Depoject, Depo-Medrol, Depopred, Duralone, M-Prednisol, Rep-Pred
A-Methapred, Solu-Medrol
Classifications: hormones and synthetic substitutes; adrenal corticosteroid; glucocorticoid; antiinflammatory
Prototype: Prednisone
Pregnancy Category: C


Methylprednisolone 2 mg, 4 mg, 8 mg, 16 mg, 24 mg, 32 mg tablets

Methylprednisolone Acetate 20 mg/mL, 40 mg/mL, 80 mg/mL injection

Methylprednisolone Sodium Succinate 40 mg, 125 mg, 500 mg, 1 g, 2 g powder for injection


Intermediate-acting synthetic adrenal corticosteroid with similar glucocorticoid activity; has considerably fewer sodium and water retention effects than hydrocortisone. Acetate has longer duration of action and more rapid onset of activity than parent compound. Sodium succinate form is characterized by rapid onset of action and is used for emergency therapy of short duration. It inhibits phagocytosis, and release of allergic substances. Also modifies the immune response of the body to various stimuli.

Therapeutic Effects

Antiinflammatory and immunosuppressive properties.


An antiinflammatory agent in the management of acute and chronic inflammatory diseases, for palliative management of neoplastic diseases, and for control of severe acute and chronic allergic processes. High-dose, short-term therapy: management of acute bronchial asthma, prevention of fat embolism in patient with long-bone fracture.

Unlabeled Uses

Acetate form used as a long-acting contraceptive and for spinal cord injury, lupus nephritis, multiple sclerosis.


Systemic fungal infections. Safety during pregnancy (category C) or lactation is not established.

Cautious Use

Cushing's syndrome; GI ulceration; hypertension; varicella, vaccinia; diabetes mellitus; emotional instability or psychotic tendencies.

Route & Dosage

Adult: PO 2–60 mg/d in 1 or more divided doses IM (Acetate) 4–80 mg/wk for 1–4 wk; (Succinate) 10–250 mg q6h IV 10–250 mg q6h
Child: PO/IM/IV 0.5–1.7 mg/kg/d divided q6–12h

Acute Spinal Cord Injury
Adult/Child: IV 30 mg/kg over 15 min, followed in 45 min by 5.4 mg/kg/h times 23 h; dose should be tapered down after long-term therapy


  • Note: Do NOT use methylprednisolone acetate for IV.

PREPARE: Direct/Intermittent: Available in ACT-O-Vial from which the desired dose may be withdrawn after initial dilution with supplied diluent. May be further diluted according to physician's orders.  

ADMINISTER: Direct/Intermittent: Give each 500 mg or fraction thereof over 2–3 min.  

INCOMPATIBILITIES Solution/additive: Dextrose 5%/sodium chloride 0.45%, calcium gluconate, glycopyrrolate, metaraminol, nafcillin, penicillin G sodium, doxapram. Y-site: Allopurinol, amsacrine, ciprofloxacin, cisatracurium (2 mg/mL concentration), diltiazem, etoposide, filgrastim, gemcitabine, ondansetron, paclitaxel, potassium chloride, propofol, sargramostim, vinorelbine.

Adverse Effects (1%)

CNS: Euphoria, headache, insomnia, confusion, psychosis. CV: CHF, edema. GI: Nausea, vomiting, peptic ulcer. Musculoskeletal: Muscle weakness, delayed wound healing, muscle wasting, osteoporosis, aseptic necrosis of bone, spontaneous fractures. Endocrine: Cushingoid features, growth suppression in children, carbohydrate intolerance, hyperglycemia. Special Senses: Cataracts. Hematologic: Leukocytosis. Metabolic: Hypokalemia.


Drug: Amphotericin B, furosemide, thiazide diuretics increase potassium loss; with attenuated virus vaccines, may enhance virus replication or increase vaccine adverse effects; isoniazid, phenytoin, phenobarbital, rifampin decrease effectiveness of methylprednisolone because they increase metabolism of steroids.


Absorption: Readily absorbed from GI tract. Peak: 1–2 h PO; 4–8 d IM. Duration: 1.25–1.5 d PO; 1–5 wk IM. Metabolism: Metabolized in liver. Half-Life: >3.5 h; HPA suppression: 18–36 h.

Nursing Implications

Assessment & Drug Effects

Patient & Family Education

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug