Methylprednisolone Sodium Succinate (SOLU-MEDROL ®)

Methylprednisolone sodium succinate (often just called “Methylprednisolone”) is a glucocorticoid. Glucocorticoids are a type of steroid hormone produced by the adrenal gland. Synthetic (man-made) forms of steroids, including methylprednisolone, are used primarily to decrease inflammation. Methylprednisolone is used to treat a variety health issues including severe allergic reactions, asthma, autoimmune diseases, blood disorders, gastrointestinal diseases and endocrine disorders. In oncology, it is most often used to treat nausea and vomiting during chemotherapy, prevent medication reactions, or as part of a chemotherapy regimen.

How to take Methylprednisolone

Methylprednisolone is given as either an intravenous infusion (IV, directly into a vein) or as an intramuscular injection (as an injection directly into a muscle). The dose, method of administration, and how often you receive it depends on why you are taking the methylprednisolone.

This medication can interact with other medications including certain antibiotics, oral anticoagulants, cyclosporine, NSAIDS, estrogen, and ketoconazole. It is important to speak to your provider about all medications you are taking, including prescribed medications, over-the-counter medications and any herbal remedies you are taking.

You, or anyone you live with, should avoid having live or live-attenuated vaccines while receiving this medication. These include herpes zoster (Zostavax) for shingles prevention, oral polio, measles, nasal flu vaccine (FluMist®), rotovirus and yellow fever vaccines.

Possible Side Effects of Methylprednisolone

There are a number of things you can do to manage the side effects of methylprednisolone sodium succinate. Talk to your healthcare team about these recommendations. They can help you decide what will work best for you. These are some of the most common or important side effects:

Increase in Appetite

This medication can cause you to be hungrier or thirstier than usual. Drink plenty of fluids and try to make your snacks healthy ones.

Nausea and Heartburn

Taking methylprednisolone with food or milk is generally enough to prevent nausea and heartburn. If possible, take the medication when you can be upright (not lying down) for a few hours after the dose. Avoid things that worsen the symptoms, and try antacids (milk of magnesia and calcium tablets, like Tums), saltines, or ginger ale to lessen symptoms.

High Blood Sugar

This medication can cause elevated blood sugar levels in patients with and without diabetes. Your oncology care team will monitor your blood sugar. If you develop increased thirst, urination or hunger, blurry vision, headaches or your breath smells like fruit, notify your healthcare team. Diabetics should monitor their blood sugar closely and report elevations to the healthcare team.

GI Bleed & Tear

This medication can cause bleeding or a tear in the intestinal wall. Signs of these problems are unexpected bleeding, blood in the stool or black stools, coughing up blood, vomiting blood, vomit that looks like coffee grounds, fever, severe pain in the abdomen (belly) or new abdominal swelling. If you have any of these, call your care team right away or go to the emergency room.

Heart Problems

This medication can cause a number of heart problems including lower or higher than normal heart rate, syncope, arrhythmias, congestive heart failure, heart attack, pulmonary edema, and thromboembolism. Notify your healthcare provider if you have sudden weight gain or swelling in the ankles or legs. If you develop chest pain or pressure, pain in the left arm, back, or jaw, sweating, shortness of breath, clammy skin, nausea, dizziness or lightheadedness, call 911 or go to the nearest emergency room.

Skin Changes

This medication can cause changes in the skin including acne, allergic dermatitis (inflammation of the skin), burning and tingling at the injection site, bruising, petechiae (little red dots), swelling, redness, changes in skin color, delayed wound healing and rash. Long-term use can lead to thinning of the skin. Use an alcohol free moisturizer on your skin and lips; avoid moisturizers with perfumes or scents. If your skin does crack or bleed, be sure to keep the area clean to avoid infection. Be sure to notify your healthcare provider of any rash that develops, as this can be a reaction. They can give you more tips on caring for your skin.

Irritability or Change in Mood

Some patients report feeling irritable or noticing a change in their mood while taking methylprednisolone. If this becomes difficult to handle or if you feel like you may harm yourself or others, contact your healthcare provider immediately.

Increased Risk of Infection

This medication can lower your ability to fight new and current infections. Contact your provider if you are experiencing any signs of infections including fever, chills, sore throat or cold, cough or burning with urination.

Tips to preventing infection:

• Washing hands, both yours and your visitors, is the best way to prevent the spread of infection.
• Avoid large crowds and people who are sick (i.e.: those who have a cold, fever or cough or live with someone with these symptoms).
• When working in your yard, wear protective clothing including long pants and gloves.
• Do not handle pet waste.
• Keep all cuts or scratches clean.
• Shower or bathe daily and perform frequent mouth care.
• Do not cut cuticles or ingrown nails. You may wear nail polish, but not fake nails.
• Ask your doctor or nurse before scheduling dental appointments or procedures.
• Ask your doctor or nurse before you, or someone you live with, has any vaccinations.

Allergic Reaction

Severe allergic reactions, including anaphylaxis have been reported with this medication. Notify your provider immediately if you experience itching, rash, heart palpitations or trouble breathing after this medication is administered.

Liver Injury

In rare cases, methylprednisolone sodium succinate can cause liver injury including hepatitis and liver dysfunction, especially when used in high doses. Your healthcare team will monitor your liver function using blood tests call liver function tests. Notify your healthcare provider if you notice yellowing of the skin or eyes, your urine appears dark or brown, or you have pain in your abdomen, as these can be signs of liver toxicity.

Other Side Effects

This medication can also cause dizziness, seizures, headaches, abdominal distension, muscle weakness, “moon face” (swelling of the face), and vision problems. Notify your provider if you experience any of these side effects.

Reproductive Concerns

Exposure of an unborn child to this medication could cause birth defects in rare cases, so you should not become pregnant or father a child while on this medication. Even if your menstrual cycle stops or you believe you are not producing sperm, you could still be fertile and conceive. You should consult with your healthcare team before breastfeeding while receiving this medication.