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Methylprednisolone Side Effects

For the Consumer

For Healthcare Professionals

Applies to methylprednisolone: compounding powder, injectable powder for injection, injectable suspension, oral tablet

General

The most commonly occurring side effects have included fluid retention, alteration in glucose tolerance, increased blood pressure, behavioral and mood changes, increased appetite, and weight gain; the incidence generally correlates with dosage, timing of administration, and duration of treatment.[Ref]

Hypersensitivity

Frequency not reported: Allergic or hypersensitivity reactions; anaphylactoid reaction, anaphylaxis, angioedema, bronchospasm[Ref]

A European review describes cases of allergic reactions, including bronchospasm and anaphylaxis, in patients allergic to cows milk proteins receiving injectable methylprednisolone products containing lactose of bovine origin. In most cases, the patients were younger than 12 years old and had childhood asthma. In some cases, the reaction was mistaken as lack of efficacy, and additional doses of were give with subsequent worsening of the patients condition. The European Union has recommended lactose-containing methylprednisolone products be reformulated to remove any trace of milk proteins by 2019.[Ref]

Cardiovascular

Frequency not reported: Bradycardia, cardiac arrest, cardiac arrhythmias, cardiac enlargement, circulatory collapse, congestive heart failure, fat embolism, hypertension, hypertrophic cardiomyopathy in premature infants, myocardial rupture following recent myocardial infarction, syncope, tachycardia, thromboembolism, thrombophlebitis, vasculitis, edema, hypotension[Ref]

Endocrine

Frequency not reported: Cushingoid state, hirsutism, secondary adrenocortical and pituitary unresponsiveness (particularly in times of stress, as in trauma, surgery, or illness), moon face[Ref]

Gastrointestinal

Frequency not reported: Abdominal distention, nausea, pancreatitis, peptic ulcer, perforation of the small and large intestine, ulcerative esophagitis, gastric hemorrhage, vomiting, abdominal pain, diarrhea, dyspepsia, nausea[Ref]

Hepatic

Reversible transaminase elevations (AST, ALT) have been observed following corticosteroid therapy. These changes have generally been small and not associated with any clinical syndrome. Toxic hepatitis has been reported with high doses of cyclically pulsed IV therapy, onset has been several weeks or longer. Resolution has been reported with discontinuation; however, recurrence has been reported with rechallenge.[Ref]

Frequency not reported: Hepatomegaly, elevation in liver enzymes, toxic hepatitis[Ref]

Metabolic

Frequency not reported: Decreased carbohydrate and glucose tolerance, manifestations of latent diabetes, hypokalemic alkalosis, potassium loss, sodium retention, increased appetite, negative nitrogen balance due to protein catabolism, weight gain, metabolic acidosis, dyslipidemia, lipomatosis[Ref]

Musculoskeletal

Frequency not reported: Suppression of growth in pediatric patients, aseptic necrosis of femoral and humeral heads, calcinosis, Charcot-like atrophy, loss of muscle mass, muscle weakness, osteoporosis, pathologic fracture of long bones, postinjection flare, steroid myopathy, tendon rupture, particularly of the Achilles tendon, vertebral compression fractures, myalgia, muscle atrophy, osteonecrosis, neuropathic arthralgia, growth retardation[Ref]

Hematologic

Frequency not reported: Leucocytosis[Ref]

Immunologic

Frequency not reported: Opportunistic infection[Ref]

Ocular

Frequency not reported: Exophthalmos, glaucoma, increased intraocular pressure, posterior subcapsular cataracts, blindness, chorioretinopathy[Ref]

Blindness has been reported with corticosteroid injection to scalp, tonsillar fauces, sphenopalatine ganglion.[Ref]

Psychiatric

Frequency not reported: Depression, emotional instability, euphoria, insomnia, mood swings, personality changes, psychic disorders, confusional states, anxiety, abnormal behavior, irritability[Ref]

Dermatologic

Frequency not reported: Acne, allergic dermatitis, cutaneous and subcutaneous atrophy, dry scaly skin, ecchymosis, petechiae, erythema, hyperpigmentation, hypopigmentation, impaired wound healing, increased sweating, rash, sterile abscess, striae, suppressed reactions to skin tests, thin fragile skin, thinning scalp hair, urticaria, hypertrichosis, angioedema, skin atrophy, hyperhidrosis, pruritus[Ref]

Local

Frequency not reported: Injection site infections, injection site reactions[Ref]

Nervous system

Frequency not reported: Convulsions, headache, increased intracranial pressure with papilledema (pseudotumor cerebri) usually following discontinuation of treatment, neuritis, neuropathy, paresthesia, amnesia, dizziness[Ref]

Other

Frequency not reported: Vertigo, abnormal fat deposits, malaise, sterile abscess, impaired healing, fatigue[Ref]

Oncologic

Frequency not reported: Kaposi's sarcoma[Ref]

Respiratory

Frequency not reported: Pulmonary edema, pulmonary embolism, hiccups[Ref]

Genitourinary

Frequency not reported: Menstrual irregularities, increased or decreased motility and number of spermatozoa, increased urine calcium, glycosuria[Ref]

References

1. "Product Information. Solu-Medrol (methylprednisolone)." Pharmacia & Upjohn, Kalamazoo, MI.

2. "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn, Kalamazoo, MI.

3. "Product Information. Depo-Medrol (methylPREDNISolone acetate)." Pfizer U.S. Pharmaceuticals Group, New York, NY.

4. "Product Information. Solu-Medrol (methylPREDNISolone sodium succinate)." Pfizer U.S. Pharmaceuticals Group, New York, NY.

5. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

6. Cerner Multum, Inc. "Australian Product Information." O 0

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.

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