Intravenous (IV) Methylprednisolone (Solu-medrol)

Methylprednisolone is strong medicine that reduces inflammation in the body. It belongs to a group of medicines called 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 may be used include lupus affecting the kidneys or brain, vasculitis and other serious autoimmune conditions. 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 given in a hospital or outpatient infusion center. First, a small needle is inserted into a vein (usually in your arm) and then the medication will be given over a period of time in which you are monitored. The dosage and length of time of the infusion will be determined by your rheumatology team.

Side Effects

Methylprednisolone can cause side effects that can occur during or shortly after an infusion, including changes in blood pressure or heart rate, electrolyte imbalances, high blood sugar, flushing or sweating, metallic taste, difficulty sleeping, mood or behavior changes (feeling anxious), psychosis, seizures and increased susceptibility to infection. Rare, but serious reactions can include severe allergic reactions (anaphylaxis).

There are many long-term side effects related to corticosteroid use including weight gain, acne, thinning of skin, stretch marks, easy bruising, high blood sugar, high cholesterol, stomach irritation and ulcers, cataracts, glaucoma, weak bones (osteoporosis), growth suppression, muscle weakness, and increased risk of infection. Your provider works to use the lowest effective dose for the shortest time possible to reduce these risks.

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 January 2026 by Nina Couette, DO, 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.