Methylprednisolone
- TRADE NAMES: Advantan (Intendis); Medrol (Pharmacia); Solu-Medrol (Pharmacia)
- INDICATIONS: Arthralgias, asthma, dermatoses, inflammatory ocular conditions, rhinitis
- CLASS: Corticosteroid / Glucocorticoid, Corticosteroid, systemic, Covid-19 putative drug
- HALF-LIFE: 12–36 hours; 2–4 hours (plasma)
Aminophylline, Aprepitant, Aspirin, Carbamazepine, Clarithromycin, Conivaptan, Cyclosporine, Daclizumab, Darunavir, Delavirdine, Erythromycin, Indinavir, Itraconazole, Ketoconazole, Live vaccines, Oral Contraceptives, Phenobarbital, Phenytoin, Rifampin, Telaprevir, Telithromycin, Troleandomycin, Voriconazole, Warfarin
PREGNANCY CATEGORY: C
See adverse reactions attributed to class:
Acute generalized exanthematous pustulosis (AGEP)
(2001): Mussot-Chia+, Ann Dermatol Venereol 128(3), 241
Anaphylactoid reactions / anaphylaxis (includes anaphylactic shock)
(2015): Alvarez Caro F+, J Investig Allergol Clin Immunol 25(4), 309
(2014): Faria E+, J Investig Allergol Clin Immunol 24(1), 40 (2 cases)
(2012): Atanaskovic-Markovic M+, Srp Arh Celok Lek 140(3-4), 233
(2004): Saito R+, Int J Urol 11(3), 171 [REVIEW]
(2002): Burgdorff T+, Ann Allergy Asthma Immunol 89(4), 425
(2000): Young MF+, J Neurol Neurosurg Psychiatry 68(2), 255
(1999): Beynel P+, Rev Mal Respir 16(4), 529 [REVIEW]
(1999): Schonwald S, Am J Emerg Med 17(6), 583 [REVIEW]
(1997): Mace S+, J Rheumatol 24(6), 1191 [REVIEW]
(1997): van den Berg JS+, J Neurol Neurosurg Psychiatry 63(6), 813
(1996): Moreno-Ancillo A+, J Allergy Clin Immunol 97(5), 1169
(1993): Hopper JM+, J Bone Joint Br 75(3), 505 [REVIEW] (with bupivacaine)
(1993): Watanabe I+, Masui 42(1), 112
(1991): Peces R+, Nephron 59(3), 497
(1990): Laine-Cessac P+, Therapie 45(6), 505 [REVIEW]
Bruise / bruising / contusion / ecchymosis (ecchymoses)
(1998): Dasgupta B+, Br J Rheumatol 37(2), 189
(1991): Anderson B+, Intern Med 151
Dermatitis
(2004): Cahill J+, Australas J Dermatol 45(3), 192
(2000): Chew AL+, Cutis 65(5), 307
(1998): Corazza M+, Contact Dermatitis 38(6), 356
(1997): Balato N+, Am J Contact Dermat 8(1), 24-5
(1992): Aramoto Y+, J Dermatol 19(6), 375
Flushing / rubefaction
(2002): Mignogna MD+, J Oral Pathol Med 31(6), 339
(1993): Chrousos GA+, JAMA 269(16), 2110
Herpes simplex
(2009): Meydani A+, Acta Dermatovenerol Alp Panonica Adriat 18 (3), 135 (following intra-articular injection)
Hypersensitivity
(2006): Sirvent AE+, Nefrologia 26(1), 128
(2006): Venturini M+, J Investig Allergol Clin Immunol 16(1), 51
(1996): Lopez-Serrano MC+, J Investig Allergol Clin Immunol 6(5), 324
Pruritus (itching)
(2005): Hardy D, Can J Anaesth 52(2), 186 (with bupivacaine and epinephrine)
(2002): Mignogna MD+, J Oral Pathol Med 31(6), 339
Rash
(2004): Kuga A+, Rinsho Shinkeigaku 44(10), 691 [REVIEW]
(2001): Macchia PE+, J Endocrinol Invest 24(3), 152
Urticaria / hives
(2011): Jang EJ+, Allergy Asthma Immunol Res 3(4), 277
(2001): Borja JM+, Allergy 56(8), 791
