Discussion:
Prednisone vs. Medrol?
(too old to reply)
MS
2004-12-21 17:05:27 UTC
Permalink
In an article I posted here (at least on the sinusitis NG, not sure about
the other two) about Chronic Sinusitis, that I found on Medscape, the author
recommended a course of prednisone, for severe chronic sinusitis, and we had
a discussion about that.

Yesterday I saw an ENT, who prescribed me some. Except it isn't prednisone,
but methylprednisone( generic for Medrol), in the "Medrol Dose Pack".

What is the difference between prednisone and methyl-prednisone? Difference
in efficacy? In strength?

I never like the "pack" dosing, as was discussed with the "Z-pac" dosing for
the antibiotic zithromax. I find that it restricts the individuality of
dosing for the particular patient from the doctor. (Of course, the doctor
could prescribe the "pack" and suggest a different dosing than that on the
pack, but usually it is just "use as directed".)

In the article about chronic sinusitis, the writer doesn't suggest a
recommended dosage for the prednisone, but does write that "one possible
dosage regimen was suggested as follows: 20 mg. twice per day for four days,
followed by twenty mg. twice per day, then stop". (Sounds a little abrupt to
me--wouldn't it be better to reduce gradually between 40 and 20mg daily, and
after the 20 mg reduce gradually to 0?) I also believe I read somewhere
dosages like 40 or even maximum 60 mg daily for a week straight, then
gradually taper to 0. (What dosages have patients here had, or doctors
prescribe?)

The Medrol dose pack, however, is a very quick taper. It starts at 24 mg the
first day (six 4mg tablets), and reduces that number by 4 mg each day (one
tablet less per day). The sixth day 4 mg, and nothing more after that. Seems
a lot less, and finished faster, than the courses I have seen recommended
for prednisone. Is Medrol stronger than prednisone?

I guess it probably has to do with being very cautious, due to the possible
harmful side effects of oral steroids? But is it too little, tapered too
fast, to do much good? Is it enough to help severe cases of
inflammation--starting at only 24 mg for one day, then so quickly tapering
off to nothing? Have many doctors and patients found the "Medrol dose pack"
effective, or have they found other dosage regimens of oral steroids more
effective for severe chronic sinusitis?

I do feel slightly better today (second day on the pack), so I hope it's
working. I hope the taper isn't too quick to really help me get over this.

For an antibiotic I suggested Biaxin (clarithromycin), as I had taken it
successfully before, and I also recently read that it has anti-inflammatory
properties, as well as its antibacterial effect. (I even read that some docs
have prescribed it to patients with severe arthritis to take regularly, for
its anti-inflammatory effect. If many were doing that though, I would
suppose that it would lose efficacy as an antibiotic, due to resistance
developing to it among the microbes. It would also be highly expensive for
those users, if they did not have prescription insurance!)

The doctor concurred, but prescribed Biaxin XL rather than regular Biaxin
What is the difference between the two? Both are 500 mg per tablet, take
twice per day. Both are clarithromycin. Is it just a scam to charge more for
the med (I don't know if the XL versions costs more, just guessing, both
inexpensive with my insurance), by putting two letters after the name, so
that people will think it is more powerful than the plain version? (Kind of
like the letters GT or something after a sportscar name, make it sound
faster and more powerful?) (OT-joke--Dr. G (sinusitis NG), perhaps you
should sue them for using "XL" after the name, like in a product of yours?
;-) ) But seriously, is there any difference? (I was prescribed it for ten
days, includes one refill though.)
computernewby
2004-12-21 19:18:02 UTC
Permalink
I am only addressing pack dosing here.

