Adults

Dosage varies widely based on the specific condition being treated. Typical initial doses range from 4 mg to 48 mg per day, given as a single dose or in divided doses. The dosage should be individualized and tapered slowly when discontinuing.

Elderly

No specific dose adjustment is generally required, but caution is advised due to increased susceptibility to side effects. The lowest effective dose should be used.

Renal_impairment

No specific dose adjustment is usually required for renal impairment, but careful monitoring for fluid and electrolyte balance is recommended.

Onset

Anti-inflammatory effects can begin within hours, but full therapeutic effects may take several days to develop, depending on the condition being treated.

Excretion

Mainly excreted in the urine as inactive metabolites. A small amount is excreted in the feces.

Half life

Plasma elimination half-life is approximately 2.4 to 3.5 hours. The biological half-life, reflecting the duration of action, is 18 to 36 hours.

Absorption

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

Metabolism

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

Antidiabetic agents

May decrease the hypoglycemic effect of antidiabetics, requiring dose adjustment of antidiabetic drugs.

Diuretics (e.g., Thiazide, Loop)

Enhanced potassium depletion.

Oral contraceptives or estrogens

May increase plasma concentrations and effects of methylprednisolone.

Warfarin and other anticoagulants

Effects may be either potentiated or diminished, requiring close INR monitoring.

Non-steroidal Anti-inflammatory Drugs (NSAIDs)

Increased risk of gastrointestinal ulceration and bleeding.

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

May increase methylprednisolone levels, potentially leading to increased side effects.