Last reviewed 2026-04-20 · How we verify

Medrol (methylprednisolone)

Potent synthetic glucocorticoid with 5x hydrocortisone potency and minimal mineralocorticoid activity, used for severe inflammatory conditions.

Methylprednisolone (Medrol/Solu-Medrol) is a potent synthetic corticosteroid approved in 1957. IV pulse therapy is standard of care for MS relapses and severe autoimmune flares. Available generically in oral, IV, IM, and intra-articular formulations.

At a glance

Mechanism of action

Methylprednisolone is a synthetic glucocorticoid approximately 5 times more potent than hydrocortisone with negligible mineralocorticoid activity (minimal salt/water retention). IV pulse dosing (Solu-Medrol) is standard treatment for acute MS relapses, severe lupus flares, and transplant rejection. The intramuscular depot formulation (Depo-Medrol) is widely used for joint injections.

Approved indications

• Acquired thrombocytopenia
• Acute lymphoid leukemia
• Adrenal cortical hypofunction
• Adrenogenital disorder
• Allergic rhinitis
• Angioedema
• Ankylosing spondylitis
• Articular gout
• Aspiration pneumonitis
• Asthma
• Atopic dermatitis
• Autoimmune disease
• Autoimmune hemolytic anemia
• Berylliosis
• Bursitis
• Cerebral edema
• Congenital adrenal hyperplasia
• Congenital hypoplastic anemia
• Contact dermatitis
• Crohn's disease

Boxed warnings

• WARNING: RISK OF CARDIAC ARREST WITH USE OF BUPIVACAINE HYDROCHLORIDE INJECTION IN OBSTETRICAL ANESTHESIA There have been reports of cardiac arrest with difficult resuscitation or death during use of Bupivacaine Hydrochloride Injection for epidural anesthesia in obstetrical patients. In most cases, this has followed use of the 0.75% (7.5 mg/mL) concentration. Resuscitation has been difficult or impossible despite apparently adequate preparation and appropriate management. Cardiac arrest has occurred after convulsions resulting from systemic toxicity, presumably following unintentional intravascular injection. The 0.75% (7.5 mg/mL) concentration of Bupivacaine Hydrochloride Injection is not recommended for obstetrical anesthesia and should be reserved for surgical procedures where a high degree of muscle relaxation and prolonged effect are necessary [see Warnings and Precautions (5.1) ]. WARNING: RISK OF CARDIAC ARREST WITH USE OF BUPIVACAINE HYDROCHLORIDE INJECTION IN OBSTETRICAL ANESTHESIA See full prescribing information for complete boxed warning. There have been reports of cardiac arrest with difficult resuscitation or death during use of Bupivacaine Hydrochloride Injection for epidural anesthesia in obstetrical patients. In most cases, this has followed use of the 0.75% (7.5 mg/mL) concentration. Resuscitation has been difficult or impossible despite apparently adequate preparation and appropriate management. Cardiac arrest has occurred after convulsions resulting from systemic toxicity, presumably following unintentional intravascular injection. The 0.75% (7.5 mg/mL) concentration of Bupivacaine Hydrochloride Injection is not recommended for obstetrical anesthesia and should be reserved for surgical procedures where a high degree of muscle relaxation and prolonged effect are necessary ( 5.1 ).

Common side effects

• Increased appetite
• Nausea
• Headache
• Insomnia
• Mood swings
• Weight gain
• Moon face
• Acne
• Increased sweating
• Fluid retention
• Hypertension
• Potassium loss

Serious adverse events

• Anaphylaxis
• Cardiac arrest
• Circulatory collapse
• Congestive heart failure
• Myocardial rupture following recent myocardial infarction
• Hepatitis
• Peptic ulcer with possible perforation and hemorrhage
• Aseptic necrosis of femoral and humeral heads
• Paraparesis/paraplegia
• Blindness associated with periocular injections

Drug interactions

• Local Anesthetics
• Monoamine Oxidase Inhibitors and Tricyclic Antidepressants
• Ergot-Type Oxytocic Drugs
• Nonselective Beta-Adrenergic Antagonists
• Drugs Associated with Methemoglobinemia (e.g., nitrates, nitrites, local anesthetics, antineoplastic agents, antibiotics, antimalarials, anticonvulsants)
• Potent Inhalation Anesthetics

Key clinical trials

• Randomized Placebo Controlled Trial of Subcutaneous rhIL-1A (Anakinra) in the Management of Hospitalized Pediatric and Adult Patients With Macrophage Activation Syndrome (Phase 1)
• A Phase I Trial of BBR 2778 in Combination With Cytarabine, Methylprednisolone and Cisplatin in the Treatment of Patients With Relapsed or Refractory Aggressive Non-Hodgkin's Lymphoma (Phase 1)
• Intra-discal Steroid Injection for MODIC I Discopathy: A Randomized Control Trial (Phase 4)
• A Phase III Double-Blind, Randomised, Placebo-Controlled Study Assessing the Efficacy and Safety of Capivasertib+Abiraterone Versus Placebo+Abiraterone as Treatment for Patients With DeNovo Metastatic (Phase 3)
• Trial of Early Aggressive Therapy in Juvenile Idiopathic Arthritis (TREAT in JIA) (Phase 4)
• Phase III Randomised Study on Liposomal Cytarabine (DepoCyte®) vs. Intrathecal Triple for CNS-Treatment During Maintenance Therapy in High-Risk Acute Lymphoblastic Leukemia Patients in NOPHO ALL 2008 (Phase 3)
• A Prospective Randomized Control Trial of Pilocarpine Use After Combined Cataract/Kahook Dual Blade Surgery (Phase 3)
• STeroids to REduce Systemic Inflammation After Infant Heart Surgery (STRESS) (Phase 3)

Primary sources

Every claim on this page is sourced from regulatory or scientific primary sources. See our editorial policy for full methodology.

Competitive intelligence

For the full competitive landscape — auto-detected comparators, recent regulatory actions across the set, upcoming PDUFA, patent timeline, sponsor landscape:

• Medrol CI brief — competitive landscape report
• Medrol updates RSS · CI watch RSS
• Generic (originally Upjohn/Pfizer) portfolio CI