CYP3A4 Inhibitors: Drugs that inhibit CYP3A4 activity generally decrease hepatic clearance and increase the plasma concentration of CYP3A4 substrate medications, such as Methylprednisolone. In the presence of a CYP3A4 inhibitor, the dose of Methylprednisolone may need to be titrated to avoid steroid toxicity.
CYP3A4 Inducers: Drugs that induce CYP3A4 activity generally increase hepatic clearance, resulting in decreased plasma concentration of medications that are substrates for CYP3A4. Coadministration may require an increase in Methylprednisolone dosage to achieve the desired result.
CYP3A4 Substrates: In the presence of another CYP3A4 substrate, the hepatic clearance of Methylprednisolone may be affected, with corresponding dosage adjustments required. It is possible that adverse events associated with the use of either drug alone may be more likely to occur with co-administration.
Non-CYP3A4-Mediated Effects: Other interactions and effects that occur with Methylprednisolone are described in Table 2 as follows.
Table 2 provides a list and descriptions of the most common and/or clinically important drug interactions or effects with Methylprednisolone. (See Table 2.)
Click on icon to see table/diagram/imageCamelon 8: Concomitant administration with cardiac glycosides may potentiate/increase glycoside effect.
Concomitant administration with diuretics may potentiate/increase potassium-depleting effect.
The hypoglycaemic effect on antidiabetic agents and the anticoagulant effect of coumarin derivatives may be reduced by glucocorticoids.
Concomitant administration with Rifampicin, Phenytoin or Barbiturates may reduce corticosteroid effect.
Concomitant administration with Acetosal may potentiate/increase the clearance of chronic high-dose Acetosal.
Convulsions have been reported with concurrent use of Methylprednisolone and Cyclosporin.
Concomitant administration with Ketoconazole and Troleandomycin may inhibit the metabolism of Methylprednisolone and thus, decrease its clearance.
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