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ReviewerNo.1Section3

ANTIALLERGICSANDMEDICINESUSEDINANAPHYLAXIS

Forproposedyellows:Arethesemedicinesforchildren?

Dothese

medicines

meet

apublic

health?

Chlorphenamine: Yes.

Dothesemedicinesmeetapublichealth?

Yes.Chlorphenamine

Aretheyregisteredforusein(allagecategoriesof)children?

No.

Chlorphenaminemaleateoral:Dosesforchildrenare:1to2years,1mgtwicedaily;2to5years,1mgevery4to6hours(maximum6mgdaily);6to12years,2mg every4to6hours(maximum12mgdaily).Martindale33ed.,P.412

Chlorphenaminemaleateoral:Children

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RegistroCochranedeEnsaiosControlados(CENTRAL/CCTR)Loratadineanddexchlorpheniramineinthetreatmentofperennialallergicrhinitisinpediatricpatients]Effectofallergymedicationonchildrensreadingcomprehension.Efficacyandsafetyofloratadinesuspensioninthetreatmentofchildrenwithallergicrhinitis.Comparativestudyoftheefficacy,toleranceandsideeffectsofdexchlorpheniraminemaleate6mgb.i.d.withterfenadine60mgb.i.d.ComparisonofCNSadverseeffectsbetweenastemizoleandchlorpheniramineinchildren:arandomized,doubleblindstudy.

Anaphylaxis

Patientswithsevereanaphylacticoranaphylactoidreactionsshouldbegivenimmediatetreatmentwithadrenaline(seeAnaphylaxisandAnaphylacticShock,AdrenalineHydrochloride).Additionofaparenteralantihistaminesuchaschlorphenaminemaleateordiphenhydraminehydrochlorideandacorticosteroidsuchashydrocortisoneaftertheacuteepisodemaydecreasethedurationandseverityofsymptomsandpreventrelapse.

MARTINDALE TheCompleteDrugReferenceacessoem28/05/2007

Indicationsanddose

Symptomaticreliefofallergysuchashayfever,urticaria

Bymouth

Child1month2years

1mgtwicedaily

Child26years

1mgevery46hours,max.6mgdaily

Child612years

2mgevery46hours,max.12mgdaily

Child1218years

4mgevery46hours,max.24mgdaily

Symptomaticreliefofallergy,emergencytreatmentofanaphylacticreactions

Bysubcutaneous,intramuscularorintravenousinjection

Child1month1year

250micrograms/kg(max.2.5mg),repeatedifrequiredupto4timesin24hours

Child16years

2.55mg,repeatedifrequiredupto4timesin24hours

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salud.org/cochrane/show.php?db=central&mfn=58036&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=58036&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=58036&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=58036&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=58036&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=58036&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=58036&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=58036&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=58036&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=58036&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=58036&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=58036&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=58036&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=58036&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=58036&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=58036&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=92537&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=92537&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=92537&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=92537&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=92537&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=92537&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=92537&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=92537&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=92537&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=92537&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=92537&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=92537&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=92537&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=92537&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=92537&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=92537&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=92537&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=92537&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=92537&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=92537&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=92537&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=92537&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=92537&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=92537&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=92537&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=92537&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=92537&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=92537&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=92537&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=92537&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=92537&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=92537&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=92537&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=92537&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=92537&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=92537&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane/show.php?db=central&mfn=92537&id=&lang=pt&dblang=&lib=COChttp://cochrane.bvsalud.org/cochrane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ow.php?db=central&mfn=48630&id=&lang=pt&dblang=&lib=COC

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3/7

Child612years

510mg,repeatedifrequiredupto4timesin24hours

Child1218years

1020mg,,repeatedifrequiredupto4timesin24hours(max.40mgin24hours)

NOTE

Intravenous route recommended for anaphylaxis; subcutaneous and intramuscular injections

rarely act quicker than oral administration

Licenseduse

syrupnotlicensedforuseinchildrenunder1year;tabletsnotlicensedforuseinchildrenunder6years;injectionnotlicensedforuseinneonates

Administration

forintravenousinjection,giveover1minute;ifsmalldoserequired,dilutewithSodiumChloride0.9%

