Methylprednisolone

The Basics

What is Methylprednisolone?

Used to treat conditions such as arthritis, blood disorders, severe allergic reactions, certain cancers, eye conditions, skin/kidney/intestinal/lung diseases, and immune system disorders.

Brand names for Methylprednisolone

Medrol

How Methylprednisolone is classified

Corticosteroids – Systemic, Glucocorticoids, Anti-Inflammatory Agents

Methylprednisolone During Pregnancy

Methylprednisolone pregnancy category

Category CNote that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.

What we know about taking Methylprednisolone while pregnant

N/A

Taking Methylprednisolone While Breastfeeding

What are recommendations for lactation if you're taking Methylprednisolone?

Amounts of methylprednisolone in breastmilk are very low. No adverse effect have been reported in breastfed infants with maternal use of any corticosteroid during breastfeeding. With maternal intravenous doses of methylprednisolone 1 gram, fully breastfed infants would receive doses less than their daily cortisol output, and much less than a therapeutic dose on the day of infusion; accumulation of the drug does not occur in breastmilk with 3 consecutive daily doses. Avoiding breastfeeding during the infusion for as little as 2 hours after a 1 gram intravenous dose would markedly reduce infant exposure. Breastfeeding abstinence for 2 to 4 hours would further reduce the infant dose. Local injections, such as for tendinitis, would not be expected to cause any adverse effects in breastfed infants, but might occasionally cause temporary loss of milk supply.

Maternal / infant drug levels

Amounts of methylprednisolone in breastmilk are very low. No adverse effect have been reported in breastfed infants with maternal use of any corticosteroid during breastfeeding. With maternal intravenous doses of methylprednisolone 1 gram, fully breastfed infants would receive doses less than their daily cortisol output, and much less than a therapeutic dose on the day of infusion; accumulation of the drug does not occur in breastmilk with 3 consecutive daily doses. Avoiding breastfeeding during the infusion for as little as 2 hours after a 1 gram intravenous dose would markedly reduce infant exposure. Breastfeeding abstinence for 2 to 4 hours would further reduce the infant dose. Local injections, such as for tendinitis, would not be expected to cause any adverse effects in breastfed infants, but might occasionally cause temporary loss of milk supply.

Possible effects of Methylprednisolone on milk supply

A patient who was 6 weeks postpartum and predominantly breastfeeding her infant received 24 mg of depot methylprednisolone plus 15 mg of lidocaine intralesionally for tenosynovitis of the wrist. Thirty hours after the injection, lactation ceased. Her breasts were soft and not engorged at that time. Thirty-six hours later, lactation resumed slowly, reaching normal milk production 24 hours later. The author hypothesized that the suppression might have occurred because the injection was in a highly mobile joint, which might have caused rapid release of the corticosteroid.[11] Large doses of triamcinolone injected into the shoulder and into the wrist have also been reported to cause temporary drop or cessation of lactation.[12][13]

A study of 46 women who delivered an infant before 34 weeks of gestation found that a course of another corticosteroid (betamethasone, 2 intramuscular injections of 11.4 mg of betamethasone 24 hours apart) given between 3 and 9 days before delivery resulted in delayed lactogenesis II and lower average milk volumes during the 10 days after delivery. Milk volume was not affected if the infant was delivered less than 3 days or more than 10 days after the mother received the corticosteroid.[14] An equivalent dosage regimen of methylprednisolone might have the same effect.

A study of 87 pregnant women found that betamethasone given as above during pregnancy caused a premature stimulation of lactose secretion during pregnancy. Although the increase was statistically significant, the clinical importance appears to be minimal.[15] An equivalent dosage regimen of methylprednisolone might have the same effect.

Sixteen nursing mothers with multiple sclerosis received 1 gram of methylprednisolone intravenously over 1 hour, either monthly (n = 7) or over 3 consecutive days (n = 9). None of the mothers reported a decrease in their milk supply.[10]

Possible alternatives to Methylprednisolone

Prednisolone, Prednisone.