Methylprednisolone

(meth ill pred niss' oh lone) 

PCaution when used during lactation / LCaution when used during lactation Caution during pregnancy and lactation

Molecule Info

 |See TERMINOLOGY & ABBREVIATIONS |
Indication(s) & Dosage Oral route
Anti-inflammatory or immunosuppressive
Adult: Initially, 2-60 mg/day in 1-4 divided doses, followed by gradual reduction in dosage to the lowest possible level consistent with maintaining an adequate clinical response. 
Child: As sodium succinate: 0.5-1.7 mg/kg/day or 5-25 mg/m2/day in divided doses every 6-12 hr; "Pulse" therapy: 15-30 mg/kg/dose over ≥30 min given once daily for 3 days. 
Intramuscular
Anti-inflammatory or immunosuppressive
Adult: As sodium succinate: 10-80 mg/day once daily; As acetate: 10-80 mg every 1-2 wk. 
Child: As sodium succinate: 0.5-1.7 mg/kg/day or 5-25 mg/m2/day in divided doses every 6-12 hr; "Pulse" therapy: 15-30 mg/kg/dose over ≥30 min given once daily for 3 days. 
Intravenous
Anti-inflammatory or immunosuppressive
Adult: As sodium succinate: 10-40 mg over a period of several min and repeated I.V. or I.M. at intervals depending on clinical response; when high dosages are needed, give 30 mg/kg over a period ≥30 min and may be repeated every 4-6 hr for 48 hr. 
Child: As sodium succinate: 0.5-1.7 mg/kg/day or 5-25 mg/m2/day in divided doses every 6-12 hr; "Pulse" therapy: 15-30 mg/kg/dose over ≥30 min given once daily for 3 days. 

Status asthmaticus
Adult: As sodium succinate: Loading dose: 2 mg/kg/dose, then 0.5-1 mg/kg/dose every 6 hr for up to 5 days. 
Child: Children: As sodium succinate: Loading dose: 2 mg/kg/dose, then 0.5-1 mg/kg/dose every 6 hr for up to 5 days.
Intravenous
Acute spinal cord injury
Adult: As sodium succinate: 30 mg/kg over 15 min, followed in 45 min by a continuous infusion of 5.4 mg/kg/hr for 23 hr.
Child: As sodium succinate: 30 mg/kg over 15 min, followed in 45 min by a continuous infusion of 5.4 mg/kg/hr for 23 hr.
Intravenous
Lupus nephritis
Adult: As sodium succinate: High-dose "pulse" therapy: 1 g/day for 3 days.
Child: Children: As sodium succinate: 30 mg/kg over ≥30 min every other day for 6 doses. 
Intravenous
Aplastic anaemia
Adult: As sodium succinate: 1 mg/kg/day or 40 mg/day (whichever dose is higher), for 4 days. After 4 days, change to oral and continue until day 10 or until symptoms of serum sickness resolve, then rapidly reduce over approx 2 wk. 
Intravenous
Pneumocystis (carinii) jiroveci pneumonia in patients with acquiredimmunodeficiency syndrome (AIDS)
Adult: As sodium succinate: 30 mg bid for 5 days, then 30 mg once daily for 5 days, then 15 mg once daily for 11 days. 
Intravenous
Life-threatening shock
Adult: As sodium succinate: 30 mg/kg initially and repeated every 4-6 hr if needed or 100-250 mg initially and repeated at 2- 6-hr intervals as required by direct IV inj over a period of 3-15 min. Alternatively, following the initial dose by direct IV inj, 30 mg/kg by slow continuous IV infusion every 12 hr for 24-48 hr. 
Intravenous
Croup
Child: 1-2 mg/kg followed by 0.5 mg/kg every 6-8 hr. 
Intra-articular
Anti-inflammatory or immunosuppressive
Adult: As acetate: Large joints: 20-80 mg every 1-5 wk; Small joints: 4-10 mg every 1-5 wk.
Intralesional
Anti-inflammatory or immunosuppressive
Adult: As acetate: 20-60 mg every 1-5 wk.
Topical/Cutaneous
Corticosteroid-responsive dermatoses
Adult: As 0.1% aceponate ointment, fatty ointment or cream or lotion: Apply a thin coating once daily to the affected area. Duration: <12 wk. 
Child: >4 mth: As 0.1% aceponate ointment, fatty ointment or cream: Apply a thin coating once daily to the affected area; Lotion: Apply sparingly once daily to the affected area and rub gently. Duration: <4 wk.