Both drugs you mentioned come in a pack because the majority of the time
that is the appropriate dose. However each of these drugs come in a bottle
so they can be counted out individually and dosed however the Dr. sees fit.
Post by MS
In an article I posted here (at least on the sinusitis NG, not sure about
the other two) about Chronic Sinusitis, that I found on Medscape, the author
recommended a course of prednisone, for severe chronic sinusitis, and we had
a discussion about that.
Yesterday I saw an ENT, who prescribed me some. Except it isn't prednisone,
but methylprednisone( generic for Medrol), in the "Medrol Dose Pack".
What is the difference between prednisone and methyl-prednisone? Difference
in efficacy? In strength?
I never like the "pack" dosing, as was discussed with the "Z-pac" dosing for
the antibiotic zithromax. I find that it restricts the individuality of
dosing for the particular patient from the doctor. (Of course, the doctor
could prescribe the "pack" and suggest a different dosing than that on the
pack, but usually it is just "use as directed".)
In the article about chronic sinusitis, the writer doesn't suggest a
recommended dosage for the prednisone, but does write that "one possible
dosage regimen was suggested as follows: 20 mg. twice per day for four days,
followed by twenty mg. twice per day, then stop". (Sounds a little abrupt to
me--wouldn't it be better to reduce gradually between 40 and 20mg daily, and
after the 20 mg reduce gradually to 0?) I also believe I read somewhere
dosages like 40 or even maximum 60 mg daily for a week straight, then
gradually taper to 0. (What dosages have patients here had, or doctors
prescribe?)
The Medrol dose pack, however, is a very quick taper. It starts at 24 mg the
first day (six 4mg tablets), and reduces that number by 4 mg each day (one
tablet less per day). The sixth day 4 mg, and nothing more after that. Seems
a lot less, and finished faster, than the courses I have seen recommended
for prednisone. Is Medrol stronger than prednisone?
I guess it probably has to do with being very cautious, due to the possible
harmful side effects of oral steroids? But is it too little, tapered too
fast, to do much good? Is it enough to help severe cases of
inflammation--starting at only 24 mg for one day, then so quickly tapering
off to nothing? Have many doctors and patients found the "Medrol dose pack"
effective, or have they found other dosage regimens of oral steroids more
effective for severe chronic sinusitis?
I do feel slightly better today (second day on the pack), so I hope it's
working. I hope the taper isn't too quick to really help me get over this.
For an antibiotic I suggested Biaxin (clarithromycin), as I had taken it
successfully before, and I also recently read that it has
anti-inflammatory
properties, as well as its antibacterial effect. (I even read that some docs
have prescribed it to patients with severe arthritis to take regularly, for
its anti-inflammatory effect. If many were doing that though, I would
suppose that it would lose efficacy as an antibiotic, due to resistance
developing to it among the microbes. It would also be highly expensive for
those users, if they did not have prescription insurance!)
The doctor concurred, but prescribed Biaxin XL rather than regular Biaxin
What is the difference between the two? Both are 500 mg per tablet, take
twice per day. Both are clarithromycin. Is it just a scam to charge more for
the med (I don't know if the XL versions costs more, just guessing, both
inexpensive with my insurance), by putting two letters after the name, so
that people will think it is more powerful than the plain version? (Kind of
like the letters GT or something after a sportscar name, make it sound
faster and more powerful?) (OT-joke--Dr. G (sinusitis NG), perhaps you
should sue them for using "XL" after the name, like in a product of yours?
;-) ) But seriously, is there any difference? (I was prescribed it for ten
days, includes one refill though.)
MS
2004-12-21 19:58:25 UTC
Permalink
Post by computernewby
I am only addressing pack dosing here.
Both drugs you mentioned come in a pack because the majority of the time
that is the appropriate dose.
Really? How is that known? I have seen many different recommendations for
this, and each patient's condition is different.

Or is that the "pack" is a clever marketing tool, seems easier to deal with
for both doctors and patients, for the former not to have to think about the
best dosing for the individual, just give him the "pack". For the patients,
med all pre-counted by day, you don't have to think about counting them from
the bottle, and remembering which day you are on, etc.

But I think it probably is a negative as far as individuality of dosing.

Prednisone comes in a "pack" as well? How does that "taper" work? The same
dosage as the Medrol pack--starting at 24 mg the first day, dropping by 4 mg
every day until 4 mg total the sixth and last day?
W4PHM
2004-12-22 20:44:36 UTC
Permalink
Predisone and Prednesilone (solumedrol) are essentially the same thing.

Prednisone is metabolized and its active metabolite is predesilone,
predesilone is metabolized and ist active metabolite is prednisone.

Anyone feel free to correct me if I am wrong but that is what an ER
Doc friend of mine told me.

