Methylprednisolone (Rx) - Medscape Reference

Dosage Forms & Strengths

tablet

• 2mg
• 4mg
• 8mg
• 16mg
• 32mg

injectable suspension

• 20mg/mL
• 40mg/mL
• 80mg/mL

powder for injection

• 40mg
• 125mg
• 500mg
• 1g
• 2g

Allergic Conditions

Day 1: 8 mg PO before breakfast, 4 mg after lunch and after dinner, and 8 mg at bedtime

Day 2: 4 mg PO before breakfast, after lunch, and after dinner and 8 mg at bedtime

Day 3: 4 mg PO before breakfast, after lunch, after dinner, and at bedtime

Day 4: 4 mg PO before breakfast, after lunch, and at bedtime

Day 5: 4 mg PO before breakfast and at bedtime

Day 6: 4 mg PO before breakfast

May be tapered over 12 days (to decrease chance of dermatitis flareup)

Acute Exacerbations of Multiple Sclerosis

160 mg IV once daily for 1 week, then 64 mg IV every other day for 1 month

COVID-19 (Off-label)

NIH guidelines recommend corticosteroids (preferably dexamethasone) to reduce mortality in hospitalized patients with COVID-19 disease who are receiving either invasive mechanical ventilation or oxygen alone, but not among those receiving no respiratory support

If dexamethasone is unavailable, use alternant glucocorticoids (eg, prednisone, methylprednisolone, or hydrocortisone)

Methylprednisolone 32 mg IV qDay for up to 10 days or discharge, whichever comes first; use in addition to standard of care

Consider methylprednisolone use as follows

• Supplement oxygen, but not requiring oxygen delivery through high-flow device, noninvasive ventilation, invasive mechanical ventilation, or ECMO
• Requires oxygen delivery through high-glow device or noninvasive ventilation
• Requires invasive mechanical ventilation or ECMO

Pneumocystis (carinii) jiroveci Pneumonia in AIDS Patients (Off-label)

30 mg IV q12hr for 5 days, then 30 mg IV q24hr for 5 days, then 15 mg IV q24hr for 11 days

Acute Spinal Cord Injury (Off-label)

1st hour: 30 mg/kg IV over 15 minutes

Next 23 hours: 5.4 mg/kg/hr IV by continuous infusion

Severe Lupus Nephritis (Off-label)

0.5-1 g IV over 1 hour once daily for 3 days

Dosing Considerations

Methylprednisolone: Usual dosing range, 2-60 mg/day PO divided q6-24hr

Methylprednisolone acetate: Usual dosing range, 10-80 mg IM every 1-2 weeks; as temporary substitute for PO, given in daily IM dose equal to daily PO dose; for prolonged effect, given in weekly IM dose equal to 7 times daily PO dose; unlike methylprednisolone sodium succinate, may not be given IV

Methylprednisolone sodium succinate: Usual dosing range, 10-250 mg IM/IV up to q4hr PRN