Reconstitution: Standard diluent: 40 mg/50 ml D5W; 125 mg/50 ml D5W. Min volume: 50 ml D5W.
Incompatibility: Y-site incompatibility: Allopurinol, amsacrine, ciprofloxacin, propofol, sargramostim, vinorelbine, docetaxel, etoposide phosphate, filgrastim, gemcitabine, ondansetron, paclitaxel. Syringe incompatibility: Doxapram. Admixture incompatibility: Calcium gluconate, glycopyrrolate, regular insulin, penicillin G sodium, metaraminol, nafcillin.
Administration Should be taken with food.
Overdose Adrenal suppression and immunosuppression in high doses for prolonged periods. Arrhythmias and cardiovascular collapse with rapid IV inj/infusion.
Contraindications Serious infections except septic shock or tuberculous meningitis; viral, fungal and tubercular skin lesions; admin of live virus vaccines. Preparations containing benzyl alcohol preservative are contraindicated in infants.
Special Precautions Children and adolescents (possible irreversible growth retardation), elderly (monitoring required on long-term treatment). Frequent monitoring if history of tuberculosis (or X-ray changes), hypertension, recent MI (rupture reported), CHF, liver and renal failure (associated with fluid retention), DM including family history (glucose regulation altered), osteoporosis especially post-menopausal women (associated with increased bone loss and osteoporotic fractures), glaucoma including family history (risk of increased intraocular pressure), corneal perforation, severe affective disorders (particularly if history of steroid-induced psychosis), epilepsy, GI disease (perforation risk), thyroid disease (changes in thyroid status may necessitate dosage adjustments ), history of steroid myopathy. Pregnancy and lactation. Avoid abrupt withdrawal after a prolonged period of use. When applied topically to large areas, broken skin, or under occlusive dressings, may cause systemic effects.
Adverse Drug Reaction(s) Oedema, hypertension, arrhythmia; CNS, endocrine, metabolic and GI effects; hirsutism, acne, skin atrophy, bruising, hyperpigmentation; transient leukocytosis; arthralgia, muscle weakness, osteoporosis, fractures, cataracts, glaucoma; infections, hypersensitivity reactions, avascular necrosis, secondary malignancy, intractable hiccups.
Drug Interactions Decreases effect of anticholinesterases in myasthenia gravis. May decrease the hypoglycaemic effects of antidiabetic agents. Decreases serum concentrations of salicylates. Increased hypokalemic effects of potassium-depleting diuretics (thiazides or furosemide), amphotericin B, bronchodilator therapy with xanthines or β2 agonists. Increase incidence of GI bleeding and ulceration with NSAIDs. May increase the anticoagulant effects of warfarin. Decreased levels/effects with CYP3A4 inducers (aminoglutethimide, carbamazepine, nafcillin, nevirapine, phenobarbital, phenytoin, and rifamycins). Increased levels/effects with CYP3A4 inhibitors (azole antifungals, clarithromycin, diclofenac, doxycycline, erythromycin, imatinib, isoniazid, nefazodone, nicardipine, propofol, protease inhibitors, quinidine, telithromycin, and verapamil). May decrease the effects of vaccines (dead organism) or increase the risk of vaccinal infection (live organism). Antacids and bile sequestrants may decrease the absorption of corticosteroids, separate admin by 2 hr. Increased risk of myopathy with neuromuscular-blocking agents, tendinopathies with fluoroquinolones. Please consult detailed drug interactions before prescribing.
Food Interaction Interferes with calcium absorption. Limit caffeine.
Lab Interference Interferes with skin test.
Pregnancy Category (FDA) Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.
Storage

Intra-articular: Store at a temperature <40°C, preferably between 15-30°C. As acetate: freezing of sterile solution suspension should be avoided; store at controlled room temperature of 20-25°C. Intralesional: Store at a temperature <40°C, preferably between 15-30 °C. As acetate: freezing of sterile solution suspension should be avoided; store at controlled room temperature of 20-25°C. 

Intramuscular: Store at a temperature <40°C, preferably between 15-30°C. As acetate: Freezing of sterile solution suspension should be avoided; store at controlled room temperature of 20-25°C. As sodium succinate: Store unreconstituted sterile powder and reconstituted solutions at a controlled room temperature of 20-25°C. Reconstituted solutions should not be used unless they are clear, and unused solutions should be discarded after 48 hr. Intravenous: Store at a temperature <40°C, preferably between 15-30 °C. As acetate: freezing of sterile solution suspension should be avoided; store at controlled room temperature of 20-25°C. As sodium succinate: Store unreconstituted sterile powder and reconstituted solutions at a controlled room temperature of 20-25°C. Reconstituted solutions should not be used unless they are clear, and unused solutions should be discarded after 48 hr. Oral: Store at a temperature <40°C, preferably between 15-30 °C. Topical/Cutaneous: Ointment or cream: <25°C, stable for 3 yr from date of manufacture; Fatty ointment or lotion: <30°C, stable for 5 yr from date of manufacture.

