Methylprednisolone: Difference between revisions
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*Excretion: Urine excretion | *Excretion: Urine excretion | ||
*Mechanism of Action: Potent anti-inflammatory properties with minimal mineralocorticoid activity | *Mechanism of Action: Potent anti-inflammatory properties with minimal mineralocorticoid activity | ||
==Indications by Condition== | |||
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==See Also== | ==See Also== | ||
Revision as of 16:42, 20 March 2026
General
- Type: Corticosteroid
- Dosage Forms: IM; IV
- Common Trade Names: Medrol, Solu-Medrol
Adult Dosing
Anaphylaxis
- 125mg IV
Pediatric Dosing
Anaphylaxis
- 2mg/kg
Special Populations
- Pregnancy Rating: C(US)
- Lactation: Oral maternal doses to 8mg daily is safe. Recommend waiting 2-8 hours after infusion of 1 gm. [1]
- Renal Dosing
- Adult: not available
- Pediatric: not available
- Hepatic Dosing
- Adult: not available
- Pediatric: not available
Controversial Use in Spinal Cord Injury
- Steroid use for spinal cord injury was a controversial treatment during the 1990s and 2000s, with the NASCIS II and III studies reporting positive outcomes in a subgroup analysis of patients who received methylpredisolone within 8 hours of injury. Multiple cochrane reviews performed by the author of the NASCIS trials concluded neurological improvement after injury, but a review of all individual studies demonstrate negative outcomes for both the retrospective and the prospective trials[2]. Most recent guidelines from the Congress of Neurological Surgeons and American Association of Neurological Surgeons discourage against the use of steroids in spinal cord injury, citing harmful side effects including death.[3]
Contraindications
- Allergy to class/drug
Adverse Reactions
Serious
Common
Pharmacology
- Half-life: 0.25 hours (IV)[4]
- Metabolism: Hepatic
- Excretion: Urine excretion
- Mechanism of Action: Potent anti-inflammatory properties with minimal mineralocorticoid activity
Indications by Condition
The following table is automatically generated from disease/condition pages across WikEM.
| Indication | Dose | Context | Route | Population | |
|---|---|---|---|---|---|
| Acute allergic reaction#Methylprednisolone Corticosteroid Adult | Acute allergic reaction | 125mg | Corticosteroid | IV/IM | Adult |
| Acute asthma exacerbation#Methylprednisolone Corticosteroid (if unable to tolerate PO) Adult | Acute asthma exacerbation | 1 mg/kg IV q4-6h | Corticosteroid (if unable to tolerate PO) | IV | Adult |
| Acute respiratory distress syndrome#Methylprednisolone Pulse-dose steroids for early established severe ARDS (Meduri protocol) Adult | Acute respiratory distress syndrome | 1mg/kg load, then 1mg/kg/day (d1-14), taper over d15-28 | Pulse-dose steroids for early established severe ARDS (Meduri protocol) | IV | Adult |
| Angioedema#Methylprednisolone Corticosteroid (allergic angioedema) Adult | Angioedema | 125 mg IV | Corticosteroid (allergic angioedema) | IV | Adult |
| COPD exacerbation#Methylprednisolone Corticosteroid (IV option) Adult | COPD exacerbation | 125 mg IV daily (1-2 mg/kg) | Corticosteroid (IV option) | IV | Adult |
| Chloramine#Methylprednisolone Airway inflammation Adult | Chloramine | 125mg IV (adults); 2mg/kg IV (children) | Airway inflammation | IV | Adult |
| Crohn's disease#Methylprednisolone Severe/fulminant flare (inpatient) Adult | Crohn's disease | 20mg IV q6hr | Severe/fulminant flare (inpatient) | IV | Adult |
| Giant cell arteritis#Methylprednisolone Visual symptoms or suspected GCA with vision loss Adult | Giant cell arteritis | 500-1000mg IV daily x 3 days (pulse dose) | Visual symptoms or suspected GCA with vision loss | IV | Adult |
| Immune thrombocytopenic purpura#Methylprednisolone Severe bleeding with high-dose steroids Adult | Immune thrombocytopenic purpura | 1g | Severe bleeding with high-dose steroids | IV | Adult |
| Immune thrombocytopenic purpura#Methylprednisolone Severe bleeding with high-dose steroids Pediatric | Immune thrombocytopenic purpura | 30mg/kg | Severe bleeding with high-dose steroids | IV | Pediatric |
| Orbital compartment syndrome#Methylprednisolone Adjunctive to lateral canthotomy Adult | Orbital compartment syndrome | 250mg IV | Adjunctive to lateral canthotomy | IV | Adult |
| Peritonsillar abscess#Methylprednisolone Adjunct steroid (pain/inflammation) Adult | Peritonsillar abscess | 125 mg | Adjunct steroid (pain/inflammation) | IV | Adult |
| Retrobulbar hemorrhage#Methylprednisolone Adjunctive to cantholysis Adult | Retrobulbar hemorrhage | 250mg IV | Adjunctive to cantholysis | IV | Adult |
| Systemic lupus erythematosus#Methylprednisolone Acute SLE flare management Adult | Systemic lupus erythematosus | 1-2mg/kg IV | Acute SLE flare management | IV | Adult |
| Thrombotic thrombocytopenic purpura#Methylprednisolone Glucocorticoid (adjunct to plasmapheresis) Adult | Thrombotic thrombocytopenic purpura | 125 mg IV (or prednisone 1 mg/kg PO) | Glucocorticoid (adjunct to plasmapheresis) | IV/PO | Adult |
See Also
References
- ↑ Lactmed: Methylprednisolone
- ↑ Steroids for Spinal Cord Injury http://www.trauma.org/archive/spine/steroids.html#NASCIS_1.2C_USA_1984
- ↑ Anderson P. New CNS/AANS Guidelines Discourage Steroids in Spinal Injury. Medscape Medical News. Mar 28 2013
- ↑ Ocejo A, Correa R. Methylprednisolone. [Updated 2022 May 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK544340/