Regards,

--
Patrick H. Mason M.Sc. OHST, EMT-I
Post by computernewby
I am only addressing pack dosing here.
Both drugs you mentioned come in a pack because the majority of the time
that is the appropriate dose. However each of these drugs come in a bottle
so they can be counted out individually and dosed however the Dr. sees fit.
Post by MS
In an article I posted here (at least on the sinusitis NG, not sure about
the other two) about Chronic Sinusitis, that I found on Medscape, the author
recommended a course of prednisone, for severe chronic sinusitis, and we had
a discussion about that.
Yesterday I saw an ENT, who prescribed me some. Except it isn't prednisone,
but methylprednisone( generic for Medrol), in the "Medrol Dose Pack".
What is the difference between prednisone and methyl-prednisone? Difference
in efficacy? In strength?
I never like the "pack" dosing, as was discussed with the "Z-pac" dosing for
the antibiotic zithromax. I find that it restricts the individuality of
dosing for the particular patient from the doctor. (Of course, the doctor
could prescribe the "pack" and suggest a different dosing than that on the
pack, but usually it is just "use as directed".)
In the article about chronic sinusitis, the writer doesn't suggest a
recommended dosage for the prednisone, but does write that "one possible
dosage regimen was suggested as follows: 20 mg. twice per day for four
days,
followed by twenty mg. twice per day, then stop". (Sounds a little
abrupt
Post by computernewby
Post by MS
to
me--wouldn't it be better to reduce gradually between 40 and 20mg daily, and
after the 20 mg reduce gradually to 0?) I also believe I read somewhere
dosages like 40 or even maximum 60 mg daily for a week straight, then
gradually taper to 0. (What dosages have patients here had, or doctors
prescribe?)
The Medrol dose pack, however, is a very quick taper. It starts at 24 mg the
first day (six 4mg tablets), and reduces that number by 4 mg each day (one
tablet less per day). The sixth day 4 mg, and nothing more after that. Seems
a lot less, and finished faster, than the courses I have seen recommended
for prednisone. Is Medrol stronger than prednisone?
I guess it probably has to do with being very cautious, due to the possible
harmful side effects of oral steroids? But is it too little, tapered too
fast, to do much good? Is it enough to help severe cases of
inflammation--starting at only 24 mg for one day, then so quickly tapering
off to nothing? Have many doctors and patients found the "Medrol dose pack"
effective, or have they found other dosage regimens of oral steroids more
effective for severe chronic sinusitis?
I do feel slightly better today (second day on the pack), so I hope it's
working. I hope the taper isn't too quick to really help me get over this.
For an antibiotic I suggested Biaxin (clarithromycin), as I had taken it
successfully before, and I also recently read that it has
anti-inflammatory
properties, as well as its antibacterial effect. (I even read that some docs
have prescribed it to patients with severe arthritis to take regularly, for
its anti-inflammatory effect. If many were doing that though, I would
suppose that it would lose efficacy as an antibiotic, due to resistance
developing to it among the microbes. It would also be highly expensive for
those users, if they did not have prescription insurance!)
The doctor concurred, but prescribed Biaxin XL rather than regular Biaxin
What is the difference between the two? Both are 500 mg per tablet, take
twice per day. Both are clarithromycin. Is it just a scam to charge more for
the med (I don't know if the XL versions costs more, just guessing, both
inexpensive with my insurance), by putting two letters after the name, so
that people will think it is more powerful than the plain version? (Kind of
like the letters GT or something after a sportscar name, make it sound
faster and more powerful?) (OT-joke--Dr. G (sinusitis NG), perhaps you
should sue them for using "XL" after the name, like in a product of yours?
;-) ) But seriously, is there any difference? (I was prescribed it for ten
days, includes one refill though.)
MS
2004-12-23 00:25:45 UTC
Permalink
Thanks for the info.

However, the question wasn't about prednisone vs prednisilone. (Aren't those
two exactly the same thing? Or is there any difference at all between them?)

The question was about prednisone vs. methylprednisolone (brand name Medrol,
also available generic). I think someone answered they are pretty much the
same, but the methyl-- version is supposed to be slightly stronger, 5/4 the
strength, that's why they come in 4 mg. pills rather than 5, and are often
prescribed only because of the "dose pack", which seems to have become a
popular method to prescribe it.

Is there any difference between prednisone vs prednisilone?

I'd still be interested in hearing from more of those who have been
prescribed any of these for severe chronic rhinosinusitis, etc. What kind of
dosage-course were you prescribed? How effective was it? Any negative
effects? (I know long-term usage has negative effects, asking about these
short-term courses.)

