What to Expect From Solu-Medrol Treatment for MS

This powerful drug can improve symptoms and shorten relapses

If you have one of the relapsing-remitting forms of multiple sclerosis (MS), your doctor may suggest a medication called Solu-Medrol, which is the liquid form of methylprednisolone. This is a powerful corticosteroid that's given through a vein to make symptoms less severe and shorten MS relapses.

Solu-Medrol works by reducing the inflammation around lesions and closing the blood-brain barrier. This drug can be almost miraculously and swiftly effective. However, for some people, this relief comes with side effects including weight gain that may linger after you stop taking the medication.

Tips to Make Solu-Medrol Infusion More Comfortable
Verywell / JR Bee

How Solu-Medrol Is Given

Solu-Medrol is usually given in doses between 500 and 1,000 milligrams per day for three to five days. It is delivered intravenously (through your vein) as an infusion. You'll have an IV line inserted into your hand or arm that consists of a small catheter attached to a couple of inches of flexible tubing. A “hub” or “lock” on the end allows tubing to be attached.

Often, you'll get your first Solu-Medrol series in a hospital on an inpatient basis. That's so your reaction can be monitored and you can be taken care of during the infusion.

For further treatments, you may go to a clinic or an infusion center, where you will be given the medicine while lying down in a bed or reclining in a chair. In some cases, a nurse goes to someone's home to give the infusion.

The actual administration of Solu-Medrol is pretty standard. After the IV line is inserted, the bag containing the Solu-Medrol is infused over a period of time, which ranges from one to four hours. You may experience about a 30-second period of stinging and a cool sensation when the medication begins to flow.

How Much Does Solu-Medrol Cost?

The cost for a 1000-milligram infusion is generally between $50 and $70.

Before Your Infusion

Taking certain steps ahead of time can make a Solu-Medrol infusion more comfortable:

  • Be well-hydrated: When you drink lots of fluids, it makes your veins larger and easier to find, which makes insertion of the IV line less difficult.
  • Eat before treatment: Solu-Medrol can cause gastritis and heartburn if administered on an empty stomach. You may also want to ask your doctor about taking an antacid an hour or two before your infusion.
  • Request paper tape: The IV line needs to be secured to your skin, but the drug can make your skin fragile, especially around the IV insertion site. Paper tape is easier to remove than other tapes, so it pays to ask for it. If necessary, other tapes or a bandage can go over the paper tape to make it more secure.
  • Choose which hand will get the IV: The line may be kept in place for up to five days, and it can be annoying to have it in the hand that you use for holding a book or using a computer mouse. Voice where you'd like the IV to be placed. Of course, this may be decided for you when the nurse looks for an “easy” vein to use, but you can state your preference.

During Your Infusion

It pays to be prepared for certain situations during your infusion as well.

  • Have mints handy: You might experience a metallic taste in your mouth. Water won't help and some foods will taste weird. Strong mints or gum are much more effective when it comes to dealing with the taste.
  • Relax and distract yourself: Try some deep breathing exercises—count each breath up to 10, then count back down to one. This can relax you and may also help you fall asleep during your infusion. In case you can't sleep, bring music or a book on tape to listen to during treatment. Because of the IV line in your hand, you may not want to hold a book, magazine, or electronic device.
  • Speak up: If your face starts feeling hot or if your heart starts beating fast, be sure to say something. Your nurse may be able to slow down the rate at which the medicine is being infused, which can eliminate these side effects.

After Treatment

Management doesn't stop when your Solu-Medrol infusion is over. You'll need to keep some things in mind for afterward:

