`
`DepoMedrol SingleDose (methylprednisolone acetate) dose, indications, adverse effects, interactions... from PDR.net
`
`tri PDR.net
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`
`CLASSES
`Systemic Corticosteroids, Plain
`
`DEA CLASS
`Rx
`
`
`Close window
`
`DESCRIPTION
`Oral and parenteral synthetic glucocorticoid; little mineralocorticoid activity; similar potency to prednisone; commonly used parenterally when
`patient cannot take oral prednisone.
`
`COMMON BRAND NAMES
`AMethapred, Depmedalone40, Depmedalone80, DepoMedrol, Medrol, Medrol Dosepak, SoluMedrol
`
`HOW SUPPLIED
`AMethapred/Methylprednisolone/Methylprednisolone Sodium Succinate/SoluMedrol Intramuscular Inj Pwd F/Sol: 1g, 2g, 40mg, 125mg,
`500mg
`AMethapred/Methylprednisolone/Methylprednisolone Sodium Succinate/SoluMedrol Intravenous Inj Pwd F/Sol: 1g, 2g, 40mg, 125mg, 500mg
`Depmedalone40/Depmedalone80/DepoMedrol/Methylprednisolone/Methylprednisolone Acetate Intralesional Inj Susp: 1mL, 40mg, 80mg
`Depmedalone40/Depmedalone80/DepoMedrol/Methylprednisolone/Methylprednisolone Acetate Intramuscular Inj Susp: 1mL, 20mg, 40mg,
`80mg
`Depmedalone40/Depmedalone80/DepoMedrol/Methylprednisolone/Methylprednisolone Acetate Intrasynovial Inj Susp: 1mL, 20mg, 40mg,
`80mg
`Depmedalone40/Depmedalone80/DepoMedrol/Methylprednisolone/Methylprednisolone Acetate Soft Tissue Inj Susp: 1mL, 40mg, 80mg
`DepoMedrol IntraArticular Inj Susp: 1mL, 40mg, 80mg
`Medrol/Medrol Dosepak/Methylprednisolone Oral Tab: 2mg, 4mg, 8mg, 16mg, 32mg
`
`DOSAGE & INDICATIONS
`For the treatment of allergic disorders including anaphylaxis or anaphylactoid reactions, angioedema, acute
`noninfectious laryngeal edema, drug hypersensitivity reactions, serum sickness, severe perennial or seasonal allergic
`rhinitis, or urticaria.
`For nonemergent treatment of hypersensitivity or allergic conditions.
`Oral dosage
`Adults
`4 to 48 mg, depending on disease treated, PO per day administered in 4 divided doses.
`Infants, Children, and Adolescents
`0.11 to 2 mg/kg/day PO, IV, or IM in 1 to 4 divided doses is the general initial dose range for methylprednisolone.
`Intramuscular dosage (methylprednisolone acetate)
`Adults
`10 to 120 mg IM. Subsequent IM doses are determined by response and condition.
`For the urgent treatment of severe conditions like anaphylaxis, angioedema, or urticarial transfusionrelated
`reactions.
`Intravenous dosage (methylprednisolone sodium succinate)
`Adults
`For anaphylaxis, 1 to 2 mg/kg/dose IV (Max: 125 mg/dose). The general dosage range in the FDAapproved product label is 10 to
`40 mg IV infused over several minutes. Subsequent doses are determined by response and condition. For druginduced
`angioedema failing to respond to epinephrine or H1blockers, short courses of 40 to 120 mg/day IV can be given for the late phase
`of an acute reaction.
`Infants, Children, and Adolescents
`1 to 2 mg/kg/dose IV (Max: 125 mg/dose).
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`For the treatment of inflammatory bowel disease during critical periods of ulcerative colitis and regional enteritis
`(Crohn's disease).
`NOTE: For many conditions, the dosing of corticosteroids is highly variable; the following general dosing
`recommendations apply.
`Oral dosage
`Adults
`4—48 mg PO per day administered in 4 divided doses.
`Children
`0.5—1.7 mg/kg or 5—25 mg/m2 PO per day in divided doses every 6—12 hours.
`Intramuscular dosage (methylprednisolone acetate)
`Adults
`10—120 mg IM. Subsequent doses are determined by patient response and condition.
