Methylprednisolone and prednisone can reduce inflammation in rheumatoid arthritis. But, recent guidelines recommend against their use, except in exceptional circumstances.
Rheumatoid arthritis (RA) is a condition that can affect many different parts of your body. It causes pain, limits your movement, and worsens without treatment.
There are many treatments for RA that can help you manage your symptoms and improve your quality of life.
Methylprednisolone and prednisone both belong to a class of drugs called corticosteroids. These drugs help people with RA by reducing immune responses that can lead to swelling, pain, and joint damage.
However, the ACR recommends against the use of corticosteroids for most cases of RA treatment. Occasionally, doctors may recommend a short-term course of corticosteroids to reduce inflammation while DMARDs take effect.
ACR recommendations state that doctors should only use corticosteroids a the lowest effective dose for the shortest duration possible.
This article assesses methylprednisolone and prednisone.
Methylprednisolone and prednisone are both corticosteroids.
The following table compares some of the features of these two medications.
|Brand-name version||Medrol, Depo-Medrol, Solu-Medrol||Rayos|
|Are generics available?||yes||yes|
|Available forms||oral tablet, intravenous solution*||oral tablet, oral solution|
|Typical treatment length||short term||short term|
|Is there a risk of withdrawal?||yes†||yes†|
* Only healthcare professionals administer this form.
† If you’ve been taking this drug for longer than a few weeks, don’t stop taking it without talking with 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:
- Prednisone Intensol (solution concentrate): 5 mg/5 mL
- Generic prednisone tablet: 1 mg, 2.5 mg, 5 mg, 10 mg, 20 mg, 50 mg
Methylprednisolone comes as an oral tablet in similar strengths to prednisone:
- Medrol: 2 mg, 4 mg, 8 mg, 16 mg, 32 mg
- Generic methylprednisolone: 4 mg, 8 mg, 16 mg, 32 mg
Additionally, methylprednisolone comes as an intravenous solution in the following 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, 500 mg, 1,000 mg
However, doctors rarely recommend intravenous methylprednisolone for RA treatment. It’s more common in the treatment of lupus.
Methylprednisolone and prednisone have similar side effects and long-term risks.
- nausea and vomiting
- weight gain
Long-term use of corticosteroids can lead to serious complications, such as osteoporosis, cardiovascular problems, and gastrointestinal disturbances.
Learn more about the side effects of methylprednisolone and prednisone.
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 and supplements 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)
Methylprednisolone also interacts with an additional drug called cyclosporine (Sandimmune, Neoral, Gengraf), which suppresses the immune system.
Methylprednisolone and prednisone can cause adverse symptoms in people with certain health conditions.
Make sure you give your doctor your complete medical history. Specifically, tell your doctor if you have any of the following conditions:
- herpes simplex of the eye
- high blood pressure
- kidney problems
- mental health conditions
- myasthenia gravis
- ulcerative colitis
Any of these conditions may complicate therapy with methylprednisolone or prednisone.
- Methotrexate: This type of DMARD is the first line of treatment for those with the condition. This medication weakens the immune system, reducing the damage to joints.
- Biologics: If DMARDs are ineffective, doctors may prescribe biologic treatments. These intravenous medications block chemicals in the blood from triggering immune responses. Common biologics include adalimumab, etanercept, and infliximab.
- Janus kinase (JAK) inhibitors: JAK inhibitors are oral medications that reduce inflammation and
slow RA progression.
Doctors often use a treat-to-target strategy when creating a treatment plan for RA. This involves the setting of attainable management goals on the way to full remission. Remission is the absence of all RA symptoms.
Treat-to-target may help people stick with treatment programs and improve overall treatment outcomes.
To learn about other treatment options for RA, check out this list of rheumatoid arthritis medications.
Both methylprednisolone and prednisone are available at most pharmacies.
If cost concerns you, 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 with them about your concerns over 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 are both corticosteroids. The ACR doesn’t recommend either for the long-term treatment of RA. In its guidelines, it recommends that doctors limit corticosteroids to the lowest effective dose for the shortest duration possible.
Talk with 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.