From the Guidelines
Medrol (methylprednisolone) is effective for treating hives, particularly for severe or persistent cases that don't respond to antihistamines, as it reduces inflammation and suppresses the immune response that triggers hives. The use of corticosteroids like methylprednisolone in managing hives is supported by guidelines that address the treatment of various conditions where hives or urticaria may be a symptom, such as infusion reactions to systemic anticancer therapy 1. For acute hives, a short course of Medrol may be prescribed, typically starting with a higher dose (such as 16-32 mg daily) and tapering down over 5-7 days. This approach is similar to the management strategies outlined for other conditions where corticosteroids are used to reduce inflammation and immune responses, such as in the treatment of severe alcoholic hepatitis where methylprednisolone may be used for patients with a high risk of mortality 1.
However, Medrol is generally not recommended as a first-line treatment for hives due to potential side effects with prolonged use, including weight gain, mood changes, increased blood sugar, and bone density loss. It's best used for short-term management of severe symptoms or when antihistamines haven't provided relief. Patients should always take Medrol exactly as prescribed, complete the full course even if symptoms improve, and never stop suddenly as this can cause withdrawal symptoms. If you experience hives regularly, it's crucial to work with your healthcare provider to identify and avoid triggers while developing an appropriate treatment plan.
Key considerations in the use of Medrol for hives include:
- Starting with a suitable dose based on the severity of symptoms
- Tapering the dose appropriately to minimize side effects
- Monitoring for potential side effects, especially with prolonged use
- Combining Medrol with other treatments, such as antihistamines, under medical supervision
- Ensuring patient education on the proper use of Medrol and the importance of adherence to the prescribed treatment plan.
From the Research
Effectiveness of Medrol for Hives
- Medrol, also known as methylprednisolone, is a corticosteroid that can be used to treat hives, particularly in cases where antihistamines are not effective 2.
- A study published in 2003 suggested that corticosteroid therapy with prednisone or methylprednisolone can be administered for a few days (7-14) if urticarial symptoms are not controlled by antihistamines and a rapid clinical response is needed 2.
- Another study published in 2010 found that a short course of oral prednisone was effective in inducing remission in nearly 50% of patients with antihistamine-resistant chronic urticaria 3.
Potential Risks and Considerations
- While Medrol can be effective in treating hives, it is not without potential risks and side effects, particularly with long-term use 2.
- A case report published in 2011 described a patient who experienced acute urticaria induced by oral methylprednisolone, highlighting the potential for allergic reactions to corticosteroids 4.
- The use of Medrol for hives should be carefully considered and monitored by a healthcare professional, particularly in patients with a history of allergies or other medical conditions 2, 3.
Alternative Treatment Options
- Other treatment options for hives may include antihistamines, leukotriene receptor antagonists, and immunomodulatory agents such as cyclosporine and methotrexate 2, 5, 6.
- A study published in 2011 found that methotrexate was effective in treating recalcitrant chronic urticaria in patients who were not responsive to conventional therapy 5.
- Another study published in 2006 found that mycophenolate mofetil was a valuable and safe treatment for patients with chronic urticaria who did not respond to antihistamines and/or corticosteroids 6.