Switching from 2.5 mg of methylprednisolone to 2.5 mg prednisone and panicked over the side effects

Posted 7 years ago, 6 users are following.

jeannae68307

They are trying to get me off steroids and this is the first step because methylprednisolone has a longer half life. Just panicked over weight gain and worrying about another adrenal crisis. Any suggestions would be appreciated. I didn't do well on prednisone two years ago when I was switched to methylprednisolone.

0 likes, 8 replies

8 Replies

EileenH jeannae68307

Posted 7 years ago

Do you have PMR or GCA? If so, whatever your doctor tries to tell you then methotrexate does NOT replace pred altogether in either.
Do I understand you have already had adrenal problems? If so, have you seen an endocrinologist to investigate your current adrenal function?
- amkoffee EileenH
  
  Posted 7 years ago
  
  Eileen am I missing something or did you make a mistake? Jeannae said the name of the drug was methylprednisolone, but in your post you talked about methotrexate. Is methylprednisolone a combination of Prednisone and methotrexate?
- rocketman42 amkoffee
  
  Posted 7 years ago
  
  amkoffee...It is not the same as methotrexate. It is another form of steroid and is actually what prednisone is metabolized to in the liver so it skips that step. It is also considered an intermediate acting steroid. Some folks can potentially do better on one vs. the other.
- EileenH amkoffee
  
  Posted 7 years ago
  
  Yes, I did make a mistake - methylprednisolone is another corticosteroid and I obviously got distracted while reading and got the meth bit mixed! - that'll teach me to check what I'm writing!!!!!! Mea culpa, mea maxima culpa
  However - I'm not sure the halflife being longer is an advantage. Many people take Medrol with no problems but, personally, the only time that I have had problems with steroids was while I was on Medrol (methypred's brand name) and it was horrible. For some reason it didn't work for me, even at 20mg, and the side effects were awful: weight gain, skin and hair went mad and a lovely black beard... It is the methyl bit added to the basic structure of prednisolone (the active part) that potentiates the effect so it is held to have a bigger effect. However the methyl bit also makes the side effects bigger. It is methylprednisolone you get when you have injections.
margaret89358 jeannae68307

Posted 7 years ago

Is Prednisolone which I take different from Prednisone. I am hoping Eileen will answer this. Thank you
- EileenH margaret89358
  
  Posted 7 years ago
  
  Prednisone is inactive in the body until it has been processed in the liver to form prednisolone which is the active substance. That's is the only difference.
- margaret89358 EileenH
  
  Posted 7 years ago
  
  Thank you Eileen how do they decide what steroid you should take when you are diagnosed .
- EileenH margaret89358
  
  Posted 7 years ago
  
  Depends on the local preference (local as in the sense of country really). The USA tends to use prednisone and methylprednisolone. The UK usually uses prednisolone as it doesn't stress the liver at all. They are all fairly much the same in activity and effect although methylpred is said to be more effective - but as I said, is also associated with more side effects. Injections or infusions are always methylpred.

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