How does this medication work? What will it do for me?

Methylprednisolone belongs to a group of medications called corticosteroids. Corticosteroids are hormones that are produced naturally in our body, and necessary for many important bodily functions.

Methylprednisolone is a synthetic (man-made) corticosteroid medication that has been developed to imitate the actions of naturally occurring corticosteroid hormones in the body. A particularly important action of methlyprednisolone is to relieve inflammation that causes symptoms such as swelling, itching, and redness.

Symptoms of inflammation are often seen with allergic reactions such as severe allergic skin reactions, reactions to insect bites, and anaphylaxis (a severe, life-threatening allergic reaction). Other conditions and symptoms associated with inflammation can also be treated with corticosteroids. These include painful swollen joints caused by arthritis, and relief of asthma symptoms caused by inflamed breathing passages.

Methylprednisolone may also be used by people who are not able to produce enough of their own corticosteroid naturally (e.g., Addison's disease). Additional conditions that may be treated with methylprednisolone include severe skin conditions (e.g., psoriasis), certain eye conditions, ulcerative colitis, certain blood disorders, leukemia, lupus, and multiple sclerosis.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are being given this medication, speak to your doctor. Do not stop using this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

Act-O-Vials

40 mg
Each 1 mL (when mixed) contains methylprednisolone (as methylprednisolone sodium succinate) 40 mg. Nonmedicinal ingredients: monobasic sodium phosphate anhydrous, dibasic sodium phosphate dried, lactose hydrous, and bacteriostatic water for injection.

125 mg
Each 2 mL (when mixed) contains methylprednisolone (as methylprednisolone sodium succinate) 125 mg. Nonmedicinal ingredients: monobasic sodium phosphate, dibasic sodium phosphate dried, and bacteriostatic water for injection.

500 mg
Each 4 mL (when mixed) contains methylprednisolone (as methylprednisolone sodium succinate) 500 mg. Nonmedicinal ingredients: monobasic sodium phosphate anhydrous, dibasic sodium phosphate dried, and bacteriostatic water for injection.

1 g
Each 8 mL (when mixed) contains methylprednisolone (as methylprednisolone sodium succinate) 1 g. Nonmedicinal ingredients: monobasic sodium phosphate anhydrous, dibasic sodium phosphate dried, and bacteriostatic water for injection.

Act-o-Vials with Preservative

40 mg
Each 1 mL (when mixed) contains methylprednisolone (as methylprednisolone sodium succinate) 40 mg. Nonmedicinal ingredients: monobasic sodium phosphate anhydrous, dibasic sodium phosphate dried, lactose hydrous, bacteriostatic water for injection, and benzyl alcohol.

125 mg
Each 2 mL (when mixed) contains methylprednisolone (as methylprednisolone sodium succinate) 125 mg. Nonmedicinal ingredients: monobasic sodium phosphate, dibasic sodium phosphate dried, bacteriostatic water for injection, and benzyl alcohol.

500 mg
Each 4 mL (when mixed) contains methylprednisolone (as methylprednisolone sodium succinate) 500 mg. Nonmedicinal ingredients: monobasic sodium phosphate anhydrous, dibasic sodium phosphate dried, bacteriostatic water for injection, and benzyl alcohol.

1 g
Each 8 mL (when mixed) contains methylprednisolone (as methylprednisolone sodium succinate) 1 g. Nonmedicinal ingredients: monobasic sodium phosphate anhydrous, dibasic sodium phosphate dried, bacteriostatic water for injection, and benzyl alcohol.

Vials

500 mg
Each 8 mL (when mixed) contains methylprednisolone (as methylprednisolone sodium succinate) 500 mg. Nonmedicinal ingredients: monobasic sodium phosphate anhydrous, dibasic sodium phosphate dried, and diluent.

1 g
Each 16 mL (when mixed) contains methylprednisolone (as methylprednisolone sodium succinate) 1 g. Nonmedicinal ingredients: monobasic sodium phosphate anhydrous, dibasic sodium phosphate dried, and diluent.

How should I use this medication?

The recommended dose of methylprednisolone varies widely depending on the condition being treated, response to the medication, the form of the medication being used, the age and size of the person using the medication, and individual circumstances.

