Methylprednisolone

Methylprednisolone

Systematic (IUPAC) name
(1S,2R,8S,10S,11S,14R,15S,17S)-14,17-dihydroxy-14-(2-hydroxyacetyl)-2,8,15-trimethyltetracyclo[8.7.0.02,7.011,15]heptadeca-3,6-dien-5-one
Clinical data
Trade names	Medrol, Meprolone
AHFS/Drugs.com	monograph
MedlinePlus	a682795
Licence data	US FDA:link
Pregnancy cat.	A(AU) C(US)
Legal status	POM (UK) ℞-only (US)
Routes	IV, IM, IV Infusion, Oral, Rectal, Topical
Pharmacokinetic data
Protein binding	78%
Metabolism	liver primarily, kidney, tissues; CYP450: 3A4 substrate
Half-life	urine; Half-life: 18-26h (biological)
Identifiers
CAS number	83-43-2 Y
ATC code	D07AA01 D07AC14, D10AA02, H02AB04
PubChem	CID 6741
DrugBank	APRD00342
ChemSpider	6485 Y
UNII	X4W7ZR7023 Y
KEGG	D00407 Y
ChEBI	CHEBI:6888 Y
ChEMBL	CHEMBL650 Y
Synonyms	(6α, 11β)-11,17,21-trihydroxy-6-methyl-pregna-1,4-diene-3,20-dione
Chemical data
Formula	C22H30O5
Mol. mass	374.471 g/mol
SMILES	eMolecules & PubChem
InChI InChI=1S/C22H30O5/c1-12-8-14-15-5-7-22(27,18(26)11-23)21(15,3)10-17(25)19(14)20(2)6-4-13(24)9-16(12)20/h4,6,9,12,14-15,17,19,23,25,27H,5,7-8,10-11H2,1-3H3/t12-,14-,15-,17-,19+,20-,21-,22-/m0/s1 Y Key:VHRSUDSXCMQTMA-PJHHCJLFSA-N Y
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Methylprednisolone is a synthetic glucocorticoid or corticosteroid drug. It is marketed in the USA and Canada under the brand names Medrol and Solu-Medrol.^[1] It is also available as a generic drug.

It is a variant of prednisolone, methylated at carbon 6 of the B ring.

Uses

Like most adrenocortical steroids, methylprednisolone is typically used for its anti-inflammatory effects. However, glucocorticoids have a wide range of effects, including changes to metabolism and immune responses. The list of medical conditions for which methylprednisolone is prescribed is rather long, and is similar to other corticosteroids such as prednisolone. Common uses include arthritis therapy and short-term treatment of bronchial inflammation or acute bronchitis due to various respiratory diseases. It is used both in the treatment of acute periods and long-term management of autoimmune diseases, most notably Systemic lupus erythematosus. Also for use as a treatment for Multiple Sclerosis.

Methylprednisolone is also prescribed for nonpenetrating spinal cord injuries. It has been shown that a dose of 30 mg/kg IV followed by IV drip at 5.4 mg/kg/hr for 23 hours improves sensory and motor recovery if given within eight hours of the injury.^{[citation needed]}

Methylprednisolone can be injected into the spinal cord by pain management specialists for the treatment of chronic pain caused by injuries or osteoarthritis.

It is also used for vestibular neuritis.^[2]

Side effects

Methylprednisolone has some serious side effects if taken long-term, including weight gain, glaucoma, osteoporosis and psychosis, especially when used at high dosage. The most serious side effect occurs after the adrenal glands cease natural production of cortisol, which methylprednisolone will replace. Abrupt cessation of the drug after this occurs can result in a condition known as Addisonian crisis, which can be fatal. To prevent this, the drug is usually prescribed with a tapering dosage, including a pre-dosed "dose pack" detailing a specific number of pills to take at designated times over a several-day period. Pharmacists sometimes advise that this drug can cause sleeplessness and "down" moods.

Additional images

• 

  4mg Methylprednisolone tablets by Sandoz

See also

• Guanacastepene A - also composed as C22H30O5

References

1. ^ Methylprednisolone - Compound Summary PubChem
2. ^ Strupp M, Zingler VC, Arbusow V, Niklas D, Maag KP, Dieterich M, Bense S, Theil D, Jahn K, Brandt T (July 2004). "Methylprednisolone, valacyclovir, or the combination for vestibular neuritis" (PDF). N. Engl. J. Med. 351 (4): 354–61. doi:10.1056/NEJMoa033280. PMID 15269315. http://www.nejm.org/doi/pdf/10.1056/NEJMoa033280. 

External links

• Medrol Prescribing Information Pfizer
• U.S. National Library of Medicine: Drug Information Portal - Methylprednisolone
• "methylprednisolone" at medicinenet.com