Methylprednisolone (Solu Medrol ®)
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Standard Dilutions [Amount of drug] [Infusion volume] [Infusion rate]
|[60 -100 mg] [50 ml] [30 min]
[101-500mg] [100ml] [As directed]
[501-1250mg][250ml] [As directed]
Stability / Miscellaneous
|Methylpred dose/ 0.8 =prednisone dose
Label: Do not Refrigerate.
High dose: 30 mg/kg over 30 minutes (may repeat q4-6h) in a 48hr period.
Asthma: 2 mg/ kg q4 -6h until severe symptoms controlled, then reduce dose.
Management of severe ulcerative colitis: 16 to 20 mg IV every eight hours.
MS acute exacerbation: 500 mg once daily x 5 days.
PCP: 40 to 60 mg every 6 hours or pulse dosing: 250 to 1000mg once daily x 3 to 5 days.
Spinal cord injury: 30 mg/kg (over 15 to 30 minutes) then 5.4 mg/ kg/ hr x 23 hours. (higher doses possible).
Medrol dose pack: (4mg tab # 21): Day#1: 2 tabs before breakfast, 1 tab after lunch & dinner, and 2 tabs at bedtime. (Total=6 tabs) If received later in the day, may take all 6 tablets at once or in divided doses. Day#2: 1 tab before breakfast, 1 tab after lunch & dinner, and 2 tablets at bedtime. Day#3: Same as day#2 except 1 tab at bedtime. Day#4: 1 tab before breakfast, after lunch and at bedtime. Day#5: 1 tab after breakfast and at bedtime. Day#6: 1 tab after breakfast.
For palliative management of:
DOSAGE AND ADMINISTRATION
In general, high dose corticosteroid therapy should be continued only until the patient’s condition has stabilized; usually not beyond 48 to 72 hours.
Although adverse effects associated with high dose short-term corticoid therapy are uncommon, peptic ulceration may occur. Prophylactic antacid therapy may be indicated.
In other indications initial dosage will vary from 10 to 40 mg of methylprednisolone depending on the clinical problem being treated. The larger doses may be required for short-term management of severe, acute conditions. The initial dose usually should be given intravenously over a period of several minutes. Subsequent doses may be given intravenously or intramuscularly at intervals dictated by the patient’s response and clinical condition. Corticoid therapy is an adjunct to, and not replacement for conventional therapy.
Dosage may be reduced for infants and children but should be governed more by the severity of the condition and response of the patient than by age or size. It should not be less than 0.5 mg/kg every 24 hours.
Dosage must be decreased or discontinued gradually when the drug has been administered for more than a few days. If a period of spontaneous remission occurs in a chronic condition, treatment should be discontinued. Routine laboratory studies, such as urinalysis, two-hour postprandial blood sugar, determination of blood pressure and body weight, and a chest X-ray should be made at regular intervals during prolonged therapy. Upper GI X-rays are desirable in patients with an ulcer history or significant dyspepsia.
A-Methapred may be administered by intravenous or intramuscular injection or by intravenous infusion, the preferred method for initial emergency use being intravenous injection. To administer by intravenous (or intramuscular) injection, prepare solution as directed. The desired dose may be administered intravenously over a period of several minutes.
To prepare solutions for intravenous infusion, first prepare the solution for injection as directed. This solution may then be added to indicated amounts of 5% dextrose in water, isotonic saline solution or 5% dextrose in isotonic saline solution.
Directions for Reconstitution
Store unreconstituted product at 20 to 25°C (68 to 77°F). [See USP Controlled Room Temperature.]
Store solution at 20 to 25°C (68 to 77°F). [See USP Controlled Room Temperature.]
Use solution within 48 hours after mixing.
List Container Concentration
Rev: October, 2005
Source: [package insert]
Additional Pain Management / Palliative Care resources
Pain Management: Its various aspects