The dose of the tablet form may range from 4 mg to 48 mg of methylprednisolone daily, or even much higher depending on the specific condition being treated.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

Injectable medications are given either into a muscle, into a joint, or into a vein by a qualified health professional.

Taking this medication with food will help to prevent stomach upset.

It is important to take this medication exactly as prescribed by your doctor. If you miss a dose of the medication, take it as soon as you remember and then go back to your regular schedule.  However, if it almost time for your next dose,  skip the missed dose and go back to your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from freezing, and keep it out of the reach of children.

If you miss an appointment to receive methylprednisolone, contact your doctor as soon as possible to reschedule your appointment.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Methylprednisolone should not be used by anyone who:

  • is allergic to methylprednisolone or to any of the ingredients of the medication
  • has chickenpox
  • has Cushing's syndrome
  • has herpes simplex keratitis
  • has systemic (in the blood) fungal infections
  • has tuberculosis
  • has vaccinia (reaction to smallpox vaccine)
  • has a low platelet count
  • is being treated with a live or live-attenuated vaccine

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • changes in the skin pigmentation at the place of injection
  • constipation
  • diarrhea
  • difficulty sleeping
  • dizziness or lightheadedness
  • facial redness
  • flushing
  • increased or decreased appetite
  • increased sweating
  • indigestion
  • nausea
  • nervousness or restlessness
  • redness, swelling, or pain at the place of injection
  • vomiting

Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • blurred or reduced vision
  • changes in menstrual periods
  • confusion
  • excitement
  • hallucinations
  • increased blood pressure
  • muscle weakness
  • mood swings
  • rapid or pounding heartbeat
  • restlessness
  • seizures
  • shortness of breath
  • signs of depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide)
  • signs of gastrointestinal bleeding (e.g., black, tarry stools, vomiting of material that looks like coffee grounds, rectal bleeding)
  • signs of reduced ability for blood to clot (e.g., bloody nose, blood in urine, coughing blood, cuts that don't stop bleeding)
  • signs of uncontrolled blood sugar (e.g., increased thirst, frequent urination, increased urination at night)
  • skin rash
  • tendon pain
  • unusual infections (symptoms may include fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness)
  • unusual skin growth

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • chest pain
  • signs of a serious allergic reaction (i.e., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)
  • signs of bleeding in the stomach (e.g., bloody, black, or tarry stools, spitting up of blood, vomiting blood or material that looks like coffee grounds)

The following side effects may occur if the medication is taken over long periods of time. Contact your doctor if any of these occur:

  • acne
  • bloody or black, tarry stools
  • continuing abdominal or stomach pain
  • eye pain or cataracts (clouding of the lens) or other vision problems
  • fever
  • headache
  • irregular heartbeat
  • menstrual problems
  • "moon face" (filling or rounding out of face)
  • muscle cramps or pain
  • muscle weakness
  • nausea
  • seizures
  • sensitivity of the eyes to light
  • sores in the mouth
  • swelling of the feet or lower legs
  • symptoms of a yeast infection (e.g., thick, white vaginal discharge, itching or burning during urination)
  • tearing of the eyes
  • thin, shiny skin
  • trouble sleeping
  • unusual bruising
  • unusual increase in hair growth
  • unusual tiredness or weakness
  • vomiting
  • weight gain that occurs quickly
  • wounds that will not heal

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Depression: Corticosteroids have been known to cause mood swings and symptoms of depression. People with depression or a history of depression should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. If you experience symptoms of depression such as poor concentration, changes in weight, changes in sleep, decreased interest in activities, or notice them in a family member who is taking this medication, contact your doctor as soon as possible.

Diabetes: Methylprednisolone may cause a loss of control of diabetes by increasing blood glucose (sugar). People with diabetes should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. You may need to check your blood glucose levels more often.

Fluid and electrolyte balance: This medication may cause electrolyte imbalances (changes in the levels of certain salts in the blood). If you notice dry mouth, thirst, weakness, fatigue, muscle pain and cramps, fast heartbeat, or decreased urination, see your doctor.

Glaucoma: Methylprednisolone may cause the pressure within the eye to increase. People with glaucoma should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Heart disease: Methylprednisolone may cause an elevation of blood pressure, salt and water retention, and increased excretion of potassium. People with heart disease should be monitored by their doctor while taking this medication. People with heart disease should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Infections: Corticosteroids can reduce your body's ability to fight infections and may hide signs of infection that is developing. If you have had tuberculosis in the past, methylprednisolone may cause the infection to return. If you experience signs of infection such as sore throat, fever, sneezing, or coughing, contact your doctor as soon as possible.

