HOW TO GET CORTISONE INJECTION IN THE UK on NHS

[Granny72]

I was diagnosed with PMR in February. Then put on prednisone. I have high blood pressure and have read that if one has high blood pressure one should have injections instead of tablets as these have fewer side effects. I can get this privately but my Doctors NHS surgery refuses to let me have injections. Two friends have managed to get injections at neighbouring NHS surgeries. Have you any suggestions for changing my GP's mind. Private injections cost £400 and have to be every 4-8 weeks.

[Hidden]

Not heard about this but it’ll all be down to cost l’d imagine as some Surgeries won’t even issue Enteric Coated Pred!

[Granny72 in reply to Hidden]

Im not sure that other surgeries will want me, with blood pressure etc, I end up as an expensive patient.

[Hidden in reply to Granny72]

You’re probably not as expensive as some but that’s not a reason for not excepting you.

I think maybe more research into why they recommend injections not tablets because of Blood Pressure.

Personally l’ve not come across it before, l have high blood pressure (Pred Induced) l’m on Meds for my BP & at no time hs it ever been suggested l change from oral PRED to Injections.

How high is your BP? Is it unstable?

[PMRpro Ambassador]

They are mentioned in the 2015 Recommendations, No 5

rheumatology.org/Portals/0/...

I've never heard anything about being better with depot injections if you have hypertension.

Change surgeries maybe?

[Granny72 in reply to PMRpro]

Thank you I am about to study the link.

[Soraya_PMR]

Do your two friends have PMR and repeated injections? Or are they a short course/one off for joint issues?

[Granny72 in reply to Soraya_PMR]

One friend is about to start, the other had two injections a year apart.

[Soraya_PMR in reply to Granny72]

Two injections a year apart doesn’t sound like PMR (unless it’s a booster for a PMR ‘add-on’ (joint bursitis).

I honestly can’t see the NHS stumping up for injections of steroid which cost £££, when pred tablets cost pennies and can be combined with antihypertensives to control BP. Neither, personally, do I think they should.

[Granny72 in reply to Soraya_PMR]

The Amount I had to pay was at a private hospital, Weighing me, measuring my height and Bp +1/2 hour consultation, + room+ another room and 2 nurses + consultant for the injection. At our doctors surgery, I could pull my own trousers down and I didn’t need anyone to hold my hand.

[Soraya_PMR in reply to Granny72]

Yes I understand.

But the injection cost + doctor or nurse appointment time will still cost the NHS around £60+£40, which is far more than self administered pills.

[Hidden in reply to Granny72]

For PMR?

[PMRpro Ambassador in reply to Granny72]

Definitely NOT for managing PMR then. The depot cortisone injections are ongoing, every several weeks as the amount of steroid releases falls away you eventually get to a daily dose that allows the symptoms to return. Then you get the next injection.

The injections are NOT particularly expensive - 80mg which would last a few weeks is IRO £60+ but they do cost more than plain pred. However, the whole point of the depot injections is that the steroid is released and gets into the system consistently over a long period - if it didn't then it wouldn't work to manage the symptoms. They do have a reduced effect in terms of gastric adverse effects as they bypass the stomach altogether. But otherwise they have the same adverse effects as any other form of corticosteroid once they get into the body. They still have the effect on blood sugar levels - and that is the reason people feel hungry and gain weight. And they still have the potential to raise BP. Which is hardly a problem, I am on pred and medication for managing BP as the autoimmune part of PMR has caused atrial fibrillation. The BP medication hasn't changed whatever dose of pred I'm on.

[Granny72 in reply to PMRpro]

Thank you, very useful.

[Granny72 in reply to PMRpro]

Thank you.

[Mai45]

I don’t have any answer to your question about getting prednisolone injections I’m afraid but for what it’s worth, I was diagnosed with high blood pressure years ago and it’s been controlled by daily medication ever since.

I developed PMR in 2016 and started on 30mgm prednisilone, orally, not injection. Nobody has ever mentioned that the two should not be combined.

I’ve reduced to 3mgms Pred now, whilst the hypertension medication remains unchanged.

I know that every individual is different and what works for one may not suit another, but hope it’s some comfort to know that the combination of tablets isn’t automatically a problem.

[Granny72]

Thank you, I work with food a lot and do not want to feel the hunger from Pred

[PMRpro Ambassador in reply to Granny72]

Using depotmedrone won't necessarily change that.