Of course, it would also be interesting to hear from anyone who has
prescribed this, how successful it has been with your patients, etc.
Post by W4PHM
Predisone and Prednesilone (solumedrol) are essentially the same thing.
Prednisone is metabolized and its active metabolite is predesilone,
predesilone is metabolized and ist active metabolite is prednisone.
Anyone feel free to correct me if I am wrong but that is what an ER
Doc friend of mine told me.
Regards,
--
Patrick H. Mason M.Sc. OHST, EMT-I
Post by computernewby
I am only addressing pack dosing here.
Both drugs you mentioned come in a pack because the majority of the time
that is the appropriate dose. However each of these drugs come in a bottle
so they can be counted out individually and dosed however the Dr. sees
fit.
Post by computernewby
Post by MS
In an article I posted here (at least on the sinusitis NG, not sure
about
Post by computernewby
Post by MS
the other two) about Chronic Sinusitis, that I found on Medscape, the author
recommended a course of prednisone, for severe chronic sinusitis, and
we
Post by W4PHM
Post by computernewby
Post by MS
had
a discussion about that.
Yesterday I saw an ENT, who prescribed me some. Except it isn't prednisone,
but methylprednisone( generic for Medrol), in the "Medrol Dose Pack".
What is the difference between prednisone and methyl-prednisone? Difference
in efficacy? In strength?
I never like the "pack" dosing, as was discussed with the "Z-pac"
dosing
Post by W4PHM
Post by computernewby
Post by MS
for
the antibiotic zithromax. I find that it restricts the individuality of
dosing for the particular patient from the doctor. (Of course, the
doctor
Post by computernewby
Post by MS
could prescribe the "pack" and suggest a different dosing than that on
the
Post by computernewby
Post by MS
pack, but usually it is just "use as directed".)
In the article about chronic sinusitis, the writer doesn't suggest a
recommended dosage for the prednisone, but does write that "one possible
dosage regimen was suggested as follows: 20 mg. twice per day for four
days,
followed by twenty mg. twice per day, then stop". (Sounds a little
abrupt
Post by computernewby
Post by MS
to
me--wouldn't it be better to reduce gradually between 40 and 20mg
daily,
Post by W4PHM
Post by computernewby
Post by MS
and
after the 20 mg reduce gradually to 0?) I also believe I read somewhere
dosages like 40 or even maximum 60 mg daily for a week straight, then
gradually taper to 0. (What dosages have patients here had, or doctors
prescribe?)
The Medrol dose pack, however, is a very quick taper. It starts at 24
mg
Post by W4PHM
Post by computernewby
Post by MS
the
first day (six 4mg tablets), and reduces that number by 4 mg each day
(one
Post by computernewby
Post by MS
tablet less per day). The sixth day 4 mg, and nothing more after that. Seems
a lot less, and finished faster, than the courses I have seen
recommended
Post by computernewby
Post by MS
for prednisone. Is Medrol stronger than prednisone?
I guess it probably has to do with being very cautious, due to the possible
harmful side effects of oral steroids? But is it too little, tapered too
fast, to do much good? Is it enough to help severe cases of
inflammation--starting at only 24 mg for one day, then so quickly
tapering
Post by computernewby
Post by MS
off to nothing? Have many doctors and patients found the "Medrol dose pack"
effective, or have they found other dosage regimens of oral steroids
more
Post by computernewby
Post by MS
effective for severe chronic sinusitis?
I do feel slightly better today (second day on the pack), so I hope it's
working. I hope the taper isn't too quick to really help me get over
this.
Post by computernewby
Post by MS
For an antibiotic I suggested Biaxin (clarithromycin), as I had taken it
successfully before, and I also recently read that it has
anti-inflammatory
properties, as well as its antibacterial effect. (I even read that
some
Post by W4PHM
Post by computernewby
Post by MS
docs
have prescribed it to patients with severe arthritis to take
regularly,
Post by W4PHM
Post by computernewby
Post by MS
for
its anti-inflammatory effect. If many were doing that though, I would
suppose that it would lose efficacy as an antibiotic, due to resistance
developing to it among the microbes. It would also be highly expensive
for
Post by computernewby
Post by MS
those users, if they did not have prescription insurance!)
The doctor concurred, but prescribed Biaxin XL rather than regular
Biaxin
Post by computernewby
Post by MS
What is the difference between the two? Both are 500 mg per tablet, take
twice per day. Both are clarithromycin. Is it just a scam to charge
more
Post by W4PHM
Post by computernewby
Post by MS
for
the med (I don't know if the XL versions costs more, just guessing, both
inexpensive with my insurance), by putting two letters after the name,
so
Post by computernewby
Post by MS
that people will think it is more powerful than the plain version?
(Kind
Post by W4PHM
Post by computernewby
Post by MS
of
like the letters GT or something after a sportscar name, make it sound
faster and more powerful?) (OT-joke--Dr. G (sinusitis NG), perhaps you
should sue them for using "XL" after the name, like in a product of
yours?
Post by computernewby
Post by MS
;-) ) But seriously, is there any difference? (I was prescribed it for
ten
Post by computernewby
Post by MS
days, includes one refill though.)
Hillary Israeli
2005-01-11 16:11:05 UTC
Permalink
In <***@news-1.nethere.net>,
MS <***@nospam.com> wrote:

*Is there any difference between prednisone vs prednisilone?

Prednisone undergoes hepatic metabolism and turns into prednisolone.
Prednisolone is the preferred drug in the case of hepatic insufficiency,
otherwise, prednisone and prednisolone are pretty much interchangeable -
at least in the nonhuman mammalian species I handle :)
--
Hillary Israeli, VMD
Lafayette Hill/PA/USA/Earth
"Outside of a dog, a book is a man's best friend. Inside of a dog, it is
too dark to read." --Groucho Marx
iJah
2004-12-21 20:53:06 UTC
Permalink
On Tue, 21 Dec 2004 09:05:27 -0800, " MS"
Post by MS
In an article I posted here (at least on the sinusitis NG, not sure about
the other two) about Chronic Sinusitis, that I found on Medscape, the author
recommended a course of prednisone, for severe chronic sinusitis, and we had
a discussion about that.
Yesterday I saw an ENT, who prescribed me some. Except it isn't prednisone,
but methylprednisone( generic for Medrol), in the "Medrol Dose Pack".
What is the difference between prednisone and methyl-prednisone? Difference
in efficacy? In strength?
They are a little different chemically and have heard some clain that
methlyprednisone works better for them than prednisone.

