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While on corticosteroid therapy, patient should not be vaccinated against small-pox or other immune vaccines especially on high doses, because of possible hazards of neurological complications.
If corticosteroids are indicated in patients with latent tuberculosis or tuberculin reactivity, close observation is necessary as reactivation of the disease may occur.
Not recommended to patients with ocular herpes simplex because it may cause corneal perforation.
Administration of this drug may mask some signs of infection and new infections may appear during their use.
Long-term treatment may decrease body's stamina against infectious diseases.
Use in pregnancy and lactation: Not recommended in pregnant women and nursing mothers, except if clearly needed. Methylprednisolone may cause fetal damage when administered to pregnant women. Corticosteroid can diffuse into breast milk and may suppress or cause other side effects in the nursing infant. Infants born of mothers who have received substantial doses of corticosteroid during pregnancy should be carefully observed and evaluated for signs of adrenal insufficiency.
Use in children: Administration of pharmacological dose of glucocorticoids in children should be avoided because the drugs can retard bone growth. If the therapy is necessary, infant growth should be closely monitored. Alternate-day therapy given as single dose in the morning may minimize growth suppression and should be instituted if growth retardation occurs. High dosage of glucocorticoids in children may cause acute pancreatitis followed by pancreatic destruction.
Use in the elderly: Hypertension may occur during adrenocorticoid therapy. Geriatric patients, especially in post-menopausal women, may also be more likely to develop glucocorticoid-induced osteoporosis.