(2001): Pollack B+, Br J Dermatol 144, 1228
(1996): Pizzuti P+, Rev Rhum Engl Ed 63(3), 223 [REVIEW]
(1990): Sieck JO+, Br J Clin Pract 44(12), 723
Mucocutaneous reactions
(2002): Wiland P+, Pol Arch Med Wewn (Polish) 108(5), 1055 (with gold (aurothiomalate))
Arrhythmias
(2014): Miskiewicz P+, Endokrynol Pol 65(5), 402
(1991): Chikanza C+, Br J Rheumatol 30(5), 392
Bradycardia / sinus bradycardia
(2015): Stroeder J+, Can Pharm J (Ott) 148(5), 235 [REVIEW]
(2013): Darling HS+, J Assoc Physicians India 61(12), 920
(2005): Chibane S+, Rev Med Interne 26(1), 2010%
(2001): Pudil R+, Arch Intern Med 161(14), 1778
(1998): Guillen EL+, Am J Kidney Dis 32(2), E4
(1998): Kucukosmanoglu O+, Nephron 80(4), 484
Cardiac arrest
(2015): Massart A+, Clin Nephrol 83(1), 61 (with basiliximab, mycophenolate and tacrolimus)
Hypertension
(2014): Choi MS+, PLoS One 9(11), Epub
(2014): Miskiewicz P+, Endokrynol Pol 65(5), 402
(2005): Chibane S+, Rev Med Interne 26(1), 20
(2005): Hardy D, Can J Anaesth 52(2), 186 (with bupivacaine and epinephrine)
(2003): Cortes-Hernandez J+, Lupus 12(4), 287
(1992): Baethge BA+, Ann Pharmacother 26(3), 316
Myocardial infarction
(2014): Choi MS+, PLoS One 9(11), Epub
(2014): Miskiewicz P+, Endokrynol Pol 65(5), 402
Myocardial toxicity
(2004): Kulig G+, Przegl Lek 61(8), 855
(1993): Cohen IJ, Pediatr Hematol Oncol 10(3), v [REVIEW]
Shock (see also anaphylactic shock)
(2015): Massart A+, Clin Nephrol 83(1), 61 (with basiliximab, mycophenolate and tacrolimus)
Arachnoiditis
(2017): Schlatter J+, Eur Spine J Nov, Epub ahead of print (via intrathecal administration)
Depression
(2012): Tamura S+, Rinsho Ketsueki 53(3), 361
(2003): Antonijevic IA+, Psychoneuroendocrinology 28(6), 780
(2002): Kulakowska A+, Pol Merkuriusz Lek 13(75), 200
(1996): Naber D+, Psychoneuroendocrinology 21(1), 25-3
(1993): Chrousos GA+, JAMA 269(16), 2110
Dysgeusia (taste perversion)
(2016): Jongen PJ+, J Neurol 263(8), 164161%
(2009): Topak M+, J Laryngol Otol 123 (11), 1221
(2001): Macchia PE+, J Endocrinol Invest 24(3), 152
(1994): Chassard D+, Presse Med 23(11), 515
Headache
(2017): Schlatter J+, Eur Spine J Nov, Epub ahead of print [REVIEW] (via intrathecal administration)
(2002): Mignogna MD+, J Oral Pathol Med 31(6), 339
Meningococcal infection
(2017): Schlatter J+, Eur Spine J Nov, Epub ahead of print [REVIEW] (via intrathecal administration)
Neurotoxicity
(2014): Miskiewicz P+, Endokrynol Pol 65(5), 402
(2004): Fodale V+, Br J Anaesth 92(2), 289 (with cisatracurium)
Psychosis
(2015): Tandon VR+, Indian J Med Res 142(1), 33
(2014): Miskiewicz P+, Endokrynol Pol 65(5), 402
(2014): Ohashi T, Nihon Rinsho (Japanese) 72(11), 1995
Seizures
(1996): Vaughn BV+, Epilepsia 37(12), 1175
(1992): Baethge BA+, Ann Pharmacother 26(3), 316
(1991): Bettinelli A+, Child Nephrol Urol 11(1), 41-3
Vertigo / dizziness
(2009): Topak M+, J Laryngol Otol 123 (11), 1221
(2005): Hardy D, Can J Anaesth 52(2), 186 (with bupivacaine and epinephrine)
