Patient Medication Information: uses, side effects, how to take - Depo-Medrol
What DEPO-MEDROL is used for:
DEPO-MEDROL is used in adults and children to treat many conditions. These include allergic reactions and inflammation.
How DEPO-MEDROL works:
DEPO-MEDROL contains a corticosteroid hormone. It decreases the body’s immune response to certain diseases and reduces inflammation.
The ingredients in DEPO-MEDROL are:
Medicinal ingredient: Methylprednisolone acetate
Non-medicinal ingredients:
- DEPO-MEDROL multi-dose: Benzyl alcohol, dibasic sodium phosphate, monobasic sodium phosphate, polyethylene glycol 3350, polysorbate 80, and sodium chloride.
- DEPO-MEDROL single-use: Myristyl-gamma-picolinium chloride, polyethylene glycol 3350, and sodium chloride.
DEPO-MEDROL comes in the following dosage forms:
DEPO-MEDROL containing benzyl alcohol:
suspension; 20 mg/mL, 40 mg/mL and 80 mg/mL.
DEPO-MEDROL containing myristyl-gamma-picolinium chloride (MGPC):
suspension; 40 mg/mL and 80 mg/mL.
Do not use DEPO-MEDROL if:
- you are allergic to methylprednisolone acetate, to any other steroid medicine or any of the other ingredients in DEPO-MEDROL;
- you have any fungal infection or any untreated infection;
- you have a blood condition called idiopathic thrombocytopenic purpura if DEPO-MEDROL is given to you through injection into your muscle. This condition is when you have a low blood platelet count;
- you have recently received a type of vaccine called a live or live-attenuated vaccine. Do not receive this vaccine during treatment with DEPO-MEDROL;
- you have viral diseases including cowpox (vaccinia), chicken pox (varicella), and herpes simplex of the eye;
- you have unstable joints, when DEPO-MEDROL is injected into the joint.
DEPO-MEDROL should not be injected into your veins or your spine.
DEPO-MEDROL with the preservative benzyl alcohol should NOT be given to premature infants. However, DEPO-MEDROL with the preservative myristyl-gamma-picolinium chloride (MGPC) may be used.
To help avoid side effects and ensure proper use, talk to your healthcare professional before you are given DEPO-MEDROL. Talk about any health conditions or problems you may have, including if you:
- have an infection (such as herpes simplex, chicken pox, tuberculosis, threadworm);
- have recently had or are about to have any vaccine;
- have recently had heart problems such as a heart attack, heart failure or heart disease;
- have bleeding or blood clotting problems;
- have brittle bone disease (osteoporosis);
- have high blood pressure;
- have water retention (edema);
- have seizures or other nervous system problems;
- have thyroid problems;
- have muscle pain or weakness (such as myasthenia gravis);
- have a tumour of the adrenal glands (pheochromocytoma);
- have certain eye diseases such as glaucoma, cataracts, herpes infection or any problems with the retina;
- have kidney disease;
- have liver disease such as cirrhosis;
- have certain mental or mood conditions (such as depression);
- have stomach or gut problems (such as ulcers or ulcerative colitis);
- have low blood potassium or calcium;
- have Cushing’s disease (caused by an excess of cortisol hormone);
- have weak immune response. Tell your healthcare professional if you suspect an infection has occurred, as corticosteroids (such as DEPO-MEDROL) can make infections more likely and may mask their signs;
- have diabetes or high blood sugar;
- have a condition known as systemic sclerosis, in which your body makes too much of a protein called collagen.
- had prior use of DEPO-MEDROL.
Other warnings you should know about:
DEPO-MEDROL with benzyl alcohol (preservative) is suitable for multidose use. However, multidose use of DEPO-MEDROL is not recommended for intrasynovial injection (injection to the joint).
DEPO-MEDROL can cause serious side effects, including:
- Kaposi’s sarcoma (skin cancer): Kaposi's sarcoma has been reported with corticosteroid therapy, such as DEPO-MEDROL. Stopping treatment of DEPO-MEDROL may result in signs of this cancer going away.
- Pheochromocytoma (tumour of the adrenal glands): This tumour has been reported with corticosteroid therapy, such as DEPO-MEDROL. Pheochromocytoma may cause death.
