Medrol

[skipspmr]

Are there any PMR patients in the United States taking Medrol instead of prednisone? Will U.S. doctors prescribe Medrol instead of prednisone if requested by the PMR patient?

[PMRpro Ambassador]

I know there have been US patients on Medrol on the forums - but there are 3 different ones and they may not be on this one.

I imagine the way to find out is to ask - but it does have downsides for reducing because the smallest tablet is 2mg I think.

[skipspmr in reply to PMRpro]

I think there is a 4 mg tablet scored up/down/across to get 4 1mg pieces. I have asked but can't get a satisfying reply. My rheumy prescribes prednisone for his patients but says, smiling sheepishly, if he had PMR he would take prednisolone. But he got his medical education in Europe.

[Hidden]

Just curious, is there an advantage to using Medrol? I can see where the lowest dose they make at 2.0 would be a problem when tapering.

[skipspmr in reply to Hidden]

Well, that's what I'm trying to determine. U.S. doctors prescribe prednisone and UK doctors prescribe prednisolone. And nowhere can I find out which is best. My US Rheumy prescribes prednisone for his patients but says if he had PMR he would take prednisolone? I think there is a 4mg Medrol tablet that is scored twice making 4 1mg tablets out of it.

[Hidden in reply to skipspmr]

Hi,

I was reading a previous post of PMRpro and they may be processed a little differently in the body. Hopefully the end result is the same. I can see where you want to make the best decision starting out. I am interested to know more.

Best

Karen

[PMRpro Ambassador]

They are all medium acting corticosteroids. Prednisone has to be processed in the liver to make prednisolone which is the active substance. So prednisolone works faster and doesn't stress the liver.

Medrol is prednisolone with an added methyl group - which is supposed to make it more effective. It also increases the potential for side effects.

All I can tell you is that I started on plain prednisolone and progressed to the enteric coated version. I had no problems with either - until I got a new batch of 5mg enteric coated that obviously was from a different manufacturer with different fillers - and it didn't work for me. I was switched to Medrol as by then I lived here in Italy and that was the standard. The side effects were amazing: massive weight gain, steroid myopathy, a black beard, to mention just a few, and it didn't work as an antiinflammatory. Even at 20mg my symptoms were almost as bad as they had been pre-pred. Then my GP suggested we try Lodotra, a delayed release version of prednisone and the only alternative available here. Brilliant - and I'd recommend it to anyone. It is available in the USA as Rayos and a few people on the forums have been on it. Some insurances cover it - it is far mroe epxensive than ordinary pred:

openaccessjournals.com/arti...

[Hidden in reply to PMRpro]

Wonderful info, thank you!