Methylprednisolone
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
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/