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11-beta,17,21-Trihydroxy-6-alpha-methylpregna-1,4-diene-3,20-dione
Also known as: 83-43-2, Medrol, Metilprednisolone, Medrone, Medrate, Urbason
Molecular Formula
C22H30O5
Molecular Weight
374.5  g/mol
InChI Key
VHRSUDSXCMQTMA-PJHHCJLFSA-N
FDA UNII
X4W7ZR7023

A PREDNISOLONE derivative with similar anti-inflammatory action.
Methylprednisolone is a Corticosteroid. The mechanism of action of methylprednisolone is as a Corticosteroid Hormone Receptor Agonist.
1 2D Structure

11-beta,17,21-Trihydroxy-6-alpha-methylpregna-1,4-diene-3,20-dione

2 Identification
2.1 Computed Descriptors
2.1.1 IUPAC Name
(6S,8S,9S,10R,11S,13S,14S,17R)-11,17-dihydroxy-17-(2-hydroxyacetyl)-6,10,13-trimethyl-7,8,9,11,12,14,15,16-octahydro-6H-cyclopenta[a]phenanthren-3-one
2.1.2 InChI
InChI=1S/C22H30O5/c1-12-8-14-15-5-7-22(27,18(26)11-23)21(15,3)10-17(25)19(14)20(2)6-4-13(24)9-16(12)20/h4,6,9,12,14-15,17,19,23,25,27H,5,7-8,10-11H2,1-3H3/t12-,14-,15-,17-,19+,20-,21-,22-/m0/s1
2.1.3 InChI Key
VHRSUDSXCMQTMA-PJHHCJLFSA-N
2.1.4 Canonical SMILES
CC1CC2C3CCC(C3(CC(C2C4(C1=CC(=O)C=C4)C)O)C)(C(=O)CO)O
2.1.5 Isomeric SMILES
C[C@H]1C[C@H]2[C@@H]3CC[C@@]([C@]3(C[C@@H]([C@@H]2[C@@]4(C1=CC(=O)C=C4)C)O)C)(C(=O)CO)O
2.2 Other Identifiers
2.2.1 UNII
X4W7ZR7023
2.3 Synonyms
2.3.1 MeSH Synonyms

1. 6 Methylprednisolone

2. 6-methylprednisolone

3. Medrol

4. Metipred

5. Urbason

2.3.2 Depositor-Supplied Synonyms

1. 83-43-2

2. Medrol

3. Metilprednisolone

4. Medrone

5. Medrate

6. Urbason

7. 6alpha-methylprednisolone

8. Metilbetasone

9. Dopomedrol

10. Promacortine

11. Besonia

12. Medesone

13. Mesopren

14. Metastab

15. Metrisone

16. Moderin

17. Noretona

18. Solomet

19. Urbasone

20. Wyacort

21. Methylprednisolon

22. Methyleneprednisolone

23. Metilprednisolone [dcit]

24. Delta(1)-6alpha-methylhydrocortisone

25. 1-dehydro-6alpha-methylhydrocortisone

26. Nsc-19987

27. Metilprednisolona

28. Methylprednisolonum

29. Methylprednisolonum [inn-latin]

30. Metilprednisolona [inn-spanish]

31. 6-alpha-methylprednisolone

32. Suprametil

33. Medrol Dosepak

34. Medrol Adt Pak

35. 6alpha-methyl-11beta,17alpha,21-triol-1,4-pregnadiene-3,20-dione

36. Chebi:6888

37. 11beta,17,21-trihydroxy-6alpha-methylpregna-1,4-diene-3,20-dione

38. (6alpha,11beta)-11,17,21-trihydroxy-6-methylpregna-1,4-diene-3,20-dione

39. (6s,8s,9s,10r,11s,13s,14s,17r)-11,17-dihydroxy-17-(2-hydroxyacetyl)-6,10,13-trimethyl-7,8,9,11,12,14,15,16-octahydro-6h-cyclopenta[a]phenanthren-3-one

40. Prednisolone, Methyl-

41. Methylprednisolone, 6-alpha

42. 6alpha-methylprednisolone Base

43. U 7532

44. Mls000028541

45. (6s,8s,9s,10r,11s,13s,14s,17r)-11,17-dihydroxy-17-(2-hydroxyacetyl)-6,10,13-trimethyl-6,7,8,9,10,11,12,13,14,15,16,17-dodecahydro-3h-cyclopenta[a]phenanthren-3-one

