Solu-Medrol Dosage/Direction for Use

Methylprednisolone sodium succinate (Solu-Medrol) may be administered by intravenous (IV) injection or infusion, or by intramuscular (IM) injection. The preferred method for initial emergency use is IV injection. Dosage may be reduced for infants and children but should be selected based on the severity of the condition and the response of the patient rather than on the age or weight of the patient. The pediatric dosage should not be less than 0.5 mg/kg every 24 hours.
Dosage requirements are variable and must be individualized on the basis of the disease under treatment, its severity and the response of the patient over the entire duration of treatment. A risk/benefit decision must be made in each individual case on an ongoing basis.
The lowest possible dose of corticosteroid should be used to control the condition under treatment for the minimum period. The proper maintenance dosage should be determined by decreasing the initial drug dosage in small decrements at appropriate time intervals until the lowest dosage, which will maintain an adequate clinical response, is reached.
If after long-term therapy the drug is to be stopped, it needs to be withdrawn gradually rather than abruptly (see Precautions).
Following the initial emergency period, consideration should be given to employing a longer acting injectable preparation or an oral preparation.
As adjunctive therapy in life-threatening conditions, administer 30 mg/kg IV over a period of at least 30 minutes. The dose may be repeated every 4 to 6 hours for up to 48 hours.
Methylprednisolone IV pulses, consisting of administration of 250 mg/day or above for a few days (usually ≤5 days) may be suitable during exacerbation episodes or conditions unresponsive to standard therapy, such as: rheumatic disorders, systemic lupus erythematosus, edematous states, such as glomerulonephritis or lupus nephritis. In multiple sclerosis unresponsive to standard therapy (or during exacerbation episodes), administer pulses of 500 or 1000 mg/day for 3 or 5 days over 30 minutes.
As adjunctive therapy in other conditions, the initial dose will vary from 10 to 500 mg IV, depending on the clinical condition. Larger doses may be required for short-term management of severe, acute conditions. Initial doses up to 250 mg should be administered IV over a period of at least 5 minutes, while larger doses should be administered over at least 30 minutes. Subsequent doses may be administered IV or IM at intervals dictated by the patient's response and clinical condition.
To avoid compatibility and stability problems, it is recommended that methylprednisolone sodium succinate (Solu-Medrol) be administered separately from other drugs whenever possible, as either IV push, through an IV medication chamber, or as an IV "piggy-back" solution or via an infusion pump (see Special Precautions for Disposal and Other Handling under Cautions for Usage).
NOTE: Some of the methylprednisolone sodium succinate formulations come with a diluent that contains 0.9% w/v benzyl alcohol as preservative (see Use in Children under Precautions).