I agree with you about getting meds in a pack. I dislike any med where
you can't really fine-tune the dosing. I especially loathe things like
72 hour patches and time-release meds. You've got no control. Can't
cut the damn pill in half or it might rapid release on you, etc.

All I can tell you is about my personal experiences. I've been
prescribed 'the pack' three times and it just didn't get the job done.
A little relief the first and second day and then no further relief.

I've also been on about three or four courses of prednisone starting
high, 50-60mg and tapering off very slowly over the course of 21 days
or so. While these where quite effective, the initial high dosages
really had a severe psychological impact on me. Very high
anxiety/restlesness/agitation and insomnia.

But, because prednisone was/is the only thing that seems to be able to
control my inflammation, I'm 'self-medicating' with it. Bad, very bad
- I know. I've found that 20mg per day gives me a 'license to survive'
for another day ;-) I can breathe.

I've been on this 20mg per day maint. schedule for a little over 2
months now though, and I'm already seeing some nasty side effects that
you'd usually expect from long term maint. 2 months doesn't seem like
much. I didn't think I was pushing it too badly, seeing as there are
people that have been using it daily for many YEARS. But, I started to
develop this pad of 'fat' between my shoulders, right at the base of
the neck directly over the spine and I swear my face looks a little
'rounded' - the 'moon face' syndrome that so many long term prednisone
users refer to - but I may be dubbing that image in because i'm
worried about getting 'moon face' and sort of expecting it.

Please keep
James Stein
2004-12-21 22:48:16 UTC
Permalink
Post by iJah
On Tue, 21 Dec 2004 09:05:27 -0800, " MS"
Post by MS
In an article I posted here (at least on the sinusitis NG, not sure about
the other two) about Chronic Sinusitis, that I found on Medscape, the author
recommended a course of prednisone, for severe chronic sinusitis, and we had
a discussion about that.
Yesterday I saw an ENT, who prescribed me some. Except it isn't prednisone,
but methylprednisone( generic for Medrol), in the "Medrol Dose Pack".
What is the difference between prednisone and methyl-prednisone? Difference
in efficacy? In strength?
They are a little different chemically and have heard some clain that
methlyprednisone works better for them than prednisone.
I agree with you about getting meds in a pack. I dislike any med where
you can't really fine-tune the dosing. I especially loathe things like
72 hour patches and time-release meds. You've got no control. Can't
cut the damn pill in half or it might rapid release on you, etc.
All I can tell you is about my personal experiences. I've been
prescribed 'the pack' three times and it just didn't get the job done.
A little relief the first and second day and then no further relief.
I've also been on about three or four courses of prednisone starting
high, 50-60mg and tapering off very slowly over the course of 21 days
or so. While these where quite effective, the initial high dosages
really had a severe psychological impact on me. Very high
anxiety/restlesness/agitation and insomnia.
But, because prednisone was/is the only thing that seems to be able to
control my inflammation, I'm 'self-medicating' with it. Bad, very bad
- I know. I've found that 20mg per day gives me a 'license to survive'
for another day ;-) I can breathe.
I've been on this 20mg per day maint. schedule for a little over 2
months now though, and I'm already seeing some nasty side effects that
you'd usually expect from long term maint. 2 months doesn't seem like
much. I didn't think I was pushing it too badly, seeing as there are
people that have been using it daily for many YEARS. But, I started to
develop this pad of 'fat' between my shoulders, right at the base of
the neck directly over the spine and I swear my face looks a little
'rounded' - the 'moon face' syndrome that so many long term prednisone
users refer to - but I may be dubbing that image in because i'm
worried about getting 'moon face' and sort of expecting it.
I see you've missed out on the other side-effects, like osteoporosis, heart
failure, and kidney failure. Give it time.
MS
2004-12-21 23:12:20 UTC
Permalink
Post by iJah
On Tue, 21 Dec 2004 09:05:27 -0800, " MS"
All I can tell you is about my personal experiences. I've been
prescribed 'the pack' three times and it just didn't get the job done.
A little relief the first and second day and then no further relief.
I've also been on about three or four courses of prednisone starting
high, 50-60mg and tapering off very slowly over the course of 21 days
or so. While these where quite effective, the initial high dosages
really had a severe psychological impact on me. Very high
anxiety/restlesness/agitation and insomnia.
But, because prednisone was/is the only thing that seems to be able to
control my inflammation, I'm 'self-medicating' with it. Bad, very bad
- I know. I've found that 20mg per day gives me a 'license to survive'
for another day ;-) I can breathe.
I've been on this 20mg per day maint. schedule for a little over 2
months now though, and I'm already seeing some nasty side effects that
you'd usually expect from long term maint. 2 months doesn't seem like
much. I didn't think I was pushing it too badly, seeing as there are
people that have been using it daily for many YEARS. But, I started to
develop this pad of 'fat' between my shoulders, right at the base of
the neck directly over the spine and I swear my face looks a little
'rounded' - the 'moon face' syndrome that so many long term prednisone
users refer to - but I may be dubbing that image in because i'm
worried about getting 'moon face' and sort of expecting it.
Please keep
Probably not a good idea, to self-medicate long-term use of an oral steroid.
Could have serious consequences? None of your doctors agreed to it? How do
you get the medication?

