methylprednisolone

Methylprednisolone is a synthetic glucocorticoid with potent anti-inflammatory and immunosuppressive properties. It is used to treat a wide range of inflammatory, autoimmune, allergic, and hematologic conditions and can be administered orally or by injection. The drug is available in several forms, including methylprednisolone sodium succinate for intravenous or intramuscular use (often sold as Solu-Medrol) and methylprednisolone acetate for depot injections, as well as oral tablets.

Mechanism of action involves binding to the glucocorticoid receptor, which then modulates gene transcription. This leads to decreased production of pro-inflammatory cytokines and mediators, reduced migration of immune cells to sites of inflammation, and increased production of anti-inflammatory proteins. These effects underlie both the anti-inflammatory and immunosuppressive actions of methylprednisolone.

Indications include acute and chronic inflammatory diseases such as asthma and COPD exacerbations, allergic reactions, rheumatic and musculoskeletal disorders, dermatologic diseases, inflammatory bowel disease, and certain CNS conditions with edema. It is also used to prevent transplant rejection and to manage severe allergic or immune-mediated reactions in some settings.

Adverse effects may be dose- and duration-dependent. Short-term use can cause insomnia, mood changes, hyperglycemia, fluid retention, hypertension, and gastritis. Long-term therapy increases the risk of osteoporosis, weight gain, Cushingoid features, adrenal suppression, infections, cataracts, glaucoma, and growth suppression in children. Potential drug interactions include increased gastrointestinal risk with NSAIDs, and altered responses to vaccines. Dosing is individualized based on indication, route, severity, and patient factors.