Methylprednisolone

Methylprednisolone Brand Names

A-Methapred | Depmedalone-40 | Depmedalone-80 | Depo-Medrol | Medrol | Medrol Dosepak | Solu-Medrol

What is Methylprednisolone

Methylprednisolone and its derivatives, methylprednisolone sodium succinate and methylprednisolone acetate, are synthetic glucocorticoids used orally or parenterally as antiinflammatory or immunosuppressive agents.

Methylprednisolone is used in many conditions in adult and pediatric patients, including many allergic, dermatologic, and inflammatory states when systemic treatment is medically necessary.

The drug is commonly used parenterally when a patient cannot take oral prednisone.

Methylprednisolone has very little mineralocorticoid activity and is therefore not used to manage adrenal insufficiency unless a more potent mineralocorticoid is administered concomitantly.

Systemic corticosteroids may be added to other long-term maintenance medications in the management of uncontrolled severe persistent asthma.

Once stabilization of asthma is achieved, regular attempts should be made to reduce or eliminate the use of systemic corticosteroids due to the side effects associated with chronic administration.

Short courses of treatment may be used in moderate to severe exacerbations of asthma or COPD.

If long-term therapy is required, the lowest possible effective dose should be used.

Indications

1. acute interstitial nephritis (AIN)
2. acute lymphocytic leukemia (ALL)
3. acute respiratory distress syndrome (ARDS)
4. Addison’s disease
5. adrenocortical insufficiency
6. adrenogenital syndrome
7. allergic conjunctivitis
8. allergic rhinitis
9. alopecia
10. anaphylaxis
11. angioedema
12. ankylosing spondylitis
13. anterior segment inflammation
14. asthma
15. atopic dermatitis
16. berylliosis
17. bursitis
18. carpal tunnel syndrome
19. chorioretinitis
20. chronic lymphocytic leukemia (CLL)
21. chronic obstructive pulmonary disease (COPD)
22. Churg-Strauss syndrome
23. congenital adrenal hyperplasia
24. contact dermatitis
25. corneal ulcer
26. Crohn’s disease
27. dermatitis herpetiformis
28. dermatomyositis
29. discoid lupus erythematosus
30. eczema
31. endophthalmitis
32. eosinophilic pneumonia
33. epicondylitis
34. erythema multiforme
35. erythroblastopenia
36. exfoliative dermatitis
37. fat embolism syndrome prophylaxis
38. food allergy
39. gouty arthritis
40. graft-versus-host disease (GVHD)
41. granuloma annulare
42. Graves’ ophthalmopathy
43. heart transplant rejection
44. hemolytic anemia
45. herpes zoster ocular infection
46. Hodgkin lymphoma
47. hypercalcemia
48. hypoplastic anemia
49. immune thrombocytopenic purpura (ITP)
50. insect bites or stings
51. iritis
52. juvenile rheumatoid arthritis (JRA)/juvenile idiopathic arthritis (JIA)
53. Kawasaki disease
54. keloids
55. keratitis
56. kidney transplant rejection
57. laryngotracheobronchitis (croup)
58. lichen planus
59. lichen simplex
60. Loeffler’s syndrome
61. lupus nephritis
62. mixed connective tissue disease
63. multiple myeloma
64. multiple sclerosis
65. multisystem inflammatory syndrome in children (MIS-C)
66. myasthenia gravis
67. mycosis fungoides
68. necrobiosis lipoidica diabeticorum
69. nephrotic syndrome
70. non-Hodgkin’s lymphoma (NHL)
71. optic neuritis
72. osteoarthritis
73. pemphigus
74. perennial allergies
75. Pneumocystis pneumonia (PCP)
76. pneumonitis
77. polyarteritis nodosa
78. polychondritis
79. polymyositis
80. postoperative ocular inflammation
81. proteinuria
82. pruritus
83. pseudogout
84. psoriasis
85. psoriatic arthritis
86. pulmonary edema
87. pulmonary fibrosis
88. rheumatic carditis
89. sarcoidosis
90. seasonal allergies
91. seborrheic dermatitis
92. serum sickness
93. severe acute respiratory syndrome (SARS)
94. spinal cord injury
95. status asthmaticus
96. Stevens-Johnson syndrome
97. systemic lupus erythematosus (SLE)
98. temporal arteritis
99. tenosynovitis
100. thrombocytopenia
101. thyroiditis
102. trichinosis
103. tuberculosis infection
104. ulcerative colitis
105. urticaria
106. uveitis
107. vernal keratoconjunctivitis
108. Wegener’s granulomatosis