I recall reading posts of people who were prescribed 5 mg per day for months
(I think Don from this NG was prescribed that after surgery), but 20 mg per
day for months sounds very high to me, although I an certainly no expert on
this. You really should perhaps consult a doctor on this. If you don't like
one doc's approach, try another.

It couldn't be good for you to keep taking 20 mg of prednisone daily for
life. And now with your body accustomed to it, it will be hard to stop it.
In fact, you shouldn't stop it cold turkey, as that could have severe
consequences, but a very gradual tapering off. It probably would be good to
have a doctor's guidance in that.

If the inflammation is in your nose, are you using a steroid nasal spray? If
not, it might help to start using one.

Are you the person who smokes? You really should quit that, if so. Since you
(if it's you) said that the inflammation gets worse when you stop smoking,
you might want to use those nicotine patches (wouldn't have the irritating
respiratory effect of smoke), and gradually lower the dose of that.

One thing I wonder about though, which perhaps someone reading knows
something about---

Cortisone is a natural hormone of the body, correct? We all have cortisone
in us, it's natural. Of course it's not good for most people to take long
term oral steroids, overloading with too much steroid, and suppressing the
body's ability to create the stuff.

But are there some people who's body does not create enough cortisone, and
therefore they need some supplementation of it long term? For instance, many
people take synthetic thyroid hormone long term, because their bodies do not
produce enough of it naturally. Is it the same with cortisone?

If that's the case, wouldn't supplementing it, to bring the cortisone level
up to normal, not be harmful, but in fact beneficial? Not to give the body
more cortisone than normal, just to bring the level up to normal? If that
were the case, I wonder if long term supplementation for that person, just
enough to bring him or her to normal levels of the hormone, would have
negative side effects, as it would be just to bring his cortisone level to
the same level as most people?

Anyone reading this know if that's the case? Are there some people on
long-term supplementation, just to bring their levels to normal, without any
negative effects? (If that is so, though, I would doubt that people on such
long-term supplementation take as much as 20 mg daily long term.)

People aren't usually tested for that, as they are with thyroid. (I have had
a lot of medical tests in my life, I cannot recall ever having a cortisone
level check. But I have seen something like that (I think called cortisol)
on the list of tests on a lab paper. Anyone here had that test? I'm
wondering if some of us with chronic inflammation of various kinds might not
have high enough cortisone levels naturally? If so, perhaps everyone should
be tested for cortisone levels, as they are for thyroid. Chronic
inflammation can cause all sorts of problems, including killers like heart
disease, etc.

What kind of doctor normally tests for cortisone level? Endocrinologists?
Anyone here been tested, and what were the results. Any doctors reading who
are knowledgeable about that?
Don Brady
2004-12-22 03:26:01 UTC
Permalink
Post by MS
....
Are you the person who smokes? You really should quit that, if so. Since you
(if it's you) said that the inflammation gets worse when you stop smoking,
you might want to use those nicotine patches (wouldn't have the irritating
respiratory effect of smoke), and gradually lower the dose of that.
Yes I agree and I am worried that if he has trouble giving up smoking, he may
also become dependent on the prednisone or medrol (although they are not
addictive in the formal sense).

