How long do side effects of medrol dose pack last?

Medrol Dosepak Side Effects

Generic Name: methylprednisolone

Medically reviewed by Drugs.com. Last updated on Jan 10, 2019.

  • Overview
  • Side Effects
  • Dosage
  • Interactions
  • Pregnancy
  • More

Note: This document contains side effect information about methylprednisolone. Some of the dosage forms listed on this page may not apply to the brand name Medrol Dosepak.

For the Consumer

Applies to methylprednisolone: oral tablet

Other dosage forms:

  • injection powder for solution, injection solution, injection suspension

Along with its needed effects, methylprednisolone (the active ingredient contained in Medrol Dosepak) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking methylprednisolone:

Incidence not known

  • Black, tarry stools
  • blindness
  • bloating
  • bloody vomit
  • blurred vision
  • bone pain
  • change in vision
  • chest pain
  • chills
  • confusion
  • constipation
  • cough
  • dark urine
  • darkening of the skin
  • decrease in height
  • decrease in the amount of urine
  • decreased range of motion
  • decreased vision
  • diarrhea
  • difficulty in swallowing
  • dilated neck veins
  • dizziness or lightheadedness
  • dry mouth
  • extreme tiredness or weakness
  • eye pain
  • eye tearing
  • eyeballs bulge out of the eye sockets
  • fainting
  • feeling of constant movement of self or surroundings
  • fever
  • flushed, dry skin
  • fruit-like breath odor
  • full or bloated feeling
  • headache
  • heartburn
  • hives, itching, skin rash
  • impaired wound healing
  • increased hunger
  • increased thirst
  • increased urination
  • indigestion
  • irregular breathing
  • irregular heartbeat
  • joint pain
  • limp
  • loss of appetite
  • loss of consciousness
  • lower back or side pain
  • mental depression
  • mood changes
  • muscle pain, cramps, or weakness
  • nausea
  • nervousness
  • noisy, rattling breathing
  • numbness or tingling in the hands, feet, or lips
  • pain in the back, ribs, arms, or legs
  • pain or burning in the throat
  • pain or swelling in the arms or legs without any injury
  • painful or difficult urination
  • painful, swollen joints
  • pains in the stomach, side, or abdomen, possibly radiating to the back
  • pounding in the ears
  • pressure in the stomach
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • seizures
  • sensation of spinning
  • severe or continuing stomach pain
  • slow growth in children
  • slow or fast heartbeat
  • sores, ulcers, or white spots on the lips or tongue or inside the mouth
  • swelling of the face, fingers, feet, abdominal or stomach area, or lower legs
  • tearing
  • tightness in the chest
  • troubled breathing
  • troubled breathing at rest
  • unexplained weight loss
  • unusual tiredness or weakness
  • vomiting
  • vomiting of material that looks like coffee grounds
  • yellow eyes or skin

Some side effects of methylprednisolone may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known

  • Abnormal fat deposits on the face, neck, and trunk
  • acne
  • bruising
  • dry scalp
  • increased sweating
  • large, flat, blue or purplish patches in the skin
  • lightening of normal skin color
  • menstrual changes
  • reddish purple lines on the arms, face, legs, trunk, or groin
  • redness of the face
  • small, red or purple spots on the skin
  • swelling of the stomach area
  • thin, fragile skin
  • thinning of the scalp hair

For Healthcare Professionals

Applies to methylprednisolone: compounding powder, injectable powder for injection, injectable suspension, oral tablet

General

The most commonly occurring side effects have included fluid retention, alteration in glucose tolerance, increased blood pressure, behavioral and mood changes, increased appetite, and weight gain; the incidence generally correlates with dosage, timing of administration, and duration of treatment.

Hypersensitivity

Frequency not reported: Allergic or hypersensitivity reactions; anaphylactoid reaction, anaphylaxis, angioedema, bronchospasm

A European review describes cases of allergic reactions, including bronchospasm and anaphylaxis, in patients allergic to cows milk proteins receiving injectable methylprednisolone products containing lactose of bovine origin. In most cases, the patients were younger than 12 years old and had childhood asthma. In some cases, the reaction was mistaken as lack of efficacy, and additional doses of were give with subsequent worsening of the patients condition. The European Union has recommended lactose-containing methylprednisolone products be reformulated to remove any trace of milk proteins by 2019.

Cardiovascular

Frequency not reported: Bradycardia, cardiac arrest, cardiac arrhythmias, cardiac enlargement, circulatory collapse, congestive heart failure, fat embolism, hypertension, hypertrophic cardiomyopathy in premature infants, myocardial rupture following recent myocardial infarction, syncope, tachycardia, thromboembolism, thrombophlebitis, vasculitis, edema, hypotension

Endocrine

Frequency not reported: Cushingoid state, hirsutism, secondary adrenocortical and pituitary unresponsiveness (particularly in times of stress, as in trauma, surgery, or illness), moon face

Gastrointestinal

Frequency not reported: Abdominal distention, nausea, pancreatitis, peptic ulcer, perforation of the small and large intestine, ulcerative esophagitis, gastric hemorrhage, vomiting, abdominal pain, diarrhea, dyspepsia, nausea

Hepatic

Reversible transaminase elevations (AST, ALT) have been observed following corticosteroid therapy. These changes have generally been small and not associated with any clinical syndrome. Toxic hepatitis has been reported with high doses of cyclically pulsed IV therapy, onset has been several weeks or longer. Resolution has been reported with discontinuation; however, recurrence has been reported with rechallenge.

