dications initial dosage will vary from 10 to 40 mg of methylprednisolone depending on the clinical problem being treated. The larger doses may be required for short-term management of severe, acute conditions. The initial dose usually should be given intravenously over a period of several minutes. Subsequent doses may be given intravenously or intramuscularly at intervals dictated by the patient's response and clinical condition. Corticoid therapy is an adjunct to, and not replacement for conventional therapy.
Dosage may be reduced for infants and children but should be governed more by the severity of the condition and response of the patient than by age or size. It should not be less than 0.5 mg per kg every 24 hours.
Dosage must be decreased or discontinued gradually when the drug has been administered for more than a few days. If a period of spontaneous remission occurs in a chronic condition, treatment should be discontinued. Routine laboratory studies, such as urinalysis, two-hour postprandial blood sugar, determination of blood pressure and body weight, and a chest X-ray should be made at regular intervals during prolonged therapy. Upper GI X-rays are desirable in patients with an ulcer history or significant dyspepsia.
SOLU-MEDROL may be administered by intravenous or intramuscular injection or by intravenous infusion, the preferred method for initial emergency use being intravenous injection. To administer by intravenous (or intramuscular) injection, prepare solution as directed. The desired dose may be administered intravenously over a period of several minutes. If desired, the medication may be administered in diluted solutions by adding Water for Injection or other suitable diluent (see below) to the Act-O-Vial and withdrawing the indicated dose.
To prepare solutions for intravenous infusion, first prepare the solution for injection as directed. This solution may then be added to indicated amounts of 5% dextrose in water, isotonic saline solution or 5% dextrose in isotonic saline solution.
Multiple Sclerosis
In treatment of acute exacerbations of multiple sclerosis, daily doses of 200 mg of prednisolone for a week followed by 80 mg every other day for 1 month have been shown to be effective (4 mg of methylprednisolone is equivalent to 5 mg of prednisolone).
DIRECTIONS FOR USING THE ACT-O-VIAL SYSTEM
Press down on plastic activator to force diluent into the lower compartment.
Gently agitate to effect solution.
Remove plastic tab covering center of stopper.
Sterilize top of stopper with a suitable germicide.
Insert needle squarely through center of stopper until tip is just visible. Invert vial and withdraw dose.
STORAGE CONDITIONS
Protect from light.
Store unreconstituted product at controlled room temperature 20° to 25°C (68° to 77°F) [see USP].
Store solution at controlled room temperature 20° to 25°C (68° to 77°F) [see USP].
Use solution within 48 hours after mixing.
HOW SUPPLIED
SOLU-MEDROL Sterile Powder is available in the following packages:
40 mg Act-O-Vial System (Single-Dose Vial)
25 ×1 mL NDC 0009-0039-32
125 mg Act-O-Vial System (Single-Dose Vial)
25 × 2 mL NDC 0009-0047-26
REFERENCES
1Fekety R. Infections associated with corticosteroids and immunosuppressive therapy. In: Gorbach SL, Bartlett JG, Blacklow NR, eds. Infectious Diseases. Philadelphia: WBSaunders Company 1992:10