Side Effects

1. abdominal pain
2. acne vulgaris
3. adrenocortical insufficiency
4. alopecia
5. amenorrhea
6. anaphylactoid reactions
7. angioedema
8. anorexia
9. anxiety
10. appetite stimulation
11. arrhythmia exacerbation
12. arthralgia
13. arthropathy
14. avascular necrosis
15. bone fractures
16. bradycardia
17. cardiac arrest
18. cardiomyopathy
19. cataracts
20. constipation
21. Cushing’s syndrome
22. depression
23. diabetes mellitus
24. diaphoresis
25. diarrhea
26. dysmenorrhea
27. ecchymosis
28. edema
29. EEG changes
30. elevated hepatic enzymes
31. emotional lability
32. erythema
33. esophageal ulceration
34. euphoria
35. exfoliative dermatitis
36. exophthalmos
37. fever
38. fluid retention
39. gastritis
40. GI perforation
41. glycosuria
42. growth inhibition
43. headache
44. heart failure
45. hepatitis
46. hepatomegaly
47. hiccups
48. hirsutism
49. hypercholesterolemia
50. hyperglycemia
51. hypernatremia
52. hypertension
53. hypertrichosis
54. hypocalcemia
55. hypokalemia
56. hypotension
57. hypothalamic-pituitary-adrenal (HPA) suppression
58. immunosuppression
59. impaired wound healing
60. increased intracranial pressure
61. infection
62. injection site reaction
63. insomnia
64. lactose intolerance
65. lethargy
66. leukocytosis
67. malaise
68. menstrual irregularity
69. metabolic alkalosis
70. myalgia
71. myopathy
72. nausea
73. neuritis
74. ocular hypertension
75. ocular infection
76. optic neuritis
77. osteoporosis
78. palpitations
79. pancreatitis
80. papilledema
81. paresthesias
82. peptic ulcer
83. peripheral neuropathy
84. petechiae
85. phlebitis
86. physiological dependence
87. pseudotumor cerebri
88. psychosis
89. pulmonary edema
90. rash
91. restlessness
92. retinopathy
93. scleroderma renal crisis
94. seizures
95. sinus tachycardia
96. skin atrophy
97. skin hyperpigmentation
98. skin hypopigmentation
99. sodium retention
100. striae
101. syncope
102. tendon rupture
103. thromboembolism
104. thrombosis
105. urinary incontinence
106. urinary urgency
107. urticaria
108. vasculitis
109. vertigo
110. visual impairment
111. vomiting
112. weakness
113. weight gain
114. withdrawal
115. xerosis

Monitoring Parameters

• blood glucose
• blood pressure
• growth rate
• pulmonary function tests (PFTs)
• serum potassium
• weight

Contraindications

• abrupt discontinuation
• breast-feeding
• cataracts
• children
• coagulopathy
• corticosteroid hypersensitivity
• Cushing’s syndrome
• diabetes mellitus
• diverticulitis
• epidural administration
• fungal infection
• geriatric
• GI perforation
• glaucoma
• growth inhibition
• head trauma
• heart failure
• hepatic disease
• herpes infection
• hypertension
• hyperthyroidism
• hypothalamic-pituitary-adrenal (HPA) suppression
• hypothyroidism
• immune thrombocytopenic purpura (ITP)
• immunosuppression
• increased intracranial pressure
• increased intraocular pressure
• infants
• infection
• intrathecal administration
• intravenous administration
• measles
• myasthenia gravis
• mycobacterial infection
• myocardial infarction
• neonates
• neurologic events
• osteoporosis
• peptic ulcer disease
• pregnancy
• premature neonates
• psychosis
• renal disease
• scleroderma
• seizure disorder
• sepsis
• surgery
• thromboembolic disease
• thyroid disease
• tuberculosis
• ulcerative colitis
• vaccination
• varicella
• viral infection
• visual disturbance

