Generic Name

Methylprednisolone

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Classification

FDA Approved Indications

• Inflammatory and autoimmune disorders
• Allergic reactions
• Asthma exacerbations
• Multiple sclerosis flare-ups
• Adrenal insufficiency

Mechanism of Action

Methylprednisolone binds to glucocorticoid receptors, resulting in modulation of gene expression that suppresses inflammation and immune responses.

Dosage and Administration

Adult: Dose varies based on condition; commonly 4-48 mg daily, divided doses; adjust based on response and severity.

Pediatric: Dosing is weight-based; usually 0.05-2 mg/kg/day in divided doses.

Geriatric: Use with caution; start at lower end of dosing range due to increased risk of side effects.

Renal Impairment: Adjust dose based on severity of impairment, closely monitor response.

Hepatic Impairment: No specific adjustment recommended, but monitor for enhanced effects or toxicity.

Pharmacokinetics

Absorption: Rapidly absorbed after oral administration.

Distribution: Widely distributed, crosses the placenta, and enters breast milk.

Metabolism: Metabolized hepatically via CYP3A4.

Excretion: Primarily excreted in urine as metabolites.

Half Life: Approximately 18-36 hours.

Contraindications

• Systemic fungal infections
• Hypersensitivity to methylprednisolone or other corticosteroids

Precautions

• Use with caution in active infections, osteoporosis, ulcers, diabetes, hypertension, psychiatric disorders, and during pregnancy/lactation. Monitor for side effects.

Adverse Reactions - Common

• Increased appetite, weight gain (Common)
• Insomnia, nervousness (Common)
• Mood changes, fluid retention (Common)

Adverse Reactions - Serious

• Adrenal suppression (Rare)
• Osteoporosis with long-term use (Rare)
• Hyperglycemia, hypertension (Less common)
• Increased risk of infection (Less common)

Drug-Drug Interactions

• NSAIDs (increased gastrointestinal risk)
• Vaccines (live vaccines may be ineffective)
• Diuretics (potassium loss)
• Antidiabetic agents (altered glucose control)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Patient/Family Teaching

• Take medication exactly as prescribed.
• Do not stop abruptly; taper off under medical supervision.
• Report signs of infection, hyperglycemia, or mood changes.
• Use caution when performing activities that require alertness.
• Maintain regular follow-up appointments.

Special Considerations

Black Box Warnings:

• Increased risk of infection and masking symptoms of infection; risk of osteoporosis with long-term use.

Genetic Factors: None specific.

Lab Test Interference: May induce false elevation of blood glucose and eosinophil count.

Overdose Management

Signs/Symptoms: Fluid retention, hyperglycemia, hypertension, hypokalemia.

Treatment: Discontinue corticosteroid gradually; symptomatic and supportive care; manage electrolyte imbalance and blood pressure.

Storage and Handling

Storage: Store at room temperature away from light and moisture.

Stability: Stable for 2-3 years when stored properly.