46. Sieropresol

47. Esametone

48. Firmacort

49. Medixon

50. Metrocort

51. Metysolon

52. Nirypan

53. Reactenol

54. Artisone-wyeth

55. X4w7zr7023

56. Meprdl

57. Predni N Tablinen

58. J3.872e

59. Medlone 21

60. Smr000058330

61. Dsstox_cid_3300

62. Pregna-1,4-diene-3,20-dione, 11,17,21-trihydroxy-6-methyl-, (6a,11b)-

63. Prednol- L

64. Dsstox_rid_76965

65. Dsstox_gsid_23300

66. Depo-medrol (acetate)

67. Summicort

68. Cas-83-43-2

69. Prednisolone, 6alpha-methyl-

70. Hsdb 3127

71. Mls002638721

72. Einecs 201-476-4

73. Prednisolone, 6.alpha.-methyl-

74. Brn 2340300

75. 6-alpha-methylprednisolone 100 Microg/ml In Acetonitrile

76. 11beta,17alpha,21-trihydroxy-6alpha-methyl-1,4-pregnadiene-3,20-dione

77. Delta(sup 1)-6-alpha-methylhydrocortisone

78. Unii-x4w7zr7023

79. .delta.1-6.alpha.-methylhydrocortisone

80. Ncgc00016330-01

81. Prestwick_622

82. Medrol (tn)

83. Pregna-1,4-diene-3,20-dione, 11,17,21-trihydroxy-6-methyl-, (6alpha,11beta)-

84. 6-methyl-prednisolone

85. Methylprednisolone [usp:inn:ban:jan]

86. Opera_id_1576

87. Prestwick0_000279

88. Prestwick1_000279

89. Prestwick2_000279

90. Prestwick3_000279

91. 6alpha-methyl Prednisolone

92. 11-beta,17,21-trihydroxy-6-alpha-methylpregna-1,4-diene-3,20-dione

93. 6alpha-methyl-11beta,17alpha,21-trihydroxy-1,4-pregnadiene-3,20-dione

94. Pregna-1,4-diene-3,20-dione, 11beta,17,21-trihydroxy-6alpha-methyl-

95. Chembl650

96. Ec 201-476-4

97. 6.alpha.-methylprednisolone

98. Schembl5084

99. Bspbio_000158

100. 4-08-00-03498 (beilstein Handbook Reference)

