II. Indications
- Anti-inflammatory
- Acute Asthma Exacerbation
- Multiple Sclerosis flare
- Optic Neuritis
III. Mechanism
IV. Medications
- Methylprednisolone tablets 2 mg, 4 mg, 8 mg, 16 mg, 32 mg
- Medrol Dose Pack (contains 21 tablets, each 4 mg in Blister pack with taper schedule over 7 days)
- Methylprednisolone Sodium succinate IV Solution (Solu-Medrol)
- Avoid in milk protein Hypersensitivity
- Avoid Benzyl Alcohol containing solution for intrathecal use or newborns
- Methylprednisolone Acetate IM Solution (Depo-Medrol)
- Duration of IM Injection is variable (1-6 days)
- Also used for Intra-articular Corticosteroid
V. Dosing: General Anti-inflammatory Dosing
- Adult
- Parenteral (Solu-Medrol) 10 to 125 mg (typically 60 mg) IV or IM every 4 to 12 hours
- Oral (Medrol) 4 to 48 mg orally daily
- Medrol Dose pack: tapers from max of 24 mg orally over 7 days
- Avoid Medrol dose pack (replace with Prednisone 30 mg orally daily for 5 to 6 days to have similar effect)
- Depo-Medrol: 4 to 120 mg IM every 1 to 2 weeks
- Child
- Dose: 1-2 mg/kg/dose orally, IV or IM every 6 to 12 hours
- Maximum: 125 mg/dose (typically up to 60 mg/dose)
VI. Dosing: Acute Asthma Exacerbation
- Methylprednisolone (Solu-Medrol) 1 mg/kg/dose (up to 60 mg) IV every 6 hours (or 80 mg IV every 8 hours)
VII. Dosing: Multiple Sclerosis (Adults)
-
Multiple Sclerosis Flare
- Initial 3 day course of Methylprednisolone IV or Oral (similar efficacy for oral dosing)
- Methylprednisolone 1000 mg orally daily (or in divided doses) for 3 days OR
- Methylprednisolone 1000 mg in 500 ml D5W infused over 4 to 6 hours each morning for 3 days
- Next: Steroid Taper after first 3 days (examples only, dosing varies widely, consult neurology for local protocol)
- Methylprednisolone 500 mg daily IV or Oral for 3 days, then 250 mg daily IV or Oral for 3 days
- Initial 3 day course of Methylprednisolone IV or Oral (similar efficacy for oral dosing)
-
Optic Neuritis
- Methylprednisolone 250 mg IV every 6 hours (or 1 g daily) for 3 days
- Typically followed by oral Corticosteroid course
- Methylprednisolone 250 mg IV every 6 hours (or 1 g daily) for 3 days
VIII. Pharmacokinetics
- Medium potency
- Medium anti-inflammatory potency
- No Mineralocorticoid Activity
- Medium Half-Life (36 hours)
IX. Adverse Effects
X. Safety
- See Systemic Corticosteroid
- Unknown safety in pregnancy
- Avoid in Lactation
XI. Resources
- Methylprednisolone Tablets (DailyMed)
- Methylprednisolone Sodium succinate injection powder for solution or Solu-Medrol (DailyMed)
- Methylprednisolone acetate or Depo-Medrol (DailyMed)
XII. References
- Swadron and Hope in Herbert (2018) EM:Rap 18(9):16-8
- Dvorin (2020) Am Fam Physician 101(2): 89-94 [PubMed]
- Lane (1998) Endocrinol Metab Clin North Am 27:465-83 [PubMed]
Images: Related links to external sites (from Bing)
Related Studies
| methylprednisolone (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| METHYLPREDNISOLONE 16 MG TAB | Generic | $1.58 each |
| METHYLPREDNISOLONE 32 MG TAB | Generic | $3.49 each |
| METHYLPREDNISOLONE 4 MG DOSEPK | Generic | $0.14 each |
| METHYLPREDNISOLONE 4 MG TABLET | Generic | $0.17 each |
| METHYLPREDNISOLONE 40 MG/ML VL | Generic | $8.70 per ml |
| METHYLPREDNISOLONE 8 MG TABLET | Generic | $0.96 each |
| METHYLPREDNISOLONE 80 MG/ML VL | Generic | $13.30 per ml |
| depo-medrol (on 7/1/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| DEPO-MEDROL 80 MG/ML VIAL | Generic | $13.30 per ml |
