Mortar and tablets Metizred

Metipred is a synthetic glucocorticosteroid, an analog of hormones produced by the adrenal cortex.

The active substance of this drug - methylprednisolone - is known for its pronounced effect on metabolic processes, flowing in the body, that is, this drug with full justification can be attributed to the category strong ones.

Metipred is available in two dosage forms: tablets and lyophilizate for the preparation of a solution for intravenous and intramuscular administration, thus, this drug is intended for systemic application. The drug has a number of clinically significant pharmacological effects, including anti-inflammatory, antiallergic, immunosuppressive.

Clinical and pharmacological group

GCS for oral administration.

Conditions of leave from pharmacies

It is released on prescription.

Price list

How much does the Metipred cost? The average price in pharmacies is at the level of210 rubles.

Form of issue and composition

Metipred is produced in the following dosage forms:

Tablets: flat, from white to almost white, round, with a transverse dividing risk and bevelled edge on one side; on one of the sides of 16 mg tablets is marked with the code "ORN 346" (in bottles of dark glass 30 and 100 pcs., 1 bottle in a cardboard bundle; containers of polyethylene for 30 and 100 pcs., 1 container in a cardboard bundle; in plastic containers of 30 pcs., 1 container in cardboard pack).
instagram viewer
Lyophilizate for solution for intravenous and intramuscular administration: hygroscopic, white or slightly yellowish lyophilized powder (in vials of 250 mg, complete with a solvent in or without ampoules, 1 vial per carton pack).

The composition of 1 bottle with lyophilizate includes:

Active substance: methylprednisolone - 250 mg (in the form of sodium succinate);
Auxiliary component: sodium hydroxide.

Solvent: water for injection - 4 ml.

The composition of 1 tablet includes:

Active substance: methylprednisolone - 4 or 16 mg;
Auxiliary components: talc, lactose monohydrate, purified water, corn starch, gelatin, magnesium stearate.

Pharmacological effect

Metired is a hormone from the glucocorticosteroid group. The active substance is methylprednisolone. The drug is able to interact with steroid receptors in the cytoplasm.

Metipred reduces the activity of the synthesis of certain proteins and enzymes that participate in the destruction of joints, as well as cytokines involved in inflammatory and immune reactions. The drug is able to reduce the tissue response to chemical thermal, immunological infectious and mechanical stimuli.

The drug helps to stabilize the hormonal background in women who take Metipred during pregnancy, if there is a problem of an overabundance of male hormones. The anti-inflammatory effect of Metipred is 5 times higher than the same effect of hydrocortisone and lasts from 18 to 36 hours. The drug is partially excreted by the kidneys (about five percent), the half-life period is two to three hours.

Indications for use

Why appoint Meti? Indications for use of this drug are as follows:

lung cancer;
subacute thyroiditis;
nephrotic syndrome;
myeloma;
hypoglycemic conditions;
hepatitis;
local enteritis, Crohn's disease, ulcerative colitis;
multiple sclerosis;
renal diseases of autoimmune genesis;
congenital adrenal hyperplasia;
adrenal insufficiency of primary or secondary type;
eye diseases of an allergic nature (conjunctivitis);
edema of the brain after prior parenteral administration of SCS;
asthmatic status, bronchial asthma;
small chorea, rheumatic carditis, acute rheumatism;
pulse therapy in the treatment of diseases in which GCS-therapy is effective;
Leffler's syndrome and berylliosis, which are not amenable to other treatment;
hypercalcemia due to oncological diseases, nausea and vomiting during cytostatic therapy;
prevention of rejection reaction during organ transplant;
aspiration pneumonia, pulmonary tuberculosis and meningitis of tuberculous origin;
interstitial lung diseases (second and third stage sarcoidosis, pulmonary fibrosis, acute alveolitis);
connective tissue diseases of a systemic nature (dermatomyositis, nodular periarteritis, scleroderma, SLE, also used in rheumatoid arthritis);
eye diseases of inflammatory nature (optic neuritis, severe sluggish posterior and anterior uveitis, sympathetic ophthalmia);
allergic diseases of a chronic or acute nature (pollinosis, drug exanthema, Quincke's edema, allergic rhinitis, urticaria, serum sickness);
Skin diseases (Stevens-Johnson syndrome, bullous herpetiform dermatitis, epidermal necrolysis of toxic character, exfoliative dermatitis, seborrheic dermatitis, toxicermy, contact and atopic dermatitis, eczema, psoriasis, pemphigus;
blood diseases and hematopoiesis system (erythroid hypoplastic anemia, erythroblastopenia, thrombocytopenia in adults of secondary type, thrombocytopenic purpura, lymphogranulomatosis, myeloid and lymphoid leukemia, autoimmune hemolytic anemia, panmyelopathy, agranulocytosis);
inflammatory joint disease of a chronic or acute nature (epicondylitis, synovitis, nonspecific tendosynovitis, bursitis, Still's syndrome adults, juvenile arthritis, ankylosing spondylitis, humerus periarthritis, polyarthritis, osteoarthritis, psoriatic and gouty arthritis.

