Examples
|
| dexamethasone | |
| methylprednisolone | Depo-Medrol, Solu-Medrol |
| prednisone | |
How It Works
Methylprednisolone, prednisone, and dexamethasone are
corticosteroids. These medicines shorten
multiple sclerosis (MS) attacks by reducing
inflammation on the brain and spinal cord.
A high dosage of methylprednisolone may be given through a vein
(intravenous, or IV) daily for 3 to 5 days during an MS attack. Prednisone or
methylprednisolone may then be given by mouth for several days after the IV
treatment.
Why It Is Used
Corticosteroids may be used to treat sudden, severe (acute) MS
attacks and acute
optic neuritis.
How Well It Works
Treatment with corticosteroids may reduce the symptoms of MS
attacks and help you recover more quickly.1 There is
no convincing evidence that corticosteroids can reduce the progression of
MS.
Side Effects
Corticosteroids cause few side effects when used over a short
period of time. People with MS who use a short course of corticosteroids to
treat severe symptom attacks may have:
These problems will usually go away after you stop taking the
medicine.
When corticosteroids are used in high doses or for longer periods
of time, they can have more serious side effects, including:
- Weight gain and swelling in the
face.
- High blood pressure.
- Blood sugar problems and
diabetes.
- Weakening and thinning of bones
(osteoporosis).
- Cataracts.
- Bleeding in the
stomach and intestines.
- Lowered resistance to
infection.
- Death of bone tissue caused by a restricted blood supply
to the bones. This is most common in the bones of the shoulders and
hips.
- Severe agitation, paranoia, and psychosis (if corticosteroids
are used in very high doses).
The side effects that may occur with prolonged corticosteroid use
can be a problem for people who have frequent MS attacks and need repeated
treatment with corticosteroids.
See Drug Reference for a full list of side effects. (Drug Reference
is not available in all systems.)
What To Think About
The safety of corticosteroids during pregnancy and breast-feeding
is not well known. Talk to your doctor if you are planning a pregnancy, if you
are pregnant, or if you are breast-feeding.
Intravenous (IV) corticosteroids may work faster and have fewer
side effects than oral steroids alone. Treatment with IV methylprednisolone may
be followed by treatment with oral prednisone or oral methylprednisolone.
Toward the end of the treatment, increasingly lower doses are used so that the
body can recover its own ability to produce natural corticosteroid
hormones.
Some doctors like to use IV corticosteroids to treat MS attacks instead of using corticosteroid pills. This is because there is some evidence that corticosteroid pills may increase the risk for repeated attacks of optic neuritis. But this connection is controversial, and many doctors use corticosteroid pills to treat MS attacks too.
Corticosteroid treatment does not work for everyone. In some people
who have severe or frequent attacks, corticosteroids are effective at first
but become less helpful after repeated use.
Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.
References
Citations
- Nicholas R, Chataway J (2009). Multiple sclerosis,
search date June 2008. Online version of BMJ Clinical Evidence:
http://www.clinicalevidence.com.
Credits
| By | Healthwise Staff |
|---|
| Primary Medical Reviewer | Anne C. Poinier, MD - Internal Medicine |
|---|
| Primary Medical Reviewer | Adam Husney, MD, MD - Family Medicine |
|---|
| Specialist Medical Reviewer | Colin Chalk, MD, CM, FRCPC - Neurology |
|---|
| Last Revised | February 18, 2010 |
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