Bedside Snapshot

Use It For: Moderate to severe asthma or COPD exacerbation when oral therapy is not possible; adjunct after epinephrine in anaphylaxis; ARDS (ICU); MS relapse and other autoimmune flares (pulse)
Adult Dose: Asthma or allergic reaction: 40–125 mg IV once
COPD: 32 mg IV daily for 5 days (GOLD)
ARDS (ICU): 1 mg/kg IV load, then 1 mg/kg/day infusion
Pediatric Dose: EMS, bronchospasm or shock (age 2 yr or older): 2 mg/kg IV once (IM for bronchospasm), max 125 mg
Hospital asthma: 1–2 mg/kg/day divided (max 60 mg/day, EPR-3)
Age 5 yr or younger (GINA): 1 mg/kg IV every 6 hr, day 1
Onset / Duration: IV/IM: allergic symptoms ease in 0.5–2 hr; asthma improvement takes at least 4 hr. Intermediate-acting: biologic effect 12–36 hr despite a plasma T½ of 2.4–3.5 hr, so once-daily dosing works
Do Not Give / Hold If: Systemic fungal infection; cow's milk allergy (40 mg vial); intrathecal or epidural route; IM in ITP; benzyl alcohol vials in premature infants; traumatic brain injury
Watch For: Hyperglycemia (glucose); arrhythmia or arrest with rapid large doses, and bradycardia with any large dose even when infused slowly (ECG); masked infection (fever may be absent); delirium (mental status)
Reversal / Rescue: No reversal agent: supportive care. Stop the infusion for arrhythmia; correct glucose and K⁺. After long courses, taper; stress-dose hydrocortisone for adrenal crisis
Must Remember: Never a substitute for epinephrine or bronchodilators: benefit takes hours. Give doses over 250 mg over at least 30 min; more than 500 mg in under 10 min has caused cardiac arrest.

Indications

Emergency & Prehospital

Moderate to severe asthma exacerbation: reach for it when the patient cannot swallow, is vomiting, or needs noninvasive ventilation or intubation. It is labeled for severe asthma.
COPD exacerbation: for when oral therapy is not possible. Oral prednisone works just as well (off-label).
Anaphylaxis: an add-on only, given after IM epinephrine. No proven benefit, per NASEMSO 2022. The 2020 practice parameter finds it does not reliably prevent biphasic reactions.

ED / ICU / Transport

ARDS: SCCM 2024 conditionally recommends corticosteroids. Methylprednisolone is one of several agents studied (off-label). See ARDS
In-hospital cardiac arrest: not routine. AHA 2025 says steroids during arrest have uncertain benefit (Class 2b). No dosing is recommended here (off-label).
Severe community-acquired pneumonia: SCCM 2024 strongly recommends corticosteroids and names no preferred agent (off-label). REMAP-CAP 2025 tested hydrocortisone, not methylprednisolone. Its 7-day course was stopped for futility. Day-90 mortality was 15% with hydrocortisone and 9.8% with no steroid. The adjusted OR was 1.52–1.63, with credible intervals crossing 1. Possible harm is not excluded.
MS relapse, transplant rejection, autoimmune crises: high-dose IV pulses, directed by a specialist. Lupus, vasculitis and temporal arteritis are labeled.
Cerebral edema from tumor or craniotomy: labeled. Dexamethasone is the more common choice.

Other Uses

Labeled inflammatory and immune disorders: dermatologic, hematologic, rheumatic, renal, ophthalmic and neoplastic conditions. Use it when oral therapy is not feasible.
Not for: septic shock (hydrocortisone is preferred), adrenal insufficiency (hydrocortisone is the labeled drug of choice), traumatic brain injury, or routine traumatic spinal cord injury

Dosing & Administration

Available Forms

Solu-Medrol Act-O-Vial: 40 mg/mL (1 mL) and 62.5 mg/mL (125 mg in 2 mL; the EMS size); also 500 mg (4 mL) and 1 g (8 mL)
Benzyl alcohol-preserved powders: 500 mg, 1 g and 2 g; reconstitute with bacteriostatic water containing benzyl alcohol
Lactose: the 40 mg vial contains lactose from cow's milk. The 125 mg vial contains none.
Not interchangeable: Depo-Medrol (acetate) is for IM or joint use only. Never give it IV. Tablets (Medrol): 2–32 mg