Interactions

• Abatacept
• Acetaminophen; Aspirin, ASA; Caffeine
• Acetaminophen; Butalbital
• Acetaminophen; Butalbital; Caffeine
• Acetaminophen; Butalbital; Caffeine; Codeine
• Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
• Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
• Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
• Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
• Acetaminophen; Dextromethorphan; Phenylephrine
• Acetaminophen; Guaifenesin; Phenylephrine
• Acetazolamide
• Acetohexamide
• Adalimumab
• Albiglutide
• Aldesleukin, IL-2
• Alefacept
• Alemtuzumab
• Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
• Aliskiren; Hydrochlorothiazide, HCTZ
• Alogliptin; Metformin
• Alpha-glucosidase Inhibitors
• Altretamine
• Ambenonium Chloride
• Amifampridine
• Amiloride; Hydrochlorothiazide, HCTZ
• Aminolevulinic Acid
• Aminosalicylate sodium, Aminosalicylic acid
• Amiodarone
• Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
• Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
• Amoxicillin; Clarithromycin; Lansoprazole
• Amoxicillin; Clarithromycin; Omeprazole
• Amphotericin B
• Amphotericin B cholesteryl sulfate complex (ABCD)
• Amphotericin B lipid complex (ABLC)
• Amphotericin B liposomal (LAmB)
• Antithymocyte Globulin
• Antitumor antibiotics
• Aprepitant, Fosaprepitant
• Argatroban
• Arsenic Trioxide
• Asparaginase Erwinia chrysanthemi
• Aspirin, ASA
• Aspirin, ASA; Butalbital; Caffeine
• Aspirin, ASA; Butalbital; Caffeine; Codeine
• Aspirin, ASA; Caffeine; Dihydrocodeine
• Aspirin, ASA; Caffeine; Orphenadrine
• Aspirin, ASA; Carisoprodol
• Aspirin, ASA; Carisoprodol; Codeine
• Aspirin, ASA; Citric Acid; Sodium Bicarbonate
• Aspirin, ASA; Dipyridamole
• Aspirin, ASA; Omeprazole
• Aspirin, ASA; Oxycodone
• Aspirin, ASA; Pravastatin
• Atazanavir
• Atazanavir; Cobicistat
• Atenolol; Chlorthalidone
• Atracurium
• Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
• Atropine; Hyoscyamine; Phenobarbital; Scopolamine
• Azathioprine
• Azilsartan; Chlorthalidone
• Basiliximab
• Belladonna Alkaloids; Ergotamine; Phenobarbital
• Benazepril; Hydrochlorothiazide, HCTZ
• Bendroflumethiazide; Nadolol
• Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
• Bepridil
• Bexarotene
• Bismuth Subsalicylate
• Bismuth Subsalicylate; Metronidazole; Tetracycline
• Bisoprolol; Hydrochlorothiazide, HCTZ
• Bivalirudin
• Boceprevir
• Bortezomib
• Bosentan
• Brompheniramine; Carbetapentane; Phenylephrine
• Brompheniramine; Dextromethorphan; Phenylephrine
• Bupropion
• Bupropion; Naltrexone
• Butabarbital
• Calcium Carbonate
• Calcium Carbonate; Magnesium Hydroxide
• Calcium Carbonate; Risedronate
• Calcium Carbonate; Simethicone
• Canagliflozin
• Canagliflozin; Metformin
• Candesartan; Hydrochlorothiazide, HCTZ
• Captopril; Hydrochlorothiazide, HCTZ
• Carbamazepine
• Carbetapentane; Chlorpheniramine; Phenylephrine
• Carbetapentane; Diphenhydramine; Phenylephrine
• Carbetapentane; Guaifenesin; Phenylephrine
• Carbetapentane; Phenylephrine
• Carbetapentane; Phenylephrine; Pyrilamine
• Carbinoxamine; Hydrocodone; Phenylephrine
