When high-dose therapy is desired, the recommended dose of Solu-Medrol is 30 mg/kg administered IV over at least 30 min. This dose may be repeated every 4-6 hrs for 48 hrs.
In general, high-dose corticosteroid therapy should be continued only until the patient's condition has stabilized, usually not beyond 48-72 hrs.
Although adverse effects associated with high-dose, short-term corticoid therapy are uncommon, peptic ulceration may occur. Prophylactic antacid therapy may be indicated.
In other indications, initial dosage will vary from 10-40 mg of methylprednisolone depending on the clinical problem being treated. Larger doses may be required for short-term management of severe, acute conditions. The initial dose usually should be given IV or IM at intervals dictated by the patient's responses and clinical condition. Corticoid therapy is an adjunct to, and not replacement for conventional therapy.
Dosage may be reduced for infants and children but should be governed more by the severity of the condition and response of the patient than by age or size. It should not be <0.5 mg/kg every 24 hrs.
Dosage must be decreased or discontinued gradually when Solu-Medrol has been administered for more than a few days. If a period of spontaneous remission occurs in a chronic condition, treatment should be discontinued. Routine laboratory studies eg, urinalysis, 2-hr postprandial blood sugar, determination of blood pressure and body weight and a chest x-ray, should be made at regular intervals during prolonged therapy. Upper GI x-rays are desirable in patients with an ulcer history or significant dyspepsia.
Solu-Medrol may be administered by IV or IM injection or by IV infusion, the preferred method for initial emergency use being IV injection. To administer by IV (or IM) injection, prepare solution as directed.
The desired dose may be administered IV over a period of several minutes. If desired, the medication may be administered in diluted solutions by adding water for injection or other suitable diluent to the Act-O-Vial and withdrawing the indicated dose.
To prepare solutions for IV infusion, first prepare the solution for injection as directed. This solution may then be added to indicated amounts of 5% dextrose in water, isotonic saline solution or 5% dextrose in isotonic saline solution.