Frequency not reported: Hepatomegaly, elevation in liver enzymes, toxic hepatitis

Metabolic

Frequency not reported: Decreased carbohydrate and glucose tolerance, manifestations of latent diabetes, hypokalemic alkalosis, potassium loss, sodium retention, increased appetite, negative nitrogen balance due to protein catabolism, weight gain, metabolic acidosis, dyslipidemia, lipomatosis

Musculoskeletal

Frequency not reported: Suppression of growth in pediatric patients, aseptic necrosis of femoral and humeral heads, calcinosis, Charcot-like atrophy, loss of muscle mass, muscle weakness, osteoporosis, pathologic fracture of long bones, postinjection flare, steroid myopathy, tendon rupture, particularly of the Achilles tendon, vertebral compression fractures, myalgia, muscle atrophy, osteonecrosis, neuropathic arthralgia, growth retardation

Hematologic

Frequency not reported: Leucocytosis

Immunologic

Frequency not reported: Opportunistic infection

Ocular

Frequency not reported: Exophthalmos, glaucoma, increased intraocular pressure, posterior subcapsular cataracts, blindness, chorioretinopathy

Blindness has been reported with corticosteroid injection to scalp, tonsillar fauces, sphenopalatine ganglion.

Psychiatric

Frequency not reported: Depression, emotional instability, euphoria, insomnia, mood swings, personality changes, psychic disorders, confusional states, anxiety, abnormal behavior, irritability

Dermatologic

Frequency not reported: Acne, allergic dermatitis, cutaneous and subcutaneous atrophy, dry scaly skin, ecchymosis, petechiae, erythema, hyperpigmentation, hypopigmentation, impaired wound healing, increased sweating, rash, sterile abscess, striae, suppressed reactions to skin tests, thin fragile skin, thinning scalp hair, urticaria, hypertrichosis, angioedema, skin atrophy, hyperhidrosis, pruritus

Local

Frequency not reported: Injection site infections, injection site reactions

Nervous system

Frequency not reported: Convulsions, headache, increased intracranial pressure with papilledema (pseudotumor cerebri) usually following discontinuation of treatment, neuritis, neuropathy, paresthesia, amnesia, dizziness

Other

Frequency not reported: Vertigo, abnormal fat deposits, malaise, sterile abscess, impaired healing, fatigue

Oncologic

Frequency not reported: Kaposi’s sarcoma

Respiratory

Frequency not reported: Pulmonary edema, pulmonary embolism, hiccups

Genitourinary

Frequency not reported: Menstrual irregularities, increased or decreased motility and number of spermatozoa, increased urine calcium, glycosuria

1. “Product Information. Solu-Medrol (methylprednisolone).” Pharmacia & Upjohn, Kalamazoo, MI.

2. “Product Information. Medrol (methylprednisolone).” Pharmacia and Upjohn, Kalamazoo, MI.

3. “Product Information. Depo-Medrol (methylPREDNISolone acetate).” Pfizer U.S. Pharmaceuticals Group, New York, NY.

4. Cerner Multum, Inc. “UK Summary of Product Characteristics.” O 0

5. “Product Information. Solu-Medrol (methylPREDNISolone sodium succinate).” Pfizer U.S. Pharmaceuticals Group, New York, NY.

6. Cerner Multum, Inc. “Australian Product Information.” O 0

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.

Related questions

  • How long does methylprednisolone stay in your system?
  • Methylprednisolone – How long does a Medrol pack stay in your system?
  • Methylprednisolone vs Prednisone – What’s the difference between them?
  • Medrol Dosepak – How long does a dose pack stay in your system?

Medical Disclaimer

More about Medrol Dosepak (methylprednisolone)

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  • Drug class: glucocorticoids
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Consumer resources

  • Medrol Dosepak
  • Medrol Dosepak (Advanced Reading)

Other brands: Medrol, Solu-Medrol, MethylPREDNISolone Dose Pack, Depo-Medrol, … +2 more

Professional resources

  • Methylprednisolone Sodium Succinate (AHFS Monograph)
  • … +1 more

Related treatment guides

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Oral Steroids and Back Pain

Oral steroids, or corticosteroids taken by mouth, are prescription anti-inflammatory medications that have been commonly prescribed for various orthopaedic conditions, including low back and neck pain. While these drugs can reduce pain and inflammation, they also have potential serious side effects that you should discuss with your doctor.

