prednisalone tablets vs IM injection

[lindyloo2018]

sorry the saga continues..

I have been prescribed 3 weeks of prednisalone tapering weekly for my flare (well it's change of meds and flare actually)

20mg day week 1, 10mg a day for week 2, then 5mg a day for week 3

previous 2 courses many years ago was for 6 weeks but starting at 15mg (not 20mg)

has anyone started at 20mg pred before?? is this ok ?

and if I can change it to IM injection instead of tablets ? how big is the usual dose of IM methyprednisalone in mg ? I have seen 160mg methlprednisalone quoted but maybe that changes acvcording to the consultant..??

if anyone has previous experience of pred tablets and/or IM injections would be great to share the info.

many thanks

[Fruitandnutcase]

Back in 2015 I took tablets, I was originally told I was to have an injection of prednisone and I asked if I could have tablets instead. I have a needle phobia. The doctor just said ok and prescribed tablets instead. So perhaps you could ask to change to injections. I started on 15mg and tapered every two weeks.

[Haz58]

I've had 2 30mg courses of Prednisolone on the past 3 months plus an injection. 1 course for 2 weeks and the other a week. I found the tablets better than the injection to be honest. All pain practically went away everywhere. But it did come back but lesser after a few days of being on them. The injection sometimes works for longer. Everyone is different unfortunately.

[Bookworm55]

I’m also on a course of prednisolone atm for a change in meds and a flare. It’s a 4 week tapered course -20mg, 15mg, 10mg and 5mg a day. I think this is quite a common pattern for short courses though the last time I had prednisolone was at diagnosis 7 years ago and I’m pretty sure I started on 40mg! My inflammation levels were through the roof then though! The course was then extended to about 6 months with more tapering down to 1 mg.

[Runrig01]

Methylprednidolone dose for deep intramuscular injection, for inflammatory disorders varies from 40-120mg. The effects lasts approx 3 weeks, so I’m unclear why your prefer injection. 20mg isn’t too high a dose, I’ve been prescribed 30-40mg for my asthma, and 60mg for GCA. Oral meds gave the benefit of less risks, especially with infection or haematomas. It seems a reasonable taper.

[helixhelix]

That is a pretty standard pred rescue pack if you like, aimed at punching the flare hard for a few days (20mg)and then reinforcing with the lower doses to make sure your flare get back in it’s box and stays there. One can start higher, but taper is longer.

The IM injections are more subtle, Quite often 80mg slow release, I see them as coaxing less aggressive flares to shut up a bit more gently. And with a lower overall load of steroid, but straight into blood stream so effective.

I tend to reject oral straight predisone, as it makes me a rather loopy, which the methylprednisolone doesn’t do. However in last year I have has one pred rescue course as was totally out of control, and 3 IM methylprednisolone when it looked as if I was heading back that way, plus 4 different steroid injections into specific joints.

So it’s horse’s for course, rather than any one being better than another.

[Gottarelax]

I’ve had intra muscular and oral steroids. Oral tapering from 20mg were effective but intramuscular (80mg) did nothing. I’ve been on 2 courses of oral now and the only side effects have been acid reflux and at 20 mg, insomnia if I take them in the morning. Taking them before bed seems to help with insomnia.

[oldtimer2]

I have found both oral and intramuscular steroids to be equally effective and with much the same side effects. Slightly more risk of stomach upsets with oral, slightly more risk of steroid injection being misplaced. Up to you and your health care provider....

[Green230461]

I am currently on prednisone tablets for a flare in my hand swelling reduced after two weeks-terrific,good luck 🍀

[Leics]

If I’m on a short course of pred I always start at 20mg sometimes for two weeks sometimes for one then decrease by 5mg for either one or two weeks until I get to zero then stop so for me it’s quite normal to start at 20. I don’t know the dose of depo steroids I leave that to the rheumy but trust they know what they’re doing as it’s rare for me to have either.

[Chockyuk]

Morning

I actually prefer the injection, mainly because the tablets give me indigestion, I definitely struggled with 20mg, which I was initially prescribed, about 10mg is the only dose of oral I can manage, even with the coated ones.

I also like the injection because you don’t have to ‘taper’ the body absorbs it naturally - well that’s what my rheumatologist told me anyway. The ones I normally have is depomedrone, think that’s how you spell it and it was 120mg I think I heard her say 🤔

[lindyloo2018 in reply to Chockyuk]

ok thanks, how long does the depomedrone stay active in your body against the inflammation ?

[Chockyuk in reply to lindyloo2018]

It lasted about 6-8 weeks, but by then I’d also started on sulphasalazine, which has really helped.