Antihistaminesshouldbeusedwithcautioninhepaticimpairment,andthedosemayneedtobereducedinrenalimpairment;also,usewithcautioninchildrenwithepilepsy.Mostantihistaminesshouldbeavoidedinporphyria,butsome(e.g.chlorphenaminearethoughttobesafe.Sedatingantihistaminesshouldnotbegiventochildrenunder2years,exceptonspecialistadvice,becausethesafetyofsuchusehasnotbeenestablished.Sedatingantihistamineshavesignificantantimuscarinicactivitytheyshouldnotbeusedinneonatesandshouldbeusedwithcautioninchildrenwithurinaryretention,glaucoma,orpyloroduodenalobstruction.Hepaticimpairment

Sedatingantihistaminesshouldbeavoidedinchildrenwithsevereliverdiseaseincreasedriskofcoma.

Sideeffects

Drowsinessisasignificantsideeffectwithmostoftheolderantihistaminesalthoughparadoxicalstimulationmayoccurrarelyinchildren,especiallywithhighdoses.Drowsiness

maydiminishafterafewdaysoftreatmentandisconsiderablylessofaproblemwiththenewerantihistamines(seealsonotesabove).Sideeffectsthataremorecommonwiththeolderantihistaminesincludeheadache,psychomotorimpairment,andantimuscariniceffectssuchasurinaryretention,drymouth,blurredvision,andgastrointestinaldisturbances.Otherraresideeffectsofantihistaminesincludehypotension,extrapyramidaleffects,dizziness,confusion,depression,sleepdisturbances,tremor,convulsions,palpitation,arrhythmias,hypersensitivityreactions(includingbronchospasm,angioedema,anaphylaxis,rashes,andphotosensitivityreactions),blooddisorders,andliverdysfunction.

Sideeffects

Alsoexfoliativedermatitisandtinnitusreported;injectionsmaycausetransienthypotensionorCNSstimulationandmaybeirritant

CDBNFC,2006.

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Forgreens:Isthereanyreasonnottoendorsetheseasessential medicinesfor children?

Dexamethasone

Dothesemedicinesmeetapublichealth?Yes?TEMOSDVIDAS

Aretheyregisteredforusein(allagecategoriesof)children?YesNeonates:I.V.Usual:0,25mg/kg/dosegiven~4hourspriortoscheduledextubationandthenevery8hoursfor3dosestotal;range:0,251mg/kg/dosefor13doses;maximumdose1mg/kg/day.Children:I.V.,I.M:0,5 2mg/kg/dose individeddosesevery6hours;begin24hourspriortoextubationandcontinuefor46dosesafterextubation.PediatricDosageHandbookAmericanPharmaceuticalAssociation,2001/2002P.308.

Aretheyanyunanswered/unexpectedclinicalissueswithrespecttoeffectivenessor

safety?

No.

Aretherespecialrequirementsortrainingneededforsafe/effectiveuse?

No.

Additionalcommentsifany:

ActionproposedfortheCommitteetotake:

PERGUNTAAOSPEDIATRAS:NECESSRIODEXAMETAZONAPARAUSOEM

ANAFILAXIA,

ALERGIAS?

Epinephrine

Dothesemedicinesmeetapublichealth?Yes

Aretheyregisteredforusein(allagecategoriesof)children?Yes

Thedoseofepinephrineshouldbe0.01mg/kg,uptoamaximumof0.30mg.Thispresentsadilemmaforcliniciansinthattheprefilledautoinjectorkitsusedosesofonly

0.15and

0.30

mg/

kg,

making

the

precise

dosing

of

children

and

adolescents

difficult

if

notimpossible.Whilethereislittledirectevidencecomparingonedosewithanother,theauthorssuggestthefollowingdosingalgorithmbasedonpatientweight:o 10kgorless:Consideruseofampuleofepinephrinewithneedleandsyringeto

drawcorrectdose(0.01mg/kg)ofepinephrine.Themaindifficultieswiththisapproacharetimingandaccuracy.Onestudydemonstratedthatparentsrequired142secondstodrawadoseof0.09mLofepinephrinevs52secondsforclinicians.Moreover,theactualdoseofepinephrinedrawnbyparentsrangedbetween0.004and0.151mL.

o 10to25kg:Autoinjectionwith0.15mgofepinephrine.

o 25

kg

or

more:

Autoinjection

with

0.30

mg

of

epinephrine.

