Guideline Recommendations for Intramuscular Methylprednisolone Use

Polymyalgia Rheumatica

• The 2015 EULAR/ACR guidelines conditionally recommend using intramuscular methylprednisolone as an alternative to oral glucocorticoids, with a starting dose of 120 mg IM every 3 weeks for disease control. 1

Situations Where Intramuscular Administration Is Not Preferred

• Current clinical guidelines advise that for anaphylaxis, corticosteroid therapy should be given intravenously at a dose equivalent to 1–2 mg/kg of methylprednisolone every 6 hours, rather than intramuscularly, because rapid maximal effect is required. [2][3]
• In acute severe ulcerative colitis, the recommended regimen is intravenous methylprednisolone 60 mg once daily (or hydrocortisone 100 mg four times daily), emphasizing that the IV route, not IM, is preferred for prompt therapeutic effect. 4