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Treatments > Medications Used In MS


Brand Name Chemical Name

Solu-Medrol
(U.S. and Canada)

Methylprednisolone
(meth-ill-pred-niss-oh-lone)

Primary Usage in MS

Generic Available
Acute exacerbations Yes (U.S. and Canada)

Description
Methylprednisolone is one of a group of corticosteroids (cortisone-like medications) that are used to relieve inflammation in different parts of the body. Corticosteroids are used in MS for the management of acute exacerbations because they have the capacity to close the damaged blood-brain barrier and reduce inflammation in the central nervous system. Although methylprednisolone is among the most commonly used corticosteroids in MS, it is only one of several possibilities. Other commonly used corticosteroids include dexamethazone, prednisone, betamethasone, and prednisolone. The following information pertains to all of the various corticosteroids.

Proper Usage
Most neurologists treating MS believe that high-dose corticosteroids given intravenously are the most effective treatment for an exacerbation, although the exact protocol for the drug's use may differ somewhat from one treating physician to another. Patients generally receive a four-day course of treatment (either in the hospital or as an outpatient), with doses of the medication spread throughout the day. This high-dose, intravenous steroid treatment is then typically followed by a gradually tapering dose of an oral corticosteroid (see Prednisone).

Precautions
Since corticosteroids can stimulate the appetite and increase water retention, it is advisable to follow a low-salt and/or potassium-rich diet and watch your caloric intake. Your physician will make specific dietary recommendations for you.

Corticosteroids can lower your resistance to infection and make any infection that you get more difficult to treat. Contact your physician if you notice any sign of infection, such as sore throat, fever, coughing, or sneezing.

Avoid close contact with anyone who has chicken pox or measles. Tell your physician right away if you think you have been exposed to either of these illnesses. Do not have any immunizations after you stop taking this medication until you have consulted your physician. People living in your home should not have the oral polio vaccine while you are being treated with corticosteroids since they might pass the polio virus on to you.

Corticosteroids may affect the blood sugar levels of diabetic patients. If you notice a change in your blood or urine sugar tests, be sure to speak to your physician.

The risk of birth defects for women taking corticosteroids is not known. Overuse of corticosteroids during pregnancy may slow the growth of the infant after birth. Animal studies have demonstrated that corticosteroids cause birth defects.

Corticosteroids pass into breast milk and may slow the infant's growth. If you are nursing or plan to nurse, be sure to discuss this with your physician. It may be necessary for you to stop nursing while taking this medication.

Corticosteroids may produce mood changes and/or mood swings of varying intensity. These mood alterations can vary from relatively mild to extremely intense, and can vary in a single individual from one course of treatment to another. Neither the patient nor the physician can predict with any certainty whether the corticosteroids are likely to precipitate these mood alterations. If you have a history of mood disorders (depression or bipolar disorder, for example), be sure to share this information with your physician. If you begin to experience mood changes or swings that feel unmanageable, contact your physician so that a decision can be made about whether or not you need an additional medication to help you until the mood alterations subside.

Possible Side Effects
Side effects that may go away as your body adjusts to the medication and do not require medical attention unless they continue or are bothersome: increased appetite; indigestion; nervousness or restlessness; trouble sleeping; headache; increased sweating; unusual increase in hair growth on body or face.

Less common side effects that should be reported as soon as possible to your physician: severe mood changes or mood swings; decreased or blurred vision*; frequent urination*.

Additional side effects that can result from the prolonged use of corticosteroids and should be reported to your physician: acne or other skin problems; swelling of the face; swelling of the feet or lower legs; rapid weight gain; pain in the hips or other joints (caused by bone cell degeneration); bloody or black, tarry stools; elevated blood pressure; markedly increased thirst (with increased urination indicative of diabetes mellitus); menstrual irregularities; unusual bruising of the skin; thin, shiny skin; hair loss; muscle cramps or pain. Once you stop this medication after taking it for a long period of time, it may take several months for your body to readjust.

* Since it may be difficult to distinguish between certain common symptoms of MS and some side effects of methylprednisolone, be sure to consult your health care professional if an abrupt change of this type occurs.

Medication Index


Other Medications Used to Treat Acute Exacerbations

A true exacerbation of MS is caused by an area of inflammation in the central nervous system (CNS). It is also known as a relapse, an attack, or a flareup.

The treatment most commonly used to control exacerbations is intravenous, high-dose corticosteroids.

Plasmapheresis (Plasma Exchange)
Only considered for the 10% or so who do not respond well to the standard steroid treatment.


Reprinted with permission from Rosalind C. Kalb (ed.), Multiple Sclerosis: The Questions You Have—The Answers You Need, 3rd Edition. New York: Demos Medical Publishing, Inc., 2004

Last updated September 21, 2006

     
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