Comment
Author: Admin | 2025-04-28
To intravenous methylprednisolone.[15][16] Dosage above 60–80 mg/day or 2 mg/kg/day is not recommended as it has not been shown to alter pulmonary function, rate of admission, or length of stay in the hospital compared to lower doses.[16] Following ED discharge, it is advised to prescribe a five-day course of methylprednisolone to decrease the probability of relapse or withdrawal symptoms.[15][16]Methylprednisolone is used to treat several rheumatic diseases, such as Systemic Lupus Erythematosus (SLE) and Rheumatoid Arthritis (RA). Methylprednisolone dosage and administration for these diseases is highly variable due to varied pathophysiology between the diseases and within patients diagnosed with a given disease.[17][18] In Lupus Nephritis, a common manifestation of SLE, patients are often prescribed methylprednisolone concomitantly with immunosuppressants. Severe manifestations are often treated with Cyclophosphamide or Rituximab and three doses of methylprednisolone IV-pulse treatment (as recommended by ACR guidelines) before switching to oral prednisolone and azathioprine for maintenance.[17][18]Intra-articular corticosteroid injections (IACI) are a second-line therapy to relieve joint pain resulting from rheumatoid arthritis.[19] It is most commonly injected into the joints of the knees and shoulders.[19] Although the injection is local, studies have shown systemic absorption as evidenced by beneficial effects on distant joints.[19] In an attempt to minimize HPA suppression, FDA guidelines have restricted IACIs to three per year, with a minimum of 30 days in between injections.[20]Primary or secondary adrenocortical insufficiency[edit]Methylprednisolone is not typically recommended for primary or secondary adrenocortical insufficiency compared to other corticosteroids which have a higher affinity for mineralocorticoid receptors and salt-retaining properties.[4]Labeled indications[edit]The labeled indications below are categorized by route of administration and then by medical discipline.Oral methylprednisolone[edit]Allergy and immunology: angioneurotic edema,[15] asthma, urticaria, seasonal or perennial allergic rhinitis, drug hypersensitivity reactions, and serum sickness.[21]Dermatology: toxic epidermal necrolysis,[15] atopic dermatitis, contact dermatitis, pemphigus, erythema multiforme, Stevens-Johnson syndrome, bullous dermatitis herpetiformis, severe seborrheic dermatitis, exfoliative dermatitis, mycosis fungoides, and severe psoriasis.[21]Endocrinology: congenital adrenal hyperplasia, hypercalcemia associated with cancer, nonsuppurative thyroiditis, and primary or secondary adrenocortical insufficiency.[21]Gastroenterology: inflammatory bowel disease and ulcerative colitis.[21]Hematology: acquired (autoimmune) hemolytic anemia, idiopathic thrombocytopenic purpura, secondary thrombocytopenia, erythroblastopenia, leukemia, lymphoma and congenital (erythroid) hypoplastic anemia.[21]Pulmonary: aspiration pneumonitis, chronic beryllium disease, eosinophilic pneumonia, symptomatic sarcoidosis, and pulmonary tuberculosis in conjunction with antituberculosis chemotherapy.[21]Nephrology: nephrotic syndrome, idiopathic type or secondary to lupus nephritis.[21]Neurology: multiple sclerosis.[21]Ophthalmology: scleritis, retinal vasculitis,[15] uveitis, choroiditis, iritis, iridocyclitis, keratitis, optic neuritis, allergic conjunctivitis, allergic corneal marginal ulcers, herpes zoster ophthalmicus, sympathetic ophthalmia, and chorioretinitis.[21]Rheumatology: rheumatoid arthritis, rheumatic carditis, acute gouty arthritis, ankylosing spondylitis, dermatomyositis and polymyositis, psoriatic arthritis, systemic lupus erythematosus, acute and subacute bursitis, synovitis of osteoarthritis, post-traumatic osteoarthritis, and epicondylitis.[21]Miscellaneous: trichinosis with neurologic or myocardial involvement.[21]Parenteral methylprednisolone[edit]Intra-articular or soft tissue injections: acute gouty arthritis, acute and subacute bursitis, acute tenosynovitis, epicondylitis, and synovitis of osteoarthritis.[18]Intralesional injections: alopecia areata, discoid lupus erythematosus, keloids, granuloma annulare, lichen planus, lichen simplex chronicus, psoriatic plaques, necrobiosis lipoidica diabeticorum.[18]Intramuscular injections are prescribed to treat many of the same conditions indicated for oral administration. Intramuscular injections are administered as an alternative to oral therapy.[18]Off-label indications[edit]Some of the off-label indications of methylprednisolone include acute spinal
Add Comment