Generic: Methylprednisolone Brand:  Depo-Medrol, Solu-Medrol, A-Methapred

1. What does it treat?

1.1. Chron's Disease

1.2. Exacerbation of multiple sclerosis

1.3. Leukemia/Palliative therapy

1.4. Malignant Lymphoma/palliative therapy

1.5. Osteoarthritis

2. Adverse Effects (No BlackBox warnings)

2.1. Cardiovascular effects

2.2. Dermatological effects

2.3. Endocrine/Metabolic Effects

2.4. Gastrointestinal Effects

2.5. Hematologic effects

2.6. Hepatic effects

2.7. Immunologic effects

2.8. Musculoskeletal effects

2.9. Neurologic Effects

2.10. Opthamalic effects

2.11. Psychiatric effects

2.12. Renal effects

2.13. Respiratory effects

3. Dosing/Administration (dosing varies by condition)

3.1. Adrenal insufficiency

3.1.1. 40 mg IM bi-weekly

3.2. Allergic condition

3.2.1. dosage varies; administer the equivalent of a total daily oral dose as a single IM injection in a 24-h period

3.3. Allergic rhinitis

3.3.1. 80-120 mg IM, relief in 6 hours, may persist up to 3 weeks

3.4. Asthma

3.4.1. 80-120 mg IM, relief in 6-48 hours

3.4.2. (in place of oral short burst; vomiting or nonadherent patients) 240 mg IM as one-time dose

3.5. Bursitis

3.5.1. 4-30 mg injected into the bursal structure

3.6. Carcinoma of breast

3.6.1. Optimal dosing and timing not yet defined

3.7. Collagen disease

3.7.1. Optimal dosing and timing not yet defined

3.8. Contact dermititis due to poison ivy (severe)

3.8.1. 80-120 mg IM once; relief within 8 to 12 hours

3.9. Chron's Disease

3.9.1. dosage varies; administer the equivalent of a total daily oral dose as a single IM injection in a 24-h period

3.10. Disorder of eye

3.10.1. dosage varies; administer the equivalent of a total daily oral dose as a single IM injection in a 24-h period

3.11. Disorder of hematopoetic structure

3.11.1. dosage varies; administer the equivalent of a total daily oral dose as a single IM injection in a 24-h period

3.12. Disorder of respiratory system

3.12.1. dosage varies; administer the equivalent of a total daily oral dose as a single IM injection in a 24-h period

3.13. Disorder of skin

3.13.1. IM, 40 to 120 mg/wk for 1-4 weeks

3.13.2. INTRALESIONALLY, 20 to 60 mg; for large lesions, 20 to 40 mg by repeated injections

3.14. Epicondylitis

3.14.1. 4 mg to 30 mg administered locally

3.15. Exacerbation of multiple sclerosis

3.15.1. 160 mg IM daily for 1 wk, followed by 64 mg every other day for 1 month

3.16. Fever due to malignancy

3.16.1. Optimal dosing and timing not yet defined

3.17. Ganglion of aponeurosis

3.17.1. 4 mg to 30 mg administered INTRALESIONALLY

3.18. Inflammatory disorder of musculoskeletal system

3.18.1. dosage varies; administer the equivalent of a total daily oral dose as a single IM injection in a 24-h period

3.19. Intracranial tumor

3.19.1. Optimal dosing and timing not yet established

3.20. Malignant lymphoma/

3.20.1. dosage varies; administer the equivalent of a total daily oral dose as a single IM injection in a 24-h period

3.21. Multiple Myeloma

3.21.1. Optimal dosing and timing not yet established

3.22. Mycosis fungoides

3.22.1. dosage varies; administer the equivalent of a total daily oral dose as a single IM injection in a 24-h period

3.23. Nephrotic syndrome

3.23.1. Dosage varies; administer equivalent of a total daily oral dose as a single IM injection in a 24-hour period

3.24. Osteoarthritis

3.24.1. INTRA-ARTICULAR, 20-80 mg for large joint; 10-40 mg for medium joint; 4-10 mg for small joint, may be repeated every 1-5 weeks or more

3.25. Prostate Cancer

3.25.1. Optimal dosing and timing not yet defined

3.26. Rheumatoid arthritis

3.26.1. IM, maintenance, 40-120 mg/wk

3.26.2. INTRA-ARTICULAR, 20-80 mg for large joint; 10-40 mg for medium joint; 4-10 mg for small joint, may be repeated every 1-5 weeks or more

3.27. Tenosynovitis

3.27.1. 4 mg to 30 mg administered locally into the tendon sheath

3.28. Trichinosis with neurologic and myocardial involvement

3.28.1. dosage varies; administer the equivalent of a total daily oral dose as a single IM injection in a 24-h period