Adult Dosing

Indication	Dose & Route	Repeat / Max	Notes
Asthma exacerbation, moderate to severe (cannot take PO)	40–125 mg IV once (IM if no IV access)	Then 40 mg IV daily or prednisone 50 mg PO daily, 5–7 days total; single dose max 125 mg	Differs from FDA label: the US label gives 10–40 mg IV initially; 125 mg / 2 mg/kg is the NASEMSO 2022 EMS dose. EMS: 2 mg/kg IV/IM, max 125 mg, once. If no IV, oral options: dexamethasone 0.6 mg/kg (max 16 mg) or prednisone 1 mg/kg (max 60 mg). Hospital guidelines use 40 mg. Intubated or critical: 40–80 mg/day IV (EPR-3). Higher doses add no known benefit. Switch to PO when able
COPD exacerbation (cannot take PO)	32 mg IV once daily	5 days total, per GOLD 2026	Equals GOLD prednisone 40 mg PO. Oral is as effective as IV
Anaphylaxis (adjunct after epinephrine)	40–125 mg IV once	Single dose; max 125 mg	Differs from FDA label: the US label gives 10–40 mg IV for allergic states; the 125 mg upper limit is the asthma EMS dose. NASEMSO 2022: no proven benefit. Avoid the 40 mg vial in cow's milk allergy
ARDS, early (within 72 hr), ICU	1 mg/kg IV load, then 1 mg/kg/day infusion, days 1–14	Then 0.5 mg/kg/day days 15–21, 0.25 mg/kg/day days 22–25, 0.125 mg/kg/day days 26–28	One SCCM 2024 regimen (off-label). Dosing weight per ICU protocol. See ARDS
ARDS, nonresolving, ICU	2 mg/kg IV load, then 2 mg/kg/day divided every 6 hr, days 1–14	Then 1 mg/kg/day days 15–21, 0.5 mg/kg/day days 22–28, 0.25 mg/kg/day days 29–30, 0.125 mg/kg/day days 31–32	Do not start 14 or more days after ARDS onset (LaSRS: late starts raised 60- and 180-day mortality)
Severe bacterial CAP, ICU	Per ICU protocol. Listed regimens: 40 mg IV load, then 40 mg/day days 1–7 (ESCAPe); or 0.5 mg/kg IV every 12 hr for 5 days, started within 36 hr of admission, if CRP above 150 mg/L (Torres)	ESCAPe taper: 20 mg/day days 8–14, 12 mg/day days 15–17, 4 mg/day days 18–20	Neither trial showed a mortality benefit (ESCAPe 60-day; Torres lowered treatment failure only)
Acute MS relapse; high-dose pulse (specialist)	500–1,000 mg IV once daily	3–5 days; max 1,000 mg/dose over at least 30 min	Transplant rejection: 500–1,000 mg/day, usually not beyond 48–72 hr. Pulses can cause toxic hepatitis weeks later
Septic shock	Not the preferred agent: use hydrocortisone	Never high-dose, short-course: more than 80 mg/day for under 3 days	SCCM 2024: against more than 400 mg/day hydrocortisone equivalent (about 80 mg/day methylprednisolone) for under 3 days

Pediatric Dosing

Indication	Dose (per kg) & Route	Max Single / Max Total	Notes
Critical bronchospasm or shock, EMS single dose (age 2 yr or older)	2 mg/kg IV (IM for bronchospasm), once	Max 125 mg single dose	Differs from FDA label: the US label gives 0.11–1.6 mg/kg/day in 3–4 divided doses; the single EMS dose is from NASEMSO 2022. GINA follow-on: then oral prednisolone (1–2 mg/kg/day, max 40 mg/day, age 6–11 yr) for 3–5 days. Hydrocortisone is preferred in shock
Hospital, ongoing asthma (EPR-3)	1–2 mg/kg/day IV in 2 divided doses	Max 60 mg/day (age 12 yr or younger)	Hospital and ongoing dosing only; the EMS dose above is one-time. UK label: status asthmaticus up to 4 mg/kg/day for 1–3 days
Age 5 yr or younger, GINA (hospital)	1 mg/kg IV every 6 hr, day 1 only	No cap for this IV option; oral prednisolone 20 mg/day under 2 yr, 30 mg/day age 2–5	Differs from FDA label: the US label gives 0.11–1.6 mg/kg/day; the UK label allows up to 4 mg/kg/day for status asthmaticus. GINA 2026 regimen (off-label). Separate from the EPR-3 cap
Other labeled indications	0.11–1.6 mg/kg/day IV or IM in 3–4 divided doses (3.2–48 mg/m²/day), US label	No fixed label max; 1.6 mg/kg/day is the top of the initial range	Dose by severity and response more than by age or size
High-dose pulse	Specialist use only	Transplant rejection (UK label): 10–20 mg/kg/day for up to 3 days, max 1,000 mg/day	Infuse over at least 30 min
Cardiac arrest, ARDS, CAP, septic shock	Not established in children	—	SCCM 2024 makes no pediatric recommendation; pediatric shock: hydrocortisone
Neonates and premature infants	Not routinely used (consult)	—	Benzyl alcohol vials and diluent are contraindicated (gasping syndrome)

Check the calculation against weight-based dosing.