`Children
`0.5—1.7 mg/kg or 5—25 mg/m2 IM per day in divided doses every 6—12 hours.
`Intramuscular or Intravenous dosage (methylprednisolone sodium succinate)
`Adults
`Initially, 10—40 mg IV infused over several minutes. Subsequent IV/IM doses are determined by response and condition.
`Children
`0.5—1.7 mg/kg or 5—25 mg/m2 IM/IV per day in divided doses every 6—12 hours.
`Rectal dosage for ulcerative colitis (methylprednisolone acetate)
`Adults
`40 mg PR 3—7 times a week for two or more weeks.
`Children
`0.5—1 mg/kg or 15—30 mg/m2 PR every 1—2 days for two or more weeks.
`For the treatment of status asthmaticus.
`Intravenous or Intramuscular dosage
`Adults
`40 to 80 mg/day IV or IM in 1 to 2 divided doses until peak expiratory flow is 70% of predicted or personal best is recommended by the
`current National Asthma Education and Prevention Program (NAEPP) guidelines.
`Infants, Children, and Adolescents
`2 mg/kg IV or IM load (Max: 60 mg/dose), then 0.5 mg/kg/dose IV every 6 hours or 1 mg/kg/dose IV every 12 hours (Max: 120 mg/day).
`Some experts recommend 0.5 to 1 mg/kg/dose IV every 4 to 6 hours.
`For the treatment of hypercalcemia associated with certain types of cancer, including myeloma, lymphoma, leukemia,
`or breast carcinoma.
`Oral dosage
`Adults
`32—80 mg PO per day is usually effective for hypercalcemia due to hematologic cancers. 12—24 mg PO per day may be sufficient for
`other tumors (e.g., breast carcinoma). The dosage listed is based on a recommended prednisone dose converted to an equivalent
`methylprednisolone dose.
`For the treatment of asthma.
`For a moderate to severe asthma exacerbation in the emergency department or the hospital.
`NOTE: See also "status asthmaticus" indication.
`Oral dosage
`Adults, Adolescents, and Children 12 years and older
`40 mg PO once daily in the morning for 5 to 7 days is adequate for most patients. Alternatively, 40 to 80 mg/day PO or IV in 1 to 2
`divided doses until peak expiratory flow is 70% of predicted or personal best may be used. Total course of treatment may range from
`3 to 10 days.
`Infants and Children 11 years and younger
`1 to 2 mg/kg/day PO in 2 divided doses (Max: 40 to 60 mg/day) for 3 to 5 days is usually sufficient. Continue until peak expiratory
`flow is 70% of predicted or personal best.
`Intravenous or Intramuscular dosage (methylprednisolone sodium succinate)
`Adults, Adolescents, and Children 12 years and older
`40 mg IV or IM once daily in the morning for 5 to 7 days is adequate for most patients. Alternatively, 40 to 80 mg/day IV or IM in 1 to
`2 divided doses until peak expiratory flow is 70% of predicted or personal best is recommended by the National Asthma Education
`and Prevention Program (NAEPP) guidelines. Change to oral therapy as soon as feasible. Oral administration of corticosteroids has
`been shown to have equivalent efficacy to that of parenteral methylprednisolone and is preferred because it is less invasive.
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`Infants and Children 11 years and younger
`1 to 2 mg/kg/day IV or IM in 2 divided doses (Max: 60 mg/day) until peak expiratory flow is 70% of predicted or personal best is
`recommended by the current National Asthma Education and Prevention Program (NAEPP) guidelines. However, both the current
`Global Initiative for Asthma (GINA) and previous NAEPP guidelines recommended 1 mg/kg/dose every 6 hours for the first 24 and 48
`hours, respectively, and this regimen is still commonly used in clinical practice. Change to oral therapy as soon as feasible. Oral
`administration of corticosteroids has been shown to have equivalent efficacy to that of parenteral methylprednisolone and is
`preferred because it is less invasive.
`For an acute asthma exacerbation on an outpatient basis.
`Oral dosage
`Adults, Adolescents, and Children 12 years and older
`40 to 60 mg/day PO in 1 to 2 divided doses for 5 to 10 days.