Contraindications

Hypersensitivity to components of Metipred is the only contraindication for short-term therapy according to vital indications.

In children during the growth period, the drug should be used only under close supervision of the doctor and on absolute indications.

Precautions should be taken when:

pregnancy;
hypoalbuminemia;
nephrourolythiasis, severe chronic hepatic and / or renal insufficiency;
closed-angle or open-angle glaucoma, poliomyelitis, acute psychosis, systemic osteoporosis;
immunodeficiency states, lymphadenitis after receiving BCG vaccination, postvaccinal and pre-vaccination period;
latent and active tuberculosis, systemic mycosis, strongyloidosis, amebiasis, cortex, chicken pox, herpes zoster in the viremic phase, herpes simplex;
endocrine diseases (obesity of the third and fourth degree, Izenko-Cushing's disease, hypotereosis, thyrotoxicosis, diabetes mellitus);
diseases of the cardiovascular system (including the transferred myocardial infarction), hyperlipidemia, arterial hypertension, severe chronic heart failure;
diseases of the gastrointestinal tract (diverticulitis, newly created intestinal anastomosis, latent or acute peptic ulcer, gastritis, esophagitis, ulcer of the duodenum and stomach.

Use in pregnancy and lactation

During pregnancy, Metipred (especially in the first trimester) can be prescribed only for life indications. Since SCSs have the property of penetrating into breast milk, when the drug is used during the lactation period, breast-feeding should be discontinued. This statement is confirmed by many reviews of Metipred when planning pregnancy.

Metizred with IVF is prescribed for the regulation of the hormonal background. Its use is undesirable, therefore it is shown only in case of emergency on the prescription of a doctor.

Dosage and route of administration

The instructions for use indicate that Metipred tablets are taken orally. The dose of the drug and the duration of treatment is determined by the doctor individually, depending on the indications and severity of the disease.

The whole daily dose of the drug is recommended to take either a single or double daily dose - every other day, taking into account the circadian rhythm of endogenous secretion of GCS in the interval from 6 to 8 am. A high daily dose can be divided into 2-4 doses, with a large dose taken in the morning. Tablets should be taken during or immediately after meals, with a small amount of liquid.
The initial dose of the drug can be from 4 mg to 48 mg of methylprednisolone per day, depending on the nature of the disease. The dose should be reduced after achieving a therapeutic effect. With less severe diseases, it is usually sufficient to use lower doses, although higher doses may be required for individual patients. High doses may be required in such diseases and conditions as multiple sclerosis (200 mg / day), cerebral edema (200-1000 mg / day) and organ transplantation (up to 7 mg / kg / day). If a satisfactory clinical effect is not obtained after a sufficient period of time, the drug should be withdrawn and another type of therapy administered to the patient.
To children, the dose is determined by the doctor taking into account the mass or surface of the body. With adrenal insufficiency - inside 0.18 mg / kg or 3.33 mg / m2 / day in 3 doses, with other indications - 0.42-1.67 mg / kg or 12.5-50 mg / m 2 / day in 3 divided doses.

With prolonged use of the drug, the daily dose should be reduced gradually. Long-term therapy can not be stopped suddenly.

Lyophilizate for the preparation of injection solution

Metipred is administered intramuscularly or in the form of slow intravenous jet injections or intravenous infusions.

To prepare the solution immediately before use, the solvent is added to the vial with the lyophilizate. The prepared solution contains 6 mg / ml methylprednisolone.

In life-threatening states of 30 mg / kg Metipred administered intravenously for at least 30 minutes (as an additional therapy). The administration of the same dose can be repeated for 48 hours every 4-6 hours.

