methylprednisolone (Medrol)

Methylprednisolone family of products include methylprednisolone, methylprednisolone acetate (Medrol, Depo-medrol), and methylprednisolone sodium acetate (Solu-medrol). They will be called methylprednisolone in this monograph. They are synthetic (man-made) corticosteroids. Corticosteroids are naturally-occurring chemicals produced by the adrenal glands located adjacent to the kidneys. Corticosteroids affect metabolism in various ways and modify the immune system. Corticosteroids also block inflammation and are used in a wide variety of inflammatory diseases affecting many organs. The FDA approved methylprednisolone in October 1957.

Medrol, Depo-Medrol, Solu-Medrol, A-Methapred

GENERIC AVAILABLE: Yes

Yes

Methylprednisolone is used to achieve prompt suppression of inflammation. Examples of inflammatory conditions for which methylprednisolone is used include:

• rheumatoid arthritis,
• systemic lupus erythematosus,
• acute gouty arthritis,
• psoriatic arthritis,
• ulcerative colitis, and
• Crohn's disease.

Severe allergic conditions that fail conventional treatment also may respond to methylprednisolone. Examples include:

• bronchial asthma,
• allergic rhinitis,
• drug-induced dermatitis, and
• contact and atopic dermatitis.

Chronic skin conditions treated with methylprednisolone include:

• dermatitis herpetiformis,
• pemphigus,
• severe psoriasis and
• severe seborrheic dermatitis.

Chronic allergic and inflammatory conditions of the uvea, iris, conjunctiva and optic nerves of the eyes also are treated with methylprednisolone.

Methylprednisolone is used for treating shock and multiple sclerosis although their use in these conditions is controversial.

Adverse effects of methylprednisolone depend on dose, duration and frequency of administration. Short courses of methylprednisolone are usually well-tolerated with few, mild side effects. Long term, high doses of methylprednisolone may produce predictable and potentially serious side effects. Whenever possible, the lowest effective doses of methylprednisolone should be used for the shortest length of time to minimize side effects. Alternate day dosing also can help reduce side effects.

Side effects of methylprednisolone and other corticosteroids range from mild annoyances to serious irreversible bodily damage. Commonly reported side effects include:

• fluid retention,
• weight gain,
• high blood pressure,
• potassium loss,
• headache,
• muscle weakness,
• puffiness of the face,
• hair growth on the face,
• thinning and easy bruising of the skin,
• glaucoma,
• cataracts,
• peptic ulceration,
• worsening of diabetes,
• irregular menses,
• growth retardation in children,
• convulsions, and
• psychic disturbances.

Important psychic disturbances may include:

• depression,
• euphoria,
• insomnia,
• mood swings,
• personality changes, and
• psychotic behavior.

Dosage requirements of corticosteroids vary among individuals and the diseases being treated. In general, the lowest effective dose is used. The oral dose range is 2-60 mg daily depending on the disease. Depo-medrol doses are 10-80 mg injected into muscle every 1-2 weeks, and Solu-medrol doses are 10-250 mg intravenous or intramuscular injections up to 6 times daily. The initial dose should be adjusted based on response. Corticosteroids given in multiple doses throughout the day are more effective but also more toxic than the same total daily dose given once daily, or every other day.

Oral methylprednisolone should be taken with food.

: Methylprednisolone has not been adequately evaluated in pregnant women.

Methylprednisolone has not been adequately evaluated in nursing mothers.

What preparations of methylprednisolone are available?

Tablets: 4, 8, 16, 24, and 32 mg. Injectable suspension: 20, 40, and 80 mg/ml. Powder for Injection: 40, 125, 500, 1000, and 2000 mg.

How should I keep methylprednisolone stored?

Methylprednisolone preparations should be kept at room temperature, from 20 C to 25 C (68 F to 77 F).