Drug Action
Methylprednisolone exerts predominantly glucocorticoid effects with minimal mineralcorticoid effects.
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Drug reference
Methylprednisolone exerts predominantly glucocorticoid effects with minimal mineralcorticoid effects.
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Suppression of inflammatory and allergic disorders | Cerebral oedema associated with malignancy ▶BY MOUTH ▶Adult: Initially 2–40 mg daily ▶BY INTRAMUSCULAR INJECTION, OR BY SLOW INTRAVENOUS INJECTION, OR BY INTRAVENOUS INFUSION ▶Adult: Initially 10–500 mg Treatment of graft rejection reactions ▶BY INTRAVENOUS INFUSION ▶Adult: Up to 1 g daily for up to 3 days Treatment of relapse in multiple sclerosis ▶BY MOUTH ▶Adult: 500 mg once daily for 5 days Treatment of relapse in multiple sclerosis (when oral steroids have failed or have not been tolerated, or in those who require hospital admission) ▶BY INTRAVENOUS INFUSION ▶Adult: 1 g once daily for 3–5 days DEPO-MEDRONE ® Suppression of inflammatory and allergic disorders ▶BY DEEP INTRAMUSCULAR INJECTION ▶Adult: 40–120 mg, then 40–120 mg after 2–3 weeks if required, to be injected into the gluteal muscle l UNLICENSED USE ▶With intravenous use or oral use g Not licensed for use by mouth for the treatment of multiple sclerosis relapse. Not licensed for use by intravenous infusion for the treatment of multiple sclerosis relapse for durations longer than 3 days. h Methylprednisolone doses in the BNF may differ from those in product literature.
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▶With intravenous use Rapid intravenous administration of large doses associated with cardiovascular collapse ▶With systemic use Systemic sclerosis (increased incidence of scleroderma renal crisis)
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MHRA/CHM ADVICE: METHYLPREDNISOLONE INJECTABLE MEDICINE CONTAINING LACTOSE (SOLU-MEDRONE ® 40 MG): DO NOT USE IN PATIENTS WITH COWS’ MILK ALLERGY (OCTOBER 2017) ▶With intramuscular use or intravenous use An EU-wide review has concluded that Solu-Medrone ® Endocrine system 40 mg may contain trace amounts of milk proteins and should not be used in patients with a known or suspected allergy to cows’ milk. Serious allergic reactions, including bronchospasm and anaphylaxis, have been reported in patients allergic to cows’ milk proteins. If a patient’s symptoms worsen or new allergic symptoms occur, administration should be stopped and the patient treated accordingly.
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→Appendix 1: corticosteroids
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▶Common or very common ▶With oral use Depressed mood ▶Frequency not known ▶With oral use Confusion. delusions. diarrhoea. dizziness. dyslipidaemia. hallucination. hiccups. Kaposi’s sarcoma. lipomatosis. myocardial rupture (following recent myocardial infarction). oedema. schizophrenia. suicidal ideation. withdrawal syndrome ▶With parenteral use Confusion. delusions. depressed mood. diarrhoea. dizziness. dyslipidaemia. hallucination. hiccups. Kaposi’s sarcoma. lipomatosis. oedema. schizophrenia. suicidal thoughts. vomiting. withdrawal syndrome
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Manufacturer advises monitor blood pressure and renal function (s-creatinine) routinely in patients with systemic sclerosis—increased incidence of scleroderma renal crisis.
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▶With intravenous use For intravenous infusion (as sodium succinate) (Solu-Medrone ®), give continuously or intermittently or via drip tubing in Glucose 5% or Sodium chloride 0.9%. Reconstitute initially with water for injections; doses up to 250 mg should be given over at least 5 minutes, high doses over at least 30 minutes.
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There can be variation in the licensing of different medicines containing the same drug. Forms available from special-order manufacturers include: oral suspension Powder and solvent for solution for injection CAUTIONARY AND ADVISORY LABELS 10 ▶Solu-Medrone (Pfizer Ltd) Methylprednisolone (as Methylprednisolone sodium succinate) 40 mg Solu-Medrone 40mg powder and solvent for solution for injection vials | 1 vial P £1.58 Methylprednisolone (as Methylprednisolone sodium succinate) 125 mg Solu-Medrone 125mg powder and solvent for solution for injection vials | 1 vial P £4.75 Methylprednisolone (as Methylprednisolone sodium succinate) 500 mg Solu-Medrone 500mg powder and solvent for solution for injection vials | 1 vial P £9.60 Methylprednisolone (as Methylprednisolone sodium succinate) 1 gram Solu-Medrone 1g powder and solvent for solution for injection vials | 1 vial P £17.30 Tablet CAUTIONARY AND ADVISORY LABELS 10, 21 ▶Medrone (Pfizer Ltd) Methylprednisolone 2 mg Medrone 2mg tablets | 30 tablet P £3.88 DT = £3.88 Methylprednisolone 4 mg Medrone 4mg tablets | 30 tablet P £6.19 DT = £6.19 Methylprednisolone 16 mg Medrone 16mg tablets | 30 tablet P £17.17 DT = £17.17 Methylprednisolone 100 mg Medrone 100mg tablets | 20 tablet P £48.32 DT = £48.32 Endocrine system Suspension for injection CAUTIONARY AND ADVISORY LABELS 10 ▶Depo-Medrone (Pfizer Ltd) Methylprednisolone acetate 40 mg per 1 ml Depo-Medrone 40mg/1ml suspension for injection vials | 1 vial P £3.44 DT = £3.44 | 10 vial P £34.04 Depo-Medrone 80mg/2ml suspension for injection vials | 1 vial P £6.18 DT = £6.18 | 10 vial P £61.39 Depo-Medrone 120mg/3ml suspension for injection vials | 1 vial P £8.96 DT = £8.96 | 10 vial P £88.81 eiiii F 709
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Patient counselling is advised for methylprednisolone tablets and injections (steroid card).
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Initially 2–40 mg daily
First-line fragment. Read the complete Indications and Dose section above.
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Initially 10–500 mg
First-line fragment. Read the complete Indications and Dose section above.
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Up to 1 g daily for up to 3 days
First-line fragment. Read the complete Indications and Dose section above.
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500 mg once daily for 5 days
First-line fragment. Read the complete Indications and Dose section above.
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1 g once daily for 3–5 days
First-line fragment. Read the complete Indications and Dose section above.
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40–120 mg, then 40–120 mg after 2–3 weeks if
First-line fragment. Read the complete Indications and Dose section above.
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