I think he should plan on giving up the oral steroid.
Post by MS
One thing I wonder about though, which perhaps someone reading knows
something about---
Cortisone is a natural hormone of the body, correct? We all have cortisone
in us, it's natural. Of course it's not good for most people to take long
term oral steroids, overloading with too much steroid, and suppressing the
body's ability to create the stuff.
But are there some people who's body does not create enough cortisone, and
therefore they need some supplementation of it long term? For instance, many
people take synthetic thyroid hormone long term, because their bodies do not
produce enough of it naturally. Is it the same with cortisone?
If that's the case, wouldn't supplementing it, to bring the cortisone level
up to normal, not be harmful, but in fact beneficial? Not to give the body
more cortisone than normal, just to bring the level up to normal? If that
were the case, I wonder if long term supplementation for that person, just
enough to bring him or her to normal levels of the hormone, would have
negative side effects, as it would be just to bring his cortisone level to
the same level as most people?
Anyone reading this know if that's the case? Are there some people on
long-term supplementation, just to bring their levels to normal, without any
negative effects? (If that is so, though, I would doubt that people on such
long-term supplementation take as much as 20 mg daily long term.)
People aren't usually tested for that, as they are with thyroid. (I have had
a lot of medical tests in my life, I cannot recall ever having a cortisone
level check. But I have seen something like that (I think called cortisol)
on the list of tests on a lab paper. Anyone here had that test? I'm
wondering if some of us with chronic inflammation of various kinds might not
have high enough cortisone levels naturally? If so, perhaps everyone should
be tested for cortisone levels, as they are for thyroid. Chronic
inflammation can cause all sorts of problems, including killers like heart
disease, etc.
What kind of doctor normally tests for cortisone level? Endocrinologists?
Anyone here been tested, and what were the results. Any doctors reading who
are knowledgeable about that?
MS
2004-12-21 23:50:54 UTC
Permalink
Post by iJah
But, because prednisone was/is the only thing that seems to be able to
control my inflammation,
Somewhat OT from the topic of this post.

I forgot your history from other posts. Do you have chronic inflammation in
nose and sinuses? Is that what often makes it hard to breathe?

Does it feel like there is some kind of anatomical blockage? If so, have you
considered sinus and/or nasal (turbinate, septum, etc.) surgery? You might
wish to consult an ENT about it. (More than one, if you seriously consider
it. Good to get 2nd, 3rd, 4th opinions about it, before having someone cut
inside your head! Certainly not a cure-all, but has helped some people.
MS
2004-12-22 07:11:15 UTC
Permalink
Post by iJah
I've also been on about three or four courses of prednisone starting
high, 50-60mg and tapering off very slowly over the course of 21 days
or so. While these where quite effective, the initial high dosages
really had a severe psychological impact on me. Very high
anxiety/restlesness/agitation and insomnia.
Seems to be a heavy course, probably more than usually prescribed.

At the opposite end of the spectrum is the Medrol dose pack, that I am
taking, probably about the lightest course of oral steroids that is
prescribed.

If anyone else reading has ever been prescribed a course of oral steroids
for severe chronic rhinosinusitis, I would be interested in hearing what the
course was like-how it started, how it tapered off, etc. And how did it help
you? Negative effects you experienced?

Also, from doctors who have prescribed them, and pharmacists who have filled
prescriptions, what have you found to work well for your chronic
sinusitis-rhinitis patients.
d***@gmail.com
2017-12-20 15:28:39 UTC
Permalink
I was on 20mg everyday for 2 years. I gained around 70 lbs. I am a high carb eater. I've never had a problem with weight until prednisone came into my life. The only side effect in the 2 years other then weight was psoriasis. A very bad case. And my sugar had to be tested 3 times a day. I weened myself off because of the weight issue. But your right you can breath. If this is what you need your Dr. Should prescribe it. They did test my blood every 3 months for liver damage and diabetes among all the other stuff. Yes the round face comes with the drug. Wish you well but go to a pulmonologist if you think you need this much. I am on oxygen 4 liters. I only have 20 % of lung usage. I had cardio workups yearly while on it. God bless.
$
2018-08-10 17:18:32 UTC
Permalink
?

