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With therapeutically equivalent dosesthe likelihood of occurrence of troublesome side effects is less with methylprednisolone than with prednisolonemoreoverside effects actually have been conspicuously absent during clinical trials with MEDROL Tablets in dogs and catsHowevermethylprednisolone is similar to prednisolone in regard to kinds of side effects and metabolic alterations to be anticipated when treatment is intensive or prolongedIn animal patients with diabetes mellitususe of thaland on line pharmacy. methylprednisolone may be associated with an increase in the insulin requirementNegative nitrogen balance may occurparticularly in animals that require protracted maintenance therapymeasures to counteract persistent nitrogen loss include a high protein intake and the administration when indicatedof a suitable anabolic agentExcessive loss of potassiumlike excessive retention of sodiumis not likely to be induced by effective maintenance doses of MEDROLHoweverthese effects should be kept in mind and the usual regulatory measures employed as indicatedEcchymotic manifestationswhile not noted during the clinical evaluation in dogs and catsmay occurIf such reactions do occur and are seriousreduction in dosage or discontinuance of methylprednisolone therapy may be indicatedConcurrent use of daily oral supplements of ascorbic acid may be of value in helping to control ecchymotic tendencies.

Potentiated by CYP3A4 inhibitorsegketoconazolemacrolidescyclosporineestrogensAntagonized by CYP3A4 inducersegbarbituratesphenytoincarbamazepinerifampincholestyramineMay potentiate cyclosporineseizure riskMay antagonize oral anticoagulantsmonitorisoniazidIncreased risk of arrhythmias with digitalisMay need to adjust dose of antidiabetic agentsMonitor for hypokalemia with potassium-depleting drugsegamphotericin BdiureticsConcomitant neuromuscular blocking agentsincreased risk of myopathyWithdraw anticholinesterase agents at least 24hrs before initiating corticosteroid therapyAminoglutethimide may lead to loss of corticosteroid-induced adrenal suppressionIncreased GI effects with aspirinother NSAIDsCaution with aspirin in hypoprothrombinemiaMay suppress reactions to skin tests.

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