101. Mls001148159

102. Mls002207191

103. Spbio_002377

104. Methylprednisolone [mi]

105. Bpbio1_000174

106. Gtpl7088

107. Methylprednisolone [inn]

108. Methylprednisolone [jan]

109. Dtxsid7023300

110. Methylprednisolone [hsdb]

111. Methylprednisolone [vandf]

112. Hms1568h20

113. Hms2090b13

114. Hms2095h20

115. Hms2230d16

116. Hms3259j04

117. Hms3712h20

118. Methylprednisolone [mart.]

119. 6alpha-methylprednisolone, >=98%

120. Methylprednisolone [usp-rs]

121. Methylprednisolone [who-dd]

122. Hy-b0260

123. Nsc19987

124. Zinc3875560

125. Tox21_110376

126. Tox21_302018

127. Bdbm50103616

128. Lmst02030178

129. Methylprednisolone (jp17/usp/inn)

130. S1733

131. Akos015969744

132. Pregna-1,4-diene-3,20-dione, 6-alpha-methyl-11-beta-17,21-trihydroxy-

133. Tox21_110376_1

134. Ccg-220279

135. Db00959

136. Ks-1273

137. Methylprednisolone [green Book]

138. Nc00691

139. Methylprednisolone [orange Book]

140. Methylprednisolone [ep Monograph]

141. Ncgc00022735-03

142. Ncgc00022735-06

143. Ncgc00255269-01

144. Methylprednisolone [usp Monograph]

145. Nci60_001657

146. M1665

147. Neo-medrol Component Methylprednisolone

148. C16437

149. D00407

150. Methylprednisolone Component Of Neo-medrol

151. 010m591

152. A855290

153. Q417222

154. Sr-01000003089

155. Q-201395

156. Sr-01000003089-2

157. 6-alpha-methylprednisolone 100 Microg/ml In Methanol

158. Brd-k35240538-001-03-1

159. Brd-k35240538-001-11-4

160. Brd-k35240538-001-26-2

161. Methylprednisolone Acetate Impurity B [ep Impurity]

162. 6alpha-methylprednisolone, Vetranal(tm), Analytical Standard

163. 1,4-pregnadien-6alpha-methyl-11beta, 17, 21-triol-3, 20-dione

164. 11?,17?,21-trihydroxy-6?-methyl-1,4-pregnadiene-3,20-dione

165. 11beta,17,21-trihydroxy-6alpha-methyl-1,4-pregnadiene-3,20-dione

166. Methylprednisolone, British Pharmacopoeia (bp) Reference Standard

167. Methylprednisolone, European Pharmacopoeia (ep) Reference Standard

168. Pregna-1,20-dione, 11.beta.,17,21-trihydroxy-6.alpha.-methyl-

169. Pregna-1,20-dione, 6.alpha.-methyl-11.beta.-17,21-trihydroxy-

170. (6?,11?)-11,17,21-trihydroxy-6-methylpregna-1,4-diene-3,20-dione

171. (6a,11b)-11,17,21-trihydroxy-6-methylpregna-1,4-diene-3,20-dione

172. 11beta,17alpha,21-trihydroxy-6alpha-methylpregna-1,4-diene-3,20-dione

173. Methylprednisolone Hydrogen Succinate Impurity A [ep Impurity]

174. Methylprednisolone, United States Pharmacopeia (usp) Reference Standard

175. 11.beta.,17,21-trihydroxy-6.alpha.-methylpregna-1,4-diene-3,20-dione

176. Methylprednisolone For System Suitability A, Europepharmacopoeia (ep) Reference Standard

177. Methylprednisolone For System Suitability, European Pharmacopoeia (ep) Reference Standard

178. Methylprednisolone, Pharmaceutical Secondary Standard; Certified Reference Material

179. Pregna-1,20-dione, 11,17,21-trihydroxy-6-methyl-, (6.alpha.,11.beta.)-

180. Pregna-1,4-diene-3,20-dione, 11,17,21-trihydroxy-6-methyl-, (6i+/-,11i(2))-

2.4 Create Date
2005-03-26
3 Chemical and Physical Properties
Molecular Weight 374.5 g/mol
Molecular Formula C22H30O5
XLogP31.9
Hydrogen Bond Donor Count3
Hydrogen Bond Acceptor Count5
Rotatable Bond Count2
Exact Mass374.20932405 g/mol
Monoisotopic Mass374.20932405 g/mol
Topological Polar Surface Area94.8 Ų
Heavy Atom Count27
Formal Charge0
Complexity754
Isotope Atom Count0
Defined Atom Stereocenter Count8
Undefined Atom Stereocenter Count0
Defined Bond Stereocenter Count0
Undefined Bond Stereocenter Count0
Covalently Bonded Unit Count1
4 Drug and Medication Information
4.1 Drug Information
1 of 8  
Drug NameA-methapred
PubMed HealthMethylprednisolone
Drug ClassesEndocrine-Metabolic Agent, Immune Suppressant
Active IngredientMethylprednisolone sodium succinate
Dosage FormInjectable
RouteInjection
Strengtheq 125mg base/vial; eq 40mg base/vial
Market StatusPrescription
CompanyHospira

2 of 8  
Drug NameMedrol
PubMed HealthMethylprednisolone
Drug ClassesEndocrine-Metabolic Agent, Immune Suppressant
Drug LabelMEDROL Tablets contain methylprednisolone which is a glucocorticoid. Glucocorticoids are adrenocortical steroids, both naturally occurring and synthetic, which are readily absorbed from the gastrointestinal tract. Methylprednisolone occurs as a white...
Active IngredientMethylprednisolone
Dosage FormTablet
RouteOral
Strength32mg; 8mg; 4mg; 2mg; 16mg
Market StatusPrescription
CompanyPharmacia And Upjohn

3 of 8  
Drug NameMethylprednisolone
Drug LabelMethylprednisolone Tablets contain methylprednisolone which is a glucocorticoid. Glucocorticoids are adrenocortical steroids, both naturally occurring and synthetic, which are readily absorbed from the gastrointestinal tract. Methylprednisolone occur...
Active IngredientMethylprednisolone
Dosage FormTablet
RouteOral
Strength32mg; 8mg; 4mg; 16mg
Market StatusPrescription
CompanyVintage Pharms; Jubilant Cadista; Sandoz; Duramed Pharms Barr; Watson Labs