Diabetic ketoacidosis
(2020): Alakkas Z+, Am J Case Rep 21, e923372 (1 case)
(2008): Cagdas DN+, J Cardiovasc Pharmacol Ther 13(4), 298 (1 case)
Hyperglycemia (includes glucose increased)
(2020): Alakkas Z+, Am J Case Rep 21, e923372 (1 case)
(2014): Choi MS+, PLoS One 9(11), Epub
(2014): Miskiewicz P+, Endokrynol Pol 65(5), 402
(2014): Ohashi T, Nihon Rinsho (Japanese) 72(11), 1995
(2010): Chebane L+, Therapie (French) 65(5), 447
Hypokalemia
(2020): Ghosh A+, Cardiol Young Dec, Online ahead of print (1 case / female)
(2016): Zhang YL+, Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi (Chinese) 51(10), 783
Abdominal pain
(2016): Jongen PJ+, J Neurol 263(8), 164153%
(2014): Choi MS+, PLoS One 9(11), Epub
(1994): Chassard D+, Presse Med 23(11), 515
Gastrointestinal bleeding
(2016): Evaniew N+, J Neurotrauma 33(5), 468 [REVIEW]
(2014): Choi MS+, PLoS One 9(11), Epub
Hepatotoxicity / liver injury / acute liver injury / drug-induced liver injury (DILI)
(2018): Rotondo E+, BMJ Case Rep 11(1)1 case
(2016): Davidov Y+, J Dig Dis 17(1), 55 [REVIEW]
(2015): Ferraro D+, Neurologist 19(6), 153 (4 cases)
(2014): Melamud B+, Isr Med Assoc J 16(3), 180
(2014): Miskiewicz P+, Endokrynol Pol 65(5), 402
(2011): Furutama D+, Med Princ Pract 20(3), 291
(2010): Loraschi A+, Clin Neuropharmacol 33 (1), 52
(2008): Rivero Fernandez M+, Rev Esp Enferm Dig 100(11), 720 (1 case)
(2006): Topal F+, Ann Pharmacother 40(10), 1868
Bladder disorder
(2017): Schlatter J+, Eur Spine J Nov, Epub ahead of print [REVIEW] (via intrathecal administration)
Febrile neutropenia
(2014): Montoro J+, Transfus Apher Sci 50(3), 411 (as R-ESHAP chemotherapy (with rituximab, etoposide, cytarabine and cisplatin) plus pegfilgastrim)
Leukocytopenia (leukopenia)
(2002): Wiland P+, Pol Arch Med Wewn (Polish) 108(5), 1055 (with gold (aurothiomalate))
Myelosuppression / bone marrow suppression / myelotoxicity
(2014): Montoro J+, Transfus Apher Sci 50(3), 411 (as R-ESHAP chemotherapy (with rituximab, etoposide, cytarabine and cisplatin) plus pegfilgastrim)
Myalgia/Myositis/Myopathy/Myotoxicity (see also Statin-induced necrotizing autoimmune myopathy)
(2006): Lee HJ+, Bone Marrow Transplant 38(4), 299
(2005): Qian T+, Spinal Cord 43(4), 199
(2001): Odabas AR+, Nephron 87(1), 95
(2000): Qian T+, Med Hypotheses 55(5), 452
Osteonecrosis / avascular necrosis
(2014): Dilisio MF, Orthopedics 37(7), e631
(2014): Ohashi T, Nihon Rinsho (Japanese) 72(11), 1995
(2004): Tanaka Y, Nippon Rinsho 62(10), 1867 [REVIEW]
(1998): Wing PC+, Spinal Cord 36(9), 633
(1996): Saisu T+, Transplant Proc 28(3), 1559
(1994): Bradbury G+, J Bone Joint Surg Am 76(9), 1385
(1993): Marsh JC+, Br J Haematol 84(4), 731
(1992): Massardo L+, Lupus 1(6), 40119%
(1992): O'Brien TJ+, Clin Orthop Relat Res (279), 176
Osteoporosis
(2004): Haugeberg G+, Ann Rheum Dis 63(8), 940
(2003): de Deus RB+, Nephron Clin Pract 94(3), c69
Tendinopathy/Tendon rupture
