Adults

Dosage varies widely based on the condition being treated and patient response. Typically ranges from 4 mg to 48 mg per day, administered as a single dose or in divided doses. Long-term use requires gradual tapering.

Elderly

No specific dose adjustment required based solely on age, but caution should be exercised due to potential increased susceptibility to side effects.

Renal_impairment

No dose adjustment is usually necessary for patients with renal impairment, as methylprednisolone is primarily metabolized by the liver.

Onset

Anti-inflammatory effects typically begin within hours, with peak effects often seen after 1-2 days of continuous therapy.

Excretion

Excreted mainly through the urine as metabolites, with a small amount of unchanged drug.

Half life

Plasma elimination half-life is approximately 2.5-3.5 hours, but the biological half-life (duration of action) is considerably longer (18-36 hours) due to cellular binding.

Absorption

Well absorbed from the gastrointestinal tract after oral administration. Peak plasma concentrations are achieved within 1-2 hours.

Metabolism

Primarily metabolized in the liver by CYP3A4 enzymes to inactive metabolites.

Antidiabetic agents

Corticosteroids can increase blood glucose levels, requiring adjustment of antidiabetic medication dosage.

Anticoagulants (e.g., Warfarin)

Methylprednisolone can alter the anticoagulant effect, requiring close monitoring of INR.

Diuretics (e.g., Thiazides, Loop diuretics)

May enhance potassium depletion, increasing the risk of hypokalemia.

NSAIDs (Nonsteroidal Anti-inflammatory Drugs)

Concurrent use may increase the risk of gastrointestinal bleeding and ulceration.

CYP3A4 inducers (e.g., Rifampin, Phenobarbital)

May decrease methylprednisolone levels, reducing efficacy. Dose adjustment may be necessary.

CYP3A4 inhibitors (e.g., Ketoconazole, Ritonavir)

May increase methylprednisolone levels, leading to increased effects and side effects. Dose adjustment may be necessary.