Home Drug Guide Methylprednisolone Sodium Succinate

Drug Guide

Generic Name

Methylprednisolone Sodium Succinate

Brand Names Solu-Medrol, A-Methapred, Methylprednisolone

Classification

Therapeutic: Anti-inflammatory, immunosuppressant

Pharmacological: Glucocorticoid

FDA Approved Indications

Moderate to severe inflammatory conditions
Allergic reactions
Autoimmune diseases
Multiple sclerosis exacerbations
Prevention of transplant rejection

Mechanism of Action

Methylprednisolone suppresses inflammation and the immune response by inhibiting multiple inflammatory cytokines, reducing leukocyte infiltration, and decreasing capillary permeability.

Dosage and Administration

Adult: Dose varies based on condition; commonly 40-125 mg IV once daily or in divided doses; duration tailored to response.

Pediatric: Dose varies depending on age and condition; usually 1-2 mg/kg/day IV, may be divided.

Geriatric: Start at lower end of dosing range; monitor closely due to increased risk of side effects.

Renal Impairment: Use with caution; adjust dose based on response and tolerability.

Hepatic Impairment: Use with caution; minimal data, monitor closely.

Pharmacokinetics

Absorption: Administered intravenously; rapid onset.

Distribution: Widely distributed; crosses cell membranes, enters many tissues.

Metabolism: Hepatic metabolism to inactive metabolites.

Excretion: Primarily renal excretion of metabolites.

Half Life: Approximately 2-3 hours; biologic effects last longer.

Contraindications

Systemic fungal infections

Precautions

Use with caution in patients with infections, diabetes, osteoporosis, gastrointestinal ulcers, mental health disorders, and in pregnancy/lactation. May increase blood glucose levels, risk of infection, and ocular effects.

Adverse Reactions - Common

Hyperglycemia (Common)
Fluid retention (Common)
Insomnia (Common)
Mood swings (Common)

Adverse Reactions - Serious

SIRS or sepsis exacerbation (Rare)
Osteoporosis with long-term use (Rare)
Adrenal suppression (Rare)
Peptic ulcer bleeding (Rare)
Psychosis or new/worsening psychiatric disturbances (Rare)

Drug-Drug Interactions

NSAIDs (increased risk of GI bleeding)
Vaccines (immunosuppression)
CYP3A4 inhibitors/inducers affecting metabolism

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor body weight, blood glucose, infection signs, electrolyte status, mental health, and wound healing.

Diagnoses:

Risk for infection
Impaired skin integrity
Altered electrolyte balance

Implementation: Administer as prescribed, preferably in the morning to mimic circadian rhythm, with meals to minimize GI upset. Monitor for adverse effects.

Evaluation: Assess clinical response, adverse effects, and laboratory parameters regularly.

Patient/Family Teaching

Do not stop medication abruptly.
Report signs of infection, unusual emotional changes, or GI discomfort.
Avoid vaccinations without approval from healthcare provider.

Special Considerations

Black Box Warnings:

Immunosuppression leading to increased infection risk, including reactivation of latent infections.
Potential for precipitating secondary infections.

Genetic Factors: Pharmacogenetic variations affect metabolism, primarily via CYP3A4.

Lab Test Interference: May alter glucose, electrolyte, and calcium levels; may cause hyperglycemia and hypokalemia.

Overdose Management

Signs/Symptoms: Cushingoid features, hyperglycemia, electrolyte disturbances, psychosis.

Treatment: Discontinue drug, provide supportive care, correct electrolyte imbalances, and manage hyperglycemia as needed.

Storage and Handling

Storage: Store at room temperature, 15-30°C (59-86°F), protected from light and moisture.

Stability: Stable until expiration date if stored properly.