Generic Name:

Methylprednisolone

Trade Name:

Solu-Medrol

Action:

Glucocorticoid

Indications:

Adrenal insufficiency

Chronic obstructive pulmonary disease

Cerebral edema

Inflammatory diseases

Transplant rejection

Reduction of neurologic damage secondary to spinal Cord injury

Reduction of allergenic reactions to exogenous substances

Asthma exacerbations

Administration Guidelines:

Usual Dosage Range and Route:

Maintenance :
40 - 60mg IVP every six hours (125 mg in Transplant Patients)

24 hour cumulative :
1 G

Spinal cord injury :
loading dose: 30mg/kg/50ml over 15 minutes
maintenance: started 45 minutes after the loading dose is finished 
5.4mg/kg/hr (mixed by pharmacy)

Transplant rejection :
250 - 500 mg IV for pediatric patients
500 mg for adult patients
1 g for cardiac transplant patients

Reduction of allergenic drug response :
32mg 12 hr and 2 hr before administration of offending drug

Standard Concentration: (Questions should be referred to the Pharmacist)

Single doses less than or equal to 250 mg, regardless of the indication, may be administered by IV push according to nursing and pharmacy policies.

Single doses exceeding 250 mg may be prepared as an infusion.

1000mg/ 100mL

500mg/ 50mL

Microinfusion concentration for pulse dosing >250mg: 1000mg/50ml, 500mg/25ml

EW Standard

Single doses less than or equal to 250 mg, regardless of the indication, may be administered by IV push according to nursing and pharmacy policies.

Single doses exceeding 250 mg may be prepared as an infusion:

1000mg/ 100mL

500mg/ 100mL

Pharmacy mixes ALL maintenance doses for spinal cord injury. Pharmacy mixes load when requested.

Special Considerations:

- Monitor serum glucose, electrolytes, and osmolality

- Prolonged administration may require tapering of dose to discontinue therapy

- May require anti-hyperglycemic therapy in susceptible patients

- Dosage range may vary depending on disease state

- The use of methylprednisolone for the reduction of allergic reactions requires administration at 12 and 2 hours pre-exposure to the causative agent to be effective

Precautions and Side Effects:

- Electrolyte imbalance

- CNS disturbances, hallucinations

- Gastrointestinal disturbances

- Adrenal suppression

- Hyperglycemia