Metilprednisolona
Methylprednisolone
6alpha-methylprednisolone
También conocido como: Depo-Medrol · Solu-Medrol · A-Methapred · Depo-Medrone · Solu-Medrone · 6alpha-methylprednisolone · methylprednisolonum · NSC-19987 · Methylprednisolone acetate · Methylprednisolone sodium succinate
Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Dosis por especie
🌎 NA — North America🌍 EU — Europe
Perros
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Labeled uses (Oral) | Dogs weighing 5-15 lbs: 2 mg; Dogs weighing 15-40 lbs: 2-4 mg; Dogs weighing 40-80 lbs: 4-8 mg; these total daily doses should be divided | PO | q6-10h | — | 🌎 NA |
| Labeled uses (Injectable) | 2-120 mg (average 20 mg) | IM | May repeat at weekly intervals | — | 🌎 NA |
| Intralesional (sub-lesional) use | 10-40 mg total dose | intralesional | — | — | 🌎 NA |
- Labeled uses (Oral): Divide total daily dose and give 6-10 hours apart.
- Labeled uses (Injectable): Depending on breed (size), severity of condition, and response.
- Intralesional (sub-lesional) use: A sufficient volume of 20 mg/mL methylprednisolone acetate is used to undermine the lesion.
Gatos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Labeled uses (Oral) | Cats weighing 5-15 lbs: 2 mg; Cats weighing >15 lbs: 2-4 mg; these total daily doses should be divided | PO | q6-10h | — | 🌎 NA |
| Labeled uses (Injectable) | up to 20 mg (average 10 mg) | IM | May repeat at weekly intervals | — | 🌎 NA |
| Intralesional (sub-lesional) use | 10-40 mg total dose | intralesional | — | — | 🌎 NA |
- Labeled uses (Oral): Divide total daily dose and give 6-10 hours apart.
- Labeled uses (Injectable): Depending on breed (size), severity of condition, and response.
- Intralesional (sub-lesional) use: A sufficient volume of 20 mg/mL methylprednisolone acetate is used to undermine the lesion.
Caballos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Antiinflammatory (glucocorticoid effects) | 200 mg | IM | repeated as necessary | — | 🌎 NA |
| Intra-articular use | 100 mg | IA | — | — | 🌎 NA |
- Antiinflammatory (glucocorticoid effects): Labeled use.
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
La metilprednisolona es un glucocorticoide sintético de acción intermedia que es aproximadamente de 4 a 5 veces más potente que la hidrocortisona y posee una actividad mineralocorticoide insignificante. Se utiliza ampliamente en medicina veterinaria por sus potentes propiedades antiinflamatorias e inmunosupresoras.
Perlas clínicas y formulaciones:
- Methylprednisolone base: Se utiliza en formulaciones de tabletas orales para terapia de mantenimiento o reducción gradual.
- Methylprednisolone acetate (Depo-Medrol®): Una suspensión microcristalina para inyección IM, intralesional o intraarticular. Se absorbe lentamente, proporcionando un efecto de depósito prolongado (semanas a meses). Nota: Puede causar una supresión profunda y prolongada del eje Hipotálamo-Pituitario-Adrenal (HPA).
- Methylprednisolone sodium succinate (Solu-Medrol®): Un éster altamente hidrosoluble diseñado para administración IV rápida en crisis agudas (p. ej., trauma de médula espinal, reacciones alérgicas graves, shock), aunque el uso de dosis altas en shock/trauma es cada vez más controvertido.
Aunque es altamente eficaz, el objetivo de la terapia con glucocorticoides es siempre utilizar la dosis efectiva más baja durante la duración más corta posible para minimizar los efectos adversos sistémicos, particularmente el hiperadrenocorticismo iatrogénico (síndrome de Cushing).
Mecanismo de acción
Glucocorticoids exert their effects by diffusing across cell membranes and binding to specific cytoplasmic glucocorticoid receptors (GR).
- Genomic Pathway: The receptor-ligand complex translocates to the nucleus → binds to glucocorticoid response elements (GREs) on target genes → alters gene transcription.
- Anti-inflammatory Mechanism: They induce the synthesis of lipocortin-1 (annexin-1) → inhibits phospholipase A2 → blocks the release of arachidonic acid from membrane phospholipids → profoundly decreases the synthesis of pro-inflammatory prostaglandins and leukotrienes.