`Infants and Children 11 years and younger
`1 to 2 mg/kg/day PO in 1 to 2 divided doses (Max: 60 mg/day) for 3 to 10 days or until patient achieves peak expiratory flow of 80%
`or personal best or symptoms resolve; a 3 to 5 day course is usually sufficient.
`Intramuscular dosage (methylprednisolone acetate)
`Adults, Adolescents, and Children 5 years and older
`240 mg IM once may be used in place of a short burst of oral steroids for patients who are vomiting or if compliance is an issue.
`Infants and Children 4 years and younger
`7.5 mg/kg IM once (Max: 240 mg/dose) may be used in place of a short burst of oral steroids for patients who are vomiting or if
`compliance is an issue.
`For longterm prevention of symptoms in severe persistent asthma.
`Oral dosage
`Adults, Adolescents, and Children 12 years and older
`7.5 to 60 mg PO administered once daily in the morning or as alternateday therapy as needed for symptom control.
`Infants and Children 11 years and younger
`0.25 to 2 mg/kg/day PO administered once daily in the morning or as alternateday therapy as needed for symptom control (Max: 60
`mg/day).
`For the management of symptomatic sarcoidosis.
`NOTE: Treatment with corticosteroids is usually indicated only if hypercalcemia is present or if there is a decline in the
`function of a vital organ (lungs, kidneys, eyes, heart, or CNS). The dosing of corticosteroids is highly variable; the
`following general dosing recommendations apply.
`Oral dosage
`Adults
`Initially, 24—32 mg PO per day. Alternatively, 40—48 mg PO every other day has also been used. Taper after several weeks to the
`lowest effective maintenance dose (often 8—12 mg PO every other day).
`Intravenous dosage (methylprednisolone sodium succinate)
`Adults
`A dose of 30 mg/kg IV once a week for 6 weeks, with or without oral maintenance corticosteroid therapy, has been used. Therapy
`produced immediate improvement in all patients, however, 66% relapsed 1 year later. One patient without oral maintenance
`corticosteroids and 3 patients with oral maintenance corticosteroids showed persistent improvement.
`For the treatment of trichinosis with neurologic or myocardial involvement.
`Oral or Intravenous dosage
`Adults
`The optimal dosage has not been established; criticallyill patients may require high doses (e.g., 48 mg PO or IV per day) for 2 or more
`weeks. The dosage listed is based on a recommended prednisone dose converted to an equivalent methylprednisolone dose.
`For the treatment of the acute respiratory distress syndrome (ARDS).
`Intravenous and Oral dosage
`Adults
`Corticosteroid use in ARDS is controversial. If there are no signs of improvement 7 to 14 days after ARDS onset, 1.6 to 3.2 mg/kg/day IV
`in divided doses for 7 to 14 days has been recommended. Alternatively, a tapered dosage (2 mg/kg/day on days 1 to 14; 1 mg/kg/day on
`days 15 to 21; 0.5 mg/kg/day on days 22 to 28; 0.25 mg/kg/day on days 29 to 30; 0.125 mg/kg/day on days 31 to 32) is used. Initiate
`with the IV route, given in 4 divided doses; PO doses are administered as a single daily dose.
`For the treatment of nonneoplastic hematologic disorders including immune thrombocytopenia/idiopathic
`thrombocytopenic purpura (ITP), secondary thrombocytopenia in adults, acquired (autoimmune) hemolytic anemia,
`erythroblastopenia (RBC anemia), and congenital hypoplastic anemia.
`NOTE: For many conditions, the dosing of corticosteroids is highly variable; the following general dosing
`recommendations apply.
`Oral dosage
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`Adults
`4—48 mg, depending on disease treated, PO per day administered in 4 divided doses.
`Children
`0.5—1.7 mg/kg or 5—25 mg/m2 PO per day in divided doses every 6—12 hours.
`Intravenous or Intramuscular dosage (methylprednisolone sodium succinate)
`NOTE: IM administration is contraindicated in patients with ITP.
`Adults
`Initially, 10—40 mg IV infused over several minutes. Subsequent IV/IM doses are determined by response and condition.
`Children
`0.5—1.7 mg/kg or 5—25 mg/m2 IM/IV per day in divided doses every 6—12 hours.
