Inpatient Dosing of Solu-Medrol (Methylprednisolone) for Specific Conditions

Asthma Exacerbations

For severe asthma exacerbations in adults, the American Academy of Allergy, Asthma, and Immunology recommends 60-80 mg/day of methylprednisolone for 3-10 days 1, 2
For moderate asthma exacerbations, the American Academy of Allergy, Asthma, and Immunology suggests 40-60 mg in single or divided doses for 5-10 days 3, 4

For non-responding or slowly responding patients, the European Association for the Study of the Liver recommends higher doses of steroids, including methylprednisolone, combined with 2 mg/kg/day azathioprine 5, 6

For grade 4 cytokine release syndrome, the National Comprehensive Cancer Network recommends dexamethasone 10 mg IV every 6 hours; if refractory, consider methylprednisolone 1000 mg/day IV for 3 days 7

The American Academy of Allergy, Asthma, and Immunology states that no proven advantage exists for higher doses of corticosteroids in severe asthma exacerbations 3, 4
The American Academy of Allergy, Asthma, and Immunology also notes that no advantage has been demonstrated for IV administration over oral therapy, provided gastrointestinal transit time or absorption is not impaired 3, 4
For corticosteroid courses of less than 1 week, the American Academy of Allergy, Asthma, and Immunology recommends that there is no need to taper the dose 3
For courses up to 10 days, the American Academy of Allergy, Asthma, and Immunology suggests that tapering is likely unnecessary, especially if patients are concurrently taking inhaled corticosteroids 4