Preparation & Administration

Push rate: up to 250 mg IV over at least 5 min; larger doses as an infusion over at least 30 min. More than 500 mg in under 10 min has caused arrhythmias and cardiac arrest.
Infusion: D5W, normal saline or D5NS. Never mix it with other drugs. Never intrathecal or epidural. IM: avoid the deltoid: subcutaneous atrophy. Never give it IM in immune thrombocytopenia.

Dosing Notes:

Equivalent doses: methylprednisolone 4 mg ≈ prednisone 5 mg ≈ hydrocortisone 20 mg ≈ dexamethasone 0.75 mg.
Courses under about 2 weeks can stop without a taper. Taper the longer ones. They suppress the HPA axis.

Contraindications & Precautions

Contraindications

Systemic fungal infection (unless needed to control a drug reaction); hypersensitivity
Cow's milk allergy: 40 mg presentation only (relative)
Intrathecal route; IM in idiopathic thrombocytopenic purpura
Benzyl alcohol formulations in premature infants; live vaccines during immunosuppressive doses
Traumatic brain injury (high doses must not be used); cerebral malaria (avoid)

Precautions

Infection: the steroid masks signs. Watch for latent tuberculosis, hepatitis B reactivation, Strongyloides hyperinfection and latent amebiasis. In non-immune patients, avoid varicella or measles exposure.
Recent MI: the concern is left ventricular free-wall rupture. Heart failure, hypertension, renal insufficiency: watch for fluid retention and potassium loss.
Diabetes, GI disease: glucose runs higher. With peptic ulcer, diverticulitis or a fresh anastomosis, perforation signs may be minimal.
Myasthenia gravis, psychiatric history, ocular herpes simplex (corneal perforation), systemic sclerosis (scleroderma renal crisis), pheochromocytoma: weakness, psychosis, corneal perforation, scleroderma renal crisis, fatal crisis.

Hold / Reassess If

Bradycardia or new arrhythmia during a high-dose infusion: stop or slow the infusion
New allergic signs after the 40 mg vial: consider milk-protein reaction; switch product
New delirium or psychosis; jaundice or rising liver enzymes after pulses
ARDS 14 or more days after onset: do not start (higher mortality in LaSRS)

Not for head or spinal cord trauma in the field: In head injury, a large IV methylprednisolone trial pushed mortality up. For acute spinal cord injury, AO Spine 2017 suggests a 24-hr high-dose infusion only for adults within 8 hr of injury. Past 8 hr, it suggests not offering it, and not running it for 48 hr. Leave that call to the trauma center.

Adverse Effects & Toxicity

Common

Hyperglycemia; leukocytosis without infection; insomnia, mood swings; fluid retention, hypertension, hypokalemia
Prolonged use: Cushingoid features, osteoporosis, cataracts, growth suppression, avascular necrosis with repeated courses

Serious / Life-Threatening

Effect	Recognition	Management
Arrhythmia, bradycardia, arrest	After more than 500 mg in under 10 min; bradycardia with any large dose	Stop the infusion; ECG; ACLS as needed
Masked infection	Fever and peritoneal signs may be blunted	Culture early; reduce the steroid if possible
GI bleeding or perforation	Melena, falling hemoglobin, abdominal pain	Resuscitate, imaging, surgical consult
Steroid psychosis, acute myopathy	Agitation, hallucinations; weakness with blockers or myasthenia	Lowest effective dose; minimize blocker exposure
Anaphylaxis	Rare; milk-protein reaction with the 40 mg vial	Stop; IM epinephrine; milk-free product
Toxic hepatitis after pulses	Jaundice or high liver enzymes weeks after 1 g/day	Stop IV methylprednisolone; do not rechallenge
Tumor lysis syndrome	Malignancy, especially high tumor burden	Monitor K⁺, phosphate, uric acid; oncology protocol
Adrenal insufficiency after withdrawal	Hypotension, hypoglycemia after a long course	Stress-dose hydrocortisone; taper

Overdose & Toxicity Management

Overdose: rarely dangerous. Give supportive care and check glucose and electrolytes. Antidote: none.

