Generic
Methylprednisolone Sodium Succinate
15 brands available in the market
At a glance
Methylprednisolone Sodium Succinate is a potent corticosteroid for IV/IM administration used in severe inflammation, allergies, rheumatic disorders, and organ transplant rejection.
Description
Methylprednisolone Sodium Succinate is a synthetic corticosteroid with mainly glucocorticoid activity and minimal mineralocorticoid properties. It is available for IV or IM administration with rapid onset of action. Used in high-dose therapy for short-term management of acute conditions. Effects are evident within one hour of IV injection and persist for a variable period.
Indications
- Endocrine Disorders (Acute Adrenocortical Insufficiency)
- Rheumatic Disorders (Rheumatoid Arthritis, Bursitis, Gout)
- Collagen Diseases (SLE, Dermatomyositis)
- Skin Diseases (Pemphigus, Stevens-Johnson Syndrome)
- Allergies (Bronchial Asthma, Anaphylaxis)
- Ophthalmic Diseases (Iritis, Keratitis, Optic Neuritis)
- Gastrointestinal Diseases (Ulcerative Colitis, Crohn's Disease)
- Respiratory Diseases (Sarcoidosis, Aspiration Pneumonitis)
- Hematologic Disorders (Hemolytic Anemia, ITP)
- Neoplastic Diseases (Leukemias, Lymphomas)
- Edematous States (Nephrotic Syndrome)
- CNS Diseases (Acute Exacerbations of Multiple Sclerosis)
- Organ Transplant Rejection (Acute Allograft Rejection)
Therapeutic class
Glucocorticoids
Pharmacological class
Synthetic Corticosteroid
Pharmacology
Methylprednisolone Sodium Succinate is a synthetic corticosteroid with mainly glucocorticoid activity. It binds to and activates intracellular glucocorticoid receptors, which modify DNA transcription and protein synthesis. It inhibits leukocyte infiltration at the site of inflammation, interferes with mediators of inflammatory response, and suppresses humoral immune responses.
Mechanism of action
Reduces inflammation by suppressing migration of inflammatory cells and decreasing capillary permeability.
Dosage
Adult Dose (IV/IM):
- Anti-inflammatory/Immunosuppressive: 10-500 mg daily (250 mg over at least 5 min; 250 mg slowly over at least 30 min)
- High-dose Therapy: 30 mg/kg IV over ≥30 min, repeated every 4-6 hours for 48 hours
- Status Asthmaticus: 40 mg (repeat according to patient response)
- Organ Transplant Rejection: 0.5-1 g daily (for up to 48-72 hours)
- Multiple Sclerosis: 160 mg daily for 3 days
Child Dose:
- 0.5-1.7 mg/kg daily or 5-25 mg/m² daily (6-12 hourly intervals)
- Pulse Therapy: 15-30 mg/kg/dose over >30 min for 3 days
- Status Asthmaticus: 1-4 mg/kg daily for 1-3 days
- Organ Transplant Rejection: 10-20 mg/kg daily for up to 3 days (Max: 1,000 mg daily)
Administration
- IV: Inject directly into vein or into tubing of running IV (over at least 1 minute)
- IV Infusion: Administer over 10-20 minutes
- IM: Deep intramuscular injection
- Reconstitute with BWI containing 0.9% benzyl alcohol
- Further dilute reconstituted mixture with D5W, NS, D5/NS
Missed dose
Not applicable (IV/IM administration)
Side effects
Common Side Effects:
- Allergic/hypersensitivity reactions (anaphylaxis, angioedema)
- Cardiovascular (bradycardia, cardiac arrest, hypertension)
- Dermatologic (acne, skin atrophy, impaired wound healing)
- Endocrine (decreased glucose tolerance, Cushingoid state)
- Fluid and Electrolyte (fluid retention, potassium loss)
- Gastrointestinal (peptic ulcer, pancreatitis)
- Musculoskeletal (osteoporosis, muscle weakness, tendon rupture)
- Neurologic/Psychiatric (convulsions, depression, pseudotumor cerebri)
- Ophthalmic (glaucoma, posterior subcapsular cataracts)
Precautions & warnings
- Caution in heart failure, HTN, DM, GI disease, multiple sclerosis, myasthenia gravis
- Caution in acute MI, cataracts, glaucoma, osteoporosis
- Caution in history of seizure disorder, thyroid disease
- Avoid abrupt withdrawal
- Caution in renal and hepatic impairment
- Monitor growth in children
- Caution in pregnancy and lactation
Contraindications
- Systemic fungal infections
- Intrathecal administration (contraindicated)
- Known hypersensitivity to components
Drug interactions
- Anticholinesterases: Severe weakness in myasthenia gravis
- Antidiabetics: Decreased hypoglycemic effects
- Salicylates: Decreased serum concentrations
- K-depleting diuretics: Increased hypokalemic effects
- NSAIDs: Increased GI bleeding and ulceration
- Warfarin: Increased anticoagulant effects
- CYP3A4 Inducers: Decreased levels/effects
- CYP3A4 Inhibitors: Increased levels/effects
- Vaccines: Decreased effects (dead organism) or increased infection risk (live organism)
Food interactions
Food interaction not applicable (IV/IM administration)
Use in pregnancy
Use in Pregnancy (Category C): Corticosteroids are teratogenic in many species. No adequate controlled studies in pregnant women. Use only if potential benefit justifies risk. Infants born to mothers who received corticosteroids during pregnancy should be monitored for hypoadrenalism.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Systemically administered corticosteroids appear in human milk and may suppress growth. Caution advised. Decision should consider importance of drug to the mother.
Pediatric use
Adverse effects in pediatric patients are similar to adults. Monitor blood pressure, weight, height, intraocular pressure. Use lowest effective dose.
Geriatric use
Clinical studies did not include sufficient patients aged 65 and over. Dose selection should be cautious, starting at low end of dosing range.
Renal / hepatic impairment
Renal Impairment: No dose adjustment required.
Hepatic Impairment: Caution advised.
Overdose effects
Acute overdose: Supportive and symptomatic treatment. Chronic overdose: Temporarily reduce dose or introduce alternate-day therapy.
Storage conditions
Protect from light. Store at controlled room temperature 20° to 25°C. Use solution within 48 hours after mixing.
Chemical structure
Methylprednisolone Sodium Succinate