- Immunosuppressive Mechanism: They suppress the transcription of inflammatory cytokines (e.g., IL-1, IL-2, IL-6, TNF-alpha), inhibit macrophage and neutrophil migration/function, and induce apoptosis in lymphocytes.
- Metabolic Effects: Stimulate hepatic gluconeogenesis, promote protein catabolism, and redistribute lipid stores.
Seguridad y advertencias
Contraindicaciones
- Systemic fungal infections (unless used for Addison's replacement)
- Viral infections
- Arrested tuberculosis
- Peptic or corneal ulcers
- Acute psychoses
- Cushingoid syndrome
- Idiopathic thrombocytopenia (for IM administration)
- Acute local infections (for intrasynovial/intratendinous use)
- Chronic systemic therapy using sustained-release injectable forms
- Pregnant animals
- Renal disease
- Diabetes mellitus
Efectos adversos
- Polyuria (PU), polydipsia (PD), polyphagia (PP)
- Iatrogenic hyperadrenocorticism (Cushingoid signs) with sustained use
- Weight gain and lipidemias
- Dull, dry haircoat and alopecia
- Muscle wasting and weakness
- Gastrointestinal ulceration, vomiting, diarrhea, melena, hematochezia
- Elevated liver enzymes (ALP, ALT) and hepatopathy
- Pancreatitis
- Activation or worsening of diabetes mellitus (especially in cats)
- Behavioral changes (depression, lethargy, viciousness, panting)
- Extracellular hyperglycemia leading to volume expansion and potential CHF (cats)
- Hypothalamic-pituitary-adrenal (HPA) axis suppression
- Adrenal atrophy
- Weight loss (catabolic effect)
- Cutaneous atrophy (thinning of skin)
- Iatrogenic hyperadrenocorticism (Cushing's syndrome)
- Diarrhoea
- Increased urine glucose levels
- Decreased serum T3 and T4 levels
- Impaired wound healing
- Delayed recovery from infections
Precauciones
Tapering Required: Animals receiving systemic glucocorticoids (other than short 'burst' therapy) must be tapered off slowly to allow endogenous ACTH and corticosteroid function to recover. Abrupt withdrawal can precipitate an Addisonian crisis.
- Stress Dosing: Additional glucocorticoids may be needed during stressors (surgery, trauma, illness) during the tapering process.
- Use with Caution: In patients with diabetes mellitus, osteoporosis, predisposition to thrombophlebitis, hypertension, congestive heart failure (CHF), and renal insufficiency.
- Pregnancy: FDA Category C. May cause teratogenic effects in early pregnancy. Exogenous steroids can induce parturition in the latter stages of pregnancy in horses and ruminants.
- Nursing Dams: Glucocorticoids enter milk and may inhibit growth or interfere with endogenous corticosteroid production in nursing offspring.
Interacciones farmacológicas
May cause hypokalemia; potential for CHF and cardiac enlargement
Combination in epidurals has caused serious CNS injuries and death
May lead to profound muscle weakness in myasthenia gravis patients
Glucocorticoids may reduce salicylate blood levels
May increase the metabolism of glucocorticoids and decrease blood levels
Glucocorticoids may inhibit hepatic metabolism of cyclophosphamide
May mutually inhibit hepatic metabolism, increasing blood levels of both drugs
May cause hypokalemia
May reduce methylprednisolone blood levels
May potentiate the effects of methylprednisolone
Insulin requirements may increase due to glucocorticoid-induced insulin resistance
May decrease metabolism of glucocorticoids; ketoconazole may induce adrenal insufficiency upon withdrawal
May decrease metabolism of glucocorticoids and increase blood levels
May alter steroid metabolism; higher steroid doses may be needed
Increased risk of severe gastrointestinal ulceration
May increase metabolism of glucocorticoids and decrease blood levels
May increase metabolism of glucocorticoids and decrease blood levels
Virus replication may be augmented; diminished immune response to vaccines
May affect INR values; requires monitoring
Increased risk of hypokalaemia
Enhanced metabolism of corticosteroids, potentially reducing their efficacy
Decreased metabolism of corticosteroids, potentially increasing their effects and toxicity
Monitorización
- Weight, appetite, and signs of edema
- Serum and/or urine electrolytes
- Total plasma proteins, albumin
- Growth and development in young animals
- ACTH stimulation test (if iatrogenic Cushing's or Addison's is suspected)
- Clinical signs of iatrogenic hyperadrenocorticism (PU/PD, polyphagia, weight gain)
- Blood glucose levels (especially in diabetic or pre-diabetic patients)
- Serum electrolytes (specifically potassium)
- Thyroid panel (T3 and T4 may be artificially decreased)
- Signs of gastrointestinal ulceration (melena, vomiting blood)
Farmacocinética
Vida media
Absorción
Orally administered methylprednisolone is relatively well absorbed. The acetate IM injection is slowly absorbed and can have a duration of effect of weeks to months. The sodium succinate IV injection is water soluble and very fast acting.
