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Methylprednisolone

    Brands

    DEA Class; Rx

    Common Brand Names; Medrol, Medrol Dosepak, DepoMedrol, SoluMedrol, A-Methapred

    • Corticosteroids; 
    • Anti-Inflammatory Agents

    Oral and parenteral synthetic glucocorticoid with little mineralocorticoid activity
    Used in many allergic, dermatologic and inflammatory conditions in adult and pediatric patients when systemic therapy is required
    Commonly used parenterally when a patient cannot take oral prednisone

    Indicated for the treatment of status asthmaticus, asthma exacerbation, Allergic Conditions

    For Acute Exacerbations of Multiple Sclerosis

    For the treatment of the acute respiratory distress syndrome (ARDS).

    For the management of symptomatic sarcoidosis. 
    For the treatment of a critical period of regional enteritis (Crohn’s disease).

    For Pneumocystis (carinii) jiroveci Pneumonia in AIDS Patients (Off-label)

    For Acute Spinal Cord Injury (Off-label)

    For Severe Lupus Nephritis (Off-label)

    COVID-19 (Off-label)

    NIH guidelines recommend corticosteroids (preferably dexamethasone) to reduce mortality in hospitalized patients with COVID-19 disease who are receiving either invasive mechanical ventilation or oxygen alone, but not among those receiving no respiratory support

    If dexamethasone is unavailable, use alternant glucocorticoids (eg, prednisone, methylprednisolone, or hydrocortisone)

    Methylprednisolone 32 mg IV qDay for up to 10 days or discharge, whichever comes first; use in addition to standard of care

    Untreated serious infections

    Documented hypersensitivity to drug or components (eg, lactose monohydrate from cow milk)

    Intrathecal administration

    Systemic fungal infection (except intra-articular injection in localized joint conditions)

    IM route is contraindicated in idiopathic thrombocytopenic purpura

    Premature infants (formulations containing benzyl alcohol only)

    Traumatic brain injury (high doses)

    Administration of live or live, attenuated vaccines is contraindicated in patients receiving immunosuppressive doses of corticosteroids

    • Acne
    • Adrenal suppression
    • Amenorrhea
    • Delayed wound healing
    • Delirium
    • Diabetes mellitus
    • Edema
    • Emotional instability
    • Erythema
    • Fluid retention
    • GI perforation
    • Glucose intolerance
    • Growth suppression (children)
    • Hallucinations
    • Headache
    • Hepatomegaly
    • Hepatitis
    • Hypokalemic alkalosis
    • Increased transaminases
    • Insomnia
    • Leukocytosis
    • Menstrual irregularity
    • Myopathy
    • Neuritis
    • Osteoporosis
    • Peptic ulcer
    • Perianal pruritus
    • Pituitary adrenal axis suppression
    • Protein catabolism
    • Pseudotumor cerebri (on withdrawal)
    • Psychosis
    • Sodium and water retention
    • Seizure
    • Tachycardia
    • Ulcerative esophagitis
    • Urticaria
    • Vasculitis
    • Vertigo
    • Weight gain

    Use with caution in cirrhosis, ocular herpes simplex, hypertension, diverticulitis, hypothyroidism, myasthenia gravis, peptic ulcer disease, osteoporosis, ulcerative colitis, psychotic tendencies, renal insufficiency, pregnancy, diabetes mellitus, history of seizure disorders, multiple sclerosis, thromboembolic disorders, myocardial infarction

    Long-term treatment: Risk of osteoporosis, myopathy, delayed wound healing

    Minimal mineralocorticoid activity

    Use in septic shock or sepsis syndrome not proven effective and may increase mortality in some patients including patients with elevated serum creatinine and patients who develop secondary infections

    Clearance of corticosteroids may increase in hyperthyroid patients and decrease in hypothyroid ones; dose adjustments may be necessary

    Patients receiving corticosteroids should avoid chickenpox or measles-infected persons if unvaccinated

    Latent tuberculosis may be reactivated (patients with positive tuberculin test should be monitored)

    Some suggestion (not fully substantiated) of slightly increased cleft palate risk if corticosteroids are used in pregnancy

    May cause hypothalamic-pituitary-adrenal (HPA) axis suppression, Cushing syndrome, or hyperglycemia

    Prolonged corticosteroid use may result in elevated IOP, glaucoma, or cataracts

    Killed or inactivated vaccines may be administered; however, the response to such vaccines cannot be predicted

    Immunization procedures may be undertaken in patients who are receiving corticosteroids as replacement therapy in physiologic doses (eg, for Addison’s disease)

    Injection may result in dermal and/or subdermal changes forming depressions in the skin at injection site; to minimize incidence of dermal and subdermal atrophy, care must be exercised not to exceed recommended doses in injections; avoid injection into deltoid muscle due to high incidence of subcutaneous atrophy

    Increased dosage of rapidly acting corticosteroids indicated in patients on corticosteroid therapy subjected to any unusual stress before, during, and after the stressful situation

    Not for use in the treatment of traumatic brain injury

    Pregnancy category: C

    Lactation: Drug enters milk; use with caution

    Corticosteroid dosage must be individualized and is highly variable depending on the nature and severity of the disease, route of treatment, and on patient response.

    Methylprednisolone acetate

    tablet

    • 2mg

    • 4mg

    • 8mg

    • 16mg

    • 32mg

    injectable suspension

    • 20mg/mL

    • 40mg/mL

    • 80mg/mL

    powder for injection

    • 40mg

    • 125mg

    • 500mg

    • 1g

    • 2g