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Methylprednisolone (Depo-Medrol, Medrol, Solu-Medrol) is a synthetic glucocorticoid, primarily prescribed for its anti-inflammatory and immunosuppressive effects. [4] [5] [6] It is either used at low doses for chronic illnesses or used concomitantly at high doses during acute flares.
[6] [7] [8] Applying once daily is enough as it is as effective as twice or more daily application. [9] To prevent tachyphylaxis, a topical steroid is often prescribed to be used on a week on, week off routine. Some recommend using the topical steroid for 3 consecutive days on, followed by 4 consecutive days off. [10]
50 mg hydrocortisone IV: 25 mg of hydrocortisone every eight hours for 24 hours. Resume usual dose thereafter. Major surgical stress (eg, esophagogastrectomy, total proctocolectomy, open heart surgery) 100 mg hydrocortisone IV: 50 mg every eight hours for 24 hours. Taper dose by half per day to maintenance level.
Prednisone is a prodrug and must be converted to prednisolone by the liver before it becomes active. [6] [7] Prednisolone then binds to glucocorticoid receptors, activating them and triggering changes in gene expression. [4] Prednisone was patented in 1954 and approved for medical use in the United States in 1955.
6.5 – 1.3 Fludrocortisone acetate: 15 200 24 Deoxycorticosterone acetate: 0 20 – Aldosterone: 0.3 200–1000 – Beclometasone: 8 sprays 4 times every day equivalent to orally 14 mg prednisone once a day – –
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The most commonly prescribed oral steroid is prednisone, which is typically dosed at 0.5 mg/kg for induction of remission in Crohn's disease. [5] Intravenous steroids, administered in a hospital setting, are used when oral steroids do not work or cannot be taken. [4]
[7] [8] [6] It differs from the similarly named prednisone in having a hydroxyl at the 11th carbon instead of a ketone. Common side effects with short-term use include nausea, difficulty concentrating, insomnia, increased appetite, and fatigue. [5] More severe side effects include psychiatric problems, which may occur in about 5% of people. [9]