Pharmacology Methylprednisolone is a synthetic corticosteroid with mainly glucocorticoid activity and minimal mineralocorticoid properties. It decreases inflammation by suppression of migration of polymorphonuclear leukocytes and reversal of increased capillary permeability.
Onset: Peak effect: Oral: 1-2 hr; IM: 4-8 days; Intra-articular: 1 wk.
Duration: Oral: 30-36 hr; IM: 1-4 wk; Intra-articular: 1-5 wk; As acetate, has a low solubility and has sustained IM effect.
Absorption: Methylprednisolone is fairly rapidly distributed after oral doses; plasma half-life:≥3.5 hr; tissue half-life: 18-36 hr. As acetate, it is absorbed from joints over a wk but is more slowly absorbed following deep IM inj. As sodium succinate ester, it is rapidly absorbed after IM doses, with peak plasma concentrations in 2 hr.
Distribution: Volume of distribution: 0.7-1.5 L/kg; crosses the placenta.
Excretion: Half-life elimination: 3-3.5 hr; clearance reduced in obese.
ATC Classification D07AA01 - methylprednisolone; Belongs to the class of weak (group I) corticosteroids. Used in the treatment of dermatological diseases. 
D10AA02 - methylprednisolone; Belongs to the class of topical corticosteroids used in the treatment of acne. 
H02AB04 - methylprednisolone; Belongs to the class of glucocorticoids. Used in systemic corticosteroid preparations.

Brand/Product Info


Total Products : 9         
Brand Name Manufacturer/Marketer Composition Dosage Form Pack Size & Price
DEPO-MEDROL Janata Traders Methyl prednisolone acetate 40mg/1ml & 80mg/2ml Injection 1ml, 2ml: 176.30 & 215.00 MRP
DEPOMED Drug International Ltd Methyl prednisolone acetate USP 40mg/1ml & 80mg/2ml Injection 1ml x3's, 2ml x3's: 225.00 & 300.00 MRP
MEDROL Techno Drugs Methyl prednisolone acetate 40mg/1ml & 80mg/2ml Injection 40mgx5's & 80mg x1's: 325.00 & 90.00 MRP
METHYL PREDNISOLONE SODIUM SUCCINATE Rotex/City Overseas Methyl prednisolone sodium succinate 500mg vial Injection 500mg vial: 760.00 TP
SOLU-MEDROL Janata Traders Methyl prednisolone sodium succinate 40mg, 125mg, 500mg & 1gm Injection 40mg, 125mg, 500mg & 1gm vial: 359.26, 1170.53, 1753.22 & 3360.36 MRP
SOLUMED-40 Aristopharma Ltd. Methyl prednisolone acetate USP 40mg/1ml Injection 1ml x2's: 150.00 MRP
SOLUMED-80 Aristopharma Ltd. Methyl prednisolone acetate USP 80mg/2ml Injection 1ml x2's: 200.00 MRP
SOLUPRED Ziska Pharmaceuticals Ltd. Methyl prednisolone sodium succinate 500mg & 1gm Injection 500mg & 1gm vial: 600.00 & 1000.00 MRP
UNI-MEDROL Chemist Laboratories Ltd. Methyl prednisolone acetate 40mg/1ml & 80mg/2ml Injection 2's each: 130.00 & 180.00 MRP

Gen. MedInfo

Why is Methylprednisolone prescribed?

Methylprednisolone, a corticosteroid, is similar to a natural hormone produced by your adrenal glands. It is often used to replace this chemical when your body does not make enough of it. It relieves inflammation (swelling, heat, redness, and pain) and is used to treat certain forms of arthritis; skin, blood, kidney, eye, thyroid, and intestinal disorders (e.g., colitis); severe allergies; and asthma. Methylprednisolone is also used to treat certain types of cancer.

Methylprednisolone is sometimes prescribed for other uses; ask your doctor for more information.

How should Methylprednisolone be used?

Methylprednisolone may come as a tablet to take by mouth. Your doctor will prescribe a dosing schedule that is best for you. Follow the directions on your prescription label carefully, and ask your doctor to explain any part you do not understand. Take methylprednisolone exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Do not stop taking methylprednisolone without talking to your doctor. Stopping the drug abruptly can cause loss of appetite, upset stomach, vomiting, drowsiness, confusion, headache, fever, joint and muscle pain, peeling skin, and weight loss. If you take large doses for a long time, your doctor probably will decrease your dose gradually to allow your body to adjust before stopping the drug completely. Watch for these side effects if you are gradually decreasing your dose and after you stop taking the tablets. If these problems occur, call your doctor immediately. You may need to increase your dose of tablets temporarily or start taking them again.