- Epidural lipomatosis (fat deposition on or outside the lining of the spine): Taking corticosteroids in high doses for a long period of time can cause epidural lipomatosis.
Surgery:
Before you have any operation, tell your health care professional (for example, your doctor, dentist or anesthetist) that you are taking DEPO-MEDROL.
Pregnancy and breastfeeding:
If you are pregnant, or still able to get pregnant and/or breast-feed, there are specific risks you must discuss with your healthcare professional. Taking DEPO-MEDROL may:
- slow the growth and cause low birth weight of the baby;
- cause cataracts in babies. This risk is associated with mothers who take corticosteroids for a long period of time during pregnancy.
- You should tell your healthcare professional if you are breast feeding or planning to breastfeed as small amounts of corticosteroid medicines (such as DEPO-MEDROL) may get into breast milk.
Male fertility:
Taking DEPO-MEDROL may affect male fertility.
Stopping treatment:
Talk to your healthcare professional before stopping DEPO-MEDROL.
If you suddenly stop taking DEPO-MEDROL, you may experience:
- Serious adrenal insufficiency: This is when the body does not make enough of the cortisol hormone. This may cause death.
- “Withdrawal syndrome”: This includes symptoms such as anorexia, nausea, vomiting, lack of energy, headache, fever, joint pain, peeling of skin, muscle pain, weight loss, and/or low blood pressure.
Immune system:
- If you or your child is exposed to measles or chickenpox during treatment with DEPO-MEDROL, contact your healthcare professional immediately. Serious or fatal side effects can occur if you or your child have not already had these infections or immunized/vaccinated for these infections previously.
DEPO-MEDROL may:
- hide symptoms of infection;
- worsen symptoms of existing infections;
- cause new infections due to lowered body resistance.
Skin:
- Dents/holes may appear at the site of injection.
- Tell your healthcare professional you are taking DEPO-MEDROL since it can affect the results of skin tests.
Children (less than 18 years of age):
- Children may experience a decrease in the speed of their growth. The healthcare professional will prescribe the lowest dose to minimize this risk.
- The healthcare professional will conduct frequent tests on the child if they are taking DEPO-MEDROL for a long period of time. Taking methylprednisolone for a long period of time increases the risk of developing a high intracranial pressure (growing pressure in skull).
- If methylprednisolone is given to a prematurely born baby, monitoring of the heart may be needed.
- DEPO-MEDROL with the preservative benzyl alcohol is not recommended to be used in premature and low-birth infants since benzyl alcohol has been reported to cause “gasping syndrome” that may result in death.
Driving and using machines:
DEPO-MEDROL may cause dizziness, vertigo, vision problems and fatigue. If you experience these side effects you should not drive or operate machinery.
Tell your healthcare professional about all the medicines you take, including any drugs, vitamins, minerals, natural supplements or alternative medicines.
The following may interact with DEPO-MEDROL:
Medicines used to:
- treat glaucoma and epilepsy such as acetazolamide
- prevent or treat nausea and vomiting associated with cancer chemotherapy treatment such as aprepitant or fosaprepitant
- treat cancer such as cyclophosphamide
- treat Cushing’s syndrome, breast or ovarian cancer (aromatase inhibitors) such as aminoglutethimide
- “thin” the blood or prevent blood clotting (anticoagulants) such as acenocoumarol, phenindione and warfarin
- treat myasthenia gravis (a muscle condition) such as distigmine and neostigmine
- treat bacterial and fungal infections (antibiotics and antifungals) such as ketoconazole, itraconazole, amphotericin B, erythromycin, clarithromycin, troleandomycin, rifampin and rifabutin
- treat inflammation such as aspirin and non-steroidal anti-inflammatory medicines (also called NSAIDs) like ibuprofen
- treat epilepsy such as barbiturates, carbamazepine, phenobarbital, phenytoin and primidone
- treat heartburn and acid indigestion such as cimetidine
- help prevent organ rejection such as cyclosporine or tacrolimus
- treat heart problems or high blood pressure such as digoxin and diltiazem
- reduce extra fluid in the body (diuretics, also known as “water pills”)
- for hormone replacement therapy or hormonal oral contraceptives such as ethinyl estradiol and norethindrone
- treat HIV infections such as indinavir or ritonavir
- in surgery to block signals between nerves and muscles (neuromuscular blocking agents) such as pancuronium or vecuronium
- vaccines. Tell your healthcare professional if you have recently had, or are about to have any vaccination
- treat diabetes
- treat tuberculosis such as isoniazid
- treat high cholesterol such as cholestyramine
Do not eat grapefruit or drink grapefruit juice while taking DEPO-MEDROL.