Kidney disease: Methylprednisolone may not clear from the body at the expected rate in cases where the kidney is not working properly. People with reduced kidney function or kidney disease should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Liver function: Methylprednisolone may not clear from the body at the expected rate in cases where the liver is not working properly. People with reduced liver function or liver disease should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Myasthenia gravis: Myasthenia gravis is a condition that causes specific muscle weakness. Methylprednisolone can cause muscle wasting or decreasing muscle. People with myasthenia gravis should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Ocular herpes simplex: People who have the herpes simplex virus affecting their eye should be monitored by their doctor while taking methylprednisolone, as the medication may cause damage to the cornea.

Osteoporosis (bone disease): Methylprednisolone causes the body to lose calcium and may cause osteoporosis to develop or worsen. People who have osteoporosis or those who are at risk of developing osteoporosis should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Skin test injection: Methylprednisolone, like other corticosteroids, can cause false negative test results (i.e., tuberculosis or allergy) by reducing the body's reaction to the test serum.

Stomach ulcer: Methylprednisolone may cause stomach ulcers to worsen or develop. People with stomach problems or a history of stomach problems, should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Stress: A dosage adjustment of methylprednisolone may be required for anyone subjected to unusual stress.

Underactive thyroid (hypothyroidism): Methylprednisolone may not clear from the body at the expected rate when a person is hypothyroid. As a result, the effects of the medication may be increased. People with hypothyroidism should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Vaccines: People receiving immunosuppressive doses of corticosteroids should not receive live or live-attenuated (modified) vaccines, as there is a risk of infection and poor immune response to the vaccine.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking methylprednisolone, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding

Children: The active ingredient in this medication, methylprednisolone, belongs to the family of medications known as corticosteroids. Children may be more likely to experience the side effects encountered by using this class of medication for long periods of time (e.g., slowing down of growth, delayed weight gain). The use of this medication by children should be limited to the smallest dose that will be effective. Discuss with your doctor the risks and benefits of the use of this medication by children.

What other drugs could interact with this medication?

There may be an interaction between methylprednisolone and any of the following:

  • aldesleukin
  • amphotericin B
  • antacids (aluminum hydroxide, calcium carbonate, magnesium hydroxide) with oral methylprednisolone only
  • antihypertensive medications (e.g., metoprolol)
  • aprepitant
  • ASA (acetylsalicylic acid)
  • azole antifungals (e.g., itraconazole, ketoconazole, voriconazole)
  • birth control pills
  • boceprevir
  • calcitriol
  • celecoxib
  • cholestyramine (with oral methylprednisolone only)
  • colestipol (with oral methylprednisolone only)
  • conivaptan
  • cyclosporine
  • diabetes medications (e.g., chlorpropamide, gliclazide, glyburide, insulin, metformin, nateglinide, rosiglitazone)
  • diuretics (water pills; e.g., furosemide, hydrochlorothiazide)
  • donepezil
  • echinacea
  • enzalutamide
  • estrogens
  • HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., delaviridine, efavirenz, etravirine, nevirapine)
  • HIV protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)
  • hyaluronidase
  • isoniazid
  • leflunomide
  • lomitapide
  • macrolide antibiotics (e.g., clarithromycin, erythromycin)
  • mitotane
  • muscle relaxants (e.g., atracurium, pancuronium, rocuronium)
  • natalizumab
  • nefazodone
  • nonsteroidal anti-inflammatory medications (NSAIDs; e.g., celecoxib, ibuprofen, naproxen)
  • phenobarbital
  • phenytoin
  • pimecrolimus
  • pimozide
  • primidone
  • pyridostigmine
  • quetiapine
  • quinidine
  • quinolone antibiotics (e.g., ciprofloxacin, levofloxacin, norfloxacin)
  • rifabutin
  • rifampin
  • rivastigmine
  • stiripentol
  • tacrolimus (topical)
  • testosterone
  • tofactitinib
  • tuberculosis vaccine (BCG)
  • vaccines (e.g., vaccines for measles, mumps, rubella)
  • warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.