Solu-Medrol is methylprednisolone sodium succinate: a powder you reconstitute, for IV or IM use. Depo-Medrol is methylprednisolone acetate: a suspension that is not for IV use. The 40 mg Solu-Medrol also contains lactose from cow's milk. Here's how to keep them straight.
· 3 min read
Written and clinically reviewed by Jacob Fuchs, PharmD
Reviewed on
NDC: 00143-9753-25
In stockSolu-Medrol and Depo-Medrol are both methylprednisolone. They aren't interchangeable. Solu-Medrol is methylprednisolone sodium succinate, a powder you reconstitute, labeled for intravenous or intramuscular use. Depo-Medrol is methylprednisolone acetate, a suspension labeled "Not For Intravenous Use" (Solu-Medrol label; Depo-Medrol label).
One more catch: the 40 mg Solu-Medrol contains lactose from cow's milk. So does at least one generic 40 mg vial.
If someone asks for "Medrol 40" with no other detail, that's three different products. Here's how to tell them apart.
| Solu-Medrol (sodium succinate) | Depo-Medrol (acetate) | |
|---|---|---|
| Form | Sterile powder, reconstituted before use | Ready-to-use aqueous suspension |
| Routes on the label | Intravenous or intramuscular | Intramuscular, intra-articular, soft tissue, intralesional |
| IV use | Yes | No. "Not For Intravenous Use" |
| Strengths | 40 mg, 125 mg, 500 mg, 1 g, 2 g | 40 mg/mL, 80 mg/mL |
| Packages | Act-O-Vial single-dose units; benzyl-alcohol-preserved vials in larger strengths | 1 mL single-dose vials |
Sources: Solu-Medrol label; Depo-Medrol label.
The Depo-Medrol label also says the suspension should not be diluted or mixed with other solutions. It points to methylprednisolone sodium succinate as the IV form when a rapid effect is needed (Depo-Medrol label).
The Solu-Medrol label says the 40 mg presentation contains "lactose monohydrate produced from cow's milk." That makes it contraindicated in patients with known or suspected milk or dairy hypersensitivity (Solu-Medrol label).
Generics can carry the same warning. Eugia's 40 mg methylprednisolone sodium succinate label, for example, says its 40 mg presentation "includes lactose monohydrate produced from cow's milk" (Eugia label). Check the label of the exact product you stock. Your clinicians need to know which vials have it.
Depo-Medrol's label warns of serious neurologic events, some fatal, with epidural injection of corticosteroids. It says corticosteroids are not approved for epidural use. Intrathecal use is contraindicated (Depo-Medrol label). The same class warning appears on other injectable corticosteroid suspensions. See our Kenalog guide.
Premier Pharma supplies licensed urgent care centers, physician offices, clinics, and pharmacies, and every invoice lists the lot number and expiration date for each item. We carry methylprednisolone sodium succinate 40 mg, 25 single-dose vials (Hikma). For where a corticosteroid fits in an office emergency protocol, see our clinic anaphylaxis kit guide. Open a free account. Credential review typically takes 1–2 business days.
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