Last update Aug. 20, 2022

Methylprednisolone

Very Low Risk

Safe. Compatible. Minimal risk for breastfeeding and infant.

It is a corticosteroid that is used to treat inflammation and immune reactions in a wide variety of diseases. Oral, intramuscular, intravenous, topical, ophthalmological, intraarticular and intralesional administration.

It is excreted into breast milk in non-significant amount (Zengin 2020, Boz 2018, Gunduz 2016, Cooper 2015, Strijbos 2015) with no problems reported in breastfed infants whose mothers were treated for a long time period. (Costanzo 2020, Zengin 2020, Grekas 1984)

Following megadoses of methylprednisolone (1 g daily) the maximum dose the infant can take through breast milk is less than half the therapeutic infant dose and with a relative dose of less than 3% (Zengin 2020, Boz 2018, Gunduz 2016, Cooper 2015, Strijbos 2015). If you want to minimize the exposure of the infant after a megadose or in chronic treatment at doses greater than 40 mg/day, 2 to 4 hours after drug administration can be expected. (Zengin 2020, Boz 2018, Gunduz 2016, Cooper 2015, Strijbos 2015)

Intra-articular injections of methylprednisolone may temporarily decrease milk production. (Babwah 2013)

Corticosteroids such as betamethasone, administered before delivery may delay initiation of phase II of Lactogenesis ("milk come in") and decrease milk production in the first postpartum week. (Henderson 2008)

Steroid drugs are commonly used for Pediatric treatment with no side effects when infrequently used and for short-time periods.

Alternatives

We do not have alternatives for Methylprednisolone since it is relatively safe.

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Methylprednisolone is also known as


Methylprednisolone in other languages or writings:

Groups

Methylprednisolone belongs to these groups or families:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 80 (rectal: 14) %
Molecular weight 375 daltons
Protein Binding 77 %
VD 1.2 - 1.5 l/Kg
pKa 12.59 -
Tmax 2 hours
3.5 hours
Theoretical Dose 0.07 - 0.2 mg/Kg/d
Relative Dose 0.5 - 1.45 %