Corticosteroids can be administered in numerous ways, though injection and oral forms are the two most commonly used for spine pain. This article describes the basics of oral steroids, which come in tablets, capsules, or syrups.

Corticosteroids can be administered in numerous ways, though injection and oral forms are the two most commonly used for spine pain. Photo Source: 123RF.com.

How Oral Steroids Work

Oral steroids are designed to work in the same way as the hormones produced by your adrenal glands in response to stress and injury. When the corticosteroids you take raise your body’s natural adrenal hormones above their normal levels, this reduces inflammation. Corticosteroids also suppress your immune system, which helps people who suffer from autoimmune conditions (such as rheumatoid arthritis) but can also decrease your ability to fight infection.

Oral Steroids: General Dosing Information

Below are examples of oral steroids (generic names are listed first, and a brand name example is in parentheses):

  • Methylprednisolone (Medrol)
  • Prednisone (Deltasone)
  • Dexamethasone (Decadron)

Oral steroids are generally prescribed for a limited time—typically 1 or 2 weeks. In most cases, you will take your strongest dose on the first day of therapy and taper down until you do not have any medication left.

  • For example: You might take 7 oral steroid pills on day 1, 6 pills on day 2, and so on until you reach 1 pill a day. Then, at the end of the week (or second week), you take no more medication.

Oral steroids are prescribed in shorter doses because of their strength and potential side effects. You can learn more about that below.

Who Should Take Oral Steroids?

With a shorter course of therapy, these medications may help ease painful inflammation associated with severe acute back and neck pain (pain that arises and resolves quickly, though it may last up to 3-6 months). Oral steroids may also help with painful flare-ups common with chronic inflammatory diseases, such as rheumatoid arthritis. Common conditions treated with oral steroids include low back pain and herniated discs.

Oral Steroids Strengths and Weaknesses

Among the biggest benefits of oral steroids is that they offer relief from pain and inflammation without the invasiveness of their injected counterparts. Unlike spinal injections, oral steroids do not require MRI or radiation exposure, and may pose less of a risk for some patients. Spinal injections, however, deliver a more concentrated dose of corticosteroids with a lower degree of systemic (whole body) side effects.

Oral steroids do have some drawbacks, though. Compared to steroid injections, it takes longer for oral forms to take effect. Oral steroids also impact your entire body—not a single area like an injected form. Because of this, oral steroids carry more significant side effects than other delivery methods.

Possible side effects may include:

  • Weight gain
  • Elevated blood pressure
  • Increased eye pressure (glaucoma)
  • Swollen legs
  • Psychological changes, such as mood swings, memory loss, and behavioral changes
  • Sleep difficulties

It is a long-held belief that short-term use of oral steroids provides protection against more serious side effects. However, a recent study published in April 2017 in the BMJ found that adults using oral steroids had a two-fold increased risk of fractures, a three-fold increased risk for venous thromboembolism, and a five-fold increased risk of sepsis within 30 days of starting the medication. The study authors recommend using the lowest dose of oral steroid possible to reduce the potential for these complications.1 In addition, there are no well-design studies that have supported the effectiveness of oral steroid medications for neck and low back pain.

If oral steroids are required as a long-term treatment—such as in treatment of certain inflammatory disorders (eg, lupus, ankylosing spondylitis)—you should be aware of the following side effects that may occur with prolonged use:

  • Slower wound healing and increased skin bruising
  • Increased infection risk
  • Clouding or blurred vision
  • High blood sugar
  • Osteoporosis and fractures
  • Avascular necrosis of bone (death of bone due to lack of blood supply)

Safely Using Oral Steroids for Spine Pain

Oral steroids are prescription-only medications. During your visit with your doctor, ask about the side effects and complications associated with these drugs. Also, make sure you understand exactly how to properly use your oral steroid, as it may be on a tapered schedule in contrast to a simple one-pill-per-day regimen.

Safely using your drug means using it exactly as your doctor prescribes. If you have questions about how to use your oral steroid, call your doctor or speak to your pharmacist when you pick up your prescription.

Oral steroids can be an adjunct to reduce pain and inflammation from back or neck pain (particularly from a pinched nerve) when other treatments have failed, but it is essential to use them as your doctor orders to prevent potentially harmful side effects. If you complete your course of medication and find that, your pain is still interfering with your quality of life, talk to your doctor about other treatments (such as physical therapy, spinal injections, etc.) that you may explore.

View Sources

Reference
1. Waljee AK, Rogers MAM, Lin P, Singal AG, et al. Short term use of oral corticosteroids and related harms among adults in the United States: population based cohort study. BMJ 2017;357:j1415.

Steroids and Sinusitis

What are steroids?