`For the treatment of adrenocortical function abnormalities, such as adrenocortical insufficiency, congenital adrenal
`hyperplasia, chronic primary (Addison's disease) or secondary adrenocortical insufficiency, or adrenogenital
`syndrome.
`NOTE: Hydrocortisone and cortisone are the preferred drugs; methylprednisolone has little to no mineralocorticoid
`properties. For acute conditions, parenteral therapy is recommended. Dosing is highly variable; the following are
`general dosages.
`Oral dosage
`Adults
`4—48 mg, depending on disease treated, PO per day administered in 4 divided doses.
`Children
`0.5—1.7 mg/kg or 5—25 mg/m2 PO per day in divided doses every 6—12 hours.
`Intramuscular dosage (methylprednisolone acetate):
`Adults
`10—120 mg IM. Subsequent IM doses are determined by response and condition.
`Children
`0.5—1.7 mg/kg or 5—25 mg/m2 IM per day in divided doses every 6—12 hours.
`Intramuscular, Intravenous, or IV infusion dosage (methylprednisolone sodium succinate)
`Adults
`Initially, 10—40 mg IV infused over several minutes. Subsequent IV/IM doses are determined by response and condition.
`Children
`0.5—1.7 mg/kg or 5—25 mg/m2 IM/IV per day in divided doses every 6—12 hours.
`For the treatment of myasthenia gravis in patients who are poorly controlled with cholinesterase inhibitor therapy.
`Oral dosage
`Adults and Adolescents
`Initially, 12 to 20 mg PO per day. Increased, as needed, by 4 mg PO every 2 to 3 days until there is marked clinical improvement or to a
`maximum of 40 mg/day PO. Dose is usually continued for 1 to 3 months and then is gradually tapered to an alternateday dosage. Some
`clinicians use initial dosages of 48 to 64 mg PO per day with gradual tapering. Although higher initial dosages may provide more rapid
`benefit, early exacerbations of myasthenic weakness may be more common than with lower initial dosages. The methylprednisolone
`dosage listed is based on a recommended prednisone dose converted to an equivalent methylprednisolone dose.
`For the treatment of complicated or disseminated pulmonary tuberculosis infection (i.e., tuberculous meningitis and
`pericarditis) as adjunctive therapy in combination with antituberculous therapy.
`Oral dosage
`Adults
`The FDAapproved initial dose is 4—48 mg PO per day, depending upon the disease being treated. Adjunctive corticosteroid therapy
`has been shown to improve survival for patients with tuberculosis involving the CNS and pericardium, but has not been universally
`recommended by guidelines for all forms of tuberculosis. Initial doses in clinical trials for tuberculosis in general include 48 mg/day PO
`daily for 4 weeks and 20 mg/kg/day IV for weights <= 50 kg or 1 g/day IV for weights > 50kg for 5 days; many trials were prior to the use
`of rifampin, which may decrease bioavailability and increase plasma clearance of corticosteroids. A metaanalysis suggests that steroid
`use may reduce mortality in all forms of tuberculosis which may be influenced by genetic variation at the LTA4H gene.
`Children and Adolescents
`0.5—1.7 mg/kg or 5—25 mg/m2 PO per day in divided doses every 6—12 hours.
`Intramuscular dosage (methylprednisolone acetate)
`Adults
`The FDAapproved initial dose is 4—120 mg IM per day, depending upon the disease being treated. Adjunctive corticosteroid therapy
`has been shown to improve survival for patients with tuberculosis involving the CNS and pericardium, but has not been universally
`recommended by guidelines for all forms of tuberculosis. Initial doses in clinical trials for tuberculosis in general include 48 mg/day PO
`daily for 4 weeks and 20 mg/kg/day IV for weights <= 50 kg or 1 g/day IV for weights > 50kg for 5 days; many trials were prior to the use
`of rifampin, which may decrease bioavailability and increase plasma clearance of corticosteroids. A metaanalysis suggests that steroid
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`of rifampin, which may decrease bioavailability and increase plasma clearance of corticosteroids. A metaanalysis suggests that steroid
`use may reduce mortality in all forms of tuberculosis which may be influenced by genetic variation at the LTA4H gene.
`Children and Adolescents
`0.5—1.7 mg/kg or 5—25 mg/m2 IM per day in divided doses every 6—12 hours.