• Carbinoxamine; Phenylephrine
• Carmustine, BCNU
• Ceritinib
• Certolizumab pegol
• Chlophedianol; Guaifenesin; Phenylephrine
• Chlorambucil
• Chlorothiazide
• Chlorpheniramine; Dextromethorphan; Phenylephrine
• Chlorpheniramine; Dihydrocodeine; Phenylephrine
• Chlorpheniramine; Hydrocodone; Phenylephrine
• Chlorpheniramine; Phenylephrine
• Chlorpropamide
• Chlorthalidone
• Chlorthalidone; Clonidine
• Cholestyramine
• Choline Salicylate; Magnesium Salicylate
• Cimetidine
• Cisatracurium
• Citalopram
• Clarithromycin
• Clindamycin
• Clofarabine
• Cobicistat
• Codeine; Phenylephrine; Promethazine
• Conivaptan
• Cyclosporine
• Dapagliflozin
• Dapagliflozin; Metformin
• Dapagliflozin; Saxagliptin
• Darunavir
• Darunavir; Cobicistat
• Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
• Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
• Deferasirox
• Denileukin Diftitox
• Denosumab
• Desmopressin
• Dextran
• Dextromethorphan; Diphenhydramine; Phenylephrine
• Dextromethorphan; Guaifenesin; Phenylephrine
• Digoxin
• Diltiazem
• Dipeptidyl Peptidase-4 Inhibitors
• Diphenhydramine; Hydrocodone; Phenylephrine
• Diphenhydramine; Phenylephrine
• Dofetilide
• Doxacurium
• Dronedarone
• Droperidol
• Drospirenone; Ethinyl Estradiol; Levomefolate
• Dulaglutide
• Echinacea
• Econazole
• Efalizumab
• Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
• Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
• Empagliflozin
• Empagliflozin; Linagliptin
• Empagliflozin; Linagliptin; Metformin
• Empagliflozin; Metformin
• Enalapril; Hydrochlorothiazide, HCTZ
• Ephedrine
• Eprosartan; Hydrochlorothiazide, HCTZ
• Erlotinib
• Ertugliflozin
• Ertugliflozin; Metformin
• Ertugliflozin; Sitagliptin
• Erythromycin
• Erythromycin; Sulfisoxazole
• Estramustine
• Estrogens
• Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
• Etravirine
• Exenatide
• Fluconazole
• Fluoxymesterone
• Fosamprenavir
• Fosinopril; Hydrochlorothiazide, HCTZ
• Gallium Ga 68 Dotatate
• Gemcitabine
• Gentamicin
• Glimepiride
• Glimepiride; Pioglitazone
• Glimepiride; Rosiglitazone
• Glipizide
• Glipizide; Metformin
• Glyburide
• Glyburide; Metformin
• Glycerol Phenylbutyrate
• Golimumab
• grapefruit juice
• Guaifenesin; Phenylephrine
• Halofantrine
• Haloperidol
• Hemin
• Heparin
• Hetastarch
• Hydantoins
• Hydralazine; Hydrochlorothiazide, HCTZ
• Hydrochlorothiazide, HCTZ
• Hydrochlorothiazide, HCTZ; Irbesartan
• Hydrochlorothiazide, HCTZ; Lisinopril
• Hydrochlorothiazide, HCTZ; Losartan
• Hydrochlorothiazide, HCTZ; Methyldopa
• Hydrochlorothiazide, HCTZ; Metoprolol
• Hydrochlorothiazide, HCTZ; Moexipril
• Hydrochlorothiazide, HCTZ; Olmesartan
• Hydrochlorothiazide, HCTZ; Propranolol
• Hydrochlorothiazide, HCTZ; Quinapril
• Hydrochlorothiazide, HCTZ; Spironolactone
• Hydrochlorothiazide, HCTZ; Telmisartan
• Hydrochlorothiazide, HCTZ; Triamterene
• Hydrochlorothiazide, HCTZ; Valsartan
• Hydrocodone; Phenylephrine
• Hydroxyurea
• Hylan G-F 20
• Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
• Ibritumomab Tiuxetan
• Idelalisib
• Incretin Mimetics