References

  1. Zengin Karahan S, Boz C, Terzi M, Aktoz G, Sen S, Ozbudun B, Caglar A, Şener M. Methylprednisolone Concentrations in Breast Milk and Serum of Patients with Multiple Sclerosis Treated with IV Pulse Methylprednisolone. Clin Neurol Neurosurg. 2020 Oct;197:106118. Abstract
  2. Costanzo G, Firinu D, Losa F, Deidda M, Barca MP, Del Giacco S. Baricitinib exposure during pregnancy in rheumatoid arthritis. Ther Adv Musculoskelet Dis. 2020 Feb 3;12:1759720X19899296. Abstract Full text (link to original source)
  3. Boz C, Terzi M, Zengin Karahan S, Sen S, Sarac Y, Emrah Mavis M. Safety of IV pulse methylprednisolone therapy during breastfeeding in patients with multiple sclerosis. Mult Scler. 2018 Aug;24(9):1205-1211. Abstract
  4. Flint J, Panchal S, Hurrell A, van de Venne M, Gayed M, Schreiber K, Arthanari S, Cunningham J, Flanders L, Moore L, Crossley A, Purushotham N, Desai A, Piper M, Nisar M, Khamashta M, Williams D, Gordon C, Giles I; BSR and BHPR Standards, Guidelines and Audit Working Group. BSR and BHPR guideline on prescribing drugs in pregnancy and breastfeeding-Part I: standard and biologic disease modifying anti-rheumatic drugs and corticosteroids. Rheumatology (Oxford). 2016 Sep;55(9):1693-7. Abstract Full text (link to original source) Full text (in our servers)
  5. Gunduz S, Gencler OS, Celik HT. Four hours is enough for lactation interruption after high-dose methylprednisolone treatment in multiple sclerosis mothers by measuring milk cortisol levels. J Matern Fetal Neonatal Med. 2016 Abstract
  6. Almas S, Vance J, Baker T, Hale T. Management of Multiple Sclerosis in the Breastfeeding Mother. Mult Scler Int. 2016;2016:6527458. Abstract Full text (link to original source) Full text (in our servers)
  7. Strijbos E, Coenradie S, Touw DJ, Aerden L. High-dose methylprednisolone for multiple sclerosis during lactation: Concentrations in breast milk. Mult Scler. 2015 Abstract
  8. Cooper SD, Felkins K, Baker TE, Hale TW. Transfer of methylprednisolone into breast milk in a mother with multiple sclerosis. J Hum Lact. 2015 Abstract
  9. Bodiguel E, Bensa C, Brassat D, Laplaud D, Le Page E, Ouallet JC, Zephir H, De Seze J; Groupe de Réflexion sur la Sclérose en Plaques. Multiple sclerosis and pregnancy. Rev Neurol (Paris). 2014 Abstract
  10. Babwah TJ, Nunes P, Maharaj RG. An unexpected temporary suppression of lactation after a local corticosteroid injection for tenosynovitis. Eur J Gen Pract. 2013 Dec;19(4):248-50. Abstract
  11. Bae YS, Van Voorhees AS, Hsu S, Korman NJ, Lebwohl MG, Young M, Bebo B Jr, Kimball AB; National Psoriasis Foundation. Review of treatment options for psoriasis in pregnant or lactating women: from the Medical Board of the National Psoriasis Foundation. J Am Acad Dermatol. 2012 Abstract
  12. Jain V, Gordon C. Managing pregnancy in inflammatory rheumatological diseases. Arthritis Res Ther. 2011 Abstract Full text (link to original source)
  13. van der Woude CJ, Kolacek S, Dotan I, Oresland T, Vermeire S, Munkholm P, Mahadevan U, Mackillop L, Dignass A; European Crohn's Colitis Organisation (ECCO). European evidenced-based consensus on reproduction in inflammatory bowel disease. J Crohns Colitis. 2010 Abstract Full text (link to original source) Full text (in our servers)
  14. Jürgens TP, Schaefer C, May A. Treatment of cluster headache in pregnancy and lactation. Cephalalgia. 2009 Abstract
  15. Mottet C, Vader JP, Felley C, Froehlich F, Gonvers JJ, Juillerat P, Stockbrügger R, Angelucci E, Seibold F, Michetti P, Pittet V; EPACT II Study Group. Appropriate management of special situations in Crohn's disease (upper gastro-intestinal; extra-intestinal manifestations; drug safety during pregnancy and breastfeeding): Results of a multidisciplinary international expert panel-EPACT II. J Crohns Colitis. 2009 Abstract Full text (link to original source) Full text (in our servers)
  16. Henderson JJ, Hartmann PE, Newnham JP, Simmer K. Effect of preterm birth and antenatal corticosteroid treatment on lactogenesis II in women. Pediatrics. 2008 Abstract Full text (link to original source) Full text (in our servers)
  17. Østensen M, Motta M. Therapy insight: the use of antirheumatic drugs during nursing. Nat Clin Pract Rheumatol. 2007 Abstract
  18. Mottet C, Juillerat P, Pittet V, Gonvers JJ, Froehlich F, Vader JP, Michetti P, Felley C. Pregnancy and breastfeeding in patients with Crohn's disease. Digestion. 2007 Abstract
  19. Heetun ZS, Byrnes C, Neary P, O'Morain C. Review article: Reproduction in the patient with inflammatory bowel disease. Aliment Pharmacol Ther. 2007 Abstract Full text (link to original source) Full text (in our servers)
  20. National Asthma Education and Prevention Program Asthma and Pregnancy Working Group. Managing asthma during pregnancy: recommendations for pharmacologic treatment-2004 update. 2004;1-57. None 2004 Full text (link to original source) Full text (in our servers)
  21. Janssen NM, Genta MS. The effects of immunosuppressive and anti-inflammatory medications on fertility, pregnancy, and lactation. Arch Intern Med. 2000 Abstract Full text (link to original source) Full text (in our servers)
  22. Nyberg G, Haljamäe U, Frisenette-Fich C, Wennergren M, Kjellmer I. Breast-feeding during treatment with cyclosporine. Transplantation. 1998 Abstract
  23. Needs CJ, Brooks PM. Antirheumatic medication during lactation. Br J Rheumatol. 1985 Abstract
  24. Grekas DM, Vasiliou SS, Lazarides AN. Immunosuppressive therapy and breast-feeding after renal transplantation. Nephron. 1984 Abstract Full text (link to original source) Full text (in our servers)

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