`Intramuscular or Intravenous dosage (methylprednisolone sodium succinate)
`Adults
`The FDAapproved initial dose is 10—40 mg IM or IV per day, depending upon the disease being treated. When high dose therapy is
`desired, the recommended dose is 30 mg/kg administered IV over at least 30 minutes. This dose may be repeated every 4 to 6 hours
`for 48 hours. Adjunctive corticosteroid therapy has been shown to improve survival for patients with tuberculosis involving the CNS and
`pericardium, but has not been universally recommended by guidelines for all forms of tuberculosis. Initial doses in clinical trials for
`tuberculosis in general include 48 mg/day PO daily for 4 weeks and 20 mg/kg/day IV for weights <= 50 kg or 1 g/day IV for weights >
`50kg for 5 days; many trials were prior to the use of rifampin, which may decrease bioavailability and increase plasma clearance of
`corticosteroids. A metaanalysis suggests that steroid use may reduce mortality in all forms of tuberculosis which may be influenced by
`genetic variation at the LTA4H gene.
`Children and Adolescents
`0.5—1.7 mg/kg or 5—25 mg/m2 IM/IV per day in divided doses every 6—12 hours.
`For the treatment of acute exacerbations of multiple sclerosis.
`Oral dosage, Intramuscular dosage (methylprednisolone acetate, methylprednisolone sodium succinate), or
`Intravenous dosage (methylprednisolone sodium succinate)
`Adults
`The manufacturer recommends 200 mg PO once daily for 7 days, followed by 80 mg PO every other day for 1 month. A dosage of 160
`mg PO, IV or IM daily for one week, followed by 64 mg PO, IV, or IM every other day for 1 month has also been used. Barnes et al.
`compared the efficacy of oral vs. IV methylprednisolone for treating acute relapses of MS in adults. Thirtyeight patients were allocated
`to methylprednisolone 1 g IV once daily for 3 days; 42 patients were allocated to 48 mg PO once daily for 7 days, then 24 mg PO once
`daily for 7 days, and then to 12 mg PO once daily for 7 days. No differences were seen in recovery between the 2 groups; however,
`limited recovery was noted in both groups. The authors concluded that the 2 routes were equally efficacious ; however, an editorialist
`(ACP Journal Club) remained unconvinced from this study that oral therapy was acceptable for this condition.
`For the treatment of corticosteroidresponsive dermatologic disorders (e.g., alopecia areata, atopic dermatitis, bullous
`dermatitis herpetiformis, contact dermatitis including Rhus dermatitis due to poison ivy, poison oak, poison sumac,
`discoid lupus erythematosus, eczema, exfoliative dermatitis, insect bites or stings, granuloma annulare, keloids, lichen
`striatus, lichen planus, lichen simplex, mycosis fungoides, necrobiosis lipoidica diabeticorum, pemphigus, pityriasis
`rosea, polymorphous light eruption, pruritus, psoriasis, seborrheic dermatitis, or xerosis).
`For mildmoderate corticosteroid responsive dermatoses.
`Oral dosage
`Adults
`4—48 mg, depending on disease treated, PO per day administered in 4 divided doses.
`Children
`0.5—1.7 mg/kg or 5—25 mg/m2 PO per day in divided doses every 6—12 hours.
`For severe inflammatory dermatoses, like exfoliative dermatitis, severe psoriasis, erythema multiforme or Stevens
`Johnson syndrome.
`Intramuscular dosage (methylprednisolone acetate)
`Adults
`10—120 mg IM. Subsequent doses may be given determined by patient response and condition.
`Children
`0.5—1.7 mg/kg or 5—25 mg/m2 IM per day in divided doses every 6—12 hours.
`Intramuscular, Intravenous, or IV infusion dosage (methylprednisolone sodium succinate)
`Adults
`Initially, 10—40 mg IV infused over several minutes. Subsequent IV/IM doses are determined by response and condition.
`Children
`0.5—1.7 mg/kg or 5—25 mg/m2 IM/IV per day in divided doses every 6—12 hours.
`For the treatment of nonsuppurative thyroiditis.
`Oral dosage
`Adults
`Glucocorticoids are reserved for severe cases. Although prednisone is commonly used, a methylprednisolone dosage of 16—32 mg/day
`PO has similar potency.