Aseconddoseofepinephrineisrequiredforanaphylaxisinupto35%ofcases.Epinephrinemayberepeated5to20minutesaftertheinitialdose.

Brasil:(RENAME)somentesolinjetvel1mg/ml

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http://www.medscape.com/viewarticle/554150acessoem22/05/2007

PediatricDosageHandbookAmericanPharmaceuticalAssociation,2001/2002P.386

Aretheyanyunanswered/unexpectedclinicalissueswithrespecttoeffectivenessor

safety?No.

Theriskiswellknown.Anecessidadedefazerumadiluiomuitograndeumrisco.

Aretherespecialrequirementsortrainingneededforsafe/effectiveuse?

Yes;carefuldilutionprocedure

Possibletransientadverseeventsassociatedwithepinephrineadministrationincludetremor,anxiety,andpalpitations.Epinephrineshouldbekeptawayfromextremetemperaturesanddirectsunlighttoprotectagainstdrugdegradation,andthesolutionwillnotnecessarilyappeardifferentafterdegradationhasoccurred.http://www.medscape.com/viewarticle/554150acessoem22/05/2007

Martindale33ed.,P.829

TheinjectionwiththeEpiPen,everychilddevelopedtransientpallor,tremor,anxiety,andpalpitationsorothercardiovasculareffects;somealsodevelopedheadacheandnausea.JAllergyClinImmunol;109(1):1715,2002Jan.EpiPenJrversusEpiPeninyoungchildrenweighing15to30kgatriskforanaphylaxis.Martindale33ed.,P.829

Additionalcomments

if

any:

InmanycountriesthereisonlyoneconcentrationmarketedActionproposedfortheCommitteetotake:toapprove;tosuggestotherdilutions;prefilledsiringues

Forgreens:Isthereanyreasonnottoendorsetheseasessential medicinesfor children?Hydrocortisone

Dothesemedicinesmeetapublichealth?Yes

Aretheyregisteredforusein(allagecategoriesof)children?YesChildren:Initial:50mg/kgthenreapeatedin4hoursand/orevery24hoursifneededPediatricDosageHandbookAmericanPharmaceuticalAssociation,2001/2002P.508Childrenupto1yearofagemaybegiven25mg,thoseaged1to5years50mg,andthoseaged6to12years100mg.Martindale33ed.,P.1074PediatricMin/MaxDose:0.16mg/kg/50.0mg/kghttp://www.medscape.com/druginfo/dosage?drugid=6829&drugname=Hydrocortisone+Sod+Succinate+Inj&monotype=defaultacessoem22/05/2007

Aretheyanyunanswered/unexpectedclinicalissueswithrespecttoeffectivenessor

safety?No.

