From the FDA Drug Label
In treatment of acute exacerbations of multiple sclerosis, daily doses of 200 mg of prednisolone for a week followed by 80 mg every other day for 1 month have been shown to be effective (4 mg of methylprednisolone is equivalent to 5 mg of prednisolone)
The oral dose of steroids that can be given to MS patients during a flare-up is 200 mg of prednisolone per day for a week, followed by 80 mg every other day for 1 month. Since 4 mg of methylprednisolone is equivalent to 5 mg of prednisolone, this can be translated to 160 mg to 200 mg of methylprednisolone per day for a week, followed by 64 mg to 80 mg every other day for 1 month 1.
- Key points:
- The dosage may vary depending on the patient's response and clinical status.
- It is essential to monitor the patient's condition and adjust the dosage as needed.
- The treatment should be individualized based on the disease entity and the patient's response.
From the Research
Yes, oral steroids can be given to MS patients during a flare-up, with a recommended dose of 1250 mg/day of methylprednisolone for 3 days, as shown to be effective in a recent study 2. The most common regimen is oral methylprednisolone, which has been compared to intravenous administration in several studies, including a 2019 pilot study that found a lesser high-dose oral regimen may not be inferior to the standard high dose in terms of clinical and radiological response 2. Some key points to consider when prescribing oral steroids for MS patients include:
- The medication should be taken with food to minimize gastrointestinal side effects
- Patients may need stomach protection medication
- Short-term side effects can include insomnia, increased appetite, mood changes, and elevated blood sugar
- Steroids work by reducing inflammation in the central nervous system, thereby shortening the duration and severity of MS flare-ups
- While steroids can speed recovery from relapses, they don't affect the long-term course of MS or prevent future relapses Other studies have also supported the use of oral steroids for MS relapses, including a 2015 study that found oral administration of high-dose methylprednisolone was not inferior to intravenous administration 3, and a 2009 review that noted high-dose short-term oral or intravenous methylprednisolone can speed up recovery from relapses 4. However, the most recent and highest quality study, 2, provides the strongest evidence for the recommended dose and regimen.