During the pulse therapy in the treatment of diseases in which glucocorticosteroids are effective, exacerbations diseases and / or ineffectiveness of standard methods of treatment. Metipred is prescribed as follows (intravenously):

Rheumatic diseases: 1-4 days to 1000 mg per day or 6 months to 1000 mg per month;
Multiple sclerosis: 3 or 5 days of 1000 mg per day;
Systemic lupus erythematosus: 3 days to 1000 mg per day;
Osteal conditions (for example, lupus nephritis, glomerulonephritis): 4 days at 30 mg / kg every other day, or 3, 5 or 7 days at 1000 mg per day.

The above doses should be administered for at least 30 minutes. If no improvement is achieved within 7 days of the therapy, or if the patient's condition requires it, the administration can be repeated.

In terminal stages of cancer, 125 mg per day for 2 months is administered daily to improve the quality of life.

During chemotherapy, characterized by a moderate or slight emetic effect, 250 mg of Metipre is injected intravenously for at least 5 minutes. The drug is used 1 hour before the introduction of the chemotherapeutic drug, at the beginning of the chemotherapy and after its completion. When expressed emetic action accompanying chemotherapy, intravenously injected 250 mg for at least 5 minutes at the same time as the corresponding doses of butyrofenone or metoclopramide 1 hour prior to the administration of the chemotherapy drug, then 250 mg at the beginning of the chemotherapy and after it endings.

The initial dose for other indications, depending on the nature of the disease, is 10-500 mg (intravenously). For short courses in acute severe conditions, higher doses may be required. The initial dose to 250 mg should be administered for at least 5 minutes, higher doses - at least 30 minutes. The following doses can be administered intravenously or intramuscularly, the duration of the intervals between administrations is determined by the patient's response to treatment and his clinical condition.

Children are prescribed lower doses (but not less, mg / kg per day), but first of all, when choosing a dose, it is important to take into account not the body weight and age of the patient, but the severity of the condition and response to therapy.

Side effects

The instruction says that the drug, like Metipred's analogues, especially when used for a long time, is able to cause the development of pobochki. The most common side effects are:

Digestive system - nausea, vomiting, flatulence (bloating), hiccups, peptic ulcer formation in the wall of the stomach or duodenum, erosive esophagitis, gastrointestinal hemorrhage, there may be an increase in the activity of enzymes of hepatic transaminases in the blood (ALT, AST), which indicates damage cells of the liver.
Cardiovascular system: arrhythmias, bradycardia (up to cardiac arrest); at predisposition - strengthening or development of expression heart failure, hypokalaemia-specific changes in the ECG, hypercoagulation, increased blood pressure, thrombosis; at myocardial infarction (acute and subacute) - slowing the formation of scar tissue, the spread of foci of necrosis (can cause a rupture of the heart muscles).
Nervous system - disorientation in time and space, delirium (acute mental disorder with concomitant appearance of visual, auditory hallucinations in the background motor and speech excitement), euphoria, depression (pronounced and prolonged decline in mood, his depression), insomnia, anxiety, nervousness, headache, periodic dizziness up to the development of vertigo (pronounced, intense dizziness), increased intracranial pressure, the appearance of obsessive thoughts down to paranoia.
Musculoskeletal system: closure before the period of epiphyseal growth zones (slowing down of processes ossification and growth in children), rupture of muscle tendons, osteoporosis, steroid myopathy, lowering muscle mass.
Endocrine system - a decrease in glucose tolerance, which is accompanied by an increase in its level in the blood after eating (especially after eating sweets and others easily digestible carbohydrates), the development of steroid diabetes mellitus against the background of a prolonged increase in the level of sugar in the blood, provoked by methylprednisolone, syndrome Itenko-Cushing (deposition of fat in the upper half of the trunk, characteristic "moon-shaped" face, intensive growth of hair on the body - hirsutism), delay of sexual development in children.
Metabolism: hypocalcemia, increased excretion of calcium, weight gain, negative nitrogen balance, increased sweating; due to mineralocorticoid drug activity - hypernatremia, sodium and fluid retention, hypokalemic syndrome (in the form of arrhythmia, hypokalemia, myalgia or muscle spasm, unusual fatigue and weakness).
The sensory organs - posterior cataract (opacity of the lens), increased intraocular pressure with a high risk of damage to the retina of the eye and optic nerve, propensity to development of infectious viral, bacterial or fungal lesions of eye tissues, trophic changes in the cornea with the formation of connective tissue in it, exophthalmos (bulging eye).
Allergic reactions: skin rash, anaphylactic shock, pruritus, local allergic reactions.
Code and subcutaneous tissue - a significant deterioration in the healing (regeneration) of skin lesions, thinning (hypotrophy or atrophy) of the skin, the appearance of petechiae (pinpoint hemorrhages on the skin), acne, the tendency to develop pyoderma (purulent bacterial skin lesions).
Local reactions with intravenous or intramuscular injection: infection of the injection site, numbness, burning, tingling, pain at the injection site; rarely - education scars at the injection site, necrosis of surrounding tissues, atrophy of subcutaneous tissue and skin with intramuscular injection (in particular, it is dangerous to administer the drug to the deltoid muscle).