Monitoring

Parameter	When / How Often	Target / Act If
Clinical: respiratory response	Work of breathing, SpO₂, peak flow	No improvement: escalate bronchodilators, magnesium, ventilatory support; the steroid needs at least 4 hr
Clinical: HR, BP, ECG, mental status	During and after large IV doses; every assessment in older adults	Bradycardia, arrhythmia or new delirium: stop the infusion, reassess
Laboratory: glucose	Baseline in diabetes or critical illness, then regularly	Above target: insulin per protocol
Laboratory: K⁺, Na⁺	Regularly during multi-day or high-dose courses	Low K⁺: replace (ECG if on digoxin); rising Na⁺ with edema: reduce dose if possible
Laboratory: liver enzymes	During and for weeks after 1 g/day pulses	Hepatitis: stop IV methylprednisolone
Laboratory: INR on warfarin	Frequently while combined	Response usually reduced: adjust to target INR
Infection surveillance (ICU)	Daily in ARDS or prolonged therapy	Fever may be absent: culture on any deterioration

Interactions & Compatibility

Clinically Significant Interactions

Drug / Class	Effect	What To Do
CYP3A4 inhibitors (ketoconazole, macrolides, ritonavir, cobicistat)	Higher methylprednisolone levels; ketoconazole cuts metabolism by up to 60%	Avoid cobicistat or ritonavir unless benefit outweighs risk
CYP3A4 inducers (phenytoin, carbamazepine, rifampin)	Faster steroid clearance	A higher steroid dose may be needed
Diuretics, amphotericin B, digoxin	Hypokalemia; arrhythmia with digoxin	Monitor K⁺ and ECG
Neuromuscular blockers; anticholinesterases	Acute myopathy; severe weakness	Limit blocker duration
Warfarin; NSAIDs and aspirin	Reduced anticoagulant response; more GI bleeding	Monitor INR; avoid or add GI protection
Insulin and antidiabetics	Higher glucose	Adjust doses; monitor glucose

IV Compatibility

Use D5W, normal saline or D5NS only. Give it separately. Never mix it with other drugs.

Special Populations

Pediatrics: asthma is the main acute use. See the Pediatric Dosing table. Long courses slow growth, so follow height, weight, BP and intraocular pressure.
Neonates: avoid the benzyl alcohol vials and diluent. Hypertrophic cardiomyopathy has been reported after methylprednisolone in premature infants.
Pregnancy: It crosses the placenta. Long or repeated courses may raise the risk of growth restriction, and newborns may have transient hypoadrenalism. Do not withhold it for a serious indication.
Lactation: Small amounts pass into milk. Doses up to 40 mg/day are unlikely to affect the infant.
Older Adults: Start low. Hyperglycemia and delirium matter more in this group.
Renal Impairment: no dose adjustment has been established. Hepatic Impairment: the effect is enhanced in cirrhosis. Use the lowest effective dose.
Dosing Weight: Asthma, COPD, anaphylaxis and EMS doses are fixed. ARDS regimens follow the ICU protocol.
Thyroid Disease: Clearance falls in hypothyroidism and rises in hyperthyroidism. Watch the potassium: steroid-induced hypokalemia can trigger thyrotoxic periodic paralysis.

Field & Transport Considerations

Scope: Paramedic, RN and critical-care transport. NASEMSO 2022 gives 2 mg/kg (max 125 mg) IV or IM for critically ill bronchospasm. For fluid-refractory shock, it gives IV only. Varies by state and agency protocol.
Storage & Stability: Keep it at 20–25°C and protect it from light. Reconstituted solution lasts 48 hr at room temperature. Diluted, it lasts 4 hr below 25°C or 24 hr refrigerated.
Carried Concentration: The 125 mg/2 mL and 40 mg/1 mL vials look alike, so read the strength aloud and state the volume. Never draw up Depo-Medrol for IV use.
Milk Allergy: which vial? The 125 mg Act-O-Vial contains no lactose. Use it, not the 40 mg vial, for cow's milk allergy.
Handoff Essentials: say the dose, route, time and indication. For ICU courses, add the regimen day, planned duration, taper step, and latest glucose and K⁺.

Clinical Pearls

A steroid is not a rescue drug: asthma improvement takes at least 4 hr. Anaphylaxis needs IM epinephrine. Bronchospasm needs bronchodilators now. Don't wait on the steroid.

