Implementing High Dose Oral Methylprednisolone for a Multiple Sclerosis Relapse in the Outpatient Setting

Main Article Content

Lauren Schleicher, PharmD, BCACP Lisa Hawk, PharmD, BCPP Kate Hartkopf, PharmD, BCACP Christopher Hulstein, PharmD, CSP Natasha Frost, MD, MS FAAN



Intravenous methylprednisolone is the standard of care for a multiple sclerosis relapse. However, intravenous medications can create several barriers for patients and healthcare organizations. A non-inferiority study by Le Page et al. demonstrated no difference between a patient’s multiple sclerosis disability score when treated with high dose oral versus intravenous methylprednisolone. Implementing an oral methylprednisolone workflow for a multiple sclerosis relapse leads to healthcare cost savings and decreased healthcare utilization.



A neurology clinical pharmacist partnered with neurology providers to create and implement a standardized workflow for high dose oral methylprednisolone to treat multiple sclerosis relapses. From October 2018 – April 2022, patients were included in the retrospective analysis if they were prescribed oral methylprednisolone for a 3 or 5 day treatment course for the purpose of an multiple sclerosis relapse by a neurology provider from the same multiple sclerosis clinic. The primary outcome was evaluating healthcare utilization measured by infusion center chair time saved and direct health system cost savings.



Overall, 290 three-day oral methylprednisolone treatment courses and 50 five-day treatment courses were prescribed. This saved the infusion center 1,680 hours of medication administration time and contributed to an estimated $80,875 in health system cost savings.


Conclusion and Relevance:

Implementing a high dose oral methylprednisolone workflow for a multiple sclerosis relapse at an outpatient neurology clinic did help reduce health system cost and infusion center chair time.

Keywords: High Dose Oral Methylprednisolone, Multiple Sclerosis Relapse, Methylprednisolone, Multiple Sclerosis Relapse in the Outpatient Setting

Article Details

How to Cite
SCHLEICHER, Lauren et al. Implementing High Dose Oral Methylprednisolone for a Multiple Sclerosis Relapse in the Outpatient Setting. Medical Research Archives, [S.l.], v. 12, n. 3, mar. 2024. ISSN 2375-1924. Available at: <>. Date accessed: 13 apr. 2024. doi:
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