Also, the drug leads to a decrease in the functional activity of immunity, in connection with which, against the background of its use, the development of various infectious complications is possible. With the development of side effects, the question about the abolition of tablets is decided by the attending physician, depending on their severity.

Overdose

Acute intoxication with methylprednisolone is unlikely. After a chronic overdose, due to the possible insufficiency of adrenal function, the dose of the drug should be gradually reduced.

special instructions

Since the complications of therapy with Metired preparation depend on the dose and duration of treatment, in each case Based on the analysis of the risk / benefit ratio, a decision is made on the need for such treatment, and also determines the duration of treatment and frequency of reception.

In order to better control the patient's condition, the lowest dose of Metipred should be used. When the effect is achieved, if possible, gradually reduce the dose to a maintenance dose or stop treatment.

In view of the risk of arrhythmia, the use of Metipred preparation in high doses should be carried out in a hospital equipped with the necessary equipment (electrocardiograph, defibrillator).

If long-term spontaneous remission occurs, treatment should be discontinued.

With prolonged treatment, the patient should undergo a regular examination (chest radiography, plasma glucose concentration 2 hours after eating, general urine analysis, blood pressure, body weight control, it is desirable to conduct an x-ray or endoscopic examination if there is a history of peptic ulcer disease Gastrointestinal tract).

It is necessary to carefully monitor the growth and development of children who are on long-term therapy with Metipred. Growth retardation can be observed in children receiving long-term daily, divided into several doses, therapy. Daily use of methylprednisolone for a long time in children is possible only on absolute indications. The use of the drug every other day may reduce the risk of developing this side effect or avoid it altogether.

Children receiving long-term therapy with Metipred are at increased risk for developing intracranial hypertension.

Metipred preparation should also be administered with great care to patients with confirmed or suspected parasitic infections, such as strongyloidiasis. Methylprednisolone-induced immunosuppression in these patients leads to strongyloid hyperinfection and dissemination of the process with widespread migration of larvae, often with the development of severe forms of enterocolitis and Gram-negative septicemia with possible lethal outcome.

Patients receiving drugs that suppress the immune system are more susceptible to infections than healthy individuals. For example, chickenpox and measles may have a more severe course, up to a lethal outcome in unimmunized children or in adults receiving Metipred.

Patients who may be exposed to stress on the background of therapy with Metizred, shows an increase in the dose of the drug before, during and after a stressful situation.

Against the background of therapy with Metizred, susceptibility to infections may increase, some infections can occur in an erased form, in addition, new infections can develop. In addition, the ability of the body to localize the infection process decreases. The development of infections caused by various pathogenic organisms, such as viruses, bacteria, fungi, protozoa or helminths, which localized in various systems of the human body, can be associated with the use of the drug Metired, both as a monotherapy, and in combination with other immunosuppressants that affect cellular immunity, humoral immunity or function neutrophils. These infections can be mild, however, in some cases, a severe course and even a lethal outcome is possible. Moreover, higher doses of the drug are used, the higher the probability of developing infectious complications.

Patients receiving treatment with Meti-prescription in doses that have an immunosuppressive effect are contraindicated in the administration of live or live weakened vaccines, but dead or inactivated vaccines can be administered, but the response to the administration of such vaccines may be reduced or even absent. Patients receiving treatment with Metiredent in doses that do not have immunosuppressive effects can be immunized according to the appropriate indications.

The use of Metipred with active tuberculosis should be limited to cases of fulminant and disseminated tuberculosis, when Metipred is used to treat the disease in combination with the corresponding anti-tuberculosis chemotherapy.

If Metizred is prescribed to patients with latent tuberculosis or positive tuberculin samples, the treatment should be carried out under strict medical supervision, since it is possible to reactivate disease. During prolonged therapy with the drug, such patients should receive appropriate preventive treatment.

It is reported that patients who received therapy with Metizred, had Kaposi's sarcoma. With the withdrawal of the drug may come a clinical remission.

