Can You Take Two Medrol Dose Packs In A Row?

Answer

Thanks for reaching out to us! This is a great question, and one that doesn't have a one size fits all answer.

The safety of taking another Medrol Dose Pack (methylprednisolone) right after finishing one depends very much on several individual factors, such as:

• Other medical conditions you have
• Whether or not you are taking other drugs that affect your immune system
• Whether or not you are taking other drugs that affect your endocrine system (specifically The Hypothalamic-Pituitary-Adrenal Axis)

I discuss your situation in more detail below but, as a general point, there isn't a significant risk of serious side effects from taking two Medrol Dose Packs in a row in healthy individuals if your doctor has found that medically necessary for you to help treat your condition.

You certainly still may experience the more common side effects of the drug (e.g.anxiousness, insomnia) but again, you wouldn't be considered at high risk for the more serious ones (e.g. significant immunosuppression, pituitary suppression, etc...).

So, there really isn't a set 'waiting period' before starting a new pack. If your doctor has recommended you take another pack, and you need it to help treat your health condition, it is generally safe to do so.

What Is A Medrol Dose Pack Used For?

Medrol Dose Packs (which consist of twenty-one (21) 4mg tablets of methylprednisolone) are generally prescribed for the short-term treatment of inflammatory conditions, such as dermatitis (e.g. poison ivy), bronchitis, and acute pain. It isn't intended to be used in a consistent manner, one after another, but that doesn't mean it can't be.

Since a Medrol Dose Pack is for short-term treatment, it consists of a tapering dose, and is dosed as follows:

• Take 6 tablets by mouth in divided doses on day one (a total of 24mg methylprednisolone)
• Take 5 tablets by mouth in divided doses on day two (a total of 20mg methylprednisolone)
• Take 4 tablets by mouth in divided doses on day three (a total of 16mg methylprednisolone)
• Take 3 tablets by mouth in divided doses on day four (a total of 12mg methylprednisolone)
• Take 2 tablets by mouth in divided doses on day five (a total of 8mg methylprednisolone)
• Take 1 tablet by mouth in divided doses on day six (a total of 4mg methylprednisolone)

I wrote more comprehensively in another article about how a Medrol Dose Pack Is recommended to be taken (Best Way To Take A Medrol Dose Pack).

A taper of steroids is generally recommended to help reduce the risk of side effects.

Risk Of Side Effects Taking Methylprednisolone Long-Term

While there is quite a list of potential side effects with steroid use, generally, what is most concerning is the suppression of our own body's steroid production. In regard to steroid use and this side effect, it is referred to as HPA (hypothalamic-pituitary-adrenal) suppression.

It is true that the risk of this and other steroid-related side effects increases with higher doses, and longer duration (i.e. the longer you are taking steroids, the more risk there is).

However, the dose of steroids you get from taking a Medrol Dose Pack, according to most sources, would be considered a low to moderate dose.

The Dose Of Steroids Form A Medrol Dose Pack Is Considered To Be In The Low To Moderate Range

Although sources vary, a moderate dose of a glucocorticoid (the type of steroid methylprednisolone is) is between 7.5mg to 40mg per day (prednisone equivalent dosing). This works out to about 6.25mg to 33mg of methylprednisolone.

Since the highest dose you'll take in a day of methylprednisolone from a dose pack is 24mg, you're right in the low-moderate dose range. Some sources even consider anything less than 80mg of methylprednisolone to be a low to moderate dose:

Low-to-moderate dose was defined as ≤80 mg per day methylprednisolone or equivalent. High-dose was defined as >80 mg per day methylprednisolone or equivalent.

Two Weeks Of Methylprednisolone Dosing Isn't Considered Long-Term

Additionally, most sources agree, that absent additional risk factors, serious side effects from long-term steroid use are thought to only occur after at least two to three weeks of consistent dosing. Some sources put this ever higher, at least four weeks of consistent dosing.

If you take two Medrol Dose Packs in a row, you would still be in the low to moderate dosage range and will have taken steroids for a total of 12 days (as each Dose Pack is a 6-day supply). So, even after taking two Medrol Dose Packs in a row, you would still be considered to be taking a dose that is in the low to moderate range for less than 2 weeks total.

Taking Two Medrol Packs In A Row: Side Effects To Be Aware Of

I've tried in the above sections to get across that even if you took two Medrol Dose Packs in a row, you would still be considered to have taken only a low to moderate dose of steroids for a time period that is not considered long-term.

Your risk of the more serious side effect of steroid use, like HPA-axis suppression and strong immunosuppression, would be considered low, absent of other risk factors.

Now, this doesn't mean you are not at risk for any side effects, since many of the side effects associated with steroid use can really happen at any dose. These side effects include:

• Nausea
• Insomnia
• Irritability
• Headache
• Dizziness
• Restlessness
• Anxiety
• Easy bruising

I do want to mention that even though you are not at a high risk of the more serious side effects of steroid use, there are some risk factors that could you more susceptible, such as if you are already taking drugs that affect your immune system or your body's steroid production.

Final Words

I hope this answer helps and please feel free to reach back out in the future!