From the Research
Methylprednisolone for DRESS syndrome is typically started at 1-2 mg/kg/day (or approximately 40-120 mg daily for adults), with gradual tapering over 8-12 weeks, as recommended by recent studies 1, 2. The treatment of DRESS syndrome involves the discontinuation of the culprit drug, supportive therapies, and administration of corticosteroids, with methylprednisolone being the preferred choice due to its potent anti-inflammatory and immunosuppressive effects 3, 4.
Key Considerations
- The tapering schedule should be slow to prevent rebound symptoms, often reducing by 5-10 mg every 1-2 weeks depending on clinical response 4.
- For severe cases involving major organ dysfunction (liver, kidney, lung, or heart), higher initial doses of 500-1000 mg/day for 3-5 days (pulse therapy) may be used before transitioning to the standard regimen 1, 4.
- Treatment should continue until clinical and laboratory abnormalities resolve, particularly eosinophilia and organ dysfunction 5, 2.
- Abrupt discontinuation must be avoided as it can lead to symptom recurrence 4.
Severe Cases
- Pulse steroid therapy (250 mg/day methylprednisolone for 3 days) or plasmapheresis can be used to treat difficult DRESS cases where organ failure is about to happen 1.
- The use of alternative systemic therapies, such as immunosuppressive agents, intravenous immunoglobulin, and biologics, may be considered in cases of primary treatment failure or suboptimal response 3.