Methylprednisolone sodium succinate

Figure 7 The effect of chamber pressure on the rate of primary drying, (a) 0.18 M methylprednisolone sodium succinate 2 mL in molded vials (2.54 cm2), shelf temperature +45°C. (Smoothed data from Ref. 6.) (b) Dobutamine hydrochloride and mannitol (4% w/w in water), 12 mL in tubing vials (5.7 cm2) and shelf surface temperature +10°C. (MJ Pikal. Unpublished data.) (Modified from Ref. 1.)... 

Monitor Monitor patients closely for the first few doses. Methylprednisolone sodium succinate 8 mg/kg IV given 1 to 4 hours prior to muromonab-CD3 administration is strongly recommended to decrease the incidence of reactions to the first dose. Acetaminophen and antihistamines, given concomitantly, may reduce early reactions. Patient temperature should not exceed 37.8°C (100°F) prior to first administration. 

Parenteral 20, 40, 80 mg/mL for IM, intralesional, or intra-articular injection Methylprednisolone sodium succinate (generic, Solu-Medrol)... 

Figure 12 Rate of appearance of methylprednisolone, the hydrolysis product of methylprednisolone sodium succinate during stress testing at 40° C control using 250 mg drug per vial with no excipient (closed circles), 40 mg of drug in 210 mg lactose (open circles), 125 mg drug in 125 mg mannitol (open triangles), and 40 mg drug in 210 mg mannitol (closed triangles).

Figure 13 X-ray powder diffractograms of methylprednisolone sodium succinate in mannitol during stress testing at 40°C, showing crystallization of mannitol during storage (A) initial freeze-dried powder (B) two months and (C) six months.

Herman BD, Sinclair BD, Milton N, Nail SL. The effect of bulking agent on the solid-state stability of freeze-dried methylprednisolone sodium succinate. Pharm Res 1994 11 1467-1473. 

Methylprednisolone sodium succinate (Solu-Medrol, others)... 

Amsacrine Amsacrine is incompatible with sodium chloride mixtures and glucose-containing injections with acyclovir sodium, ganciclovir sodium, aztreonam, amphotericin, cimetidine hydrochloride, ceftazidime, frusemide, ceftriaxone sodium, heparin sodium, methylprednisolone sodium succinate, metoclopramide hydrochloride, and some antineoplastics.204 Asparaginase is incompatible with many drugs and rubber, and should be stored at 2° to 8 °C for stability. 

The sodium succinate ester is rapidly absorbed following intramuscular administration, with peak plasma concentrations obtained in 2 h. For parenteral administration in intensive or emergency therapy, methylprednisolone sodium succinate may be given by intramuscular or intravenous injection or by intravenous infusion. The intravenous route is preferred for its more rapid effect in emergency therapy. 

Hall, E.D., Wolf, D.L. and Braughler, J.M. (1984) Effects of a single large dose of methylprednisolone sodium succinate on experimental post-traumatic spinal cord ischemia dose-response and time-action analysis, J. Neurosurg. 61, 124-130. 

Braughler, J.M., Hall, E.D., Means, E.D., Waters, T. and Anderson, D.K. (1987) Evaluation of an intensive methylprednisolone sodium succinate dosing regimen in experimental spinal cord injury, J. Neurosurg. 67, 102-105. 

A 17-year-old boy took amfebutamone (dose unstated) for attention deficit disorder and 1 week later developed a generalized pruritic rash, but continued to take amfebutamone (27). After a further week he presented as an emergency with large joint tenderness and joint swelling. A punch biopsy of a skin lesion showed urticaria with vasculitis. Amfebutamone was withdrawn and a single dose of methylprednisolone sodium succinate was given. His symptoms resolved completely within 36 hours. 

Infusion-related adverse effects of gemtuzumab ozogamicin can be treated with a brief course of an intravenous glucocorticoid. Of 143 patients with refractory myeloid leukemia treated with gemtuzumab ozogamicin, 110 received paracetamol 650 mg orally with diphenhydramine 50 mg intravenously and 33 received the same premeditations plus methylprednisolone sodium succinate 50 mg intravenously before the infusion and repeated 1 hour later (1). There were grade 2 or worse infusion-related adverse events in 32 (29%) of the former, but in only one of the latter (3%). 

Nahata, M.C. Morosco, R.S. Hippie, T.F. Stability of diluted methylprednisolone sodium succinate injection at two temperatures. Am.J.Hosp.Pharm., 1994, 51, 2157-2159... 

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