Preparing for Administration: Pediatric Parenteral: Reconstitute vials with provided diluent or bacteriostatic water (see manufacturer’s labeling for details). Neonates should only be given dosages reconstituted with preservative-free SWFI.

IV infusion: Dilute the reconstituted dose in D5W, NS, or D5NS. There is little published information on dilution in paediatric patients; in one case series, paediatric patients with rheumatic diseases received a pulse dose of 30 mg/kg up to 1,000 mg added to 100 mL of diluent (NS or D51/4NS) (Akikusa 2007); in another rheumatic disease trial, a pulse dose of 30 mg/kg up to 2,000 mg was added to 100 mL of diluent (D5W) (Miller 1980).

Intermittent IV Infusion: Rate dependent upon dose and severity of condition; typically administered as an intermittent infusion over 15 to 60 minutes. Administer doses >250 mg over at least 30 to 60 minutes; severe adverse effects, including hypotension, cardiac arrhythmia, and sudden death, have been reported in patients receiving methylprednisolone doses ≥250 mg administered over <30 minutes (Ditzian-Kadanoff 1987; Erstad 1989; Guillén 1998; Lucas 1993). Also refer to institution-specific policies and procedures. Note: In some spinal cord injury trials, bolus doses (30 mg/kg) have been administered over 15 minutes. Do not administer acetate form IV.