Consequences of sudden discontinuation of methylprednisolone

When taking methylprednisolone, you cannot stop the medication suddenly. If you need to stop the medication, you must follow the doctor's advice. If you stop the medication suddenly, it may cause adverse reactions. Even if you need to stop the medication, you must stop it gradually, that is, reduce the amount gradually. This will avoid adverse effects on your health. Let us now understand the consequences of suddenly stopping methylprednisolone.

Consequences of sudden discontinuation of methylprednisolone

1. Depending on the treatment needs of different diseases, the initial dose of methylprednisolone tablets can be adjusted between 4 mg and 48 mg of methylprednisolone per day. (1) For patients with mild symptoms, a lower dose is usually sufficient; some patients may require a higher initial dose. (2) Diseases that require higher doses clinically include multiple sclerosis (200 mg/day), cerebral edema (200-1000 mg/day) and organ transplantation (up to 7 mg/kg/day). (3) If satisfactory clinical results are not seen after a period of adequate treatment, methylprednisolone tablets should be discontinued and other appropriate treatments should be used instead. (4) If the drug needs to be discontinued after long-term treatment, it is recommended to gradually reduce the dosage rather than withdraw the drug suddenly. (5) When clinical symptoms improve, the initial dose should be gradually reduced over an appropriate period of time until the lowest dose that can maintain the existing clinical effect is reached. This dose is the optimal maintenance dose.

2. Physicians should also pay attention to continuous monitoring of drug dosages. Dosage adjustments may be necessary when the following situations occur: (1) The condition improves or worsens, leading to changes in clinical manifestations. (2) Individual differences in patients’ responses to drugs. (3) The patient encounters a stressful situation unrelated to the disease being treated. (4) In the last case, it may be necessary to increase the dose of methylprednisolone tablets over a period of time depending on the patient's condition. It must be emphasized here that dosage requirements are not fixed and must be individualized according to the disease being treated and the patient's response. 3. Alternate day therapy (ADT).

Adverse Reactions

(1) There are no obvious adverse reactions when glucocorticoids are used in physiological doses for replacement therapy. Adverse reactions mostly occur when pharmacological doses are used, and are closely related to the course of treatment, dose, type of medication, usage and route of administration. Common adverse reactions are as follows. ⑴ Rapid intravenous administration of large doses may cause systemic allergic reactions, including swelling of the face, nasal mucosa, and eyelids, urticaria, shortness of breath, chest tightness, and wheezing. ⑵ Long-term medication may cause the following side effects: iatrogenic Cushing's syndrome facial and body shape, weight gain, lower limb edema, purple striae, easy bleeding tendency, poor wound healing, acne, menstrual disorders, avascular necrosis of the humeral or femoral head, osteoporosis or fractures (including vertebral compression fractures, pathological fractures of long bones), muscle weakness, muscular atrophy, hypokalemia syndrome, gastrointestinal irritation (nausea, vomiting), pancreatitis, peptic ulcer or intestinal perforation, growth inhibition in children, glaucoma, cataracts, benign intracranial hypertension syndrome, impaired glucose tolerance and worsening of diabetes. ⑶ Patients may experience psychiatric symptoms: euphoria, agitation, restlessness, delirium, disorientation, and may also manifest as inhibition. Psychiatric symptoms are particularly likely to occur in people with chronic wasting diseases and those who have had mental disorders in the past. This may occur when the dosage reaches 40 mg or more of prednisone per day and the medication is used for several days to two weeks. ⑷ Concurrent infection is the main adverse reaction of glucocorticoids . The main infections are fungi, tuberculosis, Staphylococcus, Proteus, Pseudomonas aeruginosa and various herpes viruses. It often occurs during medium-term or long-term therapy, but can also occur after short-term use of high doses. ⑸ Inhibition of the hypothalamus-pituitary-adrenal axis is an important complication of hormone therapy, and its occurrence is related to factors such as preparation, dosage, and course of treatment. If more than 20 mg of prednisone is used daily for more than 3 weeks, or if iatrogenic Cushing's syndrome occurs, adrenal suppression should be considered.