How DEPO-MEDROL is given:
DEPO-MEDROL will be given to you by your healthcare professional. They will decide to give DEPO-MEDROL to you by either:
- Injection to your joint (intra-articular or intrasynovial);
- Injection into your muscle (intramuscular); or
- Injection into your lesion (intralesional).
- Your healthcare professional will decide on the site of injection, as well as how much of the medicine and how many injections you will receive.
- The healthcare professional will prescribe the lowest possible dose for the minimum period of time.
Usual dose:
The dose you will receive depends on:
- the condition you are being treated for;
- the severity of your condition;
- your response to the treatment; and
- your exposure to physical stress like infection, surgery or injury.
Overdose:
| If you think you, or a person you are caring for, have been given too much DEPO-MEDROL, contact a healthcare professional, hospital emergency department, regional poison control centre or Health Canada’s toll-free number, 1-844 POISON-X (1-844-764-7669) immediately, even if there are no signs or symptoms. |
|---|
Possible side effects from using DEPO-MEDROL:
These are not all the possible side effects you may have when taking DEPO-MEDROL. If you experience any side effects not listed here, tell your healthcare professional.
Side effects of DEPO-MEDROL may include:
- facial blushing;
- skin problems such as reddish spot containing blood that appears in skin, red or tender bumps on your skin, acne, rash, redness, itchy skin, dry and scaly skin, increased sweating, lightening or darkening of an area of skin, abscess (pocket of pus), thinning of hair, and stretch marks;
- abnormal hair growth;
- gastrointestinal problems such as nausea, vomiting, diarrhea, altered sense of taste, abdominal pain, bloating, abnormal appetite, and indigestion;
- loss of muscle mass and muscle weakness;
- muscle cramps and spasms;
- nervous system problems (including nerve inflammation and damage) such as headache, pain, tenderness, impaired sensation, strength and reflexes, sensation of heat, cold, numbness, sensation of tingling, tickling, prickling, or burning of a person's skin, vertigo, dizziness, forgetfulness, twitching, drowsiness, ringing in ears, and tremors;
- abnormal behaviour such as anxiety, nervousness, confusion, euphoria (intense feelings of well-being, elation, happiness, excitement and joy), personality changes, irritability, mood swings/emotional instability, mania (feeling high), drug dependence, and trouble sleeping;
- irregular periods;
- memory loss;
- suppressed growth in children.
DEPO-MEDROL can cause abnormal blood test results. Your healthcare professional will decide when to perform the tests and interpret the results.
