A patient with ulcerative colitis takes 30 mg of methylprednisolone (Medrol) daily. The primary care NP sees this patient for bronchitis and orders azithromycin (Zithromax). The NP should:
a. order intramuscular (IM) methylprednisolone.
b. temporarily decrease the dose of methylprednisolone.
c. change the dosing of methylprednisolone to 15 mg twice a day.
d. stop the methylprednisolone while the patient is taking azithromycin.
B
When given concurrently with macrolide antibiotics, methylprednisolone clearance is reduced, so a smaller dose of methylprednisolone is needed. IM administration does not affect clearance of the drug. Changing the dose to twice-daily dosing is not recommended. Stopping the drug abruptly is not recommended.
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