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Methylprednisolone

By Rania Gollakner, BS, DVM, MPH

Medications

What is methylprednisolone?

Methylprednisolone (brand names: Medrol®, Depo-Medrol®, A-Methapred®, Solu-Medrol®) is a glucocorticoid steroid medication used to treat many inflammatory conditions, pets with adrenal gland disease, and pets with immune-mediated diseases. It is similar to but slightly more potent than prednisone / prednisolone.

While some uses for dogs, cats, and horses are on label, its use to treat some other disorders is ‘off label’ or ‘extra label’. Many drugs are commonly prescribed for off label use in veterinary medicine. In these instances, follow your veterinarian’s directions and cautions very carefully as their directions may be significantly different from those on the label.

How is methylprednisolone given?

Methylprednisolone is given by mouth in the form of a tablet or a specially compounded liquid. It should be given with food. If given once daily, give it in the morning for dogs and horses and in the evening for cats. Measure liquid forms carefully. It can also be given as an injection in the hospital or clinic setting. Do not stop this medication abruptly without consulting with your veterinarian.

This medication will take effect quickly, in about 1 to 2 hours, and improvement in clinical signs should follow.

What if I miss giving my pet the medication?

If you miss a dose, give it when you remember, but if it is close to the time for the next dose, skip the dose you missed and give it at the next scheduled time, and return to the regular dosing schedule. Never give your pet two doses at once or give extra doses.

Are there any potential side effects?

Side effects most commonly include increased drinking, urination, and appetite when given at any dose. Other side effects that occur, usually with higher doses, especially in dogs, include dull/dry haircoat, weight gain, pot-bellied appearance, muscle weakness, panting, vomiting, diarrhea, or elevated fat or liver enzymes in the blood. More serious side effects include stomach or intestinal ulcers and bleeding, leading to black, tarry stools, bloody vomit, black specks like coffee grounds in the vomit, frank blood in the stools, loss of appetite, and/or fever. Other serious side effects include secondary infections, inflammation of the pancreas, activation or worsening of diabetes mellitus, muscle wasting, and severe changes in behavior.

This medication can also interfere with certain laboratory tests, including cortisol tests, blood cholesterol, urine and blood glucose (sugar) levels, potassium levels, thyroid hormones, skin tests, and white blood cell counts.  

This moderate-acting medication should stop working in a few days, although effects can be longer in pets with liver or kidney disease.

Are there any risk factors for this medication?

Methylprednisolone should not be used in pets that are allergic to it, or in pets with systemic fungal or viral infections, diabetes, Cushing’s disease, or stomach or intestinal ulcers. It also should not be used in pets that are also receiving non-steroidal anti-inflammatory drugs (NSAIDs) or in pets that are recovering from a recent surgery.

Methylprednisolone should be used cautiously in dogs as it can cause gastrointestinal complications and bleeding and should be used with caution in pets, especially cats, predisposed to diabetes mellitus, and in pets with kidney disease, heart disease, general bacterial or fungal infections, high blood pressure, or in pets that are pregnant or lactating. Methylprednisolone should be used cautiously in young animals as this medication can slow growth.

Do not stop this medication abruptly after long term use (greater than 2 weeks); taper slowly to avoid complications.

Are there any drug interactions I should be aware of?

The following medications should be used with caution when given with methylprednisolone: amphotericin b, anticholinesterase agents, aspirin, barbiturates, bupropion, cyclophosphamide, cyclosporine, digoxin, potassium-depleting diuretics, ephedrine, epidural injections, estrogens, insulin, -azole antifungals, macrolides, mitotane, NSAIDs, phenobarbital, phenytoin, rifampin, theophylline, ulcerogenic drugs (NSAIDs), vaccines, and warfarin.

Be sure to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is taking.

Is there any monitoring that needs to be done with this medication?

Depending on the reason for use and other factors, a variety of monitoring may be indicated, such as the following: weight, appetite, signs of swelling, electrolyte levels, blood protein levels, blood glucose, growth and development (young animals), and an ACTH stimulation test. Your veterinarian may monitor your pet to be sure that the medication is working.

How do I store methylprednisolone?

Store the tablets at room temperature between 59°F and 86°F (15°C and 30°C) and protect from light. Store compounded forms of the medication according to the label.

What should I do in case of emergency?

If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility.

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