Methylprednisolone

Sounds like 'METH-il-pred-NIS-oh-lone'

Key points about methylprednisolone

  • Methylprednisolone is a steroid used to treat and prevent a variety of conditions that involve inflammation.
  • Methylprednisolone is commonly called Medrol®, Solu-Medrol® or Depo-Medrol.
  • Find out how to take it safely and possible side effects.
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Methylprednisolone is a medicine used to treat many illnesses associated with inflammation, such as inflammatory bowel diseases (eg, Crohn's disease, ulcerative colitis), autoimmune diseases (eg, systemic lupus erythematosus, multiple sclerosis) or joint and muscle diseases (eg, rheumatoid arthritis). It is also used to treat severe allergic reactions or acute transplant rejection.

Methylprednisolone works by calming or suppressing your body's immune system and is especially effective for treating flare-ups of these conditions. Methylprednisolone helps to reduce the symptoms associated with these conditions – it does not cure them.

Methylprednisolone is in a class of medicines known as corticosteroids, which is similar to the steroid hormones your body naturally makes. It is available as tablets or as an injection that can be given into your vein or muscle. 

  • In New Zealand methylprednisolone tablets are available in 2 strengths — 4 mg and 100 mg. 
  • The dose of methylprednisolone is different for different people.
  • Most people may need a short course of methylprednisolone (such as 3–5 days), but some may need to take it for longer (weeks to months).
  • Always take your methylprednisolone exactly as your doctor has told you.
  • The pharmacy label on your medicine will tell you how much methylprednisolone to take, how often to take it and any special instructions.

  • Timing: Take your methylprednisolone tablets with food. Methylprednisolone is best taken in the morning, with breakfast. Swallow your tablets with a glass of water.
  • Missed dose: If you forget to take your dose, take it as soon as you remember. But if it is nearly time for your next dose, just take the next dose at the right time. Do not take double the dose.
  • Stopping methylprednisolone: If you have been taking methylprednisolone tablets regularly for more than a few weeks, do not stop taking them suddenly. Stopping suddenly can cause withdrawal symptoms, which can be serious or even life-threatening. Instead, you will be given a tapering dose, which means your dose of methylprednisolone will be gradually reduced over a few days or weeks. Read more about a steroid withdrawal plan.
My methylprednisolone dose
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How to reduce my methylprednisolone dose gradually over a few weeks
Date:   Dose:
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While taking methylprednisolone

  • Tell all your healthcare providers: It's important to tell all your healthcare providers that you are taking methylprednisolone.
  • Increased risk of infections: Taking methylprednisolone for a long time can increase your risk of all types of infections. Tell your doctor if you come into contact with someone who has a contagious illness, such as chickenpox, shingles or measles, or if you feel unwell.
  • Vaccines: It is safe to have most vaccines, including the flu vaccine, while you are taking methylprednisolone. Protecting yourself against infection is important because methylprednisolone suppresses your immune system. However, vaccination with ‘live vaccines’, such as MMR (measles, mumps, rubella) or shingles vaccine, should be postponed. Ask your doctor for advice before you have any vaccinations while you are taking methylprednisolone.

Like all medicines, methylprednisolone can cause side effects, although not everyone gets them. Most side effects are related to the dose you are taking and how long you are taking methylprednisolone for. Read more about taking steroids long term.

Changes in behaviour and mood

Methylprednisolone, especially in high doses, can cause changes in personality, behaviour and mood, such as:

  • irritability, agitation and restlessness
  • sleep problems (insomnia) and nightmares
  • mood swings and aggression
  • low mood, depression and even suicidal thoughts.

These symptoms typically develop within a few days of starting methylprednisolone, but they can occur at any time, including after stopping treatment. 

While these symptoms often go away when your dose is reduced or methylprednisolone is stopped, stopping methylprednisolone must be done under the guidance of your doctor. Stopping too quickly can make these symptoms worse. You are at higher risk of mood and behaviour changes if you have previously had similar reactions to steroids (corticosteroid-induced psychosis), or if you have a personal or family history of psychiatric disorders.  

If you have changes in mood and behaviour, especially depression and suicidal thoughts, tell your doctor immediately or phone Healthline 0800 611 116. 

Other side effects

Side effects What should I do?
  • Difficulty sleeping
  • Take methylprednisolone in the morning or at least 3 hours before bedtime.
  • Headache
  • Muscle weakness
  • Feeling tired
  • These are quite common when you first start taking methylprednisolone and usually go away with time.
  • Tell your doctor if troublesome.
  • Increased appetite (wanting to eat more)
  • Methylprednisolone increases your appetite.
  • Follow a healthy, balanced diet to maintain your weight.
  • Fluid retention causing swollen ankles and feet
  • Whenever possible, sit with your feet raised.
  • Avoid foods with high salt content.
  • Tell your doctor if this happens.
  • Raised blood glucose
  • Methylprednisolone can cause an increase in blood glucose.
  • If you have diabetes, you may need to increase the dose of your diabetes medicine to control your blood glucose. Talk to your doctor about this.
  • Methylprednisolone can also cause the onset of diabetes in people who are at risk of diabetes.
  • Your doctor will monitor your blood glucose levels regularly.  
  • Eye pain and changes to your vision
  • Tell your doctor immediately or phone Healthline 0800 611 116.
  • Problems with your stomach such as pain, blood in your stool (poo) or dark-coloured stool (poo)
  • Tell your doctor immediately or phone Healthline 0800 611 116.
Did you know that you can report a side effect to a medicine to CARM (Centre for Adverse Reactions Monitoring)? Report a side effect to a product(external link)

Methylprednisolone interacts with a number of medicines and herbal supplements, so check with your doctor or pharmacist before starting methylprednisolone and before starting any new medicines.

The following links provide further information on methylprednisolone. Be aware that websites from other countries may contain information that differs from New Zealand recommendations.

Methylprednisolone tablets(external link) Patient Info, UK

Resources

5 questions to ask about your medications(external link) Health Quality and Safety Commission, NZ, 2019 English(external link), te reo Māori(external link)

References

  1. Methylprednisolone(external link) New Zealand Formulary
  2. Glucocorticoid therapy(external link) New Zealand Formulary
  3. Prednisone treatment – follow dosing recommendations(external link) Medsafe, NZ, 2021 

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Credits: Sandra Ponen, Pharmacist, Healthify He Puna Waiora. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Angela Lambie, Pharmacist, Auckland

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