Methylprednisolone: Effects, Uses & Risks

Methylprednisolone is an active substance from the class of glucocorticoids. The drug is available as an infusion solution, an injection solution, an ointment, or a cream.

What is methylprednisolone?

Methylprednisolone is available in tablet form, but it can also be used as an infusion or injection. For skin conditions, it is applied primarily in the form of ointments, creams, lotions, or solutions. Methylprednisolone is a white crystalline powder that is practically insoluble in water. It is commercially available in the form of monopreparations or combination preparations. Methylprednisolone belongs to the non-halogenated glucocorticoids. These are used primarily in cases of cortisone deficiency. However, since the active ingredient has a fairly broad spectrum of action, it can also be administered for other conditions, such as adrenocortical insufficiency, respiratory diseases, arthritis, or chronic inflammation of the stomach or intestines. Methylprednisolone is available in tablet form. However, the drug can also be used as an infusion or injection. For skin conditions, methylprednisolone is applied primarily in the form of ointments, creams, lotions, or solutions.

Pharmacologic action

Methylprednisolone is a glucocorticoid. Glucocorticoids bind to specific receptors in cells. As a result, they interfere with protein biosynthesis. They have an anti-inflammatory and antiproliferative effect. The immune system is inhibited and occurring immunological reactions are suppressed by the drug. Methylprednisolone is also suitable for the treatment of chronic respiratory diseases, as the active substance causes the mucous membranes of the immune system to decongest. The swelling is accompanied by a widening of the bronchial tubes. As a result, the affected patients can breathe much more easily. Glucocorticoids, such as methylprednisolone, are also directed against uncontrolled tissue proliferation. The growth of tissue is inhibited so that unwanted skin appendages do not continue to grow, but shrink or even disappear.

Medical application and use

Methylprednisolone has a decongestant and anti-inflammatory effect. It is therefore used, among other things, for the treatment of allergic diseases. Chronic asthma or allergic asthma are also possible indications for taking methylprednisolone. Other respiratory diseases treated with the drug include sinusitis, chronic obstructive pulmonary disease (COPD), sarcoidosis, allergic rhinitis and chronic bronchitis. Because the drug inhibits the activity of the immune system, autoimmune diseases are also treated with methylprednisolone. These include conditions such as vasculitis, arthritis, polyarthritis, psoriatic arthritis, and lupus erythematosus. Autoimmune, chronic inflammatory bowel diseases such as Crohn’s disease or ulcerative colitis are also treated with the aid of the active substance. The same applies to severe inflammation of the kidneys caused by an autoimmune reaction. Ointments and creams containing methylprednisolone can suppress allergic skin reactions and inflammation. The active ingredient is prescribed for skin diseases such as hives, atopic dermatitis, psoriasis, or contact dermatitis. Since methylprednisolone is a glucocorticoid, it can also be used in Addison’s disease (adrenocortical insufficiency). In this case, methylprednisolone compensates for the lack of endogenous cortisone.

Risks and side effects

Cortisone is usually administered only in doses that far exceed the natural level of cortisone in the blood. Side effects occur especially with prolonged treatment. Short-term applications are usually unproblematic. With methylprednisolone, it is difficult to draw the line between side effect and desired effect. For example, in some diseases the suppression of the immune system is desired, while in other diseases it represents a serious side effect. A typical side effect of cortisone intake is the so-called Cushing’s syndrome. It manifests itself as bull neck, facial redness, full moon face and exhaustion. When cortisone is taken, blood pressure rises and blood sugar levels also increase. The same is true for blood lipid levels. Due to the immunosuppressants, there may be an increased susceptibility to infections. Water retention in the tissue leads to weight gain. Furthermore, cortisone appears to increase the risk of osteoporosis if the patient is susceptible to it.Therefore, regular bone density measurements should be performed before and during prolonged cortisone therapy. If necessary, preventive measures such as taking vitamin D or calcium should be taken. Another side effect concerns the hormonal area. By taking methylprednisolone, the body stops its own hormone production in the adrenal glands. This condition only becomes problematic when the methylprednisolone is suddenly stopped. It takes some time for the body’s own production to start up again. If there is not enough endogenous cortisone available after discontinuation, a life-threatening cortisone deficiency can result. Therefore, cortisone should never be stopped suddenly, but always phased out in consultation with the treating physician. Other side effects of methylprednisolone include growth retardation in children, cardiac arrhythmias, and depression. Methylprednisolone should not be taken if there is hypersensitivity to the active ingredient. Hepatitis and diagnosed osteoporosis are also contraindications. The same applies to difficult-to-treat hypertension, diabetes mellitus, psychoses and infectious skin diseases. Suppression of the immune system would worsen these skin diseases. During pregnancy and breastfeeding, methylprednisolone should be taken only in exceptional cases, after consultation with a physician.