Clarithromycin and
erythromycin can reduce the clearance of
methylprednisolone, thereby increasing both its therapeutic and adverse effects. Other
macrolides may also interact, although it seems unlikely that they all will, see
macrolides.
Appropriate dosage reductions (based on
symptoms) may need to be made to avoid the development of corticosteroid adverse effects. Prednisolone seems to be a non-interacting alternative, except possibly in those also taking
enzyme inducers (e.g. phenobarbital).