Adults

Dosage varies widely based on the condition being treated, ranging from 4 mg to 48 mg daily. For 4 mg, it's often a starting or maintenance dose. Typically, 4-8 mg daily initially, adjusted based on response.

Elderly

No specific dose adjustments needed for elderly patients unless hepatic or renal impairment is present. Start with the lowest effective dose.

Renal_impairment

Methylprednisolone is primarily metabolized in the liver, so renal impairment usually does not require dose adjustment. However, use with caution.

Onset

Anti-inflammatory effects typically begin within a few hours, but full therapeutic effect may take several days.

Excretion

Excreted mainly in the urine as inactive metabolites.

Half life

The plasma half-life is approximately 2.5-3.5 hours, but the biological half-life is 18-36 hours due to sustained tissue effects.

Absorption

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

Metabolism

Primarily metabolized in the liver by cytochrome P450 3A4 (CYP3A4) enzymes to inactive metabolites.

NSAIDs

Increased risk of gastrointestinal ulceration and bleeding.

Oral Contraceptives

May increase corticosteroid effects.

Diuretics (Thiazide or Loop)

May enhance potassium depletion.

Anticoagulants (e.g., Warfarin)

Effects may be altered; close monitoring of INR is required.

Phenytoin, Rifampin, Barbiturates

May decrease corticosteroid effects by increasing metabolism.