Intravenous (IV) Methylprednisolone (Solu-medrol)
Methylprednisolone is part of a potent class of anti-inflammatory agents, known as corticosteroids. Corticosteroids are used to treat many inflammatory diseases. For example, the corticosteroid prednisone is commonly used to treat rheumatoid arthritis, lupus, vasculitis, dermatomyositis, and many other conditions. Methylprednisolone is similar to prednisone but can be given at higher doses as an infusion into a vein (intravenous, IV) for treatment of severe inflammation. Examples of conditions where IV methylprednisolone is routinely used include lupus affecting the kidneys or brain and some types of vasculitis. IV methylprednisolone is also given as a “pre-medication” in lower doses to prevent infusion reactions to other medications such as rituximab.
How to Take It
IV methylprednisolone is administered in a hospital or outpatient infusion center. First, an IV is placed (usually in the arm) and then the medication will be infused over one to three hours under the supervision of health care providers. The dosage and length of time of the infusion will be determined by your doctor. Some people require slower infusions if they experience side effects during the infusion.
Side Effects
Methylprednisolone can cause short-term and long-term side effects. Side effects that can occur during or shortly after an infusion include blood-pressure changes, heart rate changes, irregular heart rate, electrolyte imbalances, elevated blood sugar, flushing of the skin, sweating, metallic taste, difficulty sleeping, mood or behavior changes, psychosis, seizures, increased susceptibility to infection, and anaphylaxis (serious allergic reaction).
If you need to take IV methylprednisolone or oral prednisone on an ongoing basis, the long-term side effects of corticosteroids include (but are not limited to) weight gain, acne, thinning of skin, stretch marks, elevated blood sugar, elevated cholesterol, peptic ulcers, cataracts, glaucoma, weight gain, decreased bone density, increased risk of osteonecrosis of the bone, growth suppression, muscle wasting, and increased susceptibility to infection.
Tell Your Rheumatology Provider
Tell your rheumatology provider if you are concerned you may be experiencing any side effects, or if you develop a fever or any new symptoms after starting this medication, as it may cause an increased risk for infection. If you miss a scheduled infusion, notify your rheumatology provider. Talk to your rheumatology provider about which vaccines are appropriate for you. If you are pregnant or are considering pregnancy, discuss this with your rheumatology provider before starting medication.
Updated February 2022 by the American College of Rheumatology Communications and Marketing Committee.
This information is provided for general education only. Individuals should consult a qualified health care provider for professional medical advice, diagnosis and treatment of a medical or health condition.