4 of 8  
Drug NameSolu-medrol
Active IngredientMethylprednisolone sodium succinate
Dosage FormInjectable
RouteInjection
Strengtheq 2gm base/vial; eq 40mg base/vial; eq 125mg base/vial; eq 500mg base/vial; eq 1gm base/vial
Market StatusPrescription
CompanyPharmacia And Upjohn

5 of 8  
Drug NameA-methapred
PubMed HealthMethylprednisolone
Drug ClassesEndocrine-Metabolic Agent, Immune Suppressant
Active IngredientMethylprednisolone sodium succinate
Dosage FormInjectable
RouteInjection
Strengtheq 125mg base/vial; eq 40mg base/vial
Market StatusPrescription
CompanyHospira

6 of 8  
Drug NameMedrol
PubMed HealthMethylprednisolone
Drug ClassesEndocrine-Metabolic Agent, Immune Suppressant
Drug LabelMEDROL Tablets contain methylprednisolone which is a glucocorticoid. Glucocorticoids are adrenocortical steroids, both naturally occurring and synthetic, which are readily absorbed from the gastrointestinal tract. Methylprednisolone occurs as a white...
Active IngredientMethylprednisolone
Dosage FormTablet
RouteOral
Strength32mg; 8mg; 4mg; 2mg; 16mg
Market StatusPrescription
CompanyPharmacia And Upjohn

7 of 8  
Drug NameMethylprednisolone
Drug LabelMethylprednisolone Tablets contain methylprednisolone which is a glucocorticoid. Glucocorticoids are adrenocortical steroids, both naturally occurring and synthetic, which are readily absorbed from the gastrointestinal tract. Methylprednisolone occur...
Active IngredientMethylprednisolone
Dosage FormTablet
RouteOral
Strength32mg; 8mg; 4mg; 16mg
Market StatusPrescription
CompanyVintage Pharms; Jubilant Cadista; Sandoz; Duramed Pharms Barr; Watson Labs

8 of 8  
Drug NameSolu-medrol
Active IngredientMethylprednisolone sodium succinate
Dosage FormInjectable
RouteInjection
Strengtheq 2gm base/vial; eq 40mg base/vial; eq 125mg base/vial; eq 500mg base/vial; eq 1gm base/vial
Market StatusPrescription
CompanyPharmacia And Upjohn

4.2 Therapeutic Uses

Anti-Inflammatory Agents, Steroidal; Antiemetics; Glucocorticoids, Synthetic; Glucocorticoids, Topical; Neuroprotective Agents

National Library of Medicine's Medical Subject Headings online file (MeSH, 1999)


MEDICATION (VET): Treatment with methylprednisolone may be helpful if instituted within the first few hours of /spinal cord/ injury.

Kahn, C.M. (Ed.); The Merck Veterinary Manual 9th ed. Merck & Co. Whitehouse Station, NJ. 2005, p. 1024


MEDICATION (VET): Glucocorticoids are usually contraindicated in animals with meningitis or meningoencephalitis with an infectious etiology; however, a high-dose, short-term course of ... methylprednisolone may control life-threatening complications such as acute cerebral edema and impending brain herniation.

Kahn, C.M. (Ed.); The Merck Veterinary Manual 9th ed. Merck & Co. Whitehouse Station, NJ. 2005, p. 1047


MEDICATION (VET): In cats with mild to moderate inflammatory bowel disease (IBD) or relapse of clinical signs, and in those in which administration of oral medication is difficult, methylprednisolone ... may be effective as the sole treatment or as an adjunct to prednisone and metronidazole.

Kahn, C.M. (Ed.); The Merck Veterinary Manual 9th ed. Merck & Co. Whitehouse Station, NJ. 2005, p. 339


For more Therapeutic Uses (Complete) data for METHYLPREDNISOLONE (29 total), please visit the HSDB record page.


4.3 Drug Warning

/SRP: High dose/ /Methylprednisolone, when administered as a therapeutic agent, has been /associated with hallucinations. /From table/

Ellenhorn, M.J. and D.G. Barceloux. Medical Toxicology - Diagnosis and Treatment of Human Poisoning. New York, NY: Elsevier Science Publishing Co., Inc. 1988., p. 666


Contraindicted in patients with systemic fungal infections. Adverse reactions include sodium and fluid retention, potassium depletion, muscle weakness, osteoporosis, peptic ulcer, thin fragile skin, development of Cushingoid state, glaucoma, cataracts, and negative nitrogen balance. May mask signs of infection and new infections may appear during use. May increase requirements for hypoglycemic agents in diabetic patients.

