methylprednisolone

Methylprednisolone is a steroid that prevents the release of substances in the body that cause inflammation.

Methylprednisolone is used to treat many different inflammatory conditions such as arthritis, lupus, psoriasis, ulcerative colitis, allergic disorders, gland (endocrine) disorders, and conditions that affect the skin, eyes, lungs, stomach, nervous system, or blood cells.

Methylprednisolone may also be used for purposes not listed in this medication guide.

Important information

You should not use this medication if you have a fungal infection anywhere in your body.

Before taking methylprednisolone, tell your doctor about all of your medical conditions, and about all other medicines you are using. There are many other diseases that can be affected by steroid use, and many other medicines that can interact with steroids.

Steroid medication, such as methylprednisolone, can weaken your immune system, making it easier for you to get an infection or worsening an infection you already have or have recently had. Tell your doctor about any illness or infection you have had within the past several weeks.

Avoid being near people who are sick or have infections. Call your doctor for preventive treatment if you are exposed to chicken pox or measles. Do not receive a "live" vaccine while using methylprednisolone. The vaccine may not work as well during this time, and may not fully protect you from disease.

Do not stop using methylprednisolone suddenly, or you could have unpleasant withdrawal symptoms. Talk to your doctor about how to avoid withdrawal symptoms when stopping the medication. Wear a medical alert tag or carry an ID card stating that you take methylprednisolone. Any doctor, dentist, or emergency medical professional who treats you should know that you take steroid medication.

Before taking this medicine

You should not use methylprednisolone if you are allergic to it, or if you have a fungal infection anywhere in your body.

Methylprednisolone can weaken your immune system, making it easier for you to get an infection. Steroids can also worsen an infection you already have, or reactivate an infection you recently had. Tell your doctor about any illness or infection you have had within the past several weeks.

To make sure methylprednisolone is safe for you, tell your doctor if you have:

• heart disease, high blood pressure;

• kidney or liver disease (especially cirrhosis);

• a history of tuberculosis;

• a parasite infection (pinworms);

• glaucoma or cataracts;

• a recent head injury;

• stomach ulcers, ulcerative colitis, or diverticulitis;

• a thyroid disorder;

• low bone mineral density (steroid medication can increase your risk of bone loss);

• depression or mental illness;

• a muscle disorder such as myasthenia gravis;

• seizures or epilepsy;

• an electrolyte imbalance (such as low levels of calcium or potassium in your blood);

• high levels of calcium in the blood related to cancer (also called hypercalcemia of malignancy);

• if you use insulin or oral diabetes medication; or

• if you take aspirin on a daily basis or at high doses.

It is not known whether methylprednisolone will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

It is not known whether methylprednisolone passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Steroids can affect growth in children. Talk with your doctor if you think your child is not growing at a normal rate while using methylprednisolone.

How should I take methylprednisolone?

Take methylprednisolone exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.

If you have major surgery or a severe injury or infection, your methylprednisolone dose needs may change. Make sure any doctor caring for you knows you are taking this medicine.

Steroid medication can weaken your immune system, making it easier for you to get an infection. Call your doctor if you have any signs of infection (fever, chills, body aches).

You should not stop using methylprednisolone suddenly, or you could have unpleasant withdrawal symptoms. Follow your doctor"s instructions about tapering your dose.

Wear a medical alert tag or carry an ID card stating that you take methylprednisolone. Any medical care provider who treats you should know that you take steroid medication.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Call your doctor for instructions if you miss a dose of methylprednisolone.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

An overdose of methylprednisolone is not expected to produce life threatening symptoms. However, long term use of high steroid doses can lead to symptoms such as thinning skin, easy bruising, changes in the shape or location of body fat (especially in your face, neck, back, and waist), increased acne or facial hair, menstrual problems, impotence, or loss of interest in sex.

What should I avoid?

Grapefruit and grapefruit juice may interact with methylprednisolone and lead to unwanted side effects. Avoid the use of grapefruit products while taking methylprednisolone.

Do not receive a "live" vaccine while using methylprednisolone. Live vaccines include measles, mumps, rubella (MMR), rotavirus, typhoid, yellow fever, varicella (chickenpox), zoster (shingles), and nasal flu (influenza) vaccine.

Avoid being near people who are sick or have infections. Call your doctor for preventive treatment if you are exposed to chicken pox or measles. These conditions can be serious or even fatal in people who are using steroid medication.

Methylprednisolone side effects

Get emergency medical help if you have any of these signs of an allergic reaction to methylprednisolone: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

• blurred vision, tunnel vision, eye pain, or seeing halos around lights;

• shortness of breath (even with mild exertion), swelling, rapid weight gain;

• severe depression, changes in personality, unusual thoughts or behavior;

• new or unusual pain in an arm or leg or in your back;

• bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;

• seizure (convulsions); or

• low potassium (confusion, uneven heart rate, extreme thirst, increased urination, leg discomfort, muscle weakness or limp feeling).

Common methylprednisolone side effects may include:

• headache;

• mild muscle pain or weakness; or

• stomach discomfort, bloating.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Methylprednisolone dosing information

Usual Adult Dose of Methylprednisolone for Allergic Rhinitis:

acetate: 80 to 120 mg intramuscular only.