Oral works as well as IV: in asthma and COPD, IV is for the patient who cannot swallow, is vomiting, or needs noninvasive ventilation or intubation.

Exam discriminator: which steroid?

Methylprednisolone: intermediate-acting, with little salt retention. Think asthma, COPD, ARDS and MS pulses.
Hydrocortisone: retains salt. Think adrenal crisis and septic shock.
Dexamethasone: long-acting. Think croup, meningitis and cerebral edema.

Big doses, slow push: Pushed in under 10 min, more than 500 mg has caused arrhythmias and cardiac arrest.

Arrest steroids: ROSC is not survival: in VAM-IHCA, vasopressin plus methylprednisolone lifted ROSC (42% vs 33%). It did not improve 30-day survival (9.7% vs 12%) or favorable neurologic outcome (7.6% vs 7.6%). AHA 2025 Part 9 puts steroids during arrest at uncertain benefit (Class 2b).

Shock points to hydrocortisone: septic shock regimens are built on hydrocortisone. Methylprednisolone is for ARDS, not shock.

Short courses are not free: even a short burst raises sepsis and thromboembolism risk in adults. Say the planned duration and taper at handoff. That keeps a 5-day course from quietly becoming a long one.

Pharmacology

Mechanism of Action

It binds intracellular glucocorticoid receptors and changes gene transcription. The result is broad anti-inflammatory and immunosuppressive effects.
It retains less sodium and water than prednisolone. That makes it a poor choice for adrenal replacement.

Pharmacokinetics

Route	Onset	Peak	Duration
IV	Allergic symptoms ease in 0.5–2 hr; asthma improvement takes at least 4 hr	—	Biologic effect 12–36 hr; excretion nearly complete in 12 hr
IM	Rapid absorption	Plasma: 2 hr (40 mg)	Similar to IV
PO	As effective as IV in asthma	—	Biologic effect 12–36 hr

Half-life: plasma T½ is 2.4–3.5 hr in healthy adults. The biologic half-life is about 12–36 hr, so once-daily dosing works.
Metabolism: hepatic, mainly through CYP3A4. Metabolites leave in the urine. It crosses the blood-brain barrier and the placenta.

Names & Classification

Generic Name: Methylprednisolone sodium succinate (IV/IM); methylprednisolone (tablets); methylprednisolone acetate (IM depot)
Brand Names: Solu-Medrol (injection); Medrol (tablets, Dosepak); Depo-Medrol (acetate suspension, not for IV)
Pharmacologic Class: Synthetic systemic glucocorticoid (intermediate-acting)
Therapeutic Class: Anti-inflammatory and immunosuppressant corticosteroid
Controlled Substance: Not controlled
ISMP High-Alert: No
Look-Alike / Sound-Alike: Solu-Medrol / Depo-Medrol (IV vs IM-only suspension); Solu-Medrol / Solu-Cortef; generic labels print the tall-man form methylPREDNISolone

