oral dose is usually sufficient; when a prolonged effect is desired a weekly dose may be given as a single IM injection.

MAINTENANCE DOSING: Adjust or maintain initial dose until a satisfactory response is obtained; then, gradually in small decrements at appropriate intervals decrease to the lowest dose that maintains an adequate clinical response.

评论：
-Doses exceeding usual doses may be justified in overwhelming, acute, life-threatening situations.
-Exogenous corticosteroids suppress adrenocorticoid activity the least when given at the time of maximal activity; consider time of maximal adrenal cortex activity (2 AM to 8 AM) when dosing.
-Alternate day therapy may be considered in patients requiring long-term treatment; it may be necessary to return to a full suppressive daily dose in the event of acute flare-ups.

LOCAL Effects: Acetate suspension only:

INTRA-ARTICULAR Administration:
General guidance: Actual doses may vary with severity of condition
-Large joints (knee, angles, shoulders): 20 to 80 mg via intra-articular injection
-Medium joints (elbows, wrists): 10 to 40 mg via intra-articular injection
-Small joints (metacarpophalangeal, interphalangeal, sternoclavicular, acromioclavicular): 4 to 10 mg via intra-articular injection
Injections may be repeated every 1 to 5 or more weeks, depending upon the degree of relief obtained from the original injection.

SOFT TISSUE Administration:
-For conditions of the tendinous or bursal structures: 4 to 30 mg
-Repeat injections may be needed for recurrent or chronic conditions.
-Product Information may be consulted for specific administration instructions

用途：
-As an anti-inflammatory or immunosuppressive agent when corticosteroid therapy is appropriate, such as treatment of certain allergic states; nervous system, neoplastic, or renal conditions; endocrine, rheumatologic, or hematologic disorders; collagen, dermatologic, ophthalmic, respiratory, or gastrointestinal diseases; specific infectious diseases or conditions related to organ transplantation.
-Intra-articular or soft tissue administration may be used as adjunctive therapy to tide patients over an acute episode or exacerbation of acute gouty arthritis, acute/subacute bursitis, acute nonspecific tenosynovitis, epicondylitis, or synovitis of osteoarthritis.

成年人的上con炎剂量

Dosing should be individualized based on disease and patient response:

口服：
-Initial dose: 4 to 48 mg orally once a day or in divided doses

Alternatively, methylprednisolone Dosepak(R) :
Day 1: 24 mg orally (8 mg before breakfast; 4 mg after lunch; 4 mg after dinner; 8 mg at bedtime)
Day 2: 20 mg orally (4 mg before breakfast; 4 mg after lunch; 4 mg after dinner; 8 mg at bedtime)
Day 3: 16 mg orally (4 mg before breakfast; 4 mg after lunch; 4 mg after dinner; 4 mg at bedtime)
Day 4: 12 mg orally (4 mg before breakfast; 4 mg after lunch; 4 mg at bedtime)
Day 5: 8 mg orally (4 mg before breakfast; 4 mg at bedtime)
Day 6: 4 mg orally (4 mg before breakfast)

肠胃外：
Sodium succinate (IV or IM); in emergency situations, IV is preferred
-High dose therapy: 30 mg/kg IV over at least 30 minutes every 4 to 6 hours until condition has stabilized, generally no more than 48 to 72 hours; after initial emergency period, a longer-acting injectable or oral preparation should be considered
-Alternatively, when oral therapy is not feasible, IM or IV administration may be substituted.

Acetate suspension (IM only): For prolonged systemic effect:
Initial dose: 4 to 120 mg IM; may r

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