What special precautions to follow?

Before taking methylprednisolone,

  • inform your doctor if you are allergic to methylprednisolone, aspirin, tartrazine (a yellow dye in some processed foods and drugs), or any other drugs.
  • inform your doctor what prescription and nonprescription medications you are taking, especially anticoagulants ('blood thinners') such as warfarin, arthritis medications, aspirin, azithromycin, clarithromycin, cyclosporine (Neoral, Sandimmune), digoxin, diuretics ('water pills'), erythromycin, estrogen, ketoconazole (Nizoral), oral contraceptives, phenobarbital, phenytoin, rifampin, theophylline and vitamins.
  • if you have a fungal infection (other than on your skin), do not take methylprednisolone without talking to your doctor.
  • inform your doctor if you have or have ever had liver, kidney, intestinal, or heart disease; diabetes; an underactive thyroid gland; high blood pressure; mental illness; myasthenia gravis; osteoporosis; herpes eye infection; seizures; tuberculosis (TB); or ulcers.
  • inform your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking methylprednisolone, call your doctor.
  • if you are having surgery, including dental surgery, inform the doctor or dentist that you are taking methylprednisolone.
  • if you have a history of ulcers or take large doses of aspirin or other arthritis medication, limit your consumption of alcoholic beverages while taking this drug. Methylprednisolone makes your stomach and intestines more susceptible to the irritating effects of alcohol, aspirin, and certain arthritis medications. This effect increases your risk of ulcers.

What special dietary instructions to follow?

 

Your doctor may instruct you to follow a low-sodium, low-salt, potassium-rich, or high-protein diet. Follow these directions.

Methylprednisolone may cause an upset stomach. Take methylprednisolone with food or milk.

What to do if I forget a dose?

 

When you start to take methylprednisolone, ask your doctor what to do if you forget a dose. Write down these instructions so that you can refer to them later.

If you take methylprednisolone once a day, take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What side effects can Methylprednisolone cause?

Methylprednisolone may cause side effects. inform your doctor if any of these symptoms are severe or do not go away:

  • upset stomach

  • stomach irritation

  • vomiting

  • headache

  • dizziness

  • insomnia

  • restlessness

  • depression

  • anxiety

  • acne

  • r
  • increased hair growth

  • easy bruising

  • irregular or absent menstrual periods

If you experience any of the following symptoms, call your doctor immediately:

  • skin rash

  • swollen face, lower legs, or ankles

  • vision problems

  • cold or infection that lasts a long time

  • muscle weakness

  • black or tarry stool

What to know about storage and disposal of Methylprednisolone?

Keep Methylprednisolone in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.
In case of emergency/overdose

In case of overdose, consult local physician. If the victim has collapsed or is not breathing, consult local medical emergency services.

What other information to know?

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to methylprednisolone. Checkups are especially important for children because methylprednisolone can slow bone growth.

If your condition worsens, call your doctor. Your dose may need to be adjusted.

Carry an identification card that indicates that you may need to take supplementary doses (write down the full dose you took before gradually decreasing it) of methylprednisolone during periods of stress (injuries, infections, and severe asthma attacks). Ask your pharmacist or doctor how to obtain this card. List your name, medical problems, drugs and dosages, and doctor's name and telephone number on the card.

This drug makes you more susceptible to illnesses. If you are exposed to chicken pox, measles, or tuberculosis (TB) while taking methylprednisolone, call your doctor. Do not have a vaccination, other immunization, or any skin test while you are taking methylprednisolone unless your doctor informs you that you may.

Report any injuries or signs of infection (fever, sore throat, pain during urination, and muscle aches) that occur during treatment.

Your doctor may instruct you to weigh yourself every day. Report any unusual weight gain.

If your sputum (the matter you cough up during an asthma attack) thickens or changes color from clear white to yellow, green, or gray, call your doctor; these changes may be signs of an infection.

If you have diabetes, methylprednisolone may increase your blood sugar level. If you monitor your blood sugar (glucose) at home, test your blood or urine more frequently than usual. Call your doctor if your blood sugar is high or if sugar is present in your urine; your dose of diabetes medication and your diet may need to be changed.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

 Ref:  U.S. National Library of Medicine.


This information is provided for reference only and not a replacement for and should only be used in conjunction with full consultation with a registered medical practitioner. It may not contain all the available information you require and cannot substitute professional medical care, nor does it take into account all individual circumstances. Although great effort has been made to ensure content accuracy, mph-bd shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise.

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