Medrol Dosage/Direction for Use

The initial dosage of Medrol may vary from 4-48 mg methylprednisolone/day depending on the specific disease entity being treated. In situations of less severity, lower doses will generally suffice, while in selected patients, higher initial doses may be required. Clinical situations in which high-dose therapy may be indicated include multiple sclerosis (160 mg/day for a week followed by 64 mg every other day for 1 month have been shown to be effective). If after a reasonable period of time there is a lack of satisfactory clinical response, Medrol should be discontinued and the patient transferred to other appropriate therapy. If after long-term therapy the drug is to be stopped, it is recommended that it be withdrawn gradually rather than abruptly.
After a favorable response is noted, the proper maintenance dosage should be determined by decreasing the initial drug dosage in small decrements at appropriate time intervals until the lowest dosage which will maintain an adequate clinical response is reached. It should be kept in mind that constant monitoring is needed in regard to drug dosage. Included in the situations which may make dosage adjustments necessary are: Changes in clinical status secondary to remissions or exacerbations in the disease process, the patient's individual drug responsiveness and the effect of patient's exposure to stressful situations not directly related to the disease entity under treatment; in the latter situation, it may be necessary to increase the dosage of Medrol for a period of time consistent with the patient's condition.
It should be emphasized that dosage requirements are variable and must be individualized on the basis of the disease under treatment and the response of the patient.
Alternate-Day Therapy (ADT): Alternate-day therapy is a corticosteroid dosing regimen in which twice the usual daily dose of corticoid is administered every other morning. The purpose of this mode of therapy is to provide the patient requiring long-term pharmacologic dose treatment with the beneficial effects of corticoids, including pituitary-adrenal suppression, the Cushingoid state, corticoid withdrawal symptoms and growth suppression in children.
Children: In general, dosage for children should be based upon clinical response and is at the discretion of the clinician. Treatment should be limited to the minimum dosage for the shortest period of time. If possible, treatment should be administered as a single dose on alternate days.
Elderly: Treatment of elderly patients, particularly if long-term, should be planned bearing in mind the more serious consequences of the common side effects of corticosteroid in old age, particularly osteoporosis, diabetes, hypertension, susceptibility to infection and thinning of skin.