| medrol (on 1/1/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| MEDROL 4 MG DOSEPAK | Generic | $0.14 each |
Ontology: Methylprednisolone (C0025815)
| Definition (CHV) | a kind of steroidal anti-inflammatory drugs |
| Definition (NCI) | A synthetic corticosteroid with anti-inflammatory and immunomodulating properties. Methylprednisolone binds to and activates specific nuclear receptors, resulting in altered gene expression and inhibition of proinflammatory cytokine production. This agent also decreases the number of circulating lymphocytes, induces cell differentiation, and stimulates apoptosis in sensitive tumor cell populations. |
| Definition (NCI_NCI-GLOSS) | A corticosteroid hormone replacement. |
| Definition (MSH) | A PREDNISOLONE derivative with similar anti-inflammatory action. |
| Definition (CSP) | synthetic glucocorticoid derived from progesterone, used in replacement therapy for adrenal insufficiency and as an anti-inflammatory and immunosuppressant. |
| Definition (PDQ) | A synthetic corticosteroid with anti-inflammatory and immunomodulating properties. Methylprednisolone binds to and activates specific nuclear receptors, resulting in altered gene expression and inhibition of proinflammatory cytokine production. This agent also decreases the number of circulating lymphocytes, induces cell differentiation, and stimulates apoptosis in sensitive tumor cell populations. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=41528&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=41528&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C647" NCI Thesaurus) |
| Concepts | Pharmacologic Substance (T121) , Steroid (T110) , Hormone (T125) |
| MSH | D008775 |
| SnomedCT | 325387001, 116593003, 27242001 |
| LNC | LP18584-0, MTHU004699 |
| English | 6 Methylprednisolone, 6-Methylprednisolone, Methylprednisolone, Metipred, Pregna-1,4-diene-3,20-dione, 11,17,21-trihydroxy-6-methyl-, (6alpha,11beta)-, Methylprednisolone [endoc], 6Alpha-Methylprednisolone, (6alpha,11beta)-11,17,21-Trihydroxy-6-methylpregna-1,4-diene-3,20-dione, methylprednisolone, Methylprednisolonum, Methylprednisolone [endocrine use], methylprednisolone (medication), METHYLPREDNISOLONE, Methylprednisolone [Chemical/Ingredient], methylPREDNISolone, Methylprednisolone [endocrine use] (product), 6-alpha-Methylprednisolone preparation, Methylprednisolone preparation, Methylprednisolone (substance), Methylprednisolone preparation (product), MePRDL, Methylprednisolone [endocrine use] (substance), Methylprednisolone preparation (substance), MethylPREDNISolone |
| Swedish | Metylprednisolon |
| Czech | methylprednisolon |
| Finnish | Metyyliprednisoloni |
| Russian | METILPREDNIZOLON, METIPRED, URBAZON, МЕТИЛПРЕДНИЗОЛОН, МЕТИПРЕД, УРБАЗОН |
| Japanese | メドロール, メチルプレドニゾロン, メチルプレドニソロン, ウルバソン |
| Spanish | preparado con 6-alfa-metilprednisolona, preparado con metilprednisolona (producto), metilprednisolona (producto), preparado con metilprednisolona, metilprednisolona (uso endocrino), metilprednisolona (uso endocrino) (producto), metilprednisolona (sustancia), metilprednisolona, preparado de 6-alfa-metilprednisolona, preparado de metilprednisolona (producto), preparado de metilprednisolona (sustancia), preparado de metilprednisolona, Metilprednisolona |
| French | 6-Méthylprednisolone, Méthylprednisolone |
| Croatian | METILPREDNISOLON |
| Polish | Metyloprednizolon |
| German | Methylprednisolon |
| Italian | Metilprednisolone |
| Portuguese | Metilprednisolona |