When ENT surgeons speak of steroids, we are generally referring to corticosteroids, which are produced naturally in the adrenal glands to help suppress bodily inflammation and cope with stress and anxiety. Cortisol and synthetic steroids such as prednisone reduce swelling, prevent the migration of white blood cells, and stabilize the membrane of cells that release inflammatory mediators. Other types of steroids include aldosterone, which is also produced in the adrenal gland and controls the balance of sodium and potassium in the body, and the sex steroids, which control secondary sex characteristics and reproduction. Anabolic steroids abused by athletes are a form of testosterone, a sex steroid.

Steroids are commonly used by otolaryngologists to treat:

  • Allergies
  • Asthma
  • Sinusitis
  • Nasal polyps
  • Ear infections
  • Sudden hearing loss

Oral Steroids

A short course of prednisone or methylprednisolone will almost certainly make you feel better. Steroids boast your energy level, alleviate pain and nausea, block allergies, reduce swelling, shrink nasal polyps, alleviate asthma, and can even restore hearing in some patients with sudden deafness. However, steroids must be used with caution, because they can have significant addictive potential and cause serious side effects – especially with long-term use. For this reason, oral or systemic steroids are reserved for the most urgent uses, and topical or local steroids are preferred.

Risks of Systemic Steroids

Steroids are the most effective anti-inflammatory drugs available, and are derivatives of natural hormones which the body creates to help the body cope with injury or stress. However, prolonged use of oral or systemic steroids can result in suppression of normal steroid levels in the body. Therefore, these medications should be taken exactly as prescribed, usually in a gradually decreasing dose, to avoid sudden withdrawal. Withdrawal symptoms are uncommon in patients who have used steroids for less than two weeks at a time. Continued or repeated use of steroids can reduce your ability to fight infection and can result in weight gain, fluid retention, acne, increased body hair, purple marks on the abdomen, collection of fatty deposits under the skin, and easy bruising. High doses of steroids will frequently cause nervousness, sleeplessness, excitation, and sometimes depression or confusion. Steroids can also cause elevation of blood sugar or blood pressure or change in salt balance. Prolonged steroids can cause thinning of the bones, muscle weakness, glaucoma, and cataracts. They can aggravate ulcers. Patients who are pregnant, have a history of stomach ulcers, glaucoma, diabetes, high blood pressure, tuberculosis, osteoporosis, or recent vaccination, should not take steroids unless absolutely necessary. A very rare complication of steroids is interruption of the blood supply to the hip bone which can result in a fracture that requires a hip replacement.

Fortunately, all of these complications are extremely rare in patients treated with short-term doses of steroids. If your doctor has prescribed systemic steroids, he or she has likely judged that the risk of these complications is outweighed by the potential benefit for the treatment of your disease. If you have any questions about this information or the instructions on how to take your steroids, please speak with your doctor before you begin the medication.

Alternatives to systemic steroids include topical applications to the nose, skin, lung or ear, so that the systemic dose – that which distributes through the body – is greatly reduced. Topical steroids greatly reduce the risk of prolonged use of steroids.

Doc. Roach: Steroids and antibiotics prescribed together: the new trend?

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Dear Dr. Roach: In late spring of 2016, I had a sinus infection and was prescribed an antibiotic and prednisone. I was told that the steroid would increase the effectiveness of the antibiotic. After reading the patient insert for prednisone, I elected to take only the antibiotic, with excellent results.

Since that time, three of my friends also were prescribed antibiotics by three different doctors for various conditions; all were also prescribed prednisone to take with it. Two of them did take the prednisone, resulting in really unpleasant side effects.

This week I went to another doctor, was diagnosed with acute nasopharyngitis and was told to take an antibiotic and prednisone. When I said I didn’t want to take the prednisone, the doctor informed me that he NEVER prescribes antibiotics without prednisone.

I was prescribed clindamycin and methylprednisolone. I again elected not to take the steroid.

Can you tell me if this dual prescribing is a widespread medical trend or just a local one? Is there really a good reason for prescribing antibiotics and prednisone together, and am I being foolish not to follow doctor’s orders?

E.D.

Dear E.D.: There have been two recent systematic reviews on the use of oral steroids, such as prednisone or methylprednisolone, in combination with antibiotics in treatment of acute sinusitis. These studies have shown a speedier recovery in those taking the combination of steroids and antibiotics than in those who take antibiotics alone, and I suspect that is why your doctors, and those of your friends, have been prescribing them.

However, there is a downside to steroids, as you note. It’s not just the unpleasant immediate side effects, such as jitteriness and difficulty sleeping; steroids can have serious side effects in the short term (confusion and even psychosis are well known). In the long term, the list of possible side effects is very long, so the benefit must always be weighed against the possible harm.

This is particularly the case in people at high risk for side effects, such as diabetics (in whom sugar levels routinely go up when taking steroids) or those with high blood pressure (which often is exacerbated by steroid use).

Personally, I prefer to use nasal steroids in combination with antibiotics. They have many of the benefits of oral steroids with few of the side effects. Nasal steroids don’t work as quickly as oral steroids, however.

In any case, I can’t condone you not following your doctor’s recommendations. I certainly do recommend that you have a discussion about the benefits versus the harms, and I’d also recommend that you ask about nasal steroids.