• Indapamide
• Inebilizumab
• Infliximab
• Insulin Degludec; Liraglutide
• Insulin Glargine; Lixisenatide
• Insulins
• Interferon Alfa-2a
• Interferon Alfa-2b
• Interferon Alfa-2b; Ribavirin
• Iohexol
• Iopamidol
• Isavuconazonium
• Isoniazid, INH
• Isoniazid, INH; Pyrazinamide, PZA; Rifampin
• Isoniazid, INH; Rifampin
• Isoproterenol
• Isotretinoin
• Itraconazole
• Ketoconazole
• L-Asparaginase Escherichia coli
• Letermovir
• Levetiracetam
• Levomefolate
• Levomethadyl
• Linagliptin; Metformin
• Liraglutide
• Live Vaccines
• Lixisenatide
• Lomustine, CCNU
• Loop diuretics
• Lopinavir; Ritonavir
• Lumacaftor; Ivacaftor
• Lumacaftor; Ivacaftor
• Macimorelin
• Magnesium Salicylate
• Mannitol
• Mecasermin rinfabate
• Mecasermin, Recombinant, rh-IGF-1
• Meglitinides
• Melphalan
• Mepenzolate
• Mephobarbital
• Metformin
• Metformin; Pioglitazone
• Metformin; Repaglinide
• Metformin; Rosiglitazone
• Metformin; Saxagliptin
• Metformin; Sitagliptin
• Methacholine
• Methazolamide
• Methenamine; Sodium Acid Phosphate
• Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
• Methoxsalen
• Methyclothiazide
• Metolazone
• Metyrapone
• Micafungin
• Mifepristone
• Mitotane
• Mitoxantrone
• Mivacurium
• Moxifloxacin
• Muromonab-CD3
• Natalizumab
• Nateglinide
• Nefazodone
• Nelarabine
• Neostigmine
• Neuromuscular blockers
• Nicardipine
• Nonsteroidal antiinflammatory drugs
• Ocrelizumab
• Ombitasvir; Paritaprevir; Ritonavir
• Omeprazole; Amoxicillin; Rifabutin
• Ondansetron
• Oritavancin
• Oxymetholone
• Ozanimod
• Pancuronium
• Pazopanib
• Pegaspargase
• Peginterferon Alfa-2a
• Penicillamine
• Phenobarbital
• Phenylephrine
• Phenylephrine; Promethazine
• Photosensitizing agents (topical)
• Physostigmine
• Pimozide
• Posaconazole
• Potassium
• Potassium Chloride
• Potassium Phosphate; Sodium Phosphate
• Potassium-sparing diuretics
• Pramlintide
• Prasterone, Dehydroepiandrosterone, DHEA (Dietary Supplements)
• Prasterone, Dehydroepiandrosterone, DHEA (FDA-approved)
• Primidone
• Propranolol
• Propylthiouracil, PTU
• Purine analogs
• Pyridostigmine
• Quetiapine
• Quinolones
• Rapacuronium
• Regular Insulin
• Repaglinide
• Rifabutin
• Rifampin
• Rifamycins
• Rifapentine
• Rilonacept
• Ritodrine
• Ritonavir
• Rituximab
• Rituximab; Hyaluronidase
• Rocuronium
• Salicylates
• Salsalate
• Saquinavir
• Sargramostim, GM-CSF
• Semaglutide
• SGLT2 Inhibitors
• Siponimod
• Sipuleucel-T
• Sodium Benzoate; Sodium Phenylacetate
• Sodium Chloride
• Sodium Phenylbutyrate
• Sodium Phosphate Monobasic Monohydrate; Sodium Phosphate Dibasic Anhydrous
• Somatropin, rh-GH
• Succinylcholine
• Sulfonylureas
• Tacrolimus
• Telaprevir
• Telbivudine
• Telithromycin
• Telotristat Ethyl
• Testosterone
• Thiazide diuretics
• Thiazolidinediones
• Thyroid hormones
• Tobramycin
• Tolazamide
• Tolbutamide
• Tositumomab
• Trandolapril; Verapamil
• Tranexamic Acid
• Tretinoin, ATRA
• Tuberculin Purified Protein Derivative, PPD
• Tubocurarine
• Tucatinib
• Vancomycin
• Vecuronium
• Verapamil
• Vigabatrin
• Vincristine Liposomal
• Voriconazole
• Vorinostat
• Warfarin
• Zafirlukast