`For the treatment of acute kidney transplant rejection.
`Intravenous dosage (methylprednisolone sodium succinate)
`Adults, Adolescents and Children
`
`250—1000 mg IV given once daily or on alternate days for 3—5 doses. Renal transplant guidelines recommend corticosteroids for the
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`250—1000 mg IV given once daily or on alternate days for 3—5 doses. Renal transplant guidelines recommend corticosteroids for the
`initial treatment of acute rejection.
`For the treatment of acute graftversushost disease (GVHD).
`Intravenous dosage (methylprednisolone sodium succinate)
`Adults, Adolescents and Children
`2—2.5 mg/kg/day IV, tapered slowly over 2—3 weeks. Initial doses of 10 mg/kg/day IV have also been used; although there is no
`definitive data that higher doses are more effective than lower doses. For GVHD limited to the skin, an initial dose of 1 mg/kg/day IV may
`be used. One study indicated that a cumulative methylprednisolone dose of 2000 mg/m2 (or roughly 50 mg/kg) is required for complete
`resolution of acute graftversushost disease in most patients.
`Intramuscular dosage (methylprednisolone acetate)
`Adults, Adolescents and Children
`2—2.5 mg/kg IM per day, tapered slowly over 2—3 weeks.
`For the palliative management of leukemia and lymphoma in adults and acute leukemias of childhood including acute
`lymphocytic leukemia (ALL), chronic lymphocytic leukemia (CLL), Hodgkin's disease, nonHodgkin's lymphoma (NHL),
`or multiple myeloma†.
`NOTE: For many conditions, the dosing of corticosteroids is highly variable; the following general dosing
`recommendations apply.
`Oral dosage
`Adults
`4—48 mg PO per day administered in 4 divided doses.
`Children
`0.5—1.7 mg/kg or 5—25 mg/m2 PO per day in divided doses every 6—12 hours.
`Intramuscular dosage (methylprednisolone acetate)
`Adults
`10—120 mg IM. Subsequent doses are determined by patient response and condition.
`Children
`0.5—1.7 mg/kg or 5—25 mg/m2 IM per day in divided doses every 6—12 hours.
`Intramuscular or Intravenous dosage (methylprednisolone sodium succinate)
`Adults
`Initially, 10—40 mg IV infused over several minutes. Subsequent IV/IM doses are determined by response and condition.
`Children
`0.5—1.7 mg/kg or 5—25 mg/m2 IM/IV per day in divided doses every 6—12 hours.
`For the treatment of respiratory conditions including airwayobstructing hemangioma† in infants, aspiration
`pneumonitis, berylliosis, chronic obstructive pulmonary disease (COPD), Loeffler's syndrome, or noncardiogenic
`pulmonary edema†.
`For chronic oral management of nonasthmatic respiratory conditions.
`Oral dosage
`Adults
`4 to 48 mg, depending on disease treated, PO per day administered in 4 divided doses.
`Children and Adolescents
`0.5 to 1.7 mg/kg or 5 to 25 mg/m2 PO per day in divided doses every 6 to 12 hours. Do not exceed adult maximum dose of 48
`mg/day.
`For parenteral management of nonasthmatic respiratory conditions when oral dosing not feasible or severity or
`compromised airway warrants.
`Intramuscular dosage (methylprednisolone acetate)
`Adults
`10 to 120 mg IM. Frequency of dosing varies with the condition being treated and patient response.
`Children and Adolescents
`0.5 to 1.7 mg/kg or 5 to 25 mg/m2 IM per day in divided doses every 6 to 12 hours.
`Intramuscular, Intravenous, or IV infusion dosage (methylprednisolone sodium succinate)
`Adults
`Initially, 10 to 40 mg IV infused over several minutes. Subsequent IV/IM doses are determined by response and condition.
`Children and Adolescents
`0.5 to 1.7 mg/kg or 5 to 25 mg/m2 IM/IV per day in divided doses every 6 to 12 hours. Do not exceed the adult maximum dose of 40
`mg/day.
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`For chronic maintenance therapy for idiopathic pulmonary fibrosis†.