Dear Dr. Roach: I have read that atrial fibrillation gives you a greater chance of getting dementia. Do you agree?

K.N.

Dear K.N.: People with atrial fibrillation are at higher-than-average risk for developing dementia. However, it’s not clear if the atrial fibrillation causes dementia or whether it is because some of the risks for developing dementia are also risks for developing atrial fibrillation. What is clear is that people who are not treated well for atrial fibrillation (specifically, those people whose anticoagulation dosage is frequently too much or too little) have a greater risk for dementia than those whose atrial fibrillation is well-controlled. This is yet another reason that both patients and doctors should take particular care with anticoagulation. It isn’t clear whether the newer anticoagulant drugs will have less risk of dementia.

Email questions to [email protected]

Methylprednisolone vs Prednisone: Main Differences and Similarities

Methylprednisolone and prednisone are two corticosteroid medications that can be used to treat a variety of conditions. As corticosteroids, they primarily act as anti-inflammatory and immunosuppressive agents for allergic, respiratory, and autoimmune conditions. They work by modifying glucocorticoid receptors and suppressing mediators responsible for inflammation in the body. Both medications have similar side effects with differences in their formulations and strengths.

Methylprednisolone

Methylprednisolone is the generic name for Medrol, Solu-Medrol, and Depo-Medrol. Medrol is the oral tablet form while Solu-Medrol is the sterile powder form which can be used for intravenous or intramuscular injection. Depo-Medrol is an injectable suspension which can be administered into the muscle, joint, or directly into soft tissue. This may make it more suitable for certain applications such as acute pain from arthritis of the knee.

Methylprednisolone is slightly more potent than prednisone. Approximately 4 mg of methylprednisolone equates to 25 mg of cortisone, a natural steroid produced in the body. Oral methylprednisolone comes in oral tablets with strengths of 2 mg, 4 mg, 8 mg, 16 mg, and 32 mg. The injectable formulations come in varying strengths and must be administered by a healthcare provider.

Prednisone

Prednisone is the generic name for Deltasone and Rayos. Deltasone is the immediate release oral tablet and Rayos is the extended release oral tablet. Prednisone is a prodrug that is metabolized in the liver to form prednisolone. Unlike methylprednisolone, approximately 5 mg of prednisone equates to 25 mg of cortisone. Therefore, it is slightly less potent. Prednisone comes in oral tablets with strengths of 1 mg, 2.5 mg, 5 mg, 10 mg, 20 mg, and 50 mg. An oral solution is also available in a 5 mg/1 mL strength which may make it suitable for individuals who have trouble swallowing.

Methylprednisolone vs Prednisone Side by Side Comparison

Methylprednisolone and prednisone are two oral corticosteroids with many similarities and differences. These can be explored in detail below.

Methylprednisolone Prednisone
Prescribed For
  • Allergic conditions
  • Dermatologic diseases
  • Endocrine conditions
  • Gastrointestinal diseases
  • Hematologic diseases
  • Neoplastic conditions
  • Nervous system conditions
  • Ophthalmic conditions
  • Conditions related to organ transplantation
  • Pulmonary diseases
  • Renal conditions
  • Rheumatologic conditions
  • Specific infectious diseases
  • Allergic conditions
  • Dermatologic diseases
  • Endocrine conditions
  • Gastrointestinal diseases
  • Hematologic diseases
  • Neoplastic conditions
  • Nervous system conditions
  • Ophthalmic conditions
  • Conditions related to organ transplantation
  • Pulmonary diseases
  • Renal conditions
  • Rheumatologic conditions
  • Specific infectious diseases
Drug Classification
  • Corticosteroid
  • Corticosteroid
Manufacturer
  • Generic
  • Generic
Common Side Effects
  • Fluid retention
  • Altered glucose tolerance
  • New onset or worsened diabetes
  • High blood pressure
  • Behavioral and mood changes
  • Agitation
  • Insomnia
  • Increased appetite
  • Weight gain
  • Fluid retention
  • Altered glucose tolerance
  • New onset or worsened diabetes
  • High blood pressure
  • Behavioral and mood changes
  • Agitation
  • Insomnia
  • Increased appetite
  • Weight gain
Is there a generic?
  • Methylprednisolone is the generic name
  • Prednisone is the generic name
Is it covered by insurance?
  • Varies according to your provider
  • Varies according to your provider
Dosage Forms
  • Oral tablet
  • Injectable suspension
  • Oral tablet
  • Oral tablet, extended release
  • Oral solution
Average Cash Price
  • $28 (per 24 tablets)
  • $112 (per 20 tablets)
SingleCare Discount Price
  • Methylprednisolone Price
  • Prednisone Price
Drug Interactions
  • NSAIDs
  • Antidiabetic agents
  • Barbiturates
  • Phenytoin
  • Carbamazepine
  • Rifampin
  • Ketoconazole
  • Macrolide antibiotics
  • Erythromycin
  • Cyclosporine
  • Amphotericin-B
  • Aminoglutethimide
  • Isoniazid
  • Diuretics
  • Anticholinesterase agents
  • Cholestyramine
  • Digoxin
  • Estrogens
  • Oral contraceptives
  • Skin tests
  • Vaccines
  • Warfarin
  • Anticoagulants
  • NSAIDs
  • Antidiabetic agents
  • Barbiturates
  • Phenytoin
  • Carbamazepine
  • Rifampin
  • Ketoconazole
  • Macrolide antibiotics
  • Erythromycin
  • Cyclosporine
  • Amphotericin-B
  • Aminoglutethimide
  • Isoniazid
  • Diuretics
  • Anticholinesterase agents
  • Cholestyramine
  • Digoxin
  • Estrogens
  • Oral contraceptives
  • Skin tests
  • Vaccines
  • Warfarin
Can I use while planning pregnancy, pregnant, or breastfeeding?
  • Methylprednisolone is in Pregnancy Category C. Animal studies have shown adverse effects to the fetus. Adequate studies have not been performed in humans. Consult a doctor regarding steps to take while pregnant. Methylprednisolone should not be taken while breastfeeding.
  • Prednisone is in Pregnancy Category D. Therefore, it should not be taken during pregnancy. Consult a doctor regarding steps to take while planning pregnancy. Prednisone should not be taken while breastfeeding.