Hussar, D.A. (ed.). Modell's Drugs in Current Use and New Drugs. 38th ed. New York, NY: Springer Publishing Co., 1992., p. 104


We describe a 61 year-old caucasian male diagnosed with rheumatoid arthritis. He was started on methylprednisolone pulses because of a severe flare of symmetric polyarthritis while he was on weekly intramuscular methotrexate and low-dose oral prednisone. After the second pulse of methylprednisolone the patient suddenly developed severe abdominal pain with free air under the right hemidiaphragm in the chest roentgenogram. The emergency surgery revealed the perforation of a colonic diverticulum. We suggest that methylprednisolone pulses should be carefully used in those patients over 50 years of age and/or people with demonstrated or suspected diverticular disease.

PMID:9572644 Candelas G et al; Scand J Rheumatol 27 (2): 152-3 (1998)


The immunosuppressive effects of glucocorticoids may result in activation of latent infection or exacerbation of intercurrent infections, including those caused by Candida, Mycobacterium, Toxoplasma, Strongyloides, Pneumocystis, Cryptococcus, Nocardia, or Ameba. Glucocorticoids should be used with great care in patients with known or suspected Strongyloides (threadworm) infection. In such patients, glucocorticoid-induced immunosuppression may lead to Strongyloides hyperinfection and dissemination with widespread larval migration, often accompanied by severe enterocolitis and potentially fatal gram-negative septicemia. /Corticosteroids/

McEvoy, G.K. (ed.). American Hospital Formulary Service. AHFS Drug Information. American Society of Health-System Pharmacists, Bethesda, MD. 2007., p. 3033


For more Drug Warnings (Complete) data for METHYLPREDNISOLONE (33 total), please visit the HSDB record page.


4.4 Drug Indication

Oral and intramuscular methylprednisolone are indicated for a number of endocrine, rheumatic, collagen, dermatologic, allergic, ophthalmic, respiratory, hematologic, neoplastic, edematous, gastrointestinal, nervous system, and other disorders. Intra-articular and soft tissue injections are indicated for short term treatment of acute gouty arthritis, acute and subactute bursitis, acute nonspecific tenosynovitis, epicondylitis, rheumatoid arthritis, and synovitis of osteoarthritis. Intralesional injections are indicated for alopecia areata, discoid lupus erythematosus, keloids, lichen planus, lichen simplex chronicus and psoriatic plaques, necrobiosis lipoidica diabeticorum, and localized hypertrophic infiltrated inflammatory lesions of granuloma annulare.


FDA Label


5 Pharmacology and Biochemistry
5.1 Pharmacology

Corticosteroids bind to the glucocorticoid receptor, inhibiting pro-inflammatory signals, and promoting anti-inflammatory signals. Corticosteroids have a wide therapeutic window as patients may require doses that are multiples of what the body naturally produces. Patients taking corticosteroids should be counselled regarding the risk of hypothalamic-pituitary-adrenal axis suppression and increased susceptibility to infections.


5.2 MeSH Pharmacological Classification

Anti-Inflammatory Agents

Substances that reduce or suppress INFLAMMATION. (See all compounds classified as Anti-Inflammatory Agents.)


Neuroprotective Agents

Drugs intended to prevent damage to the brain or spinal cord from ischemia, stroke, convulsions, or trauma. Some must be administered before the event, but others may be effective for some time after. They act by a variety of mechanisms, but often directly or indirectly minimize the damage produced by endogenous excitatory amino acids. (See all compounds classified as Neuroprotective Agents.)


Glucocorticoids

A group of CORTICOSTEROIDS that affect carbohydrate metabolism (GLUCONEOGENESIS, liver glycogen deposition, elevation of BLOOD SUGAR), inhibit ADRENOCORTICOTROPIC HORMONE secretion, and possess pronounced anti-inflammatory activity. They also play a role in fat and protein metabolism, maintenance of arterial blood pressure, alteration of the connective tissue response to injury, reduction in the number of circulating lymphocytes, and functioning of the central nervous system. (See all compounds classified as Glucocorticoids.)


Antiemetics

Drugs used to prevent NAUSEA or VOMITING. (See all compounds classified as Antiemetics.)


