Elephant specific information, if available, is in blue.

METHYLPREDNISOLONE
METHYLPREDNISOLONE ACETATE
METHYLPREDNISOLONE SODIUM SUCCINATE
 

Note: For more information refer to the monograph: Glucocorticoids, General Information or to the manufacturer’s product information.

Chemistry – Also known as 6-alpha-methylprednislone , methylprednisolone is a syntheti­cally produced glucocorticoid. Both the free alcohol and the acetate ester occur as odor­less, white or practically white, crystalline powder. They are practically insoluble in water and sparingly soluble in alcohol.

Methylprednisolone sodium succinate occurs as an odorless, white or nearly white, hy­groscopic, amorphous solid. It is very soluble in both water and alcohol.

Storage/Stability/Compatibility – Commercially available products of methylpred­nisolone should be stored at room temperature (15-30°C); avoid freezing the acetate injec­tion. After reconstituting the sodium succinate injection, store at room temperature and use within 48 hours; only use solutions that are clear.

Methylprednisolone sodium succinate injection is reportedly compatible with the follow­ing fluids and drugs: amino acids 4.25%/dextrose 25%, amphotericin B (limited amounts), chloramphenicol sodium succinate, cimetidine HCl, clindamycin phosphate, dopamine HCl, heparin sodium, metoclopramide, norepinephrine bitartrate, penicillin G potassium, sodium iodide/aminophylline, and verapamil.

The following drugs and fluids have either been reported to be incompatible with methylprednisolone sodium succinate, compatible dependent upon concentration, or data conflicts: D5/half normal saline, D5 normal saline (80 mg/l reported compatible), D5W (up to 5 grams/L reported compatible), Lactated Ringer’s (up to 80 mg/L reported compatible), normal saline (data conflicts; some reports of up to 60 grams/liter compati­ble), calcium gluconate, cephalothin sodium (up to 500 mg/L in D5W or NS compatible), glycopyrrolate, insulin, metaraminol bitartrate, nafcillin sodium, penicillin G sodium and tetracycline HCl. Compatibility is dependent upon factors such as pH, concentration, tem­perature and diluents used. It is suggested to consult specialized references for more spe­cific information (e.g., Handbook on Injectable Drugs by Trissel; see bibliography).

Contraindications/Precautions – The manufacturer (Upjohn Veterinary) states that the drug (tablets) should not be used in dogs or cats “in viral infections, …animals with ar­rested tuberculosis, peptic ulcer, acute psychoses, corneal ulcer, and Cushinoid syndrome. The presence of diabetes, osteoporosis, chronic psychotic reactions, predisposition to thrombophlebitis, hypertension, CHF, renal insufficiency, and active tuberculosis necessi­tates carefully controlled use.”

The injectable acetate product is contraindicated as outlined above when used systemi­cally. When injected intrasynovially, intratendinously, or by other local means, it is con­traindicated in the “presence of acute local infections.”

Doses –

Horses:

As an antiinflammatory (glucocorticoid effects):

a)   Methylprednisolone: 0.5 mg/kg PO; Methylprednisolone sodium succinate: 0.5 mg/kg IV or IM (Robinson 1987)

b)   For labeled uses: Methylprednisolone acetate 200 mg IM repeated as necessary (Package insert; Depo-Medrol®—Upjohn) The manufacturer has specific di­rections for use of the drug intrasynovially. It is recommended to refer directly to the package insert for more information.

For shock:

a)   Methylprednisolone sodium succinate: 10 – 20 mg/kg IV (Robinson 1987)

Dosage Forms/Preparations/Approval Status/Withdrawal Times–

Veterinary-Approved Products: A 10 ppb tolerance has been established for methyl­prednisolone in milk.

Methylprednisolone Tablets 1 mg, 2 mg

Medrol®  (Upjohn), generic; (Rx)  Approved for use in dogs and cats.

Methylprednisolone Acetate Injection 20 mg/ml, 40 mg/ml

Depo-Medrol®  (Upjohn), generic; (Rx)  Approved for use in dogs, cats and horses.

Human-Approved Products:

Methylprednisolone Tablets 2 mg, 4 mg, 8 mg, 16 mg, 24 mg, 32 mg; Medrol® (Upjohn), generic; (Rx)

Methylprednisolone Acetate for Injection 20 mg/ml, 40 mg/ml, 80 mg/ml in 1, 5 & 10 ml vials; Depo-Medrol® (Upjohn) many other trade names and generically-labeled products are available; (Rx)

Methylprednisolone Sodium Succinate Powder for Injection: 40 mg/vial; 125 mg/vial; 500 mg/vial; 1000 mg/vial (62.5 mg/ml after reconstitution), 2000 mg/vial; Solu-Medrol®  (Upjohn), A-methaPred®  (Abbott), generic; (Rx)