Rheumatoid arthritis (RA) is a condition that can affect many different parts of your body. It causes pain and limits your movement, and it gets worse the longer it goes untreated.
There are many treatments for RA that can help you manage your symptoms and improve your quality of life, however.
Take a look at two such drugs: methylprednisolone and prednisone. Knowing how they’re similar and how they’re not can help you have a more informed conversation with your doctor about the right RA treatment for you.
Methylprednisolone and prednisone both belong to a class of drugs called corticosteroids. They reduce inflammation. For people with RA, these drugs help by reducing immune responses that can lead to swelling, pain, and joint damage.
The following table compares some of the features of these two medications.
|What class is it?||corticosteroid||corticosteroid|
|What are the brand-name versions?||Medrol, Depo-Medrol, Solu-Medrol||Rayos|
|Is a generic version available?||yes||yes|
|What forms does it come in?||oral tablet, injectable solution*||oral tablet, oral solution|
|What is the typical length of treatment?||short term for flare-ups, long term for maintenance||short term for flare-ups, long term for maintenance|
|Is there a risk of withdrawal with this drug?||yes†||yes†|
* Only healthcare providers administer this form.
† If you’ve been taking this drug for longer than a few weeks, don’t stop taking it without talking to your doctor. You’ll need to taper off the drug slowly to avoid withdrawal symptoms such as anxiety, sweating, nausea, and trouble sleeping.
Prednisone comes in these strengths:
- generic prednisone solution: 5 mg/mL
- Prednisone Intensol (solution concentrate): 5 mg/mL
- Rayos (extended release tablet): 1 mg, 2 mg, 5 mg
- generic prednisone tablet: 1 mg, 2.5 mg, 5 mg, 10 mg, 20 mg, 50 mg
- generic prednisone pack: 5 mg, 10 mg
Methylprednisolone comes as an oral tablet in similar strengths to prednisone:
- Medrol: 2 mg, 4 mg, 8 mg, 16 mg, 32 mg
- Medrol Pak: 4 mg
- generic methylprednisolone: 4 mg, 8 mg, 16 mg, 32 mg
- generic methylprednisolone pack: 4 mg
Additionally, methylprednisolone comes as an injectable solution that a healthcare provider must inject. That is, you won’t give yourself the medication at home. The injectable solution comes in these strengths:
- Depo-Medrol: 20 mg/mL, 40 mg/mL, 80 mg/mL
- Solu-Medrol: 40 mg, 125 mg, 500 mg, 1,000 mg, 2,000 mg
- generic methylprednisolone acetate: 40 mg/mL, 80 mg/mL
- generic methylprednisolone sodium succinate: 40 mg, 125 mg, 1,000 mg
Both of these drugs are available at most pharmacies. They cost about the same, but prednisone is slightly less expensive than methylprednisolone. GoodRx can help you find the most current pricing.
If cost is a concern for you, both methylprednisolone and prednisone come in generic versions, except for the extended-release prednisone tablet. Prednisone extended-release tablet is only available as the brand-name drug Rayos.
Brand-name drugs are more expensive than generic versions. You and your doctor will decide which form is best for you, so talk to them about any concerns you have about paying for your medication.
That said, methylprednisolone and prednisone are also both covered by most health insurance plans. The brand-name drugs may require prior authorization from your doctor.
Methylprednisolone and prednisone have the same side effects and the same long-term risks. The risks that are associated with these two medications are due to the class of medications that they belong to — corticosteroids.
Both methylprednisolone and prednisone can interact with other drugs. An interaction is when a substance changes the way a drug works. It can be harmful or prevent either drug from working well.
Tell your doctor about all medications, vitamins, or herbs you’re taking. This can help your doctor prevent possible interactions.
Both methylprednisolone and prednisone interact with the following drugs:
- aspirin (Bufferin)
- rifampin (Rifadin)
- warfarin (Coumadin)
- metyrapone (Metopirone)
Methylprednisolone also interacts with an additional drug called cyclosporine (Sandimmune, Neoral, Gengraf), which is used to suppress the immune system.
Make sure you give your doctor your complete medical history. Specifically, tell your doctor if you have any of the following conditions:
- any head injuries
- emotional problems
- herpes simplex of the eye
- high blood pressure
- kidney problems
- mental illness
- myasthenia gravis
- ulcerative colitis
Any of these conditions may complicate therapy with methylprednisolone or prednisone.
Methylprednisolone and prednisone are very similar drugs. One may work better for you than the other simply because of the severity of your disease. However, one drug may be available in a more convenient form.
Talk to your doctor about these two drugs as well as other RA treatment options to get an idea of the choices that will work best for you.
To learn about other options for RA, check out this list of rheumatoid arthritis medications.