Managing the Side Effects of Solu-Medrol
HealthCentral Editorial Staff Mar 28, 2012 (updated Oct 16, 2013)
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The dreaded "IVSM"
If you have multiple sclerosis, it just might be possible that you’ve also experienced the dreaded intravenous Solu-Medrol (IVSM). IVSM is a treatment which involves really high doses of glucocorticoid steroids, specifically methylprednisolone. It's used as an emergency treatment for acute exacerbations of MS. In this slideshow, HealthCentral MS expert Lisa Emrich offers these tips to help make your IVSM experience more tolerable.
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If you have small or hard-to-find veins, take care to be well hydrated so that your veins are easier to find. When Emrich goes through IVSM herself, her nurse, Janice, uses a heating pad to further plump up her veins and help her get a good IV line started. Also, protect your IV line by not getting it wet.
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Solu-Medrol causes a really yucky, penny-like taste in the mouth. Emrich recommends sucking on hard candies and mints during the infusion session. Her personal favorites? Jolly Ranchers and LifeSaver Mints. "Don’t leave home without them," she says.
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If you get a headache during or after the infusion, Emrich suggests that you ask the nurse to slow down the drip on following days. For her, the 60-minute drip was too fast. She found that a 90-minute drip avoided a pounding headache later in the day.
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Protect your stomach
Solu-Medrol causes increased stomach acid production, and this can cause severe heartburn and gastritis. Emrich suggests that rather than let this excess acid eat away at your stomach lining, take Zantac or another acid-reducing medication as a precautionary measure before each meal and each infusion.
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The cookie monster
Steroids will make you hungry! Be careful, Emrich cautions. Solu-Medrol causes water retention, so avoid salty and sugary foods. It can cause increased blood sugar levels while it depletes potassium levels. To counter this side effect, she suggests Increasing your intake of potassium-rich foods such as bananas, apricots, lima beans, beets, and baked potatoes with the skin.
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Many people report feeling a surge of energy after IVSM, so much so that laundry gets done, the house gets cleaned, and other tasks are seemingly magically completed. Emrich urges you use this burst of energy carefully. The steroids being put into your body are putting a huge strain on it and you need to rest and recuperate. "It’s tempting to be an Energizer Bunny for a few days," Emrich says, "But you’ll just end up paying for it later."
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According to Emrich, each time she underwent a round of IVSM, her heart wanted to pound right out of her chest and she couldn't sleep. Rather than suffer with less than three hours of shut-eye each night while on the drip, Emrich decided to take advantage of sleep medications such as Ambien and Rozerem.
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Emrich reports that she talked to one MS patient who called IVSM "PMS in a bag." Mood swings and increased irritability ("Okay, RAGE," Emrich admits) are very common side effects during treatment. In addition, Emrich said she usually usually feels cognitively deficient, "almost downright dumb," she admits. She offers this advice: "This is NOT the time to make big decisions, but a good time to avoid confrontation."
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Corticosteroids may aggravate existing emotional instability or psychotic tendencies. If you suffer from depression, Emrich suggests you keep a close eye on your mood. Knowing in advance that your depression might become exaggerated helps tremendously when you feel the tug of that dark hole. Also, reassure yourself that it’s just a temporary condition and will pass.
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Solu-Medrol is a powerful immunosuppressant. Your body will be vulnerable to infection during and after treatment, so you should avoid contact with people who have symptoms of a cold or virus. You should also not receive any vaccinations. If you do begin to exhibit signs of infection--such as increased fever, chills, rash, and respiratory distress--Emrich says you should contact your doctor immediately.