(2011): Pantalone A+, Int J Immunopathol Pharmacol 24(2), 519 (with ciprofloxacin)
(2005): Chiou YM+, Lupus 14(4), 321
Cataract
(2003): Nakamura T+, Jpn J Ophthalmol 47(3), 254 (with cyclosporine)
(1999): Marsh P+, Ophthalmology 106(4), 811
(1992): Yokota S+, Ryumachi 32(3), 215
Glaucoma
(1995): Katsushima H, Nippon Ganka Gakkai Zasshi 99(2), 238 [REVIEW]
(1992): Yokota S+, Ryumachi 32(3), 215
Acute respiratory distress syndrome
(2015): Massart A+, Clin Nephrol 83(1), 61 (with basiliximab, mycophenolate and tacrolimus)
Dysphonia
(2006): Loeches-Yague B+, Med Clin (Barc) 126(2), 79
(2005): Hardy D, Can J Anaesth 52(2), 186 (with bupivacaine and epinephrine)
Adverse effects
(2017): Patel P+, Br J Clin Pharmacol 83(10), 2148 [REVIEW] (pharmacokinetic interaction with aprepitant or fosaprepitant)
(2015): Gaydukova IZ+, Ter Arkh (Russian) 87(5), 47 (13 cases)
(2015): Riedl M+, J Endocrinol Invest 38(2), 17723%
(2015): Sun X+, Pulm Pharmacol Ther 31, 111
(2014): Machado-Alba JE+, Rev Panam Salud Publica 36(6), 396
(2005): Chibane S+, Rev Med Interne 26(1), 20
(1992): Pozzi C+, Nephron 60(2), 235
Allergic reactions
(2003): Freymond N+, Rev Med Interne 24(10), 698
(2003): Ventura MT+, Br J Dermatol 148(1), 139
(1998): Vanpee D+, Ann Emerg Med 32(6), 754
Hiccups
(2021): Egbu E+, Cureus 13(1), e12893 (1 case)
(2006): Iijima M+, Eur J Neurol 13(2), 201
(1986): Baethge BA+, Ann Intern Med 104(1), 58
Infection
(2014): Miskiewicz P+, Endokrynol Pol 65(5), 402
(2012): Pettitt AR+, J Clin Oncol 30(14), 164751% (grade 3 to 4) (with alemtuzumab)
(2004): Kulig G+, Przegl Lek 61(8), 855
(2004): Offidani M+, Leuk Lymphoma 45(8), 1617
(2004): Tanaka Y, Nippon Rinsho 62(10), 1867 [REVIEW]
(1994): Sayer HG+, Blood 84(4), 1328
(1992): Baethge BA+, Ann Pharmacother 26(3), 316
Multiorgan failure
(2015): Massart A+, Clin Nephrol 83(1), 61 (with basiliximab, mycophenolate and tacrolimus)
Adverse reactions attributed to entire drug class Corticosteroid / Glucocorticoid
Atrophy / Skin atrophy
(2020): Niculet E+, Clin Cosmet Investig Dermatol 13, 1041-1050 [REVIEW]
Cushingoid features
(2016): Matthews E+, Cochrane Database Syst Rev (5), CD003725 [REVIEW]
Cutaneous adverse reaction / severe cutaneous adverse drug reaction (SCAR)
(2013): Guillot B, Rev Med Interne (French) 34(5), 310-4 [REVIEW]
Hirsutism
(2016): Matthews E+, Cochrane Database Syst Rev (5), CD003725 [REVIEW]
Behavioral disturbances / personality changes
(2016): Matthews E+, Cochrane Database Syst Rev (5), CD003725 [REVIEW]
Cognitive impairment
(2017): Ismail MF+, Future Oncol 13(29), 2719 [REVIEW]
Depression
(2017): Ismail MF+, Future Oncol 13(29), 2719 [REVIEW]
(2011): Celano CM+, Dialogues Clin Neurosci 13(1), 109 [REVIEW]
Insomnia
(2017): Ismail MF+, Future Oncol [REVIEW]
Mania
(2017): Ismail MF+, Future Oncol 13(29), 2719 [REVIEW]
Mood changes
(2017): Ismail MF+, Future Oncol 13(29), 2719 [REVIEW]
Neuropsychiatric / neuropsychological adverse effect
(2020): Cole JL, Fed Pract 37(6), 260-267 [REVIEW]
