Pred shots v oral

[Ida-June128]

I have just had an injection of the steroid as my rheumy said he would rather have me visit the nurse clinic for the shot than increase my oral pred in the case of a flare. When I asked the nurse if it is a long lasting slow release dose she was unable to tell me so can anyone explain the difference between this and taking oral pred please? I am still taking the same dose as before the shot...15mg per day. I have also heard that some people prefer to take the medication by injection rather than orally. Is there any chance that the injection can decrease the weight problem or am I just hoping for a miracle?

A very Merry Christmas to everyone here, thanks for all your help over the last year and my wishes for a healthy and mainly pain free 2017. xxx

[piglette]

I don't understand why you are having injections and still taking 15mg of steroids if it is just for the PMR. The injection was not for something like an arthritic hip or knee or shoulder or some such was it?

The side effects are pretty much the same though. Although some people reckon that they vary on the type of steroids they have.

[Ida-June128 in reply to piglette]

Dr Hughes told me if I had a flare of the PMR I was to have a shot rather than increase the oral steroids. He gave me one the first time I saw him. The nurse was unable to really give me any details when I asked her about it, I asked if it was a slow acting dose and she said no, some people feel it helps immediately, some after a few days.

[PMRpro Ambassador]

It really does depend on what sort of injection it was. There are several different types - without knowing which it's impossible to say more.

If it was a Depot Medrol shot into muscle it releases the pred slowly over a few weeks, according to someone on here about 12mg/day to start with (I think) falling to about 5mg after about 3 weeks. That is the sort that can be used to manage PMR.

If it was a short-acting soluble steroid shot then it will give a high dose locally and the effect will only last a short time. But it will bring the inflammation down quickly - how long that effect will last in terms of symptoms is anyone's guess.

The short acting ones probably won't contribute greatly to side effects - the depot ones have potentially the same side effects as oral pred and in fact can be worse - there is pred present in your body 24/7, with oral pred there is far less, most of the pred is washed out in about 8 hours, leaving 16 hours for your body to have a rest.

[granny-b]

Hi, my consultant arranged an injection to manage a flare rather than change my oral dose. He said this was because the steroid in the injection is 'self weaning' so afterwards I would be back on the reduction plan. Worked for me.

The side effects are the same but much shorter lived.

[suzy1959]

I am with Dr. Hughes too and travel quite a distance to see him. Because I have had so many flares and then struggled to get back to my previous dose, he gave me 2 vials of Depo for the practice nurse to use on me when I have a flare so that I don't have to change my oral dose. Unfortunately, my last flare was in USA when I couldn't use the vial and had to increase the pred.. Once up to 15mgs. I had to stay there until I got back and after 2 very painful weeks, I asked the nurse to inject me- it took another 2 weeks to start to feel better and now I am still trying to get back to 11 or 10 mgs., going slowly so as not to have yet another flare. I am very grateful to Dr. Hughes for this option.

[Ida-June128 in reply to suzy1959]

I have a feeling that I should have had the Depo and not the normal injection but I thought the nurse would check my records first.