Diffuse Sclerosis Medication

Updated: Aug 08, 2019
  • Author: Emad R Noor, MBChB; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM  more...
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Medication Summary

The use of methylprednisolone, its indications, and its possible effects have been reviewed in Treatment. Other corticosteroids or intravenous gamma globulin (IVIG) possibly would also prove beneficial during the acute phase of presentation, but no information exists at present upon which to base any but the most general statements concerning these approaches. Whether intravenous corticosteroid therapy should be followed by an oral taper is unclear, although in most instances of recognized Schilderlike disease, such a taper is generally undertaken. No information exists concerning the appropriate length of such a taper or the influence of such a taper on outcome. No information exists concerning the efficacy of immunomodulatory therapy in Schilder disease as defined by the strict 1912-type criteria posed by CM Poser.

Patients who have received intravenous methylprednisolone should generally receive oral methylprednisolone for a period of 6 weeks, during which time they are tapered from an initial daily dose to every-other-day doses over 3 weeks and then the remaining alternate-day dose is tapered over the ensuing 3 weeks. The initial dose is 2 mg/kg/d or a maximum daily dose of 60-80 mg/kg/d. This taper may be prolonged as needed for patients who demonstrate recurrence of such symptoms and signs of illness as may have resolved during intravenous treatment. The enteral doses may be administered by nasogastric tube or other feeding tubes if the neurologic condition of the patient does not permit the doses to be swallowed. Coadministration of antacids or of histamine (H2) blockers is prudent during the entire course of corticosteroid therapy.

Patients must be monitored for such possible complications of corticosteroid therapy as hypertension, gastrointestinal hemorrhage, hypokalemia, hyperglycemia, and opportunistic infection.



Class Summary

Have anti-inflammatory properties and cause profound and varied metabolic effects. Corticosteroids modify the body's immune response to diverse stimuli.

Methylprednisolone (Depo-Medrol, Solu-Medrol, Medrol)

The initial dose should be administered under close supervision because rare instances of anaphylaxis after initial dose have been reported.