Neurotoxicity
(2014): Prescrire Int 23(150), 153 (violent behavior)
Psychiatric adverse effect
(2019): Staub Y+, J Oncol Pharm Pract Oct, Epub ahead of print65–78%
Psychosis
(2021): Huynh G+, J Pharm Technol 37(2), 120-126 [REVIEW] (13 cases)
(2017): Ismail MF+, Future Oncol 13(29), 2719 [REVIEW]
Sleep disturbances
(2020): Cole JL, Fed Pract 37(6), 260-267 [REVIEW]
Diabetes mellitus
(2016): Broder MS+, Semin Arthritis Rheum 46(2), 246 [REVIEW]
Hyperglycemia (includes glucose increased)
(2020): Delfs N+, J Clin Med 9(12), E407934%
Hypoglycemia
(2020): Delfs N+, J Clin Med 9(12), E40794%
Weight gain
(2016): Matthews E+, Cochrane Database Syst Rev (5), CD003725 [REVIEW]
Gastrointestinal disorder / discomfort
(2019): Qian G+, Int Urol Nephrol March, Epub ahead of print [REVIEW]
Pancreatitis / acute pancreatitis
(2010): Lipsker D+, Dermatology 220 (3), 264
(2010): Ouakaa-Kchaou A+, Tunis Med 88 (2)
(2008): Bhavsar B+, JOP 9 (5), 664
(2008): Cagdas DN+, J Cardiovasc Pharmacol Ther 13 (4), 298
(2008): Tsuruoka K+, Nihon Jinzo Gakkai Shi 50 (7), 948
(2007): Fardet L+, Drug Saf 30 (10), 861
(2005): Trivedi CD+, J Clin Gastroenterol 39 (8), 709
(2003): Boruchowicz A+, Gastroenterol Clin Biol 27 (5), 560
Osteonecrosis / avascular necrosis
(2021): Zgheib NK+, Per Med Aug, Online ahead of print7% (grade 4)
Osteoporosis
(2021): Cho SK+, Endocrinol Metab (Seoul) Jun, Online ahead of print [REVIEW]
(2020): Ward LM, Front Endocrinol (Lausanne) Dec, eCollection
Tendinopathy/Tendon rupture
(2016): Knobloch K, Adv Exp Med Biol 920, 229
Cataract
(2016): Broder MS+, Semin Arthritis Rheum 46(2), 246 [REVIEW]
(2010): Habot-Wilner Z+, Acta Ophthalmol 88 (8), e299
(2010): Lee SW+, Acta Ophthalmol 88 (8), e344
(2010): Taylor JB+, J Child Neurol 25 (8), 1017
(2010): Thorne JE+, Ophthalmology 117 (7), 1436
(2009): Weatherall M+, Respirology 14 (7), 983
(2008): Nerome Y+, Pediatr Int 50 (4), 541
(2007): James ER, J Ocul Pharmacol Ther 23 (5), 403
(2006): Conti SM+, Curr Opin Ophthalmol 17 (3), 235
(2006): Ernst P+, Eur Respir J 27 (6), 1168
(2006): Gartlehner G+, Ann Fam Med 4 (3), 253
Chorioretinopathy
(2006): Bouyon A+, Rev Med Interne 27 (6), 487
Endophthalmitis
(2006): Conti SM+, Curr Opin Ophthalmol 17 (3), 235
Glaucoma
(2016): Broder MS+, Semin Arthritis Rheum 46(2), 246 [REVIEW]
(2010): Lee SW+, Acta Ophthalmol 88 (8), e344
(2007): El Afrit MA+, J Fr Ophtalmol 30 (1), 49
Pneumonia
(2016): Broder MS+, Semin Arthritis Rheum 46(2), 246 [REVIEW]
Adverse effects
(2021): Ma S+, Signal Transduct Target Ther 6(1), 83 [REVIEW] (passim)
(2021): Santiago T+, Rheumatology (Oxford) Jan, Online ahead of print [REVIEW]
(2020): Cheng W+, Front Pharmacol Sep, eCollection [REVIEW] (mild) (passim)
(2020): Sterne JAC+, JAMA Sep, Online ahead of print [REVIEW]
Adverse reactions attributed to entire drug class Corticosteroid, systemic
Bradycardia / sinus bradycardia
(2019): Duffy C+, J Pediatr Hematol Oncol Apr, Epub ahead of print98% (with induction chemotherapy)
