Indications : התוויות

4.1     Therapeutic indications
Methylprednisolone sodium succinate is indicated in the following conditions: 
Endocrine Disorders
• primary or secondary adrenocortical insufficiency (in conjunction with mineralocorticoids, where applicable)
• acute adrenocortical insufficiency (mineralocorticoid supplementation may be necessary) 

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•   shock secondary to adrenocortical insufficiency, or shock unresponsive to conventional therapy when adrenal cortical insufficiency may be present (when mineralocorticoid activity is undesirable)
•   preoperatively, or in the event of serious trauma or illness, in patients with known adrenal insufficiency or when adrenocortical reserve is doubtful
•   congenital adrenal hyperplasia
•   nonsuppurative thyroiditis
•   hypercalcemia associated with cancer.

Rheumatic Disorders (as adjunctive therapy for short-term administration in the management of an acute episode or exacerbation)

•   post-traumatic osteoarthritis
•   synovitis of osteoarthritis
•   rheumatoid arthritis, including juvenile rheumatoid arthritis
•   acute and subacute bursitis
•   epicondylitis
•   acute nonspecific tenosynovitis
•   acute gouty arthritis
•   psoriatic arthritis
•   ankylosing spondylitis.

Collagen Diseases and Immune Complex Diseases (during an exacerbation or as maintenance therapy in selected cases)
• systemic lupus erythematosus (and lupus nephritis)
• acute rheumatic carditis
• systemic dermatomyositis (polymyositis)
• polyarteritis nodosa
• Goodpasture's syndrome.

Dermatologic Diseases
• pemphigus
• severe erythema multiforme (Stevens-Johnson syndrome)
• exfoliative dermatitis
• severe psoriasis
• bullous dermatitis herpetiformis
• severe seborrheic dermatitis
• mycosis fungoides.

Allergic States (to control severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment)
• bronchial asthma
• contact dermatitis
• atopic dermatitis
• serum sickness
• drug hypersensitivity reactions
• urticarial transfusion reactions
• acute non-infectious laryngeal oedema (epinephrine is the drug of first choice).

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• herpes zoster ophthalmicus
• iritis, iridocyclitis
• chorioretinitis
• diffuse posterior uveitis and choroiditis
• optic neuritis
• sympathetic ophthalmia
• anterior segment inflammation
• allergic conjunctivitis
• allergic corneal marginal ulcers
• keratitis.

Gastrointestinal Diseases (to manage critical periods of the disease)
• ulcerative colitis
• regional enteritis.

Respiratory Diseases
• symptomatic sarcoidosis
• berylliosis
• fulminating or disseminated tuberculosis (when used concurrently with appropriate antituberculous chemotherapy)
• Loeffler's syndrome not manageable by other means
• aspiration pneumonitis
• moderate to severe Pneumocystis jiroveci pneumonia in AIDS patients (as adjunctive therapy when given within the first 72 hours of initial anti-pneumocystis treatment)
• exacerbations of chronic obstructive pulmonary disease (COPD).

Hematologic Disorders
• acquired (autoimmune) hemolytic anemia
• idiopathic thrombocytopenic purpura in adults
• secondary thrombocytopenia in adults
• erythroblastopenia (RBC anemia)
• congenital (erythroid) hypoplastic anemia.

Neoplastic Diseases (palliative management)
• leukemias and lymphomas in adults
• acute leukemia of childhood
• to improve quality of life in patients with terminal cancer.
Edematous States
• To induce diuresis or remission of proteinuria in the nephrotic syndrome without uremia.

Nervous System
• cerebral oedema from primary or metastatic tumors, or surgical or radiation therapy
• acute exacerbations of multiple sclerosis
• acute spinal cord injury. The treatment should begin within 8 hours of injury.

Other Indications
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•     tuberculous meningitis with subarachnoid block or impending block (when used concurrently with appropriate antituberculous chemotherapy)
•     trichinosis with neurologic or myocardial involvement
•     organ transplantation
•     prevention of nausea and vomiting associated with cancer chemotherapy.