Aretherespecialrequirementsortrainingneededforsafe/effectiveuse? No

http://www.medscape.com/viewarticle/554150http://www.medscape.com/viewarticle/554150%20acesso%20em%2022/05/2007http://www.medscape.com/viewarticle/554150%20acesso%20em%2022/05/2007http://www.medscape.com/viewarticle/554150%20acesso%20em%2022/05/2007http://www.medscape.com/viewarticle/554150%20acesso%20em%2022/05/2007http://www.medscape.com/viewarticle/554150%20acesso%20em%2022/05/2007http://www.medscape.com/viewarticle/554150%20acesso%20em%2022/05/2007http://www.medscape.com/viewarticle/554150%20acesso%20em%2022/05/2007http://portal.revistas.bvs.br/transf.php?xsl=xsl/titles.xsl&xml=http://catserver.bireme.br/cgi-bin/wxis1660.exe/?IsisScript=../cgi-bin/catrevistas/catrevistas.xis|database_name=TITLES|list_type=title|cat_name=ALL|from=1|count=50&lang=pt&comefrom=home&home=false&task=show_magazines&request_made_adv_search=false&lang=pt&show_adv_search=false&help_file=/help_pt.htm&connector=ET&search_exp=J%20Allergy%20Clin%20Immunolhttp://portal.revistas.bvs.br/transf.php?xsl=xsl/titles.xsl&xml=http://catserver.bireme.br/cgi-bin/wxis1660.exe/?IsisScript=../cgi-bin/catrevistas/catrevistas.xis|database_name=TITLES|list_type=title|cat_name=ALL|from=1|count=50&lang=pt&comefrom=home&home=false&task=show_magazines&request_made_adv_search=false&lang=pt&show_adv_search=false&help_file=/help_pt.htm&connector=ET&search_exp=J%20Allergy%20Clin%20Immunolhttp://portal.revistas.bvs.br/transf.php?xsl=xsl/titles.xsl&xml=http://catserver.bireme.br/cgi-bin/wxis1660.exe/?IsisScript=../cgi-bin/catrevistas/catrevistas.xis|database_name=TITLES|list_type=title|cat_name=ALL|from=1|count=50&lang=pt&comefrom=home&home=false&task=show_magazines&request_made_adv_search=false&lang=pt&show_adv_search=false&help_file=/help_pt.htm&connector=ET&search_exp=J%20Allergy%20Clin%20Immunolhttp://portal.revistas.bvs.br/transf.php?xsl=xsl/titles.xsl&xml=http://catserver.bireme.br/cgi-bin/wxis1660.exe/?IsisScript=../cgi-bin/catrevistas/catrevistas.xis|database_name=TITLES|list_type=title|cat_name=ALL|from=1|count=50&lang=pt&comefrom=home&home=false&task=show_magazines&request_made_adv_search=false&lang=pt&show_adv_search=false&help_file=/help_pt.htm&connector=ET&search_exp=J%20Allergy%20Clin%20Immunolhttp://portal.revistas.bvs.br/transf.php?xsl=xsl/titles.xsl&xml=http://catserver.bireme.br/cgi-bin/wxis1660.exe/?IsisScript=../cgi-bin/catrevistas/catrevistas.xis|database_name=TITLES|list_type=title|cat_name=ALL|from=1|count=50&lang=pt&comefrom=home&home=false&task=show_magazines&request_made_adv_search=false&lang=pt&show_adv_search=false&help_file=/help_pt.htm&connector=ET&search_exp=J%20Allergy%20Clin%20Immunolhttp://portal.revistas.bvs.br/transf.php?xsl=xsl/titles.xsl&xml=http://catserver.bireme.br/cgi-bin/wxis1660.exe/?IsisScript=../cgi-bin/catrevistas/catrevistas.xis|database_name=TITLES|list_type=title|cat_name=ALL|from=1|count=50&lang=pt&comefrom=home&home=false&task=show_magazines&request_made_adv_search=false&lang=pt&show_adv_search=false&help_file=/help_pt.htm&connector=ET&search_exp=J%20Allergy%20Clin%20Immunolhttp://portal.revistas.bvs.br/transf.php?xsl=xsl/titles.xsl&xml=http://catserver.bireme.br/cgi-bin/wxis1660.exe/?IsisScript=../cgi-bin/catrevistas/catrevistas.xis|database_name=TITLES|list_type=title|cat_name=ALL|from=1|count=50&lang=pt&comefrom=home&home=false&task=show_magazines&request_made_adv_search=false&lang=pt&show_adv_search=false&help_file=/help_pt.htm&connector=ET&search_exp=J%20Allergy%20Clin%20Immunolhttp://www.medscape.com/druginfo/dosage?drugid=6829&drugname=Hydrocortisone+Sod+Succinate+Inj&monotype=defaulthttp://www.medscape.com/druginfo/dosage?drugid=6829&drugname=Hydrocortisone+Sod+Succinate+Inj&monotype=defaulthttp://www.medscape.com/druginfo/dosage?drugid=6829&drugname=Hydrocortisone+Sod+Succinate+Inj&monotype=defaulthttp://www.medscape.com/druginfo/dosage?drugid=6829&drugname=Hydrocortisone+Sod+Succinate+Inj&monotype=defaulthttp://portal.revistas.bvs.br/transf.php?xsl=xsl/titles.xsl&xml=http://catserver.bireme.br/cgi-bin/wxis1660.exe/?IsisScript=../cgi-bin/catrevistas/catrevistas.xis|database_name=TITLES|list_type=title|cat_name=ALL|from=1|count=50&lang=pt&comefrom=home&home=false&task=show_magazines&request_made_adv_search=false&lang=pt&show_adv_search=false&help_file=/help_pt.htm&connector=ET&search_exp=J%20Allergy%20Clin%20Immunolhttp://www.medscape.com/viewarticle/554150%20acesso%20em%2022/05/2007http://www.medscape.com/viewarticle/554150

