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Drug Safety-related Labeling Changes (SrLC)

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DEPO-MEDROL (NDA-011757)

(METHYLPREDNISOLONE ACETATE)

Safety-related Labeling Changes Approved by FDA Center for Drug Evaluation and Research (CDER)

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11/04/2025 (SUPPL-124)

Approved Drug Label (PDF)

6 Adverse Reactions

Additions and/or revisions underlined:

Musculoskeletal: Aseptic necrosis of femoral and humeral heads, calcinosis (following intra-articular or intralesional use), Charcot-like arthropathy, loss of muscle mass, muscle weakness, osteoporosis, pathologic fracture of long bones, post injection flare (following intra- articular, soft tissue, and tendon sheath injections), steroid myopathy, tendon rupture, vertebral compression fractures.

Vascular: Flushing.

06/05/2024 (SUPPL-125)

Approved Drug Label (PDF)

5 Warnings and Precautions

WARNINGS

Additions and/or revisions underlined:

Cardio-renal

There have been cases reported in which concomitant use of amphotericin B and hydrocortisone was followed by cardiac enlargement and congestive heart failure (see CONTRAINDICATIONS and PRECAUTIONS: Drug Interactions, Amphotericin B injection and potassium-depleting agents).

Immunosuppression and Increased Risk of Infection

Corticosteroids, including DEPO-MEDROL, suppress the immune system and increase the risk of infection with any pathogen, including viral, bacterial, fungal, protozoan, or helminthic pathogens. Corticosteroids can:

  • Reduce resistance to new infections

  • Exacerbate existing infections

  • Increase the risk of disseminated infections

  • Increase the risk of reactivation or exacerbation of latent infections

  • Mask some signs of infection

     

    Corticosteroid-associated infections can be mild but can be severe and at times fatal. The rate of infectious complications increases with increasing corticosteroid dosages.

    Monitor for the development of infection and consider DEPO-MEDROL withdrawal or dosage reduction as needed.

    Do not administer DEPO-MEDROL by an intraarticular, intrabursal, intratendinous or intralesional route in the presence of acute local infection.

    Tuberculosis

    If DEPO-MEDROL is used to treat a condition in patients with latent tuberculosis or tuberculin reactivity, as reactivation of the disease may occur. Closely monitor such patients for reactivation. During prolonged DEPO-MEDROL therapy, patients with latent tuberculosis or tuberculin reactivity should receive chemoprophylaxis.

    Varicella Zoster and Measles Viral Infections

    Varicella and measles can have a serious or even fatal course in non-immune patients taking corticosteroids, including DEPO-MEDROL. In corticosteroid treated patients who have not had these diseases or are non-immune, particular care should be taken to avoid exposure to varicella and measles:

  • If a DEPO-MEDROL-treated patient is exposed to varicella, prophylaxis with varicella zoster immune globulin (VZIG) may be indicated. If varicella develops, treatment with antiviral agents may be considered.

  • If a DEPO-MEDROL-treated patient is exposed to measles, prophylaxis with immunoglobulin (IG) may be indicated.

    Hepatitis B Virus Reactivation

    Hepatitis B virus reactivation can occur in patients who are hepatitis B carriers treated with immunosuppressive dosages of corticosteroids, including DEPO-MEDROL. Reactivation can also occur infrequently in corticosteroid-treated patients who appear to have resolved hepatitis B infection.

    Screen patients for hepatitis B infection before initiating immunosuppressive (e.g., prolonged) treatment with DEPO-MEDROL. For patients who show evidence of hepatitis B infection, recommend consultation with physicians with expertise in managing hepatitis B regarding monitoring and consideration for hepatitis B antiviral therapy.

    Fungal Infections

    Corticosteroids, including DEPO-MEDROL, may exacerbate systemic fungal infections; therefore, avoid DEPO-MEDROL use in the presence of such infections unless DEPO-MEDROL is needed to control drug reactions. For patients on chronic DEPO-MEDROL therapy who develop systemic fungal infections, DEPO-MEDROL withdrawal or dosage reduction is recommended.

    Amebiasis

    Corticosteroids, including DEPO-MEDROL, may activate latent amebiasis. Therefore, it is recommended that latent amebiasis or active amebiasis be ruled out before initiating DEPO-MEDROL in patients who have spent time in the tropics or patients with unexplained diarrhea.

    Cerebral Malaria

    Avoid corticosteroids, including DEPO-MEDROL, in patients with cerebral malaria.

               

12/20/2023 (SUPPL-123)

Approved Drug Label (PDF)

5 Warnings and Precautions

PRECAUTIONS

Additions and/or revisions underlined:

Tumor Lysis Syndrome

In post marketing experience, tumor lysis syndrome (TLS) has been reported in patients with malignancies, including hematological malignancies and solid tumors, following the use of systemic corticosteroids alone or in combination with other chemotherapeutic agents. Patients at high risk of TLS, such as patients with tumors that have a high proliferative rate, high tumor burden and high sensitivity to cytotoxic agents, should be monitored closely and appropriate precautions should be taken.

07/24/2018 (SUPPL-114)

Approved Drug Label (PDF)

5 Warnings and Precautions

PRECAUTIONS

Newly added information:

Cardio-renal

Caution is required in patients with systemic sclerosis because an increased incidence of

scleroderma renal crisis has been observed with corticosteroids, including methylprednisolone.

09/08/2016 (SUPPL-104)

Approved Drug Label (PDF)

6 Adverse Reactions

  • Blood and lymphatic system disorders: Leukocytosis (addition)