`Intravenous dosage
`Adults
`Highdose (pulse doses) of 1 to 2 g IV once weekly or every other week; however, there is no proven advantage over oral
`corticosteroids.
`For the treatment of laryngotracheobronchitis (croup)†.
`Intravenous or Intramuscular dosage (methylprednisolone sodium succinate)
`Infants and Children
`1 to 2 mg/kg/dose IV or IM as an initial dose. Continued or maximum dosing is not specified; however, continued corticosteroid dosing
`may be warranted to ensure a sustained effect on airway patency. Of note, prednisolone has a similar biological halflife as
`methylprednisolone and, when prescribed for mild to moderate croup, is often continued for a total of 2 to 3 days.
`For the treatment of acute spinal cord injury†.
`Intravenous infusion dosage (methylprednisolone sodium succinate)
`Adults, Adolescents, and Children
`30 mg/kg IV given over 15 minutes, followed 45 minutes later by 5.4 mg/kg/hour IV infusion given for 23 hours. Although not widely
`employed, the continuous infusion has been repeated for an additional 23 hours in selected patients.
`For adjunctive therapy in the treatment of rheumatic disorders including acute gouty arthritis, ankylosing spondylitis,
`juvenile rheumatoid arthritis (JRA)/juvenile idiopathic arthritis (JIA), posttraumatic osteoarthritis, pseudogout†,
`psoriatic arthritis, or rheumatoid arthritis, or for the treatment of acute episodes or exacerbation of nonrheumatic
`inflammatory conditions including acute and subacute bursitis, epicondylitis, and acute nonspecific tenosynovitis.
`NOTE: For many conditions, the dosing of corticosteroids is highly variable; the following general dosing
`recommendations apply.
`Oral dosage
`Adults
`4 to 48 mg, depending on clinical status and severity of condition, PO per day administered in 4 divided doses.
`Children and Adolescents
`0.5 to 1.7 mg/kg/day PO in divided doses every 6 to 12 hours. Do not exceed upper limit of adult dosage (48 mg/day).
`Intramuscular dosage (methylprednisolone acetate)
`Adults
`10 to 120 mg IM. Subsequent doses may be given determined by patient response and condition.
`Children and Adolescents
`0.11 to 1.6 mg/kg/day IM initially. Subsequent doses may be given determined by patient response and condition.
`Intraarticular injection or Intralesional dosage (methylprednisolone acetate)
`Adults
`10 to 80 mg at the appropriate site, depending upon degree of inflammation and size and location of affected area. Repeat doses are
`not usually required for 1 to 5 weeks. Dosage ranges for specific joints: large joints: 20 to 80 mg; medium joints: 10 to 40 mg; small
`joints: 4 to 10 mg. Suggested intralesional dosage range is 20 to 60 mg.
`Intramuscular, Intravenous, or IV infusion dosage (methylprednisolone sodium succinate)
`Adults
`Initially, 10 to 40 mg IV infused over several minutes. Subsequent IV/IM doses are determined by response and condition.
`Children and Adolescents
`0.5 to 1.7 mg/kg IM/IV per day in divided doses every 6 to 12 hours. Do not exceed upper limit of adult dosage (40 mg/day). Subsequent
`IV/IM doses are determined by response and condition.
`For adjunctive therapy in the treatment of carpal tunnel syndrome†.
`NOTE: The definitive treatment for mediannerve entrapment is surgery. Corticosteroids are temporary measures;
`patients who have intermittent pain and paresthesias without any fixed motorsensory deficits may respond to
`conservative therapy.
`Local injection (methylprednisolone acetate, e.g., DepoMedrol)
`Adults
`40 to 80 mg as a single injection adjacent to the carpal tunnel. Reassess at 6 to 8 weeks. To avoid mediannerve injury, use specialized
`administration techniques. Use of 2 or more repeat injections is not advised; local tendon damage may occur.
`For the treatment of selected cases of acute rheumatic carditis, systemic dermatomyositis (polymyositis), systemic
`lupus erythematosus (SLE), temporal arteritis†, ChurgStrauss syndrome†, mixed connective tissue disease†,
`polyarteritis nodosa†, relapsing polychondritis†, polymyalgia rheumatica†, vasculitis†, or Wegener's granulomatosis†.