Distribución
Extensively distributed throughout the body.
Metabolismo
The liver is the primary site for metabolism (oxidation).
Eliminación
Most of the drug is excreted renally as metabolites.
Sobredosis
Short-term administration of massive doses is unlikely to cause harmful effects, though one case of acute CNS effects in a dog after accidental ingestion has been reported. If acute overdose occurs, provide supportive treatment as required.
Chronic Overdosage: Chronic usage leads to serious adverse effects, primarily iatrogenic hyperadrenocorticism (Cushing's syndrome), characterized by profound metabolic, dermatologic, and immunosuppressive changes.
Productos disponibles
Formulaciones
- Injectable suspension (Acetate)
- Powder for injection (Sodium Succinate)
- Injectable depot suspension: 40 mg/ml
- Injectable powder for reconstitution: 125 mg, 500 mg
- Oral tablets: 2 mg, 4 mg
Veterinario
- Methylprednisolone Tablets: 4 mg (Medrol®)
- Methylprednisolone Acetate Injection: 20 mg/mL, 40 mg/mL (Depo-Medrol®)
- Depo-Medrone 40 mg/ml depot suspension
- Solu-Medrone 125 mg powder for reconstitution
- Solu-Medrone 500 mg powder for reconstitution
- Medrone 2 mg tablets
- Medrone 4 mg tablets
Etiquetado para humanos
- Methylprednisolone Oral Tablets: 2 mg, 4 mg, 8 mg, 16 mg, 24 mg, 32 mg (Medrol®)
- Methylprednisolone Acetate Injection: 20 mg/mL, 40 mg/mL, 80 mg/mL (Depo-Medrol®)
- Methylprednisolone Sodium Succinate Powder for Injection: 40 mg, 125 mg, 500 mg, 1 gram, 2 grams per vial (Solu-Medrol®, A-Methapred®)
Estado regulador
Sin datos reguladores para: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
Store commercially available products at room temperature (15-30°C). Avoid freezing the acetate injection. After reconstituting the sodium succinate injection, store at room temperature and use within 48 hours; only use solutions that are clear.
Información para el cliente
Directrices importantes para los propietarios de mascotas:
- No suspenda el tratamiento abruptamente: Nunca interrumpa este medicamento repentinamente sin consultar a su veterinario. La producción natural de esteroides del cuerpo disminuye mientras se toma este fármaco, y suspenderlo abruptamente puede causar una crisis potencialmente mortal. Su veterinario le proporcionará un programa de reducción gradual.
- Efectos secundarios esperados: Es muy común que las mascotas beban más agua, orinen con mayor frecuencia y tengan un aumento del apetito mientras toman este medicamento. Asegúrese de que siempre tengan acceso a agua fresca y salidas frecuentes para hacer sus necesidades.
- Esté atento a signos graves: Comuníquese con su veterinario si nota efectos secundarios graves como vómitos, heces oscuras/alquitranadas, diarrea con sangre, letargo extremo, jadeo o cambios significativos en el comportamiento.
- Siga las instrucciones: Administre el medicamento exactamente como se le recetó. Si utiliza un programa de días alternos, puede ser útil marcar un calendario para evitar omitir dosis.
La referencia de medicamentos de VetSheet está destinada a profesionales veterinarios autorizados como ayuda para la toma de decisiones clínicas, no como sustituto del criterio profesional ni del prospecto actual del fabricante.