References

Pharmacia & Upjohn Company (Pfizer). (2025). Solu-Medrol (methylprednisolone sodium succinate for injection, USP) [prescribing information] (revised November 2025). DailyMed, National Library of Medicine; and Pfizer Limited. (2026). Methylprednisolone 125 mg powder for solution for injection: Summary of Product Characteristics (revised September 2026; pharmacokinetics, administration rates, pediatric and lactation data). electronic medicines compendium. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=cd99be87-c8d9-48d6-a8e5-e081052e3f19 ; https://www.medicines.org.uk/emc/product/100417/smpc
Wigginton, J. G., Agarwal, S., Bartos, J. A., Coute, R. A., Drennan, I. R., Haamid, A., et al. (2025). Part 9: Adult advanced life support: 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation, 152(16 Suppl 2), S538–S577. https://doi.org/10.1161/CIR.0000000000001376
Andersen, L. W., Isbye, D., Kjærgaard, J., Kristensen, C. M., Darling, S., Zwisler, S. T., et al. (2021). Effect of vasopressin and methylprednisolone vs placebo on return of spontaneous circulation in patients with in-hospital cardiac arrest: A randomized clinical trial (VAM-IHCA). JAMA, 326(16), 1586–1594. https://doi.org/10.1001/jama.2021.16628.
Chaudhuri, D., Nei, A. M., Rochwerg, B., Balk, R. A., Asehnoune, K., Cadena, R., et al. (2024). 2024 focused update: Guidelines on use of corticosteroids in sepsis, acute respiratory distress syndrome, and community-acquired pneumonia. Critical Care Medicine, 52(5), e219–e233. https://doi.org/10.1097/CCM.0000000000006172 ; with Steinberg, K. P., Hudson, L. D., Goodman, R. B., Hough, C. L., Lanken, P. N., Hyzy, R., et al. (2006). Efficacy and safety of corticosteroids for persistent acute respiratory distress syndrome (ARDSNet LaSRS). New England Journal of Medicine, 354(16), 1671–1684. https://doi.org/10.1056/NEJMoa051693 ; and Bone, R. C., Fisher, C. J., Clemmer, T. P., Slotman, G. J., Metz, C. A., Balk, R. A., et al. (1987). A controlled clinical trial of high-dose methylprednisolone in the treatment of severe sepsis and septic shock. New England Journal of Medicine, 317(11), 653–658. https://doi.org/10.1056/NEJM198709103171101.
REMAP-CAP Investigators, & Angus, D. C. (2025). Effect of hydrocortisone on mortality in patients with severe community-acquired pneumonia: The REMAP-CAP Corticosteroid Domain randomized clinical trial. Intensive Care Medicine, 51(4), 665–680. https://doi.org/10.1007/s00134-025-07861-w
Meduri, G. U., Shih, M. C., Bridges, L., & Martin, T. J. (2022). Low-dose methylprednisolone treatment in critically ill patients with severe community-acquired pneumonia (ESCAPe trial). Intensive Care Medicine, 48(8), 1009–1023. https://doi.org/10.1007/s00134-022-06684-3
Torres, A., Sibila, O., Ferrer, M., Polverino, E., et al. (2015). Effect of corticosteroids on treatment failure among hospitalized patients with severe community-acquired pneumonia and high inflammatory response: a randomized clinical trial. JAMA, 313(7), 677–686. https://pubmed.ncbi.nlm.nih.gov/25688779/
Global Initiative for Asthma. (2026). Global strategy for asthma management and prevention (2026 update) (adult and pediatric acute asthma). https://ginasthma.org/wp-content/uploads/2026/05/GINA-2026-Strategy-Report-WMS.pdf ; with National Asthma Education and Prevention Program. (2007). Expert Panel Report 3: Guidelines for the diagnosis and management of asthma (full report; Section 5, emergency and hospital corticosteroid dosages). National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/sites/default/files/media/docs/EPR-3_Asthma_Full_Report_2007.pdf.
National Association of State EMS Officials. (2022). National model EMS clinical guidelines (Version 3.0, March 2022; Respiratory Distress and Anaphylaxis guidelines). https://hhs.iowa.gov/media/198/download
Global Initiative for Chronic Obstructive Lung Disease. (2026). Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease (2026 report). https://goldcopd.org/wp-content/uploads/2026/01/GOLD-REPORT-2026-v1.3-8Dec2025_WMV2.pdf
Shaker, M. S., Wallace, D. V., Golden, D. B. K., Oppenheimer, J., Bernstein, J. A., Campbell, R. L., et al. (2020). Anaphylaxis: A 2020 practice parameter update, systematic review, and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) analysis. Journal of Allergy and Clinical Immunology, 145(4), 1082–1123. https://doi.org/10.1016/j.jaci.2020.01.017
McDearman, J. C., Attelah, J., & Nourbakhsh, A. (2026). Traumatic spinal cord injury: A contemporary review of classification, evaluation, and acute management. Journal of Clinical Medicine, 15(16), 6175. https://doi.org/10.3390/jcm15166175 ; with Fehlings, M. G., Wilson, J. R., Tetreault, L. A., Aarabi, B., Anderson, P., Arnold, P. M., et al. (2017). A clinical practice guideline for the management of patients with acute spinal cord injury: Recommendations on the use of methylprednisolone sodium succinate. Global Spine Journal, 7(3 Suppl), 203S–211S. https://doi.org/10.1177/2192568217703085

Last updated October 2026 Spotted something wrong? Report an error and include the page URL.

Medical Disclaimer

For Educational Purposes Only: This content is intended for educational reference and should not be used for clinical decision-making.
Not a Substitute for Professional Judgment: Always consult your local protocols, institutional guidelines, and supervising physicians.
Verify Before Acting: Users are responsible for verifying information through authoritative sources before any clinical application.

AI Assistance Notice

AI was used to assist in organizing, paraphrasing, and formatting this information.

Methylprednisolone (Solu-Medrol)