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Understanding Multiple Sclerosis Medications (cont.)

Corticosteroids

Methylprednisolone (Solu-Medrol) is the corticosteroid most frequently used intravenously to speed up the recovery from MS attacks. It is most helpful if administered shortly (within a few days) after the onset of the attack.

  • How corticosteroids work: Corticosteroids affect immunologic actions, such as inflammation (swelling) and immune responses associated with an acute (sudden) attack of multiple sclerosis. Corticosteroids are used for short periods to reduce the duration and severity of symptoms associated with a sudden attack.
  • Who should not use these medications:
  • Who should use caution in using these medications:
  • Use: Solu-Medrol is administered intravenously (IV) for 3-5 days to treat a sudden multiple sclerosis attack. Steroids do not have an impact on the degree of clinical recovery, but rather in shortening the timing to recovery.
  • Drug or food interactions: Many drug interactions are possible. Contact a doctor or pharmacist before taking a new prescription or over-the-counter medications. Aspirin; nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil) or naproxen (Aleve); or other medications associated with stomach ulcers may increase the risk of developing stomach ulcers. Corticosteroids may decrease potassium levels; therefore, caution must be used when taking other medications that decrease potassium levels, such as diuretics, for example, furosemide (Lasix).
  • Side effects: Ideally, corticosteroids are used for short periods in order to control sudden flares in multiple sclerosis symptoms. Short-term use may cause fluid retention, potassium loss, stomach distress, weight gain, and changes in emotion. Long-term use is associated with serious side effects such as osteoporosis (calcium and vitamin D supplementation is advised), adrenal insufficiency, psychosis, immunosuppression, peptic ulcer, hypertension, insomnia, menstrual irregularities, acne, skin atrophy, elevated blood sugar, abnormal appearance of the face (Cushingoid face), increased risk of infection, and cataracts.
    • Induction of problems with blood sugar levels and worsening of diabetes control: Changes in diet or initiating oral antidiabetic medications or insulin may be required. For individuals who already have diabetes, dosage changes may be needed for the insulin or the antidiabetic medications.
    • Weight gain: This is a common problem with high-dose corticosteroids due to fluid retention and endocrine alterations. Salt restriction is advised, and with a doctor's approval, potassium supplementation may be needed. A doctor may prescribe a diuretic (water pill) to increase urination to eliminate some of the excess fluid.
Medically Reviewed by a Doctor on 3/10/2017
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