3.29. Tuberculosis of meninges

3.29.1. dosage varies; administer the equivalent of a total daily oral dose as a single IM injection in a 24-h perio

3.30. Ulcerative Colitis

3.30.1. dosage varies; administer the equivalent of a total daily oral dose as a single IM injection in a 24-h period

4. Drug Interactions

4.1. Drug-food interactions

4.1.1. Grapefruit juice

4.2. Drug-drug interactions

4.2.1. Lyme Disease Vaccine, Measles Virus Vaccine,   Mumps Virus Vaccine, Plague Vaccine, Pneumococcal Vaccine, Rabies Vaccine, Rotavirus Vaccine, Live Rubella Virus Vaccine, Warfarin, Yellow Fever Vaccine

5. Drug indication

5.1. Used as antiinflammatory or immunosuppressant.

5.2. Corticosteroids have multiple mechanisms of action including anti-inflammatory activity, immunosuppressive properties, and antiproliferative actions. Anti-inflammatory effects result from decreased formation, release and activity of the mediators of inflammation (eg, kinins, histamine, liposomal enzymes, prostaglandins, leukotrienes) which reduce the initial manifestations of the inflammatory process

6. How is it supplied?

6.1. Generic: injection suspension  40 MG/1 ML, 80 MG/1 ML

6.2. Depo-Medrol: Injection Suspension: 20 MG/1 ML, 40 MG/1 ML, 80 MG/1 M

6.3. Novaplus Depo-Medrol: Injection Suspension: 40 MG/1 ML, 80 MG/1 ML

7. Drug classification

7.1. Corticosteroid

8. Non-drug treatments for inflammation

8.1. Anti-inflammatory diet- eliminate grains/gluten, sugar, alcohol, allergenic foods, trans fats, aspartame, chemicals, caffeine, excess iron, and toxic heavy metals.

8.2. Resolve psychological traumas

8.3. Exercise

8.4. Meditation and deep breathing for ultimate relaxation

8.5. Turmeric

8.6. Licorice root

8.7. Serrapeptase; enzyme derived from silkworm

8.8. Pancreatin; enzyme extracted from porcine pancreas

8.9. Bromelain; enzyme derived from pineapple

8.10. Ginger

9. Dosing

9.1. Pediatric

9.1.1. Pediatric specific dosing not provided by the manufacturer; dosage will be reduced but should be governed more by the severity of the condition and response of the patient than by age or size

9.2. Adult

9.2.1. Dosage varies depending on condition

9.3. Geriatric

9.3.1. Dose selection should start low

10. Administration

10.1. The actual administration of Solu-Medrol is pretty standard. After the IV line is inserted, the bag containing the Solu-Medrol (between 500 and 1000 mg diluted in 100 to 500 ml of fluid) is infused over a period of time ranging from one to four hours. You will experience a brief (30 seconds) period of stinging and a cool sensation when the medication begins to flow.

10.2. Precautions should be taken to prevent leakage into the dermis during intrasynovial and IM injections

11. Drug Reconstitution

11.1. Methylprednisolone sodium succinate is soluble in water; it may be administered in a small volume of diluent and is well suited for intravenous use in situations where high blood levels of methylprednisolone are required rapidly.

11.2. IMPORTANT - Use only the accompanying diluent or Bacteriostatic Water For Injection with Benzyl Alcohol when reconstituting SOLU-MEDROL. Use within 48 hours after mixing.

11.3. When necessary, the pH of each formula was adjusted with sodium hydroxide so that the pH of the reconstituted solution is within the USP specified range of 7 to 8

11.4. Each vial of powder contains methylprednisolone sodium succinate 1326.0 mg equivalent to 1000 mg of methylprednisolone. After reconstitution in water for injections, each ml of solution contains the equivalent of 59.6 mg of methylprednisolone.

12. Antidote for patient reactions

12.1. If overdose is suspected, contact a poison control center or emergency room right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

12.2. Treatment of acute overdosage is by supportive and symptomatic therapy. For chronic overdosage in the face of severe disease requiring continuous steroid therapy, the dosage of the corticosteroid may be reduced only temporarily, or alternate day treatment may be introduced.

12.3. Taking this medication for a long time may cause brittle bones (osteoporosis). Lifestyle changes that help promote healthy bones include increasing weight-bearing exercise, stopping smoking, getting enough calcium and vitamin D, and limiting alcohol. Consult your doctor for specific advice.

13. Ongoing Monitoring

13.1. Usually the first Solu-Medrol series is given in a hospital  for the 3-5 day treatment so that your reaction can be monitored and you can be taken care of during this time. You can also go to a clinic or an infusion center, where you will be given the medicine while laying down in a bed or reclining in a chair. Arrangements may occasionally be made for a nurse to come to your home to administer the treatment, as well.