In the application of Metipred in therapeutic doses for a long period may develop suppression of the hypothalamic-pituitary-adrenal system (secondary adrenocortical insufficiency). The degree and duration of insufficiency of the adrenal cortex are individual for each patient and depend on the dose, frequency of application, time of administration and duration of therapy.

The severity of this effect can be reduced by using the drug every other day or by gradually reducing the dose. This type of relative insufficiency of the adrenal cortex can continue for several months after end of treatment, therefore, under any stressful situations during this period, the drug should again be prescribed Metizred. Since the secretion of mineralocorticosteroids may be impaired, the concomitant use of electrolytes and / or mineralocorticosteroids is necessary.

The development of acute adrenal insufficiency, leading to a lethal outcome, is possible with a sharp cancellation of Metizred. The "cancellation" syndrome, apparently, not related to adrenal insufficiency, can also arise due to the sharp cancellation of the drug Metizred. This syndrome includes symptoms such as anorexia, nausea, vomiting, lethargy, headache, fever, joint pain, skin flaking, myalgia, weight loss and lowering blood pressure. It is assumed that these effects arise due to a sharp fluctuation in the concentration of methylprednisolone in the blood plasma, and not because of a decrease in the concentration of methylprednisolone in the blood plasma.

In patients with hypothyroidism or cirrhosis of the liver, the effect of Metipred is noted.

The use of Metizred can lead to an increase in the concentration of glucose in the blood plasma, worsening of the current diabetes mellitus. Patients receiving long-term therapy with Meti-prescription may be predisposed to the development of diabetes mellitus.

Against the background of therapy with the drug Metipred, it is possible to develop various mental disorders: from euphoria, insomnia, mood instability, personality changes and severe depression to acute mental manifestations. In addition, the already existing emotional instability or propensities to psychotic reactions may increase.

Potentially severe mental disorders can occur with the use of the drug Metizred. Symptoms usually appear within a few days or weeks after the start of therapy. Most reactions disappear either after a dose reduction or after the drug is discontinued. Despite this, specific treatment may be required.

Patients and / or their relatives should be warned that if there is a change in psychological status patient (especially with the development of a depressive state and suicidal attempts) it is necessary to apply for medical help. Also, patients or their relatives should be warned about the possibility of developing mental disorders during or immediately after lowering the dose of the drug or completely canceling it.

Prolonged use of Metizred can lead to the emergence of posterior subcapsular cataract and nuclear cataract (especially in children), exophthalmos or glaucoma with possible damage to the optic nerve and provoke attachment of a secondary ophthalmic fungal or viral infection. When using Metipred, there is an increase in blood pressure, fluid and salt retention in the body, loss of potassium, hypokalemic alkalosis. These effects are less pronounced when using synthetic derivatives, except for cases when they are used in large doses. It may be necessary to limit the need for salt and products containing sodium.

Therapy with Metizred can mask the symptoms of peptic ulceration and in this case perforation or bleeding can develop without a significant pain syndrome.

Such adverse reactions of Metipred from the cardiovascular system, such as dyslipidemia, increased blood pressure, can To provoke new patients in predisposed patients in case of high doses of Metipred and long-term treatment. In this regard, Metipred should be used with caution in patients with risk factors for cardiovascular disease. Regular monitoring of heart function is necessary. The use of low doses of Metipred every other day can reduce the severity of these side effects.

Patients taking the drug Metipred should be cautious about prescribing analgesics based on acetylsalicylic acid and NSAIDs.

Allergic reactions are possible. Due to the fact that in patients receiving SCS, rarely observed such phenomena as skin irritations and anaphylactic or pseudo-anaphylactic reactions, Before the appointment of the SCS, the necessary measures should be taken, especially if the patient has a history of allergic reactions to medication preparations. Due to the existing risk of corneal perforation, prescribe GCS in the treatment of eye infection caused by the herpes simplex virus (ophthalmoherpes) with caution.

High doses of GCS can cause acute pancreatitis.

Therapy with high doses of GCS can cause acute myopathy; with the disease most affected by patients with disorders of neuromuscular transfer (for example, myasthenia gravis), as well as patients receiving concomitant therapy with anticholinergics, for example, neuromuscular blockers transfer. Myopathy of this kind is generalized; it can affect the muscles of the eyes or the respiratory system and even lead to paralysis of all limbs. In addition, the level of creatine kinase may increase. In such cases, clinical recovery may take weeks or even years.

Osteoporosis is a common (but rarely detected) complication of long-term therapy with high doses of GCS.

