💊 Methylprednisolone

Systemic Corticosteroid (Intermediate-acting Glucocorticoid)

Generic Name	Methylprednisolone
Drug Class	Corticosteroid (Intermediate-acting glucocorticoid)
Indications	Severe allergic reactions and anaphylaxis (adjunct) Acute asthma and COPD exacerbations Autoimmune and inflammatory disorders Rheumatologic diseases Spinal cord injury (selected protocols) Cerebral edema
Mechanism of Action	Potent anti-inflammatory and immunosuppressive effects by inhibiting cytokine production, leukocyte migration, and inflammatory mediators; minimal mineralocorticoid activity.
Available Forms & Strengths	• Tablet: 2 mg, 4 mg, 8 mg, 16 mg, 32 mg • Injection (Sodium succinate): 40 mg, 125 mg, 500 mg, 1 g vials
Dosage	Adults: 4–48 mg/day orally (divided or single dose) IV pulse therapy: 500 mg–1 g/day for 3–5 days (selected conditions) Children: 0.5–2 mg/kg/day (max varies by indication)
Route	Oral, IV, IM
Common Side Effects	Hyperglycemia Fluid retention Gastric irritation Mood changes Insomnia
Serious Adverse Effects	Adrenal suppression, severe infections, hypertension, GI bleeding, osteoporosis, psychosis
Contraindications	• Systemic fungal infections • Hypersensitivity to methylprednisolone
Precautions	• Diabetes mellitus • Hypertension, heart failure • Peptic ulcer disease • Tuberculosis or latent infections
Drug Interactions	• NSAIDs (↑ GI bleeding risk) • Rifampicin, phenytoin (↓ steroid effect) • Live vaccines (avoid)
Pregnancy & Lactation	Pregnancy: Use if benefit outweighs risk Lactation: Compatible with short-term use
Storage	Store below 30°C, protect from light
References	BNF \| BNF for Children \| Goodman & Gilman

⚠️ Clinical note: Do not stop abruptly after prolonged therapy. Monitor BP, blood glucose, electrolytes, and signs of infection.