Usual Adult Dose of Methylprednisolone for Dermatologic Lesion:

acetate: 40 to 120 mg intramuscular weekly for 1 to 4 weeks.

Usual Adult Dose for Rheumatoid Arthritis:

Acetate: 40 to 120 mg intramuscular weekly
Large joints: 20 to 80 mg intraarticular
Medium joints: 10 to 40 mg intraarticular
Small joints: 4 to 10 mg intraarticular

Usual Adult Dose of Methylprednisolone for Adrenogenital Syndrome:

Acetate: 40 mg intramuscular every 2 weeks.

Usual Adult Dose for Anti-inflammatory:

4 to 48 mg/day orally.

Sodium succinate: 10 to 40 mg Intravenous over 1 to several minutes. Give subsequent doses IV or IM.

Usual Adult Dose of Methylprednisolone for Shock:

30 mg/kg IV repeated every 4 to 6 hours or 100 to 250 mg IV repeated every 2 to 6 hours.

Usual Adult Dose for Immunosuppression:

4 to 48 mg orally per day.
2 to 2.5 mg/kg per day IV or IM, tapered slowly over 2 to 3 weeks or 250 to 1,000 mg IV once daily or on alternate days for 3 to 5 doses.

Usual Adult Dose of Methylprednisolone for Asthma -- Acute:

Asthma exacerbations (emergency medical care or hospital doses):
Oral or IV: 40 to 80 mg/day in divided doses 1 to 2 times/day until peak expiratory flow is 70% of predicted or personal best

Short-course "burst" (acute asthma):
Oral: 40 to 60 mg/day in divided doses 1 to 2 times/day for 3 to 10 days; Note: Burst should be continued until symptoms resolve and peak expiratory flow is at least 80% of personal best; usually requires 3 to 10 days of treatment (approximately 5 days on average); longer treatment may be required
IM (acetate): 240 mg as a one-time dose (Note: This may be given in place of short-course "burst" of oral steroids in patients who are vomiting or if compliance is a problem)

Usual Adult Dose of Methylprednisolone for Asthma -- Maintenance:

Oral: 7.5 to 60 mg daily given as a single dose in the morning or every other day as needed for asthma control

Usual Pediatric Dose for Anti-inflammatory:

Sodium succinate: not less than 0.5 mg/kg/24 hours intravenous or intramuscular.

High dose therapy: 30 mg/kg intravenous over 10 to 20 minutes. May repeat every 4 to 6 hours, but not beyond 48 to 72 hours.

Usual Pediatric Dose for Asthma -- Acute:

Up to 11 years:
Asthma exacerbations (emergency medical care or hospital doses):
Oral or IV: 1 to 2 mg/kg/day in 2 divided doses (maximum: 60 mg/day) until peak expiratory flow is 70% of predicted or personal best.

Short-course "burst" (acute asthma):
Oral: 1 to 2 mg/kg/day in divided doses 1 to 2 times/day for 3 to 10 days; maximum dose: 60 mg/day; Note: Burst should be continued until symptoms resolve or patient achieves peak expiratory flow 80% of personal best; usually requires 3 to 10 days of treatment (approximately 5 days on average); longer treatment may be required
IM (acetate) : Note: This may be given in place of short-course "burst" of oral steroids in patients who are vomiting or if compliance is a problem:
Children up to 4 years: 7.5 mg/kg as a one-time dose; maximum dose: 240 mg
Children 5 to 11 years: 240 mg as a one-time dose.

11 years or older:
Asthma exacerbations (emergency medical care or hospital doses):
Oral or IV: 40 to 80 mg/day in divided doses 1 to 2 times/day until peak expiratory flow is 70% of predicted or personal best
Short-course "burst" (acute asthma):
Oral: 40 to 60 mg/day in divided doses 1 to 2 times/day for 3 to 10 days; Note: Burst should be continued until symptoms resolve and peak expiratory flow is at least 80% of personal best; usually requires 3 to 10 days of treatment (approximately 5 days on average); longer treatment may be required
IM (acetate): 240 mg as a one-time dose (Note: This may be given in place of short-course "burst" of oral steroids in patients who are vomiting or if compliance is a problem)

Usual Pediatric Dose of of Methylprednisolone for Asthma -- Maintenance:

Up to 11 years:
0.25 to 2 mg/kg/day given as a single dose in the morning or every other day as needed for asthma control; maximum dose: 60 mg/day.

11 years or older:
Oral: 7.5 to 60 mg orally daily given as a single dose in the morning or every other day as needed for asthma control

What other drugs will affect methylprednisolone?

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with methylprednisolone, especially:

• aspirin (taken on a daily basis or at high doses);

• cyclosporine;

• insulin or oral diabetes medication;

• St. John"s wort;

• antifungal medication--itraconazole, ketoconazole; or

• HIV/AIDS medication--efavirenz, nevirapine, ritonavir;

• seizure medication--phenobarbital, phenytoin, and others; or

• tuberculosis medication--rifabutin, rifampin, rifapentine.

This list is not complete. Other drugs may interact with methylprednisolone, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.