Dosage of Depo- medrol injection

[suzy1959]

Does anyone know what the equivalent oral dose of Pred. Is to a 40 mg depo- medrol injection?

I am having yet another flare and usually this injection heads it off without my having to change my usual oral dose( 11 mgs). The first few days after the injection I was feeling much better but now seem to be going downhill again, so I’m going to up the oral dose as well, but I would prefer to have some sense of how much is in my system. I also think that I used to get phials of 80 mgs depo and maybe 40 mgs would never have been enough?

[PMRpro Ambassador]

There isn't a real daily equivalent in that it will change (be less) every day - what is likely is that a 40mg i.m. injection will start at a lower dose being released than an 80mg one and/or be finished or negligible sooner.

This post

healthunlocked.com/pmrgcauk...

gives figures for an 80mg depot injection - running from 20mg to 5.9mg per day over a week. I have no idea how to find the equivalent figures for the smaller dose - but I imagine it will also last a similar time but the doses might be about half? So your top-up on the oral dose is much less - and is now not enough to manage the flare. If the flare had been due to a one off event then I would expect an injection to deal with that one-off lot of inflammation and you go back to the usual oral dose being enough. OTOH, if the disease activity has increased, that will continue and need more pred on an ongoing daily basis.

They usually use 120mg depot injections when managing PMR with them - and they repeat after 3 weeks which is when the daily released dose is so low the symptoms return. Then, in order to taper, they use a lower dose over the same period. You can't use the same dose and then wait longer - there will be a longish period with no pred which will cause a flare.

[suzy1959 in reply to PMRpro]

Thank you very much.

The flare is a post-op flare. I seem to get them after every joint replacement op I have ( twice after my knee). I thought I had got away with it this time, but no such luck. Excess pain can also give me a flare which is why I am not reducing Pred. till well after my (hopefully) last op in February. The injections have usually worked for me but I happen to know that my CRP was 30 a few weeks ago which is the highest I have known it to be. Interestingly, when the blood was taken, I was feeling OK and it took 10 days or so before I began to feel horrible.

[PMRpro Ambassador in reply to suzy1959]

It sounds as if this is a bit bigger flare - and I wonder if there is anything different in the prosthesis? And it would be good to get them to check the CRP again - and again ...

[suzy1959 in reply to PMRpro]

I did have a further check the next week and it had gone down to 27- a little better! At the same time my wound area was very swollen ( more than 8 weeks after op)- I had the blood test as my surgeon was a bit worried I had a haematoma and might have an infection but GP and I both thought that there wasn't any infection. In fact, the swelling has gone right down now. I think I am just very slow to recover from the ops- my body is very tired after 3 in 15 months! One more to go.....

[PMRpro Ambassador in reply to suzy1959]

We all take longer to recover from anything as we age - however much it hurts to admit it. Repeated procedures add to that and so does pred.

[suzy1959 in reply to PMRpro]

So true!

[moonieboy9358]

I don't know if this will make sense. First, everyone's body processes medication at different rates. But, according to the drug package insert the half life of injectable medrol is 120 hours. What that means is if I am given say 120 mg of injectable medrol right now. In 60 hours there would be 60mg still in my body and in 60 more hours there would be 30 mg and so forth. I realize youbare in pain. However please weight the risks to benefits. Steroids demineralizes bones taking two forms at the same time could possibly increase bone density loss and also increase other possible side effects