Methylprednisolone(meth ill pred niss’ oh lone)
Methylprednisolone
Oral: Medrol
Methylprednisolone Acetate
IM injection: Depo-Medrol
Methylprednisolone Sodium Succinate
IV, IM injection: A-Methapred, Solu-Medrol
PREGNANCY CATEGORY C
Drug Classes
Corticosteroid
Glucocorticoid
Hormone
Therapeutic Actions
Enters target cells and binds to intracellular corticosteroid receptors, initiating many complex reactions that are responsible for its anti-inflammatory and immunosuppressive effects.
Indications
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Short-term management of various inflammatory and allergic disorders, such as rheumatoid arthritis, collagen diseases (eg, SLE), dermatologic diseases (eg, pemphigus), status asthmaticus, and autoimmune disorders (eg, MS)
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Hematologic disorders: Thrombocytopenia purpura, erythroblastopenia
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Ulcerative colitis, acute exacerbations of MS, and palliation in some leukemias and lymphomas
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Trichinosis with neurologic or myocardial involvement
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Prevention of nausea and vomiting associated with chemotherapy
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Unlabeled uses: Septic shock, RDS, acute spinal cord injury, postherpetic neuralgia, nausea and vomiting of pregnancy.
Contraindications and Cautions
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Contraindicated with infections, especially TB, fungal infections, amebiasis, vaccinia and varicella, and antibiotic-resistant infections; idiopathic thrombolytic purpura; lactation. Aqueous solution cannot be given intrathecally.
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Administration of live vaccines is contraindicated in patients receiving immunosuppressive doses.
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Use cautiously with kidney or liver disease, hypothyroidism, ulcerative colitis with impending perforation, diverticulitis, active or latent peptic ulcer, inflammatory bowel disease, heart failure, hypertension, thromboembolic disorders, osteoporosis, seizure disorders, diabetes mellitus, pregnancy.
Available Forms
Tablets—2, 4, 8, 16, 24, 32 mg; powder for injection—40, 125, 500 mg/vial; 1, 2 g/vial; suspension for injection—20, 40, 80 mg/mL
Dosages
Adults
Individualize dosage, depending on severity and response. Give daily dose before 9 AM to minimize adrenal suppression. For maintenance, reduce initial dose in small increments at intervals until the lowest satisfactory clinical dose is reached. If long-term therapy is needed, consider alternate-day therapy with a short-acting corticosteroid. After long-term therapy, withdraw drug slowly to prevent adrenal insufficiency.
Oral
4–48 mg/day PO. For alternate-day therapy, give twice the usual dose every other morning.
IV, IM
10–40 mg IV administered over several min. Give subsequent doses IV or IM.
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High-dose therapy: 30 mg/kg IV infused over 10–30 min; may repeat every 4–6 hr but not longer than 72 hr.
Warning Rapid IV administration of large doses (more than 0.5–1 g in less than 10 min) has caused serious cardiac complications.
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