Serious side effects and what to do about them
| Frequency/Side Effect/Symptom | Talk to your healthcare professional | Stop taking this drug and get immediate medical help | |
|---|---|---|---|
| Frequency/Side Effect/Symptom | Talk to your healthcare professional | Stop taking this drug and get immediate medical help | |
| Frequency/Side Effect/Symptom | Talk to your healthcare professional | Stop taking this drug and get immediate medical help | |
| Frequency/Side Effect/Symptom | Talk to your healthcare professional | Stop taking this drug and get immediate medical help | |
| Frequency/Side Effect/Symptom | Talk to your healthcare professional | Stop taking this drug and get immediate medical help | |
| Frequency/Side Effect/Symptom | Talk to your healthcare professional | Stop taking this drug and get immediate medical help | |
| Only if severe | In all cases | ||
| Only if severe | In all cases | ||
| Only if severe | In all cases | ||
| Only if severe | In all cases | ||
| Only if severe | In all cases | ||
| Only if severe | In all cases | ||
| Unknown | |||
| Abnormal (high or low) blood pressure: headaches, dizziness, fainting, light-headedness, blurred vision, nausea, vomiting, fatigue (may occur when you go from lying or sitting to standing up), racing pulse, or heart palpitations. | √ | ||
| Allergic reactions: rash, hives, swelling of the face, lips, tongue, or throat, itching, difficulty swallowing, difficulty breathing, drop in blood pressure, dizziness, fainting, | √ | ||
| wheezing, nausea, or vomiting. | |||
| Arrhythmia (abnormal heart rhythms): fast, slow, pounding, or irregular heartbeat. | √ | ||
| Aseptic necrosis (tissue death): progressive or persistent pain, limited range of motion in a joint or limb, joint pain, swelling, tenderness, weakness, or joint stiffness. | √ | ||
| Bladder problems: not reaching the bathroom in time, or having to pee multiple times during the night. | √ | ||
| Bleeding, poor wound healing | √ | ||
| Blood clots: swelling, pain or tenderness, usually in the arm or leg, tingling, numbness, pale skin, muscle pain, or muscle spasms. | √ | ||
| Breathing problems or breathing stops | √ | ||
| Cardiac arrest (heart stops beating suddenly): fatigue, loss of consciousness, dizziness, nausea, chest pain, shortness of breath, or pounding heart beat. | √ | ||
| Cardiomyopathy in children (thickening of the heart muscle): fatigue, cough, shortness of breath, swelling, poor growth, or difficulty gaining weight. | √ | ||
| Charcot joint disease (foot and ankle issues due to nerve-related problems): joint swelling, foot pain, or heat or redness over the joint. | √ | ||
| Coma (deep loss of consciousness) | √ | ||
| Cushingoid syndrome (increased cortisol levels): weight gain, rounded “moon” face, thin and fragile skin, easy bruising, fatigue, headache, or weak muscles. | √ | ||
| Depression (sad mood that won’t go away): difficulty sleeping, sleeping too much, changes in appetite or weight, feelings of worthlessness, | √ | ||
| guilt, regret, helplessness or hopelessness, withdrawal from social situations, family, gatherings and activities with friends, or reduced libido (sex drive). | |||
| Diabetes (high blood sugar) or decreased sugar tolerance: increased thirst, increased urination, increased appetite, or have blurry vision. | √ | ||
| Edema (swelling or fluid retention): unusual swelling of the arms, hands, legs, feet and ankles, face or airway passages. | √ | ||
| Epidural lipomatosis (fat build-up around the spine): back pain, weakness, loss of sensation, or reflexes that are too slow or too fast. | √ | ||
| Eye problems including cataracts: retina pulled away from normal position, double vision, blurry vision, eye pain, increased pressure in the eyes, blindness in one or both eyes, or bulging eyes. | √ | ||
| Flare up of a previous tuberculosis: cough that does not go away, fever, loss of weight, coughing blood, or pain in the chest. | √ | ||
| Fractures (broken bones): pain, bruising, swelling over the broken bone, or sudden pain that is worse when walking or standing. | √ | ||
| Heart attack: pressure or squeezing pain between the shoulder blades, in the chest, jaw, left arm or upper abdomen, shortness of breath, dizziness, fatigue, light-headedness, clammy skin, sweating, indigestion, anxiety, feeling faint, or irregular heartbeat. | √ | ||
| Heart failure: dizziness, fatigue, weakness, shortness of breath, fainting, irregular heart rate, or fast | √ | ||
| pounding heart beat. | |||
| Increased intracranial pressure (pressure within the skull with swelling) | √ | ||
| Infections: symptoms of an existing infection worsen, reactivation of a dormant infection, persistent fever, cough, feeling unwell, sore throat, painful urination, eye pain, eye discharge. | √ | ||
