Methylprednisolone
Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.
| ID | DRUG-METHYLPREDNISOLONE |
|---|---|
| Type | Drug |
| Aliases | Depo-MedrolMedrolMetypredSolu-MedrolМетилпреднізолон |
| Status | reviewed 2026-04-27 | pending_clinical_signoff |
| Diseases | None declared |
| Sources | SRC-NCCN-BCELL-2025 SRC-NCCN-MM-2025 |
Drug Facts
| Class | Corticosteroid — intermediate-acting synthetic glucocorticoid (minimal mineralocorticoid activity) |
|---|---|
| Mechanism | Synthetic glucocorticoid that binds the cytoplasmic glucocorticoid receptor and modulates transcription of inflammatory and immune genes — broadly suppressing cytokine production, leukocyte trafficking, mast cell mediator release, and complement activation. Compared to hydrocortisone: 4-5× greater anti-inflammatory potency per mg, longer duration of biological effect (~12-36 h vs 8-12 h), and minimal mineralocorticoid activity (no significant sodium / water retention) — preferred over hydrocortisone for non-adrenal-replacement indications. In oncology supportive care, principal uses: (1) premedication and treatment of chemotherapy infusion reactions (intermediate dose 40-125 mg IV); (2) high-dose pulse therapy for immune-related adverse events (irAEs) from immune checkpoint inhibitors (1-2 mg/kg/day for moderate, 1-2 mg/kg/day IV for severe/Grade 3-4 colitis, pneumonitis, hepatitis, hyp... |
| Typical dosing | ANAPHYLAXIS / SEVERE INFUSION REACTION ADJUNCT (adult): 40-125 mg IV bolus over 1-2 min after epinephrine IM; may repeat every 6 h for 24 h. CHEMOTHERAPY PREMEDICATION (e.g., docetaxel hypersensitivity prevention): 40-80 mg IV 30 min before infusion; or 8 mg PO BID × 3 days starting day before docetaxel for retention prevention. irAE management (immune checkpoint inhibitor toxicity): Grade 2 → 0.5-1 mg/kg/day PO; Grade 3-4 → 1-2 mg/kg/day IV with subsequent taper over 4-6 weeks. CYTOKINE RELEASE SYNDROME (CAR-T) escalation: 1 mg/kg IV q12h or 1000 mg IV daily × 3 days for severe / refractory CRS not responding to tocilizumab. CEREBRAL EDEMA: 32-128 mg/day IV (alternative when dexamethasone... |
| Ukraine registered | True |
| NSZU reimbursed | True |
| Ukraine last verified | 2026-04-27 |
Notes
Workhorse corticosteroid for: (1) acute infusion reactions and anaphylaxis adjunct (40-125 mg IV after epinephrine); (2) immune- related adverse events from checkpoint inhibitors — the defining role; (3) CRS escalation when tocilizumab inadequate. Compared to hydrocortisone: more potent per mg (4-5×), longer duration, less mineralocorticoid effect (preferred when fluid retention undesirable). Compared to dexamethasone: slightly less potent (×6), shorter duration, but lower CNS penetration (slightly less psychiatric AE per equivalent dose); dex preferred for cerebral edema and antiemesis, methylprednisolone preferred for irAE management per NCCN / ESMO immunotherapy toxicity guidelines. CRITICAL: high-dose pulse (≥250 mg IV) must be infused over ≥30 min — rapid bolus risks fatal cardiac arrhythmia. Aprepitant DDI: aprepitant increases methylprednisolone exposure ~2.5× — reduce methylprednisolone ~50% when both prescribed (e.g., in HEC chemotherapy with antiemetic regimen). Single bolus of 40-125 mg has minimal long-term consequences; courses ≥2 weeks require taper to prevent adrenal crisis. Long-acting Depo-Medrol IM is for joint injections only — never for systemic IV use. Ukraine...
Used By
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