`NOTE: For many conditions, the dosing of corticosteroids is highly variable; the following general dosing
`recommendations apply.
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`For routine treatment.
`Oral dosage
`Adults
`4—48 mg, depending on disease treated, PO per day administered in 4 divided doses.
`Children
`0.5—1.7 mg/kg or 5—25 mg/m2 PO per day in divided doses every 6—12 hours.
`Intramuscular dosage (methylprednisolone acetate)
`Adults
`10—120 mg IM. Frequency of dosing varies with the condition and response.
`Children
`0.5—1.7 mg/kg or 5—25 mg/m2 IM per day in divided doses every 6—12 hours.
`Intramuscular, Intravenous, or IV infusion dosage (methylprednisolone sodium succinate)
`Adults
`Initially, 10—40 mg IV infused over several minutes. Subsequent IV/IM doses are determined by response and condition.
`Children
`0.5—1.7 mg/kg/day or 5—25 mg/m2/day IM/IV, in divided doses every 6—12 hours.
`For lifethreatening manifestations including diffuse proliferative glomerulonephritis (i.e., lupus nephritis†),
`cerebritis, or hemolytic disease.
`Intravenous dosage (methylprednisolone sodium succinate)
`Adults
`500—1000 mg/day IV for 3 doses then 0.5—1 mg/kg/day PO prednisone (1 mg/kg/day recommended if crescents seen) tapered
`after a few weeks to lowest effective dose in combination with either cyclophosphamide or mycophenolate for induction therapy of
`class III/IV disease. For class V disease without proliferative changes and with proteinuria > 3 grams/24 hours that does NOT
`respond to induction with prednisone and mycophenolate, use a glucocorticoid pulse then prednisone 0.5—1 mg/kg/day along with
`cyclophosphamide 500—1000 mg/m2 monthly for 6 doses.
`Children
`30 mg/kg IV infused over 30 minutes every other day for 6 doses, followed by longterm oral prednisone/prednisolone.
`For the treatment of Pneumocystis pneumonia (PCP)† in HIV patients as adjunctive therapy.
`Intravenous dosage (methylprednisolone sodium succinate)
`Adults and Adolescents
`30 mg IV twice daily on days 1—5; 30 mg IV once daily on days 6—10; 15 mg IV once daily on days 11—21. Begin therapy as early as
`possible and within 72 hours of PCP therapy. Corticosteroids are recommended in patients with a PaO2 < 70 mmHg at room air or with
`an alveolararterial O2 gradient > 35 mmHg. The benefits of corticosteroid therapy started after 72 hours of PCP therapy is unknown,
`but some clinicians may recommend for moderatetosevere PCP.
`For the systemic treatment of ophthalmic disorders including allergic conjunctivitis, allergic marginal corneal ulcer,
`anterior segment inflammation, chorioretinitis, endophthalmitis†, Graves' ophthalmopathy, herpes zoster ocular
`infection (herpes zoster ophthalmicus), iritis, keratitis, postoperative ocular inflammation, optic neuritis, diffuse
`posterior uveitis, or vernal keratoconjunctivitis.
`NOTE: For many conditions, the dosing of corticosteroids is highly variable; the following general dosing
`recommendations apply.
`Oral dosage
`Adults
`4—48 mg, depending on disease treated, PO per day administered in 4 divided doses.
`Children
`0.5—1.7 mg/kg or 5—25 mg/m2 PO per day in divided doses every 6—12 hours.
`Intramuscular dosage (methylprednisolone acetate)
`Adults
`10—120 mg IM. Subsequent doses are determined by response and condition.
`Children
`0.5—1.7 mg/kg or 5—25 mg/m2 IM per day in divided doses every 6—12 hours.
`Intramuscular or Intravenous dosage (methylprednisolone sodium succinate)
`Adults
`Initially, 10—40 mg IV infused over several minutes. Subsequent IV/IM doses are determined by response and condition.
`Children
`0.5—1.7 mg/kg or 5—25 mg/m2 IM/IV per day in divided doses every 6—12 hours.
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`For the treatment of Severe Acute Respiratory Syndrome (SARS)†.
`NOTE: Other than supportive care, there is no established treatment for SARS. Due to lack of efficacy data, ribavirin
`and methylprednisolone combination therapy should be reserved for patients with the