Methylprednisolone

Adults: The usual range is 2 to 48 mg daily in divided doses, depending on the disease being treated. Initial dosage for anti-inflammatory or immunosuppressive use: the starting dose of Methylprednisolone tablets may vary from 4 to 48 mg per day, depending on the specific disease. In less severe conditions lower doses will generally be enough, while some patients may need higher initial doses. The initial dose should be kept or adjusted until a satisfactory response is seen. If there is no satisfactory response after a reasonable period, Methylprednisolone should be stopped and the patient moved to other appropriate therapy. Dosage requirements vary, so they must be individualized on the basis of the disease under treatment and how the patient responds. Maintenance dosage for anti-inflammatory or immunosuppressive use: once a favorable response is seen, the proper maintenance dose is found by lowering the initial dose in small steps at suitable time intervals, until the lowest dose that still maintains an adequate clinical response is reached. The dose needs constant monitoring. If the drug is to be stopped after long-term therapy, it is recommended that it be withdrawn gradually rather than abruptly. Multiple Sclerosis: in acute exacerbations of multiple sclerosis, daily doses of 160 mg of Methylprednisolone for a week, followed by 64 mg every other day for 1 month, have been shown to be effective. Methylprednisolone 4 mg tablet can be used to treat and control severe allergy and dermatitis. The guideline below should be followed to minimize steroid withdrawal syndromes. Day 1: 2 tablets before breakfast + 1 tablet after lunch + 1 tablet after dinner + 2 tablets at bedtime Day 2: 1 tablet before breakfast + 1 tablet after lunch + 1 tablet after dinner + 2 tablets at bedtime Day 3: 1 tablet before breakfast + 1 tablet after lunch + 1 tablet after dinner + 1 tablet at bedtime Day 4: 1 tablet before breakfast + 1 tablet after lunch + 1 tablet at bedtime Day 5: 1 tablet before breakfast + 1 tablet at bedtime Day 6: 1 tablet before breakfast Alternate-day therapy (ADT) Alternate-day therapy is a corticosteroid regimen in which twice the usual daily dose of corticoid is given every other morning. It is meant for patients who need long-term treatment at pharmacologic doses. They get the beneficial effects of corticoids, while certain unwanted effects are kept to a minimum. These include pituitary-adrenal suppression, Cushingoid state, Corficoid withdrawal symptoms, and growth suppression in children. Several points apply when alternate-day therapy is being considered. The basic principles and indications for corticosteroid therapy still apply. The technique is mainly meant for patients in whom long-term pharmacologic corticoid therapy is expected. In less severe disease where corticoid therapy is indicated, it may be possible to start treatment with alternate-day therapy. More severe disease usually needs daily divided high-dose therapy to bring the disease under initial control. The initial suppressive dose should be continued until a satisfactory clinical response is obtained, usually four to ten days in many allergic and collagen diseases.