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Action/Kinetics:
Low incidence of increased appetite, peptic ulcer, psychic stimulation, and sodium and water retention. May mask negative nitrogen balance.
Onset: Slow, 12-24 hr.
t
1/2, plasma: 78-188 min.
Duration: Long, up to 1 week. Rapid onset of sodium succinate by both IV and IM routes. Long duration of action of the acetate.
Additional Uses:
Severe hepatitis due to alcoholism. Within 8 hr of severe spinal cord injury (to improve neurologic function). Septic shock (controversial).
Special Concerns:
Use during pregnancy only if benefits outweigh risks.
Laboratory Test Alterations:
Immunoglobulins A, G, M.
Additional Drug Interactions:
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Erythromycin /
Methylprednisolone effect R/T
liver metabolism
-
Troleandomycin /
Methylprednisolone effect R/T
liver metabolism
How Supplied:
Methylprednisolone:
Tablet: 2 mg, 4 mg, 8 mg, 16 mg, 24 mg, 32 mg.
Methylprednisolone acetate:
Injection: 20 mg/mL, 40 mg/mL, 80 mg/mL.
Methylprednisolone sodium succinate:
Powder for injection: 40 mg, 125 mg, 500 mg, 1 g, 2 g
Dosage
Methylprednisolone
?Tablets
Rheumatoid arthritis.
Adults: 6-16 mg/day. Decrease gradually when condition is under control.
Pediatric: 6-10 mg/day.
SLE.
Adults, acute: 20-96 mg/day;
maintenance: 8-20 mg/day.
Acute rheumatic fever.
1 mg/kg body weight daily. Drug is always given in four equally divided doses after meals and at bedtime.
Methylprednisolone acetate
?IM
Adrenogenital syndrome.
40 mg q 2 weeks.
Rheumatoid arthritis.
40-120 mg/week.
Dermatologic lesions, dermatitis.
40-120 mg/week for 1-4 weeks; for severe cases, a single dose of 80-120 mg should provide relief.
Seborrheic dermatitis.
80 mg/week.
Asthma, rhinitis.
80-120 mg.
?Intra-articular, Soft Tissue and Intralesional Injection
4-80 mg, depending on site.
?Retention Enema
40 mg 3-7 times/week for 2 or more weeks.
Methylprednisolone sodium succinate
?IM, IV
Most conditions.
Adults, initial: 10-40 mg, depending on the disease;
then, adjust dose depending on response, with subsequent doses given either
IM, IV.
Severe conditions.
Adults: 30 mg/kg infused IV over 10-20 min; may be repeated q 4-6 hr for 2-3 days only.
Pediatric: not less than 0.5 mg/kg/day.
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