IV Steroids for Multiple Sclerosis

Overview

What is steroid treatment for multiple sclerosis (MS)?

Methylprednisolone is a potent anti-inflammatory steroid that may improve the symptoms of MS. The medication methylprednisolone (Solu-Medrol®) is used for treatment of multiple sclerosis. Methylprednisolone is given intravenously (directly into a vein) for 30 to 45 minutes.

You will have blood tests before the treatment (to monitor your blood count, and sodium and potassium levels) or urine tests to rule out a bladder infection.

Procedure Details

What can I expect the day of my treatment?

  • Plan to be at the treatment center for about one hour on the day(s) of your treatment.
  • A nurse will check your blood pressure and pulse before and after the treatment.
  • The medication is given by intravenous drip for 30 to 45 minutes or injected directly into a vein.
  • After the treatment, you can return to your normal daily activities, including driving.
  • Following the intravenous treatments, you will be asked to take an oral form of a steroid called prednisone. Your healthcare provider will give you a written schedule of when and how often to take the medicine.
  • You may also be given a prescription for a medication to reduce stomach irritation and possibly a medication to assist with sleep during the time you are on medication.

What are pulse steroids?

In some patients with MS, the neurologist may suggest pulse steroids, a steroid given intermittently. This is usually done with an IV of methylprednisolone daily for three days every 2 to 3 months, sometimes with a taper after each course of steroids. In some patients, adding this to standard disease modifying agents may help improve the response to medications. Other patients may benefit from this type of treatment alone. Your healthcare provider will decide the most approrpirate method for you.

Risks / Benefits

What are some possible side effects?

It's important to remember that not everyone experiences these side effects.

Short term:

  • Metallic taste in the mouth
  • Flushing of the face, neck, or chest
  • Rapid heartbeat, elevated blood pressure
  • Feeling warm or cool
  • Stomach irritation such as indigestion and heartburn
  • Increased energy, which may result in difficulty sleeping
  • Mood changes (euophoria, irritability, nervousness, restlessness)
  • Increase in blood sugar level
  • Stretch marks, especially with weight gain
  • Increase risk of infection
  • Change in vision
  • Insomnia

Long term:

  • Joint problems (some cases of hip or shoulder joint injury due to steroids)
  • Thinning of the bones (osteoporosis)
  • Hypertension
  • Diabetes
  • Cataracts
  • Rounding of the face
  • Irregular heart beat
  • Menstrual problems
  • Slow healing

When to Call the Doctor

What should I be aware of if I have diabetes or glucose (sugar) intolerance?

Steroids will usually raise blood levels of glucose (sugar) during the few days of steroid treatment. In most patients, this elevation is not a problem and should night require monitoring or treatment. However, in patients with diabetes or glucose intolerance (i.e., “pre-diabetes”), additional monitoring and treatment may be indicated. These patients should discuss how to monitor and treat increases in glucose with their primary care provider, which may include oral medications or a ‘sliding scale’ for insulin. If you have any concerns about your glucose (sugar) level, contact your primary care provider, or if necessary seek treatment at an emergency room.

Additional Details

Does insurance cover IV steroid treatment?

Insurance coverage for this treatment varies greatly, depending on individual insurance plans. Intravenous methylprednisolone (Solu-Medrol®) is usually covered. You may want to check with your insurance company before receiving treatment.

Last reviewed by a Cleveland Clinic medical professional on 01/28/2019.

References

  • Expert knowledge of caregivers at Cleveland Clinic

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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy