Intravenous (IV) Methylprednisolone (Solu-medrol)
Methylprednisolone is part of a potent class of anti-inflammatory medicines, 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 like prednisone but can be given in liquid forms at higher doses 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 vasculitis. IV methylprednisolone is also given as a “pre-medication” at 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, a needle is inserted into a vein (usually your arm) and then the medication will be given under the supervision of your rheumatology provider. The dosage and length of time of the infusion will be determined by your rheumatology team.
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, high 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).
The long-term side effects of corticosteroids include weight gain, acne, thinning of skin, stretch marks, high blood sugar, high cholesterol, gastritis and stomach ulcers, cataracts, glaucoma, soft bones, increased risk of osteonecrosis of the bone, growth suppression, muscle wasting, and increased risk of 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. 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 March 2025 by Rebecca Fitzpatrick, MD, and reviewed 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.