5.3 FDA Pharmacological Classification
5.3.1 Active Moiety
METHYLPREDNISOLONE
5.3.2 FDA UNII
X4W7ZR7023
5.3.3 Pharmacological Classes
Corticosteroid [EPC]; Corticosteroid Hormone Receptor Agonists [MoA]
5.4 ATC Code

H02AB04

S76 | LUXPHARMA | Pharmaceuticals Marketed in Luxembourg | Pharmaceuticals marketed in Luxembourg, as published by d'Gesondheetskeess (CNS, la caisse nationale de sante, www.cns.lu), mapped by name to structures using CompTox by R. Singh et al. (in prep.). List downloaded from https://cns.public.lu/en/legislations/textes-coordonnes/liste-med-comm.html. Dataset DOI:10.5281/zenodo.4587355


D - Dermatologicals

D07 - Corticosteroids, dermatological preparations

D07A - Corticosteroids, plain

D07AA - Corticosteroids, weak (group i)

D07AA01 - Methylprednisolone


D - Dermatologicals

D10 - Anti-acne preparations

D10A - Anti-acne preparations for topical use

D10AA - Corticosteroids, combinations for treatment of acne

D10AA02 - Methylprednisolone


H - Systemic hormonal preparations, excl. sex hormones and insulins

H02 - Corticosteroids for systemic use

H02A - Corticosteroids for systemic use, plain

H02AB - Glucocorticoids

H02AB04 - Methylprednisolone


5.5 Absorption, Distribution and Excretion

Absorption

Oral methylprednisolone has 89.9% the bioavailability of oral methylprednisolone acetate, while rectal methylprednisolone has 14.2% the bioavailability. Intravitreal methylprednisolone has a Tmax of 2.5h. Approximately 1/10 of an oral or IV dose of methylprednisolone will reach the vitreous humor. Further data regarding the absorption of methylprednisolone are not readily available.


Route of Elimination

Methylprednisolone and its metabolites have been collected in urine in humans. A study in dogs showed 25-31% elimination in urine and 44-52% elimination in feces.


Volume of Distribution

The average volume of distribution of methylprednisolone is 1.38L/kg.


Clearance

The average plasma clearance of methylprednisolone is 336mL/h/kg.


ORAL ABSORPTION IN SINGLE-DOSE STUDY OF 12 NORMAL MALE VOLUNTEERS. MEAN BIOAVAIL AFTER ORAL ADMIN 89.9%, INDICATING BETTER SYSTEMIC AVAIL OF ESTER THAN ALC. AVG ELIMINATION RATE CONSTANT AFTER ORAL ADMIN OF ESTER & ALC 0.290 H-1, HALF-LIFE OF 2.39 HR.

PMID:455892 GARG DC ET AL; CLIN PHARMACOL THER 26 (2): 232-9 (1979)


The pharmacokinetics of methylprednisolone (MP) were studied in five normal subjects following intravenous doses of 20, 40 and 80 mg methylprednisolone sodium succinate (MPSS) and an oral dose of 20 mg methylprednisolone as 4 x 5 mg tablets. Plasma concentrations of MP and MPSS were measured by both high performance thin layer (h.p.t.l.c.) and high pressure liquid chromatography (h.p.l.c.). 2. The mean values (+/- s.d.) of half-life, mean residence time (MRT), systemic clearance (CL) and volume of distribution at steady state (Vss) of MP following intravenous administration were 1.93 +/- 0.35 h, 3.50 +/- 1.01 h, 0.45 +/- 0.12 lh-1 kg-1 and 1.5 +/- 0.63 1 kg-1, respectively. There was no evidence of dose-related changes in these values. The plasma MP concentration-time curves were superimposable when normalized for dose. 3. The bioavailability of methylprednisolone from the 20 mg tablet was 0.82 +/- 0.11 (s.d.). 4. In vivo hydrolysis of MPSS was rapid with a half-life of 4.14 +/- 1.62 (s.d.) min, and was independent of dose. In contrast, in vitro hydrolysis in plasma, whole blood and red blood cells was slow; the process continuing for more than 7 days. Sodium fluoride did not prevent the hydrolysis of MPSS.