Summary

Both methylprednisolone and prednisone are common corticosteroids that can be used for different conditions. They work primarily to reduce inflammation and immune response in the body for different diseases. Because of the way corticosteroids work, they can cause side effects such as insomnia or worsened diabetes. It is important to take note of other drugs that may interact with these medications as they can increase the potential for adverse effects. Liver impairment should be a concern when dosing corticosteroids due to the way they are metabolized.

While both drugs have similar effects, methylprednisolone is more potent than prednisone. It also comes in an injectable formulation for more direct treatment for conditions such as arthritis. On the contrary, prednisone comes in an oral solution which may be preferable for some individuals. Always consult a physician when initiating treatment with any of these drugs. An adequate consultation and assessment is needed to properly prescribe and administer an oral corticosteroid like methylprednisolone or prednisone.

Medrol

Precautions

Before taking methylprednisolone, tell your doctor or pharmacist if you are allergic to it; or to prednisone; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: bleeding problems, blood clots, brittle bones (osteoporosis), diabetes, eye diseases (such as cataracts, glaucoma, herpes infection of the eye), heart problems (such as recent heart attack, congestive heart failure), high blood pressure, current/past infections (such as those caused by tuberculosis, threadworm, herpes, fungus), kidney disease, liver disease, mental/mood conditions (such as psychosis, depression, anxiety), stomach/intestinal problems (such as diverticulitis, ulcer, ulcerative colitis), seizures.

This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Talk to your doctor if you are using marijuana (cannabis).

This medicine may cause stomach bleeding. Daily use of alcohol while using this medicine may increase your risk for stomach bleeding. Limit alcoholic beverages. Consult your doctor or pharmacist for more information.

Methylprednisolone can make you more likely to get infections or may worsen any current infections. Therefore, wash your hands well to prevent the spread of infection. Avoid contact with people who have infections that may spread to others (such as chickenpox, measles, flu). Consult your doctor if you have been exposed to an infection or for more details.

This medication may cause vaccines to not work as well. Live vaccines may cause serious problems (such as infection) if given while you are using this medication. Do not have immunizations/vaccinations/skin tests without the consent of your doctor. Avoid contact with people who have recently received live vaccines (such as flu vaccine inhaled through the nose).

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Using corticosteroid medications for a long time can make it more difficult for your body to respond to physical stress. Therefore, before having surgery or emergency treatment, or if you get a serious illness/injury, tell your doctor or dentist that you are using this medication or have used this medication within the past 12 months. Tell your doctor right away if you develop unusual/extreme tiredness or weight loss. If you will be using this medication for a long time, carry a warning card or medical ID bracelet that identifies your use of this medication. See also Medical Alert section.

Older adults may be more sensitive to the side effects of this drug, especially brittle bones (osteoporosis). Talk to your doctor about the ways to prevent osteoporosis. See also Notes section.

This medication may slow down a child’s growth if used for a long time. Consult the doctor or pharmacist for more details. See the doctor regularly so your child’s height and growth can be checked.

During pregnancy, this medication should be used only when clearly needed. It may rarely harm an unborn baby. Discuss the risks and benefits with your doctor. Infants born to mothers who have been using this medication for a long time may have hormone problems. Tell your doctor right away if you notice symptoms such as persistent nausea/vomiting, severe diarrhea, or weakness in your newborn.

This medication passes into breast milk, but is unlikely to harm a nursing infant. Consult your doctor before breast-feeding.

How is Sinusitis treated?

