What to avoid while taking Methylprednisolone? 

In this brief article, we will be answering the question “What to avoid while taking Methylprednisolone?” and other queries related to this topic. 

What to avoid while taking Methylprednisolone? 

It is best to avoid the following while being treated with Methylprednisolone:

• Non-steroidal anti-inflammatory drugs (NSAIDs) 
• Anticoagulants / Blood thinners
• Antidiabetic medications
• Alcoholic beverages 
• Excessive caffeine 
• Grapefruit juice 

Non-steroidal anti-inflammatory drugs (NSAIDs) 

It is in your best interest to avoid using NSAIDs while you’re on Methylprednisolone. Some commonly used NSAIDs are

• Ibuprofen 
• Aspirin 
• Diclofenac 
• Naproxen 

These medications are associated with several gastrointestinal side effects, just like Methylprednisolone. Both NSAIDs and Methylprednisolone are heavy on your stomach and the concomitant use can cause significant damage, especially in the long run (1). 

This combination can lead to stomach ulceration and can increase the risk of gastrointestinal bleeding. This is why it’s better not to use NSAIDs while taking Methylprednisolone (2). 

Anticoagulants / Blood thinners

It is not recommended to pair anticoagulants with Methylprednisolone. This is because this steroidal medication can either make your blood thinner more efficient or reduce its effectiveness (4,5). 

Either way, you will not be able to achieve the desired therapeutic response as too much drug activity will increase the risk of bleeding and insufficient drug activity will increase the risk of blood clotting (4,5). 

So it’s better to avoid using these medications together. If you’re already on blood thinners, talk to your doctor before starting Methylprednisolone. 

Antidiabetic medications

Methylprednisolone doesn’t interact with antidiabetic medications per se, but it can make them ineffective by raising your blood glucose levels (6). 

This is one of the most common side effects of Corticosteroids and even a healthy individual is warned about increased blood glucose levels and is advised to limit sugar intake while being on Methylprednisolone (6). 

If you’re diabetic, talk to your healthcare provider before starting Methylprednisolone. 

Alcoholic beverages 

It is recommended to avoid using alcoholic beverages while being on Methylprednisolone as both the medication and alcohol can induce depression by lowering serotonin levels in your body (7). 

Behavioural and mood changes are frequently reported on the concomitant use of alcohol and corticosteroids. The two can also cause a number of gastrointestinal side effects when used together as they both can be heavy on your stomach (7,8). 

Excessive caffeine 

It is recommended to limit caffeine while being on Methylprednisolone because of increased gastrointestinal side effects (9,10).

Now, you don’t necessarily have to stop drinking coffee altogether while being treated with Methylprednisolone, but limiting its intake can be beneficial for your stomach health. 

Grapefruit juice 

Grapefruit juice may affect the time taken by Methylprednisolone to get removed from your body. Grapefruit can inhibit some liver enzymes, including the one that metabolizes Methylprednisolone and breaks it down into its inactive components (11). 

This inhibition can increase the duration of action of this medication and can cause more intense side effects. This is why it’s better to avoid grapefruit while you’re on Methylprednisolone (11). 

What are the safe options while taking Methylprednisolone?

While using Methylprednisolone, it is important to consider the following:

Acetaminophen

If you have body pain, you can take Acetaminophen which is a safer option, as compared to NSAIDs (3). If you’re still concerned about your symptoms, it’s better to talk to your healthcare provider. 

In case of common cold and flu, Methylprednisolone and Prednisone can be taken with OTC antihistamines, expectorants, etc.

Anticoagulants

As we discussed earlier, bleeding complications increase when Methylprednisolone is co-prescribed with Anticoagulants/blood thinners or agents with antiplatelet properties (NSAIDs).

These combinations should be minimized whenever possible and carefully balanced against improved thrombosis prevention when clinically indicated (12,13). 

If concomitant therapy cannot be avoided, the addition of H2 antihistamine receptor blockers or proton pump inhibitors to mitigate gastrointestinal bleeding should be undertaken (12,13).

H2 antihistamine receptor blockers and proton pump inhibitors act by reducing stomach acid production and secretion. This can be advantageous in alleviating gastrointestinal problems such as acid reflux, ulcers, and potential bleeding caused by certain medications (12,13).

It is important to emphasize that the decision to use these combinations and medicines should be taken by the healthcare professional, based on a complete assessment of the risk and benefit profile for each patient individually.

Antidiabetics

Methylprednisolone has the potential to affect blood glucose control and may diminish the efficacy of metformin and other diabetic medications. It requires strict blood glucose and clinical monitoring (14). 

During and after treatment with Methylprednisolone, you may need a dose adjustment based on capillary glycemia and changes in the dose of glucocorticoids (15).

Conclusions

In this article, we addressed topics like what to avoid while taking Methylprednisolone, as well as some safe options while taking this drug.

Always make sure that you stick to your doctor’s recommended doses and do not combine Methylprednisolone, or steroids in general, with any medication unless advised by your healthcare provider. It is also important to check for drug expiry, as expired steroids should not be taken.

References