The Solu-Medrol Experience: Side Effects and Tips

How to Make it Through a Solu-Medrol Infusion

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Solu-Medrol is the liquid form of methylprednisone, a powerful corticosteroid. Solu-Medrol is used for multiple sclerosis (MS) in high intravenous doses to reduce the severity and duration of relapses by reducing the inflammation around a lesion and closing the blood-brain barrier. It's usually given in doses between 500 and 1000 mg/day for three to five days.

About the Solu-Medrol Experience

  • Hospital, Clinic or Home: Often the first Solu-Medrol series is given in a hospital on an inpatient basis for the duration of the treatment (three to five days), so that your reaction can be monitored and you can be taken care of during this time. You can also go to a clinic or an infusion center, where you will be given the medicine while laying down in a bed or reclining in a chair. Arrangements may occasionally be made for a nurse to come to your home to administer the treatment, as well.
  • The IV Line: Your IV line will be inserted into your hand or arm and will consist of a small catheter attached to a couple of inches of flexible tubing with a “hub” or “lock” on the end which allows tubing to be attached to it. This will be taped in place and probably left there to be used for a couple of treatments, if not all of them.
  • Giving the Medication: The actual administration of Solu-Medrol is pretty standard. After the IV line is inserted, the bag containing the Solu-Medrol (between 500 and 1000 mg diluted in 100 to 500 ml of fluid) is infused over a period of time ranging from one to four hours. You will experience a brief (30 seconds) period of stinging and a cool sensation when the medication begins to flow.

Tips for Before Your Solu-Medrol Infusion Starts

  • Be Well-Hydrated: Drink lots of fluids before you go for your infusion. Being well-hydrated makes your veins larger and easier to find, which makes insertion of the IV line a breeze.
  • Protect Your Gut: Solu-Medrol causes gastritis and heartburn if administered on an empty stomach. It is wise to eat a large meal before your treatment. Treat yourself to your favorite foods and fill up -– food will taste strange for a couple hours after your treatment, anyway. Make sure that you take a Zantac an hour or two before getting your infusion.
  • Request Paper Tape: Ask that paper tape be used to secure the IV line, at least on the first layer next to the skin, which can then be covered with standard tape or a bandage for protection. Solu-Medrol makes your skin very fragile, especially around the area where the IV line is inserted. Paper tape will come off much easier when it is time to remove the IV.
  • Choose Your Hand: Decide ahead of time which hand you prefer to be used for the IV. The line may be kept in place for up to five days, and I find that it can be annoying to have it in the hand that you use for holding a book or using a computer mouse. Of course, the placement may be decided for you when the nurse looks for an “easy” vein to use, but you can state your preferences.

Tips for During Your Infusion

  • Have Mints Handy: During the infusion, you might experience a metallic taste in your mouth. It is helpful to have strong mints or gum to use, as water doesn’t help and other beverages or foods taste terrible.
  • Try to Relax: Bring your iPod or Walkman with music or a book on tape to listen to during the infusion. Books and magazines are also good, but there is always a chance that the IV line will make these awkward to handle, plus I like closing my eyes to avoid staring up into the inevitable fluorescent lights. Try some deep breathing exercises –- count each breath up to ten, then count back down to one. I have fallen asleep this way during an infusion.
  • Slow Down: If your face starts feeling hot or if your heart starts beating fast, ask the nurse to slow down the rate at which the medicine is being infused.
  • Flush With Saline: Make sure that the nurse flushes your line with saline after each infusion. Some nurses may scoff at this, but I have noticed a huge difference in the number of infusions I can use each line for and also a decrease in the bruising and thinning of the skin in that arm.

What You Should Do After Your Treatment

  • Eat Comfort Food: As mentioned, food will taste strange for a couple hours after treatment, so bland is good. However, you will want to avoid anything greasy, as this could aggravate heartburn. Also, limit sweets and things with high sugar content, as Solu-Medrol will increase blood sugar levels. (If you are diabetic, get specific instructions from your nurse or doctor on monitoring and regulating your blood sugar during treatment and the day after.)
  • Avoid Salty Foods: Solu-Medrol causes water retention. This can lead to feeling bloated all over, as well as to swollen feet and ankles. Avoid salty foods and drink lots of water to minimize this effect, which should disappear within a week of the last treatment.
  • Be Quiet: Solu-Medrol makes most people feel anxious and agitated. During this time, it is best to stay home and be calm and quiet. Do not try to go to work –- you will not be productive and your interactions with your co-workers may come back to haunt you.
  • Don’t Drive: You may have a hard time concentrating, may be nervous, or your perception may be “off.” Even if you think it will be okay to drive, it is a good idea to have someone drive you home after each infusion. Leave the worries about traffic and the quick decision-making needed for driving to someone else.
  • Troubleshoot Insomnia: Solu-Medrol causes insomnia, which some people call a “welcome” side effect, as they end up cleaning house, balancing checkbooks and answering e-mails. However, you need your rest during this time –- this treatment is putting a huge strain on your body. Try different techniques to help you sleep, but don’t hesitate to ask your doctor for medicine for this purpose.

Other Useful Solu-Medrol Infusion Tips

  • Protect Your IV Line: If you need an MRI during this time, do not allow the MRI technicians to use your IV line to administer the gadolinium. While this saves them time, the gadolinium is caustic and could cause your vein to collapse, meaning the IV line will have to be reinserted for your next Solu-Medrol treatment.
  • Avoid Infections: Steroids greatly reduce your immune system’s ability to fight infection. Avoid any contact with people who have symptoms of colds or other viruses. Notify your doctor immediately if you develop a fever, chills, respiratory symptoms or a rash.
  • Avoid Vaccinations: Solu-medrol may make you less responsive to vaccinations, as your ability to mount an immune response is weakened. Speak with your doctor about when is the best time to get your vaccinations.

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