After diagnosing sinusitis and identifying a possible cause, your doctor can suggest treatments that will reduce your inflammation and relieve your symptoms.

In cases of acute sinusitis – your doctor may recommend:

  • Topical or oral decongestants to reduce congestion
  • Antibiotics to control a bacterial infection, if present
  • An oral corticosteroid, to decrease congestion and inflammation, and help the antibiotic work better.

In our office, it is common practice to give all patients a “sinusitis flow sheet”, which they follow strictly. Patients should avoid using over the counter decongestant nose drops for longer than 5 to 7 days, as they can lead to even more congestion and swelling. Patient commonly refer to this phenomenon as “addiction” to nose sprays.

Many cases of acute sinusitis will spontaneously resolve without antibiotics. If you have allergic disease along with infectious sinusitis, however, you may need medicine to relieve your allergy symptoms also. If you are a patient who suffers from asthma, keep in mind that an acute sinus infection usually worsens asthma symptoms, and can

Chronic sinusitis treatment

Doctors often find it difficult to treat chronic sinusitis successfully, realizing that symptoms persist even after taking antibiotics for a long period. In our office, we have to become really creative in devising different methods getting the medication to its site of action. In general, treating chronic sinusitis is no different than treating acute sinusitis with antibiotics and decongestants. Because inflammation plays such an important role in chronic sinusitis, doctors also add topical corticosteroid nasal sprays (e.g. Flonase, Nasonex, Nasacort AQ, Rhinocort AQ, Veramyst, Omnaris) which are used daily. Depending on the origin and predisposing factors, oral prednisone or methylprednisolone (Medrol dose pack) can be added.
Also, various combinations of oral antihistamines and leukotriene modifiers (Singulair, Zyflo) can be used. In our office, we have devised a method of direct, concentrated delivery of topical corticosteroid drops to the sinuses, thereby reducing the overall need for oral corticosteroids.
Because oral corticosteroids tend to have a wide range of side effects, it is prudent to use them with caution. In many severe cases, however, oral corticosteroid preparations are absolutely essential for proper resolution of the sinus infection.

Patients with moderate to severe asthma may have dramatic improvement of their symptoms when their chronic sinusitis is treated with antibiotics, lending more support for the “one airway” hypothesis.

Home Remedies

Although home remedies cannot cure a sinus infection, they might give you some comfort. Inhaling steam from a vaporizer or a hot cup of water can soothe inflamed sinus cavities. Numerous studies have demonstrated the effectiveness saline nasal sprays or rinses (Netti-pot or commercially available preparations) when used as part of a general sinus care routine. Gentle heat applied over the inflamed area can also be very comforting. There are numerous folk remedies used for sinusitis too.

Surgical treatment

When medical treatment fails, sinus surgery may be the only alternative for treating chronic sinusitis. Research studies suggest that the vast majority of people who undergo surgery have fewer symptoms and better quality of life.
In children, sinus infections can often be eliminated by removal of adenoids obstructing nasal-sinus passage drainage.

Nasal polyps which are more prevalent in people with allergies or chronic sinus infections can also interfere with sinus drainage, thereby leading to repeat bouts of sinusitis. Removal of these polyps and/or repair of a deviated septum to ensure an open airway often provides considerable relief from sinus symptoms.

The most common sinus surgery done today is functional endoscopic sinus surgery (FESS), in which the natural openings from the sinuses are enlarged to allow proper drainage. This type of surgery is less invasive than conventional sinus surgery, and serious complications are rare.

What Conditions does Medrol Treat?

