Adults

Initial dose ranges from 4 mg to 48 mg daily, depending on the specific disease being treated. Dosage should be individualized based on the patient's response and tolerance. Should be taken once daily or in divided doses.

Elderly

No specific dose adjustments are typically required for the elderly, but caution is advised due to potential increased susceptibility to adverse effects.

Renal_impairment

No specific dose adjustment is generally required in patients with renal impairment, as methylprednisolone is primarily metabolized in the liver.

Onset

Anti-inflammatory effects typically begin within hours of oral administration.

Excretion

Excreted primarily in the urine as metabolites.

Half life

Plasma elimination half-life is approximately 2.5-3.5 hours, but the biological half-life (duration of action) is much longer, typically 18-36 hours.

Absorption

Rapidly and well absorbed from the gastrointestinal tract following oral administration. Peak plasma concentrations are usually reached within 1-2 hours.

Metabolism

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

Anticoagulants (e.g., warfarin)

Methylprednisolone may either potentiate or inhibit the effects of anticoagulants; close monitoring of INR is advised.

Diuretics (e.g., thiazides, loop diuretics)

May enhance the potassium-depleting effects of corticosteroids, increasing the risk of hypokalemia.

NSAIDs (Nonsteroidal Anti-inflammatory Drugs)

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

CYP3A4 Inhibitors (e.g., ketoconazole, erythromycin)

May decrease methylprednisolone metabolism, increasing its plasma concentration and potential for adverse effects.

CYP3A4 Inducers (e.g., rifampin, phenobarbital, phenytoin)

May increase methylprednisolone metabolism, decreasing its plasma concentration and therapeutic efficacy.