Mania
(2021): Chen P+, Cureus 13(1), e12594 (1 case / female)
Neuropsychiatric / neuropsychological adverse effect
(2020): Cole JL, Fed Pract 37(6), 260-267 [REVIEW]
Sleep disturbances
(2020): Cole JL, Fed Pract 37(6), 260-267 [REVIEW]
Diabetes mellitus
(2015): Satyanarayanasetty D+, J Clin Diagn Res 9(5), Epub
Asthenia / fatigue
(2015): Satyanarayanasetty D+, J Clin Diagn Res 9(5), Epub
Osteoporosis
(2015): Satyanarayanasetty D+, J Clin Diagn Res 9(5), Epub
Cataract
(2015): Satyanarayanasetty D+, J Clin Diagn Res 9(5), Epub
Adverse effects
(2017): Aljebab F+, PLoS One 12(1), Epub [REVIEW]
Adverse reactions attributed to entire drug class Covid-19 putative drug
Cutaneous adverse reaction / severe cutaneous adverse drug reaction (SCAR)
(2020): Tursen U+, Dermatol Ther May, Epub ahead of print [REVIEW]
Cardiovascular adverse effect
(2020): Carpenter A+, Front Cardiovasc Med 7, 85 [REVIEW]
(2020): Giudicessi JR+, Mayo Clin Proc May, Online ahead of print [REVIEW]
(2020): Naksuk N+, Eur Heart J Acute Cardiovasc Care May, Epub ahead of print [REVIEW]
(2020): Sarayani A+, Res Social Adm Pharm Apr, Epub ahead of print [REVIEW]
(2020): Zhang D+, Zhongguo Zhong Yao Za Zhi (Chinese) 45(10), 2275-2286 [REVIEW]
Neuropsychiatric / neuropsychological adverse effect
(2021): Borah P+, Front Mol Biosci 8, 627723
(2020): García CAC+, Gen Hosp Psychiatry Jun, Online ahead of print [REVIEW]
Gastrointestinal disorder / discomfort
(2020): Sun J+, Clin Pharmacol Ther Apr, Epub ahead of print23%
Hepatic (liver) disorder / hepatic (liver) dysfunction
(2020): Sun J+, Clin Pharmacol Ther Apr, Epub ahead of print14%
Thrombocytopenia
(2020): Nham E+, Infect Chemother Apr, Epub ahead of print
Adverse effects
(2021): Bérard A+, PLoS One 16(5), e0251746 [REVIEW] (in pregnancy)
(2021): Cheng Q+, Aging (Albany NY) Sep, Online ahead of print [REVIEW]
(2021): Cruciani F+, Recenti Prog Med 112(3), 195-206 [REVIEW]
(2021): Ommati MM+, J Biochem Mol Toxicol May, Online ahead of print [REVIEW]
(2021): Qiu R+, Medicine (Baltimore) 100(16), e25532 [REVIEW]
(2021): Wu SS+, Chin Med J (Engl) Jul, Online ahead of print [REVIEW]
(2020): Favilli A+, J Matern Fetal Neonatal Med Jun, Online ahead of print [REVIEW]
(2020): Griffiths G+, Trials 21(1), 544
(2020): Patil VM+, Life Sci May, Epub ahead of print [REVIEW]
(2020): Rhodes NJ+, medRxiv Jun, Preprint
(2020): Sun J+, Clin Pharmacol Ther Apr, Epub ahead of print38%
(2020): Svensson M, Lakartidningen (Swedish) Apr, 117
(2020): Wen CY+, Zhonghua Nei Ke Za Zhi (Chinese) May, Epub ahead of print
(2020): Zekarias A+, Drug Saf Sep, Online ahead of print [REVIEW]
(2020): Zhong H+, Pharmacol Res Apr, Epub ahead of print [REVIEW]
Page last updated 08/02/2021
Symbol key
Incidence 
- <1%
- 1-5%
- 5-10%
- 10-15%
- 15-20%
- 20-30%
- >30%
Seriousness
- Hospitalization possible
- Life threatening
- Fatal
Warnings in other populations
- Breast feeding
- Geriatric
- Pediatric