  • Eat plainly: Food may continue to taste strange for a couple of hours after treatment, so bland choices are a good idea. Avoid anything greasy, as it could make heartburn worse. Also, limit sweets and things with high sugar content, as Solu-Medrol will increase blood sugar levels.
  • Avoid salt: Solu-Medrol may cause salt and water retention. This can lead to feeling bloated all over, as well as to swollen feet and ankles. Avoid salty foods to minimize this effect, which should disappear within a week of the last treatment.
  • Stay home: Solu-Medrol makes most people feel anxious and agitated. During this time, it is best to stay home and be calm and quiet. Since it's unlikely that you'll be productive at work, or even in the mood to interact with co-workers, it's best to take some time off if you can.
  • Don’t drive: It's a good idea to have someone drive you home after each infusion. You may have a hard time concentrating, be nervous, or have perceptions that are just “off.” Leave the worries about traffic and the quick decision-making to someone else.
  • Troubleshoot insomnia: Solu-Medrol may cause insomnia. While you may welcome the time to be productive, remember that the treatment puts a huge strain on your body and you'll benefit from rest. Don’t hesitate to ask your doctor about sleep medications or other treatments that may help.

If You Have Diabetes

Because this medication can raise blood-sugar levels, get specific instructions from your nurse or doctor on monitoring and regulating your blood sugar during treatment and the day after.

Side Effects

The side effects mentioned above (anxiety, water retention, insomnia, etc.) aren't the only ones Solu-Medrol can cause. Others include:

  • Acne (cystic), which is characterized by small blemishes on the back and chest (though it can affect the face and other areas)
  • Appetite changes
  • Cataracts
  • Convulsions
  • Dizziness
  • Erectile dysfunction
  • Facial hair growth
  • Glaucoma
  • Growth retardation (in children)
  • Headache
  • High blood pressure
  • Increased sweating
  • Injection site pain, swelling, or redness
  • Irregular menstrual period
  • Lowered potassium levels
  • Muscle weakness
  • Nausea and/or vomiting
  • Puffiness in the face
  • Psychiatric disturbances
  • Risk of infection due to immune system suppression (avoid sick people as much as possible)

Most side effects will go away quickly once you're no longer receiving infusions. A notable exception is weight gain.

Weight Gain

Solu-Medrol may cause some people to gain weight because it's a corticosteroid, which may stimulate the appetite and cause you to eat more. It's also possible that stomach pain sometimes caused by the medication may trigger you to eat more in an effort to ease the discomfort. Water retention can play a role in weight gain as well.

In rare cases, corticosteroids have been known to cause some people to develop a rare hormonal disorder called Cushing's syndrome. This condition leads to deposits of fat in the upper body and abdomen and can make the face look plump and rounded. This is more likely to happen to someone who takes small doses of corticosteroids over an extended period—oral prednisone to treat asthma, for example—than for someone with MS who has to take large infrequent doses given for relapses.

To help prevent weight gain while taking this drug:

  • Steer clear of sodium.
  • Eat small, frequent meals.
  • Reach for low-calorie snacks if you find yourself eating more than usual.
  • Get plenty of protein.
  • Eat small amounts of healthy fats, like avocados and nuts, which help you feel fuller longer.
  • Stay active to keep burning off calories.

If you need help taking off weight, talk to your doctor about healthy options.

Interactions and Contraindications

Solu-Medrol may interact negatively with many drugs, including live vaccines, diabetes medications, and estrogens. Check with your doctor and pharmacist to make sure you're not combining drugs in a dangerous way. There's not much information on using this drug during pregnancy or nursing, so it's best to avoid it.

If you have any further questions or concerns, always talk to your doctor. Our Doctor Discussion Guide below can help you start that conversation.

Multiple Sclerosis Doctor Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

Doctor Discussion Guide Woman

A Word From Verywell

Solu-Medrol is just one option among many when it comes to treating your MS. Working with your healthcare team to find the treatments that work best for you is an important part of managing your illness and retaining—or regaining—your ability to function well.

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Article Sources

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  2. Ciriaco M, Ventrice P, Russo G, et al. Corticosteroid-related central nervous system side effects. J Pharmacol Pharmacother. 2013;4(Suppl 1):S94-8. doi: 10.4103/0976-500X.120975

  3. Jongen PJ, Stavrakaki I, Voet B, et al. Patient-reported adverse effects of high-dose intravenous methylprednisolone treatment: a prospective web-based multi-center study in multiple sclerosis patients with a relapse. J Neurol. 2016;263(8):1641-51. doi: 10.1007/s00415-016-8183-3

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