Class: Adrenal Corticosteroid
Dosage Forms. Tablet: 2 mg, 4 mg, 8 mg, 16 mg, 32 mg
Common FDA Label Indication and Dosing.
Dosing for indications listed below: Adults, 4-48 mg po daily; Children, specific dosing parameters not specified; for all patients, adjust dose according to patient response
1. Allergic states (eg, asthma, etc)
2. Dermatologic diseases (eg, exfoliative erythroderma, etc)
3. Endocrine disorders (eg, adrenocortical insufficiency, etc)
4. Gastrointestinal diseases (eg, regional enteritis, ulcerative colitis, etc)
5. Hematologic disorders (eg, acquired hemolytic anemia, etc)
6. Neoplastic diseases (eg, palliative management of leukemias and lymphomas, etc)
7. Nervous system (eg, multiple sclerosis, cerebral edema, etc)
8. Renal diseases (eg, idiopathic nephrotic syndrome, systemic lupus erythematosus, etc)
9. Respiratory diseases (eg, idiopathic eosinophilic pneumonia, etc)
10. Rheumatic disorders (eg, rheumatoid arthritis, etc)
Off-Label Uses. None
MOA. Corticosteroids are naturally occurring and synthetic adrenocortical steroids cause varied metabolic effects, modify the body’s immune responses to diverse stimuli, and are used primarily for their anti-inflammatory effects in disorders of many organ systems.
Drug Characteristics: Methylprednisolone
Medication Safety Issues: Methylprednisolone
Drug Interactions: Methylprednisolone
Adverse Reactions: Methylprednisolone
Efficacy Monitoring Parameters. Improvement or resolution of clinical signs and symptoms; monitor for decrease in ESR, or improvement of PFT.
Toxicity Monitoring Parameters. Monitor for signs of hyperglycemia, osteoporosis, adrenocortical insufficiency, and infection; frequency and severity of adverse effects are dependent on the length of treatment and dose.
Key Patient Counseling Points. For short-term treatment, inform patients to take doses with meals to prevent GI upset. For high-dose or longer-term treatment, inform patients to monitor for signs of hyperglycemia, osteoporosis, adrenocortical insufficiency, and infection.
Clinical Pearls. Available in a variety of dosage forms for various indications, including ophthalmic preparations. Use lowest effective and discontinued as soon as possible to avoid serious long-term adverse effects. Injectable formulations sold by compounding pharmacies have been associated with outbreak of fatal fungal infections.