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Additionalcommentsifany:

ActionproposedfortheCommitteetotake:

PERGUNTAMOSAOSPEDIATRAS:ESTEMEDICAMENTONECESSRIONESTACATEGORIA?

Forproposedyellows:Arethesemedicinesforchildren?

Prednisolone

Dothesemedicinesmeetapublichealth?

Yes.

Aretheyregisteredforusein(allagecategoriesof)children?Yes

Prednisolone Oral

Somecliniciansstatethatchildrenmaybegivenaprednisolonedosageof0.142mg/kgdailyor460mg/m2daily,administeredin4divideddoses.http://www.medscape.com/druginfo/dosage?drugid=6307&drugname=Prednisolone+Oral&monotype=defaultacessoem28/05/2007

PrednisoloneSodiumPhosphateOral(bettertaste)

PediatricMin/MaxDose:0.1mg/kg/2.0mg/kghttp://www.medscape.com/druginfo/dosage?drugid=13557&drugname=Prednisolone+Sodiu

m+Phosphate+Oral&monotype=defaultacessoem28/05/2007

MethylprednisoloneAcetateInjectableSuspensionUSP

Intramuscular,0.14to0.84mgperkgofbodyweightor4.16to25mgpersquaremeterofbodysurfaceareaeverytwelvetotwentyfourhours.USPExpertCommitteesconsensusonreviewoftheballot,01/2002.

Arethereanyunanswered/unexpectedclinicalissueswithrespecttoeffectivesorsafety?

No.

Additionalcommentsifany:

http://www.medscape.com/druginfo/dosage?drugid=6307&drugname=Prednisolone+Oral&monotype=defaulthttp://www.medscape.com/druginfo/dosage?drugid=6307&drugname=Prednisolone+Oral&monotype=defaulthttp://www.medscape.com/druginfo/dosage?drugid=13557&drugname=Prednisolone+Sodium+Phosphate+Oral&monotype=defaulthttp://www.medscape.com/druginfo/dosage?drugid=13557&drugname=Prednisolone+Sodium+Phosphate+Oral&monotype=defaulthttp://www.medscape.com/druginfo/dosage?drugid=13557&drugname=Prednisolone+Sodium+Phosphate+Oral&monotype=defaulthttp://www.medscape.com/druginfo/dosage?drugid=13557&drugname=Prednisolone+Sodium+Phosphate+Oral&monotype=defaulthttp://www.medscape.com/druginfo/dosage?drugid=6307&drugname=Prednisolone+Oral&monotype=defaulthttp://www.medscape.com/druginfo/dosage?drugid=6307&drugname=Prednisolone+Oral&monotype=default

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METHYLPREDNISOLONEACETATEINJECTABLESUSPENSIONUSP

Useofpreparationscontainingbenzylalcoholisnotrecommendedinneonates.Afataltoxicsyndromeconsistingofmetabolicacidosis,centralnervoussystem(CNS)depression,respiratoryproblems,renalfailure,hypotension,andpossiblyseizuresandintracranial

hemorrhages

has

been

associated

with

this

use.

USPExpertCommitteesconsensusonreviewoftheballot,01/2002.

PrelonesyroupcontainsbenzoicacidandOrapredoralsolutioncontainssodiumbenzoate;usewithcautioninneonates,asthesepreservativesmaydisplacebilirubinfromproteinbindingsitesandatlargesdosescancausethegaspingsyndrome.