prednisolone 3 week course followd by surgery

[lindyloo2018]

Hi

please can anyone advise how long to wait in between a prednisolone course and surgery ?

I have heard from the nurses that if you have an IM steroid injection they postpone surgery for 6 to 8 weeks to allow the imunosuppresant effects to wear off before surgery.

my RA consultant seems to think that I only have to wait 1 week after a 3 week prednisolone course before having surgery...this does not sound safe to me..

any ideas/experiences anyone ?

many thanks

[KittyJ]

I think the thing here is tablets versus injection, maybe because lower dose of tablets leave your body much quicker than an injection. I’d talk to your doctors for reassurance. They must come across this all the time so I’m sure they’re correctly advising you.

[Gottarelax in reply to KittyJ]

This is correct. The IM dose is slow release to the body and is long lasting whereas the oral dose is metabolised quickly. The difference of 8 weeks for IM and 1 week oral sounds about right.

[lindyloo2018 in reply to KittyJ]

ok many thanks, I thought the IM was quick release to the body but long lasting because it works after 2 days where prednisolone takes a week to kick in..

[bpeal1]

This is something you need to discuss with your surgeon. It’s his/her final decision whether or not surgery goes ahead. A big factor will be the type of surgery and the infection risk.

[AgedCrone]

There are different rules for different types of steroids,& indeed different steroids used for different surgeries..please listen to your RA consultant who knows what medication you are on & which surgery is anticipated.

We cannot advise on your situation.

[Runrig01]

I would contact those doing the surgery and ask. It will vary greatly depending on what surgery you’re having. I worked many years with Orthopaedic consultants who because they were doing bone surgery had quite strict criteria.

Generally I’d agree with your rheumatologist, as a 3 week course will not impact your adrenals, which can be an issue with planned surgery. The dosage by tablets is very different to IM & joints injections, and clears the body much faster, so they cannot be compared. It is not prednisolone that is injected, but a different steroid which gives a longer lasting result. Contact your surgeon and rheumatologist. It may well be it’s the anaesthetist who has the decision whether it’s safe, and also whether you need extra steroids during surgery which bis often the case if you’ve have a history with steroids.

[lindyloo2018 in reply to Runrig01]

thank you so much for your learned experience, I have asked my surgeon and he will ask the anaesthatist, I don't usually take prednisolone courses, it's just that my RA is active at the moment affecting many body parts. I am hoping my changed meds will work soon. I stopped hydroxy and that seemed to be a bad move. now on higher levels of mtx instead.