Methylprednisolone

( Medrol )

Medically Reviewed by Dr. Harshi Dhingra, M.D.

Last Reviewed: Jul 12, 2022

Warnings


What are the risks of taking Methylprednisolone?


Methylprednisolone can cause serious health problems, especially in certain high-risk patients. Some of the risks of methylprednisolone use include:

  • EFFECTS ON HEART AND KIDNEY FUNCTION: Methylprednisolone can lead to high blood pressure, rapid weight gain, and other changes that can affect how your heart and kidneys work. Before starting methylprednisolone, tell your doctor or pharmacist if you have a history of high blood pressure, heart failure, or kidney problems.

  • WEAK BONES AND GROWTH SUPPRESSION: Long-term methylprednisolone use can lead to the weakening of the bones and an increased risk of fractures, especially in postmenopausal women and women older than 60 years of age. Smoking and alcohol use can increase the risk of weak bones.  Methylprednisolone can also lead to growth suppression in infants and children. The risk of this occurring is higher if the medication is taken at high doses or for a long time. 

  • RISK DURING PREGNANCY: Methylprednisolone can harm an unborn baby, especially if taken during the first trimester of pregnancy. Tell your doctor if you are pregnant, planning a pregnancy, or breastfeeding before starting this medication.

  • ADRENAL SUPPRESSION: The adrenal glands are small glands located near the kidneys that make certain hormones in the body. Methylprednisolone is similar to these hormones. Therefore, taking this medication for a long time can lead to adrenal suppression (reduced function of the adrenal glands where they stop making natural hormones). The risk of this occurring is greater if you take high doses of methylprednisolone or take it for a long time. Young children are at higher risk. Injuries, trauma, and infection can increase the risk of adrenal suppression. Stopping the medication abruptly can be dangerous because the body starts to depend on methylprednisolone. Symptoms of withdrawal from methylprednisolone may include fever, joint pain, body aches, and low energy. Talk to your doctor or pharmacist before making any dosage adjustments in your methylprednisolone dose. 

  • INCREASED RISK OF INFECTIONS: Long-term use of methylprednisolone can reduce your body’s ability to fight infections. The medication can also mask the common signs of infection. The risk is higher if you take high doses of methylprednisolone, take it for a long time, have not been vaccinated against viral illnesses, or are taking other medications that weaken the immune system.  While taking methylprednisolone, be careful to avoid contact with people who have tuberculosis (TB) or chicken pox. People who have had tuberculosis (TB) in the past or have latent tuberculosis need to be monitored carefully during methylprednisolone treatment and may need adjunctive therapy to treat or prevent TB.  Methylprednisolone can also cause live vaccines not to work properly and increase the risk of infection. Inactivated vaccines are generally safe. 

  • EYE PROBLEMS: Long-term methylprednisolone use can increase the risk of certain eye infections, cataracts, and glaucoma. People who have a herpes infection of the eye should not take methylprednisolone. Tell your doctor or pharmacist if you develop eye pain, blurry vision, or other vision changes while on methylprednisolone. Keep all appointments for eye exams if you are on long-term methylprednisolone treatment. 

  • PSYCHIATRIC EFFECTS: Methylprednisolone and other corticosteroid medicines can lead to mood and behavior changes. Tell your healthcare professional if you have a history of mental illness. Also, contact your doctor without delay if you experience severe depression or anxiety, mood swings, problems with sleep, or hallucinations while on this medication. 

  • STOMACH DISCOMFORT AND IRRITATION: Taking methylprednisolone (Medrol) can damage the stomach and cause worsening stomach irritation. Tell your healthcare provider right away if you develop persistent stomach pain or black, tarry, or bloody stools. Your doctor may ask you to take medication to protect your stomach if you have been taking methylprednisolone for a long time. The risk of stomach irritation is higher in people with a history of stomach bleeding, stomach ulcers, and ulcerative colitis. The risk is also higher if you drink alcohol or are taking other medications that can affect the stomach, such as nonsteroidal anti-inflammatory drugs like ibuprofen and naproxen.  If you are at a high risk of complications from methylprednisolone use, your doctor or pharmacist can help you find other medicines for your condition.


What should I tell my doctor before starting Methylprednisolone?

Tell your healthcare provider if you have ever had an allergic reaction to methylprednisolone, any inactive ingredients in methylprednisolone tablets, aspirin, tartrazine (a yellow dye), or any other medications. Your pharmacy can give you a list of ingredients. 

Give your healthcare provider a complete medical history. Methylprednisolone may not be right for people with certain medical conditions such as liver, kidney, intestinal, or heart disease, diabetes, high blood pressure, osteoporosis, underactive thyroid, mental illness, stomach ulcers, seizures, TB, herpes infection in the eye, and myasthenia gravis.

Give your doctor a complete list of all your medications, including prescription drugs, over-the-counter medicines, vitamins, dietary supplements, and herbal products. This can help avoid serious interactions between methylprednisolone and your other drugs.

Tell your doctor if you are pregnant, could be pregnant, plan to get pregnant, or are breastfeeding.

What precautions should I take while on Methylprednisolone?

Keep all your appointments for medical tests and doctor’s visits while on methylprednisolone. Your doctor may want to order frequent eye exams or other tests. 

Call your doctor if you become pregnant while on methylprednisolone.

Do not take methylprednisolone if you have a fungal infection (other than a fungal skin infection) without talking to your doctor first.

Tell your doctors that you are taking methylprednisolone before surgery, including dental procedures.

Limit alcohol consumption while taking methylprednisolone, especially if you are on aspirin or other medications that can irritate the stomach and intestines. Methylprednisolone can make you more susceptible to the irritating effects of alcohol and increase your risk of developing stomach ulcers.

Seek emergency medical help if you develop signs and symptoms of allergic reactions, such as skin rash or swelling of the face, lower legs, and ankles.

What drugs can interact with Methylprednisolone?

Taking methylprednisolone with certain other drugs can affect how each of the medications works. Interactions between medications can also increase the risk of serious side effects. Your physician may choose a different drug combination, change the dose or frequency of one or both medicines, and/or closely monitor you for side effects if there are known interactions between methylprednisolone and your other drugs.

Methylprednisolone can have potential drug interactions with the following medications:

  • Anticoagulants or blood thinners like warfarin (Coumadin)
  • Aspirin
  • Arthritis medications
  • Antibiotics like clarithromycin (Biaxin), azithromycin (Zithromax), and erythromycin
  • Immunosuppressant drugs like cyclosporine (Neoral, Sandimmune)
  • Heart medications like digoxin (Lanoxin)
  • Diuretics or water pills
  • Antifungals like ketoconazole (Nizoral)
  • Estrogen (Premarin) and oral contraceptives
  • Anti-seizure medications like phenobarbital and phenytoin (Dilantin)
  • TB medicines like rifampin (Rifadin)
  • Asthma medications like theophylline (Theo-Dur)
  • Vitamins

This list does not describe all possible methylprednisolone drug interactions. Give your healthcare professionals a complete list of your medications, including prescription drugs, over-the-counter medicines, vitamins, dietary supplements, and herbal products. Also, tell your health care provider if you smoke, drink alcohol, or use illegal drugs because some of these substances can cause serious health complications when used with prescription drugs.