  • sarcoidosis
  • a type of cancer of the lymph nodes called Hodgkin’s lymphoma
  • non-Hodgkin’s lymphoma
  • decreased platelets due to a disease state or a drug
  • inflammation of the heart with rheumatic fever
  • contact dermatitis
  • a type of skin rash that occurs from contact with an offending substance
  • pemphigus
  • a type of skin disorder
  • inflammation of skin and muscles all over the body
  • rheumatoid arthritis
  • a type of lymphoma involving the skin called mycosis fungoides
  • increased calcium in the blood from cancer
  • destruction of red blood cells by body’s own antibodies
  • eye inflammation
  • Crohn’s disease
  • systemic lupus erythematosus
  • an autoimmune disease
  • inflammation of the sac surrounding the joint – bursitis
  • low platelet count and bleeding from immune response
  • inflammation of the nose due to an allergy
  • beryllium poisoning
  • nephrotic syndrome
  • a type of kidney disorder
  • skin rash with sloughing
  • psoriasis associated with arthritis
  • psoriasis
  • thyroid gland inflammation
  • adrenogenital disorder
  • decreased function of the adrenal gland
  • infiltration of white blood cells into the lungs
  • ankylosing spondylitis
  • a rheumatic disease causing pain and stiffness in backbone
  • inflammation of the elbow and surrounding tissue
  • a hypersensitivity reaction to a drug
  • rejection of a transplanted organ
  • acute lymphoid leukemia
  • acute inflammation of the joints due to gout attack
  • erythema multiforme
  • a type of allergic skin reaction
  • inflammation of the lining of a joint
  • anemia from too few young red blood cells
  • asthma
  • aspiration pneumonitis
  • or lung inflammation due to inhaled gastric contents
  • inflammatory bowel disease
  • a type of allergy that causes red and itchy skin called atopic dermatitis
  • joint inflammatory disease in children and young adults
  • any disease following trauma involving joint cartilage
  • inflammation of a tendon
  • inflammation of the covering of a tendon
  • follicular lymphoma
  • acute exacerbation of multiple sclerosis
  • a condition where the adrenal glands produce less hormones called Addison’s disease
  • a type of allergic reaction called angioedema
  • miliary tuberculosis
  • infection caused by the trichinae parasite
  • diagnostic test for Cushing’s syndrome
  • Diamond Blackfan anemia
  • chronic inflammatory skin disease marked by blisters
  • joint capsule membrane inflammation of a diseased joint
  • a serum sickness reaction
  • increase in cell growth of adrenal gland present at birth
  • polyarteritis nodosa
  • pemphigoid
  • a blistering skin disorder
  • inflammation of the blood vessels
  • increased calcium in the blood from sarcoidosis
  • pseudogout
  • a joint disease with sudden attacks of joint pain
  • nasal polyp
  • a type of skin condition with redness and itching called eczema
  • muscle pain and stiffness in the shoulder
  • neck and pelvis
  • inflammation of the artery in the temple area
  • a sensitivity to gluten called celiac disease
  • rheumatic fever
  • inflammation of the heart
  • obstructive pulmonary disease
  • multiple myeloma
  • inflammation of the covering of the heart or pericardium

If you’ve got a sinus infection, you probably want to get rid of it pretty fast. And you may have heard that a Z-Pak can knock it out. But not so fast. A Z-Pak isn’t always your best option, depending on what type of sinus infection you have.

What is the Z-Pak used to treat?

The Z-Pak is a 5-day course of azithromycin (Zithromax), an antibiotic. It’s used to treat certain bacterial infections, including some sinus infections and upper respiratory tract infections that lead to headaches, sore throat, congestion, and runny noses.

Because it’s so easy to use, the Z-Pak is often a go-to prescription for sinus infections. But it turns out that only a minority of these prescriptions are appropriate because the majority of sinus infections are viral and not bacterial. In fact, studies have found that about a third of antibiotic prescriptions for sinus infections, sore throats, and ear infections aren’t even necessary. Overprescribing the Z-Pak increases the chance that bacteria will become resistant to azithromycin and disrupts the gut bacterial flora for months.

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When is a Z-Pak good for a sinus infection?

First, if you have a sinus infection, expect to feel lousy for several days. After all, your body is waging war against an infection. You might get a runny nose, sneezing, nasal congestion, sore throat, and a cough. You’re also likely to feel more tired and achy, and maybe even experience a low-grade fever. Most people improve within a week, but symptoms can last up to 2 weeks. Coughs can linger for a week after that.

Treating a sinus infection boils down to whether it’s viral or bacterial. Colds, for example, are viral. And antibiotics like the Z-Pak are not effective against viral infections. In fact, viral sinus infections have no cure. Treatment is aimed at managing symptoms and includes:

  • Getting plenty of rest and drinking lots of fluids
  • Inhaling steam from a vaporizer or shower to help you breathe easier
  • Zinc lozenges, which can shorten and lessen the severity of a cold if you take them in the first 24 hours of getting symptoms
  • Pain medications like acetaminophen (Tylenol) or ibuprofen (Advil) to help with fever, muscle aches, and throat pain
  • Decongestants like loratadine/pseudoephedrine (Claritin-D) or pseudoephedrine (Sudafed) to relieve sinus congestion and runny nose

If you still don’t feel better, your doctor may suggest nasal or lung inhalers for other symptoms.

The only way to really tell if you have a viral or bacterial sinus infection is to see a doctor and possibly get some tests run. With viral infections, you’ll have to let the illness run its course.

What are the side effects of a Z-Pak?

Common side effects of azithromycin are usually gastrointestinal, like nausea, stomach pain, constipation, and diarrhea. Serious side effects like allergic reactions, dizziness, and chest pain are rare.

A note about cardiovascular risk: Though the FDA warning from 2013 remains—that azithromycin use may be associated with an increased risk for ventricular arrhythmia, a type of irregular heartbeat, compared to taking nothing—a 2017 study of over 14 million people found no increased risk of arrhythmia with azithromycin compared to amoxicillin, another commonly prescribed antibiotic.

When should I see a doctor for a sinus infection?

See a doctor right away if you develop any of these symptoms:

  • A temperature above 101°F
  • A fever that lasts longer than 2 days
  • Severe or persistent headache, ear pain, sinus pain, or chest pain
  • A prolonged cough, a cough that brings up blood, or wheezing

– – –

Hang in there.

Dr O.

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