PMID:2655680 Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1379824 Al-Habet SM, Rogers HJ; Br J Clin Pharmacol 27 (3): 285-90 (1989)


High-dose methylprednisolone is used to treat acute spinal cord injury (ASCI). The objective of the present study was to determine the pharmacokinetics of the pro-drug methylprednisolone hemisuccinate and methylprednisolone in accident victims with ASCI. The patients (n = 26) were treated with a bolus intravenous loading dose of 30 mg/kg MPHS within 2 hr after injury and this was followed by a maintenance infusion of 5.4 mg/kg/h up to 24 hr. Blood, CSF and saliva samples were collected up to 48 hr after the initial dose and the samples were analyzed by HPLC. Concentration-time data of MPHS and methylprednisolone were analyzed using population pharmacokinetic analysis with NONMEM software. RESULTS: Methylprednisolone hemisuccinate and methylprednisolone could be monitored in plasma and CSF. Methylprednisolone but not methylprednisolone hemisuccinate was present in saliva. High variability was seen in the methylprednisolone hemisuccinate levels in CSF. The pharmacokinetics of the pro-drug and the metabolite were adequately described by a 2-compartment model with exponential distribution models assigned to the interindividual and the residual variability. At steady state, the average measured methylprednisolone concentration in plasma was 12.3+/-7.0 microg/ml and 1.74+/-0.85 microg/ml in CSF. The CSF levels of methylprednisolone could be modeled as a part of the peripheral compartment. This study demonstrated that CSF concentrations of methylprednisolone were sufficiently high after IV. administration and reflected the concentrations of unbound drug in plasma. Salivary levels of methylprednisolone were about 32% of the plasma level and may serve as an easily accessible body fluid for drug level monitoring.

PMID:15487809 Barth J et al; Int J Clin Pharmacol Ther 42 (9): 504-11 (2004)


Sodium fluoride (6--8 mg/ml) inhibits hydrolysis of methylprednisolone acetate to methylprednisolone. An HPLC method for simultaneous determination of hydrocortisone, methylprednisolone and methylprednisolone acetate in plasma is presented. Analysis of plasma samples (containing NaF) for methylprednisolone acetate shows no significant change in concentration over extended periods of storage at -20 degrees C. In vitro hydrolysis of methylprednisolone acetate at 37 degrees C in human whole blood is rapid (average t1/2 = 19 min). In one cat, the bioavailabilities of methylprednisolone acetate rectally was 13% and of methylprednisolone (alcohol) rectally was 26%, relative to intravenous administration of methylprednisolone. In the same cat, the bioavailabilities of methylprednisolone acetate orally was 93% and of methylprednisolone was 82%, relative to intravenous administration of methylprednisolone. All samples collected after oral administration of methylprednisolone acetate to a human subject were found to contain only methylprednisolone (alcohol) indicating hydrolysis of the drug during absorption through the gastrointestinal membrane and/or in the liver. If the ester had the same half-life in blood in vivo as measured in vitro, it would have been measurable in plasma.

PMID:725320 Garg DC et al; Res Commun Chem Pathol Pharmacol 22 (1): 37-48 (1978)


For more Absorption, Distribution and Excretion (Complete) data for METHYLPREDNISOLONE (7 total), please visit the HSDB record page.


5.6 Metabolism/Metabolites

The metabolism of methylprednisolone is thought to be mostly mediated by 11beta-hydroxysteroid dehydrogenases and 20-ketosteroid reductases.


METAB OF 6ALPHA-METHYLPREDNISOLONE NA SUCCINATE IN RATS; METABOLITES; 6ALPHA-METHYLPREDNISOLONE, 6ALPHA-METHYL-11BETA,17ALPHA,20BETA- TRIHYDROXY-1,4-PREGNADIEN-3-ONE,21-OIC ACID, & 6ALPHA-METHYL-11BETA,17ALPHA,20,21-TETRAHYDROXY-1,4-PREGNADIEN-3-ONE 21-SUCCINATE.