SCS is cautiously prescribed for prolonged therapy in elderly patients because of the increased risk of osteoporosis and fluid retention in the body, potentially causing an increase in blood pressure.

Simultaneous treatment with methylprednisolone and fluoroquinolones increases the risk of rupture of tendons, especially in elderly patients.

High doses of GCS can cause pancreatitis in children.

High doses of methylprednisolone should not be used in cases of brain damage due to head trauma.

Because methylprednisolone may enhance the clinical manifestations of Cushing's syndrome, methylprednisolone should be avoided in patients with Isenko-Cushing's disease.

It is necessary to closely monitor patients receiving systemic GCS, and recently undergoing myocardial infarction.

Careful observation of patients with a history or present thrombosis or thromboembolic complications is necessary.

Impact on the ability to drive vehicles and manage mechanisms

In connection with the possibility of developing dizziness, visual impairment and weakness in the use of Metipred, caution should be exercised by individuals, manager of vehicles or engaged in activities that require increased concentration and speed of psychomotor reactions.

Drug Interactions

When using the drug, it is necessary to take into account the interaction with other drugs:

With simultaneous administration with NSAIDs, an increased risk of erosive and ulcerative gastrointestinal lesions is possible.
When combined with barbiturates, a decrease in the effectiveness of methylprednisolone is possible.
With simultaneous use with phenobarbital and phenytoin, the clearance of methylprednisolone increases and its effectiveness decreases.
In case of complex application, the effect of phenytoin may be reduced. With erythromycin - there is a possibility of inhibiting the metabolism of methylprednisolone. With cyclosporin - the inhibition of metabolism of methylprednisolone and cyclosporine.
With the combined use of methylprednisolone with oral anticoagulants, heparin, the anticoagulant effect is enhanced or decreased. With furosemide and thiazide diuretics - potentiation of hypokalemia is possible. With salicylates - it is possible to reduce the effect of salicylates.
With simultaneous use with insulin, metformin and glibenclamide, the effectiveness of hypoglycemic agents decreases. With itraconazole and ketoconazole - the concentration of methylprednisolone in the blood plasma increases. With methotrexate - synergism of immunosuppressive effects. With pankuronium, a reduction in the neuromuscular blockade. With pyridostigmine and neostigmine, a myasthenic crisis may develop. With salbutamol, an increase in the potential toxicity and effectiveness of salbutamol. With rifampicin - an increase in the clearance of methylprednisolone.

Reviews

We picked up some responses from people who took the drug Metipre:

Olga. Last year, I first encountered pollinosis - an allergy to flowering plants. It was unpleasant and uncomfortable to walk the streets, immediately began to flow tears. I decided to get rid of allergies forever and passed the course of Metipred. I took the pill according to the instructions and under the supervision of a doctor. It helped, this year the disease did not come.
Anna. His son was diagnosed with atopic dermatitis when he was just born. Doctors said that this disease is not treated, but it is possible to alleviate its symptoms. The child is in the growth phase, so he still can not take glucocorticosteroids, so we have an analogue of Metipred. We make a course of injections, while everything is fine. I hope that we will not need the GCS either.
Nastya. I've been buying a month now. 12 tablets per day (48 mg). The diagnosis is chronic glomerulonephritis. I follow the diet number 7. For a month I lost 4 kg, no cheeks grew (on the contrary, the cheekbones were clearer than steel), the skin was good, but it became straight silky, the vegetation did not increase. The first week was a little bit worried about insomnia, then passed. Soon I go to take tests, I'll see how the results on them. Who is afraid to take, do not listen to anyone, everything is very individual. But of course, if you do not want to fatten - keep the diet. All of health!

Analogues

Analogues of Metipred are: Ivepren, Medrol, Solu-Medrol, Methylprednisolone Sopharma, Lemod.

Before using analogues, consult your doctor.

Storage conditions and shelf life

Store in a place protected from light and out of the reach of children, at temperatures up to 25 ° C.

Shelf life of the lyophilizate and tablets is 5 years.

The prepared solution is stored at a temperature of 15-20 ° C for 12 hours; reconstituted solution - at a temperature of 2-8 ° C in the refrigerator for 24 hours.

How to choose probiotics for the intestine: a list of drugs.

Effective and inexpensive cough syrups for children and adults.

Modern non-steroidal anti-inflammatory drugs.

Review of tablets from the increased pressure of the new generation.

Antiviral drugs are inexpensive and effective.