| Injection site infections/reactions: blistering, pain, skin changes or depressions, tenderness, warmth in the area around the injection, or inflammation. | √ | ||
| Kaposi's sarcoma (cancer that causes tumours in the blood vessels and skin): slightly elevated purple, pink, brown, black, blue, or red blotches or bumps anywhere on the skin or in the mouth and/or throat. | √ | ||
| Liver problems including liver injury and hepatitis (inflammation of the liver): yellowing of the skin or whites of eyes, urine turns dark, nausea, vomiting, lower stomach pain, fatigue, fever, light-coloured stool, or unusual tiredness. | √ | ||
| Meningitis (infection of membranes that surround brain and spinal cord): fever, nausea, vomiting, headache, stiff neck, extreme sensitivity to bright light, confusion, seizures, sleepiness, difficulty waking, no appetite or thirst, or skin rash. | √ | ||
| Metabolic acidosis (high level of acid in the blood): fatigue, abdominal pain, confusion, dizziness, loss of appetite, headache, nausea, vomiting, weakness, or increased heart rate. | √ | ||
| Osteoporosis (thin, fragile bones): broken bones, joint pain, bone pain, or back pain that gets worse when | √ | ||
| standing or walking. | |||
| Pancreatitis or esophagitis (inflammation of the pancreas or esophagus): abdominal pain, nausea, vomiting, hard or painful swallowing, heartburn, fever, rapid heart beat, or tenderness when touching the abdomen. | √ | ||
| Perforation of the bowel (a hole in the intestines): abdominal pain, feeling bloated, nausea, vomiting, chills, or fever. | √ | ||
| Peritonitis (inflammation of the stomach lining): severe abdominal pain that is worse when you move, feeling sick to your stomach or throwing up, fever, or swollen belly. | √ | ||
| Pheochromocytoma (adrenal gland tumour): high blood pressure, sweating, rapid heartbeat, pale appearance, or headache. | √ | ||
| Rhabdomyolysis (breakdown of damaged muscle): muscle pain that you cannot explain, muscle tenderness or weakness, dark urine. | √ | ||
| Schizophrenia or worsening of schizophrenia: hallucinations (feeling, seeing, or hearing things which do not exist), delusions, disorganized or incoherent thinking, feeling paranoid, suspicious, or scared. | √ | ||
| Seizures (fits): loss of consciousness with uncontrollable shaking. | √ | ||
| Skin cancer (unusual skin growth): blotches of skin that may be red, purple, brown or black and may be raised. | √ | ||
| Stomach ulcers (burst or bleeding ulcers): stomach pain, bleeding from the rectum, black or bloodstained stools, vomiting blood, loss of appetite, or weight loss. | √ | ||
| Suicidal thoughts or actions | √ | ||
| Suppression of hypothalamic pituitary-adrenal axis: (body’s responses to natural stress do not work properly): fatigue, depression and anxiety, difficulty sleeping, weakness, or loss of muscle mass. | √ | ||
| Tendon rupture (particularly of the Achilles tendon): a snap or popping sound with severe pain at the site of the break, bruising, or inability to use the arm or leg with the break. | √ | ||
| Thinning of skin, fragile skin | √ | ||
| Tumour lysis syndrome (sudden, rapid death of cancer cells due to the treatment): life-threatening kidney failure and heart problems, nausea, shortness of breath, irregular heartbeat, heart rhythm disturbances, lack of urination, clouding of urine, muscle spasms, muscle twitching, tiredness, joint pain, severe muscle weakness, or seizures. | √ | ||
If you have a troublesome symptom or side effect that is not listed here or becomes bad enough to interfere with your daily activities, tell your healthcare professional.
Reporting side effects
You can report any suspected side effects associated with the use of health products to Health Canada by:
NOTE: Contact your healthcare professional if you need information about how to manage your side effects. The Canada Vigilance Program does not provide medical advice. |
Storage:
For DEPO-MEDROL containing benzyl alcohol: Store between 15°C and 30°C. Protect from freezing.
- For DEPO-MEDROL containing myristyl-gamma-picolinium chloride (MGPC): Store between 20°C to 25°C. Excursions permitted between 15°C to 30°C. Protect from freezing.
- Keep out of reach and sight of children.
If you want more information about DEPO-MEDROL:
- Talk to your healthcare professional
- Find the full product monograph that is prepared for healthcare professionals and includes the Patient Medication Information by visiting the Health Canada Drug Product Database website: (https://www.canada.ca/en/health-canada/services/drugs-health-products/drug-products/drug-product-database.html); the manufacturer’s website http://www.pfizer.ca; or by calling 1-800-463-6001.
Date of Authorization: 2025-06-19