Introduction

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. Fortunately, there are many treatments for RA that can help you manage your symptoms and improve your quality of life.

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 vs. prednisone

Methylprednisolone and prednisone both belong to a class of drugs called corticosteroids. They reduce inflammation. For people with RA, these drugs help by reducing your immune responses that can lead to swelling, pain, and joint damage.

Methylprednisolone and prednisone are very similar drugs. The following table compares some of their features.

MethylprednisolonePrednisone
What class is it?corticosteroidcorticosteroid
What are the brand-name versions?Medrol, Depo-Medrol, Solu-MedrolRayos
Is a generic version available?yesyes
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 a healthcare providers administer this form.
†If you’ve been taking this drug for longer than a few weeks, do not 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 it 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

Cost and availability

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. However, the brand-name drugs may require prior authorization from your doctor.

Side effects

Methylprednisolone and prednisone have the same side effects. For more information, see the side effects of methylprednisolone or side effects of prednisone.

Drug interactions

Both methylprednisolone and prednisone can interact with other drugs. 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
  • ketoconazole
  • phenobarbital
  • phenytoin
  • rifampin
  • warfarin
  • metyrapone

Methylprednisolone also interacts with an additional drug called cyclosporine, which is used to suppress your immune system.

Use with other medical conditions

Make sure you give your doctor your complete medical history. Specifically, tell your doctor if you have any of the following conditions:

  • hypothyroidism
  • cirrhosis
  • herpes simplex of the eye
  • emotional problems
  • mental illness
  • ulcerative colitis
  • ulcers
  • kidney problems
  • high blood pressure
  • osteoporosis
  • myasthenia gravis
  • seizures
  • tuberculosis
  • any head injuries
  • diabetes

Any of these conditions may complicate therapy with methylprednisolone or prednisone.

Talk with your doctor

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.