But there are important nuances about taking any steroid, whether prednisone or the Medrol Dosepak that people just don’t know.
Nobody has to think…
I mean, it’s just a punch-packet with a few pills in it, right?
Find out what those nuances are in this video or read on below for the best way to take a Medrol Dosepak.
You should take them first thing in the morning unless your doctor gave specific reasons to take it another time.
You might have been prescribed a Medrol Dosepak, or a methylprednisolone 6-day pack, or a prednisone 6-day pack. You might be wondering “how do I take this? There are so many pills ! Do I take them all at once? Do I take them with food? What should I do?”
Hi, I’m Dr. Megan, your Prednisone Pharmacist and I’m here to help you know how to take it and counteract as many side effects as possible while taking it.
So, what you’ll see is a pack with pills listed in lines, ok? Each line is a day. The first day – that first line – is going to have 6 pills on it. It’s going to be in a punch and you just punch out through the foil. It has several options for how to take it (it’s so confusing how they make it!) and what I recommend is not what you’ll first see. There are two options on there and that first option I do not recommend . It says “take one in the morning, take one mid morning, take one at lunch…” DON’T DO THAT!
Counterintuitive Way to Take a Medrol Dosepak
What I recommend is punch all six for that day out and take all of them first thing in the morning, or whatever time you picked up your prescription. If you saw your doctor at 9am and you got your prescription from the pharmacy at noon, take all 6 right then. Don’t spread it out throughout the day because if you take this medication at bedtime, you might have a really hard time sleeping because the #1 tweeted side effect of this medication is insomnia. So, if you take it at bedtime or spread it out throughout the day, it won’t have time to wear off so you can sleep restfully.
I recommend you take it all at once first thing in the morning and if you just got your prescription, then right when you get the prescription.
So, take – on day 1 – all 6 tablets in one swallow with a glass of water (and food if you tend to get an upset stomach or are taking other medications that might cause a drug interaction. That is to prevent a side effect called GERD, or stomach ulcers, or stomach upset.)
Then, on day 2, it’ll have 5 tablets. Instead of spreading them out throughout the days, what’re you going to do? You’re going to punch out all 5 and you’re going to swallow them in one swallow, first thing in the morning. What does that mean? It means at dawn or whenever you wake up in the morning.
Then, on day 3, it’ll have 4 tablets. Punch out all 4 tablets, take them all at once first thing in the morning.
Then, the next day it’ll have 3 tablets; punch them all out, swallow.
The following day, 2 tablets.
The last day will have 1 tablet. Take it all at once first thing in the morning and you will be all done with your Medrol Dospak, or methylprednisolone dosepak, or prednisone dosepak – or whatever you want to call it – and you’ll hopefully be feeling lots better!
But what if you’re not feeling better yet? What if it hasn’t gone away (whatever you were taking prednisone for or methylprednisolone for?) Then, definitely call your doctor, let them know you aren’t feeling well, that you haven’t quite recovered all the way, and that maybe you’ll have to take it longer.
What you just did by taking the tablets by 6, 5, 4, 3, 2, 1, was called a taper that was going from a super high dose, to a lower and lower dose over those few days. This helps your brain and system that you had knocked out – your hypothalamic pituitary adrenal system – you had stopped it from working! The whole idea of the taper is that it allows you to let it kick back so it can start making its own cortisol again.
So, if you take prednisone, or methylprednisolone, or any other steroid, for longer than 7 to 10 days, you will want to do a taper again. It means to go slowly off and you don’t ever want to go cold turkey without talking to your doctor. That’s between you and your doctor. Stopping cold turkey is never a good idea so follow your doctor’s orders because the withdrawal can actually be fatal.
To recap: don’t go cold turkey, get the taper, take it first thing in the morning to prevent the insomnia, and take it with food if you get stomach upset. Otherwise, it’s ok to take it without food.
You can take it with or without food. Generally it’s recommended to be taken with food to possibly prevent stomach ulcers.
If your packet says “Prednisone” instead of methylprednisolone, then you’ve got a Prednisone Dose Pack. The instructions are the same for both Medrol and Prednisone Dose Packs. Prednisone is another steroid similar to methylprednisolone, with the main difference being that you need a bit more prednisone to equal the effect of methylprednisolone. The tablet in the Medrol Dosepak contains methylprednisolone 4 mg, which is equivalent to 5 mg of prednisone. Most of the instructions, cautions, and side effects of methylprednisolone are the same as for prednisone. If you’d like to learn more about the Prednisone Dose Pack, check out my article with Prednisone Dose Pack Instructions .
The Medrol Dose Pack contains 6 days of tablets, a total of 21 methylprednisolone tablets. You take 6 tablets the first day and then one fewer each day for a total of 6 days.
If your doctor prescribed the Medrol 4 mg Dose Pack, then this is how much methylprednisolone you are taking per day:
Each day you’re just dropping down by one less pill. That’s called a taper . That’s the best way to stop taking methylprednisolone because your body needs time to recover to go slowly off.
The reason you taper is so you don’t go into what’s called an adrenal crisis . That is terrible. It can actually be fatal if you go straight from one dose to zero without slowly tapering off. And if you’ve taken just one day, it may be okay to go off completely. But you definitely have to check with your doctor. Going beyond five days of methylprednisolone therapy and definitely beyond 10 to 14 days, you must taper.
There are no exceptions. Going “cold turkey” off prednisone can literally be fatal.
So if you’re just taking the methylprednisolone dose pack, the six days worth, you can just follow that taper plan on the packet and it should be just right for you.
Methylprednisolone can work quickly to douse inflammation and provide pain relief. It depends on what you’re taking it for, but generally methylprednisolone can start working after 2-3 hours .
Doctors may prescribe a Medrol Dosepak for any type of inflammation or short-term autoimmune disease flare. Read my article for all the reasons that prednisone (and methylprednisolone) is used for.
Yes, the main ingredient in a Medrol Dosepak, methylprednisolone, is a steroid. It’s an anti-inflammatory type of steroid, which is different than the kind of steroids that bodybuilders use and abuse.
There are up to 150 side effects possible from a Medrol Dosepak. The most common you might experience include insomnia, extra energy (euphoria), jitteriness, anxiety, hot flashes, or hunger. Check out my searchable list of steroid side effects. to see if what you’re experiencing is a methylprednisolone side effect or something else.
One Prednisone Warrior commented these side effects:
Extreme hot flashes, racing heart, high BP, anxiety shot thru the roof! This was from a 6 day pack of prednisone for asthma and a shot of Decadron during same time period.
What if you stop taking it and you feel awful, you feel exhausted, have a hard time getting off the couch, or you’re miserable? Then tell your doctor, be in touch with your doctor’s office, because you might be going through withdrawals. Most people are fine doing just that six day taper and don’t go into withdrawal. But a small percentage of people need a more prolonged taper to help your adrenal system to recover. Discuss this with your doctor.
If you are looking to counteract the side effects of this short six day methylprednisolone dose pack taper, then check out my Prednisone Checklist.
You can download it by clicking the link below. In the free Prednisone Checklist, I have my tips for how to counteract the top side effects that happen while you’re taking prednisone or methylprednisolone. That way you can feel your very best, even though you’re taking this drug with so many side effects.
Dr. Megan Milne, PharmD, BCACP, is an award-winning clinical pharmacist board certified in the types of conditions people take prednisone for. Dr. Megan had to take prednisone herself for an autoimmune condition so understands what it feels like to suffer prednisone side effects and made it her mission to counteract them as the Prednisone Pharmacist.
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