Dr. C P Ravi Kumar
Dr. C. P. Ravi Kumar Lead & Senior Consultant – Paediatric Neurology, The Krishna Institute of Medical Sciences (KIMS), Mahadevapura, Bangalore
What is methyl prednisolone?
Methylprednisolone is a steroid medicine used to treat conditions like asthma, allergies, arthritis, and other health issues. Swelling and inflammation will be reduced by calming down your immune system or replacing a hormone called cortisol that your body usually makes.
What is the mechanism of action of Methylprednisolone?
Corticosteroids work by entering cells, binding to specific receptors, and affecting gene activity. They influence many body functions, including metabolism of carbohydrates, proteins, and fats, as well as fluid and electrolyte balance. They also affect the heart, immune system, muscles, hormones, and nervous system. Additionally, corticosteroids reduce inflammation by limiting white blood cell movement and decreasing leaky blood vessels.
Different indications where methyl prednisolone helps in your treatment-
- Asthma, acute exacerbation
- Gout
- Inflammatory bowel disease
- Multiple sclerosis
There are various indications for which methylprednisolone is used in neurology, content below is based in this context.
How intravenous methylprednisolone assists in treating my child?
- Epileptic encephalopathy
- Multiple sclerosis
- Acute disseminated encephalomyelitis
Initially your doctor may keep your child with a high dose intravenous methyl prednisolone pulse therapy to treat above conditions.
What is methyl prednisolone pulse therapy mean?
Pulse therapy means giving a high dose of steroids through a vein for a few initial days which supports the treatment work faster and more effectively, while also reducing the risks of side effects from using steroids for a longer time.
What do I need to discuss with doctor when my child is on intravenous methylprednisolone?
- If your child is allergic to methylprednisolone or to any other drugs.
- If you are having surgery, including dental surgery, tell the doctor or dentist that you are receiving methylprednisolone injection.
- Any injuries or signs of infection, such as fever, sore throat, pain while urinating, or muscle aches, that occur during treatment.
- Ask about potential side effects, such as changes in mood, appetite, or sleep patterns, and what to look out for.
What precautions should be followed while my child is on intravenous methylprednisolone?
- Avoid getting any vaccinations, immunizations, or skin tests while taking methylprednisolone, unless your doctor advises you to do so.
- Keep regular appointments with your doctor to monitor the effects of the medication and make adjustments as necessary.
- Steroids can make your child’s body keep extra water, so make sure they drink enough fluids.
- Steroids can make your child hungrier. Make sure they eat a healthy diet with less salt and sugar, and check with the doctor if you need to adjust their meals.
- Since steroids can lower your child's ability to fight off germs, keep them away from sick people, have them wash their hands often, and call the doctor if they get a fever, sore throat, or cough.
What things should be checked while my child is on intravenous methylprednisolone?
Please note this is not an issue in short courses, like pulsed doses.
- 1. Creatinine levels: Methylprednisolone may lead to a sudden rise in serum creatinine (SCr) levels, which could be mistaken for a sign of worsening kidney function.
- 2. Blood sugar levels: This medication can increase your blood sugar, so if you have diabetes, ask your doctor if you need to adjust your diet or medication. Also, tell your doctor if your eyesight changes
- 3. Bone health: Long-term steroid use can affect your child's bones. Make sure they get enough calcium and vitamin D, and ask the doctor about checking their bone health.
What are the side effects of methyl prednisolone?
Every drug has their own side effects. But some may experience, and some do not have any side effects. Reach out to your doctor immediately if any of these symptoms are noted.
- 1. GI effects: ulcer, gastritis and dyspepsia
- 2. Infection: more prone to infections- your body's ability to fight off germs (like bacteria or viruses) is weaker than usual.
- 3. Hyperglycaemia: increased blood glucose levels
- 4. Osteoporosis: a condition where your bones become weak and brittle, making them more likely to break or fracture WHEN used for long duration meaning months / years.
- 5. Glaucoma: a condition that affects your eyes and can cause damage to the nerve that connects your eye to your brain.
- 6. Varicella or Chicken pox – If your child gets infected with chicken pox, then seek immediate doctors consultation in the nearest hospital.
Are there serious side effects with methylprednisolone?
Serious side effects are rare and these include:
- 1. Hypertension: increased blood pressure
- 2. Arrythmia: when your heart beats irregularly—either too fast, too slow, or in an uneven pattern.
- 3. Hypokalemia: when you don't have enough potassium in your blood causing weakness, tiredness, muscle cramps, or even heart problems.
- 4. Psychosis: you might see or hear things that aren’t there (like hallucinations), believe things that aren't true (like delusions), or have trouble thinking clearly
What foods do I need to avoid giving my child during intravenous methyl prednisolone?
Certain foods you need to avoid giving your child during methyl prednisolone treatment as they may increase the side effects of the medicine.
- 1. High sodium foods like fast foods, salty snacks and processed foods.
- 2. Avoid sugary foods and drinks, like soda, candy, and cakes, because they can cause your blood sugar to rise
- 3. Caffeine
What medicines to avoid during methyl prednisolone treatment?
This medication should not be taken with any of the following:
- 1. Anti-platelet medications
- 2. NSAIDS
- 3. Macrolide antibiotics (erythromycin, azithromycin)
- 4. Azole antifungal medications (ketoconazole, itraconazole)
Do not take any OTC/ herbal medications without informing to the doctor.
Is methyl prednisolone safe for pregnant and breast-feeding mothers?
Methylprednisolone can be used during pregnancy and breastfeeding, but only if clearly needed and under the strict guidance of a doctor.
SUMMARY:
Intravenous methylprednisolone is a powerful steroid used to treat various inflammatory and neurological conditions in children, including epileptic encephalopathy, multiple sclerosis, and acute disseminated encephalomyelitis. Administered as high-dose pulse therapy, it works quickly to reduce inflammation and support recovery while minimizing long-term side effects. Careful monitoring, appropriate diet, and attention to potential side effects are essential during treatment. With proper medical guidance, methylprednisolone can be a safe and effective therapy for managing serious conditions in children.
REFERENCE:
Author:
- Dr. Likitha B S, Pharm. D, Clinical Pharmacologist, Aster Hospitals, Bengaluru
- Dr Praveen Kumar, B. Pharm, Pharm D(PB), Lead Clinical Pharmacologist, REGIONAL HEAD KIMS Hospitals, Bengaluru
- Dr. C. P. Ravi Kumar Lead & Senior Consultant – Paediatric Neurology KIMS HOSPITALS BENGALURU