KITAGAWA H ET AL; OYO YAKURI 13 (2): 249-57 (1977)


Prednisone, prednisolone, and methylprednisolone are currently administered in association with cyclosporin A in the postoperative treatment of transplant patients. The aim of this work was to evaluate the effects of these corticosteroids on the expression of several forms of cytochromes p450, including p450 1A2, 2D6, 2E1, and 3A, and on cyclosporin A oxidase activity in human liver. For this purpose, human hepatocytes prepared from lobectomies were maintained in culture in a serum-free medium, in collagen-coated dishes, for 96-144 hr, in the absence or presence of 50-100 uM corticosteroids, rifampicin, or dexamethasone. To mimic more closely the current clinical protocol, hepatocyte cultures were also co-treated with corticosteroids and cyclosporin A or ketoconazole (a selective inhibitor of cytochromes p450 3A). Cyclosporin A oxidase activity, intracellular retention of cyclosporin A oxidized metabolites within hepatocytes, accumulation of cytochromes p450 proteins and corresponding messages, and de novo synthesis and half-lives of these cytochromes p450 were measured in parallel in these cultures. Our results, obtained from seven different hepatocyte cultures, showed that 1) dexamethasone and prednisone, but not prednisolone or methylprednisolone, were inducers of cytochrome p450 3A, at the level of protein and mRNA accumulation, as well as of cyclosporin A oxidase activity, known to be predominantly catalyzed by these cytochromes p450; 2) although corticosteroids are known to be metabolized in human liver, notably by cytochrome p450 3A, partial or total inhibition of this cytochromes p450 by cyclosporin or ketoconazole, respectively, did not affect the inducing efficiency of these molecules; 3) corticosteroids did not affect the half-life of cytochrome p450 3A or the accumulation of other forms of cytochromes p450, including 1A2, 2D6, and 2E1; 4) chronic treatment of cells with cyclosporin did not affect cytochrome p450 3A accumulation; 5) corticosteroids were all competitive inhibitors of cyclosporin A oxidase in human liver microsomes, with Ki values of 61 + or - 12, 125 + or - 25, 190 + or - 38, and 210 + or - 42 uM for dexamethasone, prednisolone, prednisone, and methylprednisolone, respectively; and 6) chronic treatment of cells with corticosteroids did not influence the excretion of oxidized metabolites of cyclosporin from the cells.

PMID:1614409 Pichard L et al; Mol Pharmacol 41 (6): 1047-55 (1992)


5.7 Biological Half-Life

Methylprednisolone has a half life of 2.3h.


IV HALF-LIFE IS APPROX 80 MIN IN DOGS.

Rossoff, I.S. Handbook of Veterinary Drugs. New York: Springer Publishing Company, 1974., p. 359


PLASMA HALF-LIFE IS 3-4 HR.

Osol, A. and J.E. Hoover, et al. (eds.). Remington's Pharmaceutical Sciences. 15th ed. Easton, Pennsylvania: Mack Publishing Co., 1975., p. 895


SINGLE DOSE STUDY OF 12 NORMAL MALE VOLUNTEERS. HALF-LIFE OF 2.39 HR.

GARG DC ET AL; CLIN PHARMACOL THER 26(2) 232-9 (1979)


5.8 Mechanism of Action

The short term effects of corticosteroids are decreased vasodilation and permeability of capillaries, as well as decreased leukocyte migration to sites of inflammation. Corticosteroids binding to the glucocorticoid receptor mediates changes in gene expression that lead to multiple downstream effects over hours to days. Glucocorticoids inhibit neutrophil apoptosis and demargination; they inhibit phospholipase A2, which decreases the formation of arachidonic acid derivatives; they inhibit NF-Kappa B and other inflammatory transcription factors; they promote anti-inflammatory genes like interleukin-10. Lower doses of corticosteroids provide an anti-inflammatory effect, while higher doses are immunosuppressive. High doses of glucocorticoids for an extended period bind to the mineralocorticoid receptor, raising sodium levels and decreasing potassium levels.


Glucocorticoids are capable of suppressing the inflammatory process through numerous pathways. They interact with specific intracellular receptor proteins in target tissues to alter the expression of corticosteroid-responsive genes. Glucocorticoid-specific receptors in the cell cytoplasm bind with steroid ligands to form hormone-receptor complexes that eventually translocate to the cell nucleus. There these complexes bind to specific DNA sequences and alter their expression. The complexes may induce the transcription of mRNA leading to synthesis of new proteins. Such proteins include lipocortin, a protein known to inhibit PLA2a and thereby block the synthesis of prostaglandins, leukotrienes, and PAF. Glucocorticoids also inhibit the production of other mediators including AA metabolites such as COX, cytokines, the interleukins, adhesion molecules, and enzymes such as collagenase. /Glucocorticoids/

Kahn, C.M. (Ed.); The Merck Veterinary Manual 9th ed. Merck & Co. Whitehouse Station, NJ. 2005, p. 2128


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