Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks
Mode of Action
Methylprednisolone is a synthetic corticosteroid with mainly glucocorticoid activity and minimal mineralocorticoid properties. It decreases inflammation by suppression of migration of polymorphonuclear leukocytes and reversal of increased capillary permeability.
Interaction
Loss of corticosteroid-induced adrenal suppression w/ aminoglutethimide. Risk of hypokalaemia w/ K-depleting agents (e.g. amphotericin B, diuretics). Decreased clearance w/ macrolide antibiotics. May decrease serum levels of isoniazid. Increased clearance w/ cholestyramine. Risk of convulsions w/ ciclosporin. Increased risk of arrhythmias w/ digitalis glycosides. Decreased metabolism w/ oestrogens, including OCs. Enhanced metabolism w/ CYP3A4 inducers (e.g. rifampicin, barbiturates). Increased plasma concentrations w/ CYP3A4 inhibitors (e.g. ketoconazole, erythromycin). Risk of GI effects w/ aspirin or other NSAIDs. May increase the anticoagulant effect of warfarin. May reduce the therapeutic effect of antidiabetics.
Potentially Fatal: May diminish response to live or live, attenuated vaccines.
Pregnancy Category Note
Pregnancy category: C
Lactation: Drug enters milk; use with caution
Adult Dose
Oral
Anti-inflammatory or immunosuppressive
Adult: Initially, 2-60 mg daily in 1-4 divided doses, depending on the disease being treated.
Allergic conditions
Adult:
24 mg on day 1 (8 mg before breakfast, 4 mg after lunch, 4 mg after supper, and 8 mg at bedtime) or 24 mg as a single or in 2-3 divided doses upon initiation (regardless of time of day);
20 mg on day 2 (4 mg before breakfast, 4 mg after lunch, 4 mg after supper, and 8 mg at bedtime);
16 mg on day 3 (4 mg before breakfast, 4 mg after lunch, 4 mg after supper, and 4 mg at bedtime);
12 mg on day 4 (4 mg before breakfast, 4 mg after lunch, and 4 mg at bedtime);
8 mg on day 5 (4 mg before breakfast and 4 mg at bedtime);
4 mg on day 6, given before breakfast.
May be tapered over 12 days (to decrease chance of dermatitis flareup)
Child Dose
Oral
Anti-inflammatory or immunosuppressive
Child: 0.5-1.7 mg/kg daily or 5-25 mg/m2 daily in divided doses 6-12 hrly.
Usual dosing range, 0.117-1.66 mg/kg/day PO divided q6-8hr
Renal Dose
N/A
Administration
Should be taken with food.
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