Vaxcel Methylprednisolone Dosage/Direction for Use

Methylprednisolone sodium succinate may be administered by intravenous (IV) injection or infusion, or by intramuscular (IM) injection. The preferred method for initial emergency use is IV injection. Dosage may be reduced for infants and children but should be selected based on the severity of the condition and the response of the patient rather than on the age or weight of the patient. The pediatric dosage should not be less than 0.5mg/kg every 24 hours.
Adjunctive therapy in life threatening conditions: Administer 30mg/kg IV over a period of at least 30 minutes. Dose may be repeated every 4 to 6 hours for up to 48 hours.
Rheumatic disorders unresponsive to standard therapy (or during exacerbation episodes): 1g/day for 1 to 4 days, or 1g/month for 6 months. Administer either regimen as IV pulse dosing over at least 30 minutes. The regimen may be repeated if improvement has not occurred within a week after therapy, or as the patient's condition dictates.
Systemic lupus erythematosus unresponsive to standard therapy (or during exacerbation episodes): Administer 1g/day for 3 days as IV pulse dosing over at least 30 minutes. The regimen may be repeated if improvement has not occurred within a week after therapy, or as the patient's condition dictates.
Multiple sclerosis unresponsive to standard therapy (or during exacerbation episodes): Administer 1g/day for 3 or 5 days as IV pulse dosing over at least 30 minutes. The regimen may be repeated if improvement has not occurred within a week after therapy, or as the patient's condition dictates.
Prevention of nausea and vomiting associated with cancer chemotherapy: For mild to moderately emetogenic chemotherapy: Administer 250mg IV over at least 5 minutes 1 hour before start of chemotherapy. Repeat dose of methylprednisolone at the initiation of chemotherapy and at the time of discharge. A chlorinated phenothiazine may also be used with the first dose of methylprednisolone for increased effect.
For severely emetogenic chemotherapy: Administer 250mg IV over at least 5 minutes with appropriate doses of metoclopramide or a butyrophenone 1 hour before start of chemotherapy. Repeat dose of methylprednisolone at the initiation of chemotherapy and at the time of discharge.
Acute spinal cord injury - Treatment should begin within 8 hours of injury: For patients initiated on treatment within 3 hours of injury: Administer 30mg/kg as an IV bolus over a 15-minute period, followed by a 45 minute pause, and then a continuous IV infusion of 5.4mg/kg/h for 23 hours.
For patients initiated on treatment within 3 to 8 hours of injury: Administer 30mg/kg as an IV bolus over a 15-minute period, followed by a 45-minute pause, and then a continuous IV infusion of 5.4mg/kg/h for 47 hours. There should be a separate intravenous site for the infusion pump.
As adjunctive therapy in other indications: Initial dose will vary from 10 to 500mg IV, depending on the clinical condition. Larger doses may be required for short-term management of severe, acute conditions. Initial doses up to 250mg should be administered IV over a period of at least 5 minutes, while larger doses should be administered over at least 30 minutes. Subsequent doses may be administered IV or IM at intervals dictated by the patient's response and clinical condition. To avoid compatibility and stability problems, it is recommended that methylprednisolone sodium succinate be administered separately from other drugs whenever possible, as either IV push, through an IV medication chamber, or as an IV "piggy-back" solution.
Reconstitution: Under aseptic conditions, add the bacteriostatic water for injection to the vial with sterile powder. If desired, the medication may be administered in dilute solutions by admixing the reconstituted product with dextrose 5% in water, normal saline, dextrose 5% in 0.45% sodium chloride. The resulting solutions are physically and chemically stable for 48 hours.