David Rind
2004-12-21 23:52:42 UTC
Permalink
Post by MS
In an article I posted here (at least on the sinusitis NG, not sure about
the other two) about Chronic Sinusitis, that I found on Medscape, the author
recommended a course of prednisone, for severe chronic sinusitis, and we had
a discussion about that.
Yesterday I saw an ENT, who prescribed me some. Except it isn't prednisone,
but methylprednisone( generic for Medrol), in the "Medrol Dose Pack".
What is the difference between prednisone and methyl-prednisone? Difference
in efficacy? In strength?
I never like the "pack" dosing, as was discussed with the "Z-pac" dosing for
the antibiotic zithromax. I find that it restricts the individuality of
dosing for the particular patient from the doctor. (Of course, the doctor
could prescribe the "pack" and suggest a different dosing than that on the
pack, but usually it is just "use as directed".)
In the article about chronic sinusitis, the writer doesn't suggest a
recommended dosage for the prednisone, but does write that "one possible
dosage regimen was suggested as follows: 20 mg. twice per day for four days,
followed by twenty mg. twice per day, then stop". (Sounds a little abrupt to
me--wouldn't it be better to reduce gradually between 40 and 20mg daily, and
after the 20 mg reduce gradually to 0?) I also believe I read somewhere
dosages like 40 or even maximum 60 mg daily for a week straight, then
gradually taper to 0. (What dosages have patients here had, or doctors
prescribe?)
The Medrol dose pack, however, is a very quick taper. It starts at 24 mg the
first day (six 4mg tablets), and reduces that number by 4 mg each day (one
tablet less per day). The sixth day 4 mg, and nothing more after that. Seems
a lot less, and finished faster, than the courses I have seen recommended
for prednisone. Is Medrol stronger than prednisone?
I guess it probably has to do with being very cautious, due to the possible
harmful side effects of oral steroids? But is it too little, tapered too
fast, to do much good? Is it enough to help severe cases of
inflammation--starting at only 24 mg for one day, then so quickly tapering
off to nothing? Have many doctors and patients found the "Medrol dose pack"
effective, or have they found other dosage regimens of oral steroids more
effective for severe chronic sinusitis?
Methylprednisolone is about 5/4 as potent as prednisone. No one is
certain that oral steroid are of benefit for chronic sinusitis, and if
they are there is certainly no evidence to support one particular
dosing/tapering regimen over another, so selecting such a regimen is
likely to be purely one of what the particular doctor feels he or she
has seen work in the past or, as the OP suggests, simply the regimen
that comes written on a Medrol dose pack.
--
David Rind
***@caregroup.harvard.edu
James Stein
2004-12-23 00:25:51 UTC
Permalink
Post by MS
In an article I posted here (at least on the sinusitis NG, not sure about
the other two) about Chronic Sinusitis, that I found on Medscape, the author
recommended a course of prednisone, for severe chronic sinusitis, and we had
a discussion about that.
Yesterday I saw an ENT, who prescribed me some. Except it isn't prednisone,
but methylprednisone( generic for Medrol), in the "Medrol Dose Pack".
What is the difference between prednisone and methyl-prednisone? Difference
in efficacy? In strength?
I never like the "pack" dosing, as was discussed with the "Z-pac" dosing for
the antibiotic zithromax. I find that it restricts the individuality of
dosing for the particular patient from the doctor. (Of course, the doctor
could prescribe the "pack" and suggest a different dosing than that on the
pack, but usually it is just "use as directed".)
In the article about chronic sinusitis, the writer doesn't suggest a
recommended dosage for the prednisone, but does write that "one possible
dosage regimen was suggested as follows: 20 mg. twice per day for four days,
followed by twenty mg. twice per day, then stop". (Sounds a little abrupt to
me--wouldn't it be better to reduce gradually between 40 and 20mg daily, and
after the 20 mg reduce gradually to 0?) I also believe I read somewhere
dosages like 40 or even maximum 60 mg daily for a week straight, then
gradually taper to 0. (What dosages have patients here had, or doctors
prescribe?)
The Medrol dose pack, however, is a very quick taper. It starts at 24 mg the
first day (six 4mg tablets), and reduces that number by 4 mg each day (one
tablet less per day). The sixth day 4 mg, and nothing more after that. Seems
a lot less, and finished faster, than the courses I have seen recommended
for prednisone. Is Medrol stronger than prednisone?
I guess it probably has to do with being very cautious, due to the possible
harmful side effects of oral steroids? But is it too little, tapered too
fast, to do much good? Is it enough to help severe cases of
inflammation--starting at only 24 mg for one day, then so quickly tapering
off to nothing? Have many doctors and patients found the "Medrol dose pack"
effective, or have they found other dosage regimens of oral steroids more
effective for severe chronic sinusitis?
Methylprednisolone is about 5/4 as potent as prednisone. No one is certain
that oral steroid are of benefit for chronic sinusitis, and if they are
there is certainly no evidence to support one particular dosing/tapering
regimen over another, so selecting such a regimen is likely to be purely
one of what the particular doctor feels he or she has seen work in the
past or, as the OP suggests, simply the regimen that comes written on a
Medrol dose pack.
Completely anecdotal: I was given prednisone for my colitis. While on the
prednisone, my sinusitis was completely alleviated. It returned when I was
tapered off.
p***@hotmail.com
2005-01-15 15:01:24 UTC
Permalink
How safe would it be to obtain Omeprazole from India, rather than
taking Prilosec OTC?


Thanks
***@mn.rr.com
Matt Beckwith M.D.
2004-12-23 03:00:24 UTC
Permalink
Post by MS
What is the difference between prednisone and methyl-prednisone? Difference
in efficacy? In strength?
The potency is about the same milligram-for-milligram.
Post by MS
I never like the "pack" dosing, as was discussed with the "Z-pac" dosing for
the antibiotic zithromax. I find that it restricts the individuality of
dosing for the particular patient from the doctor. (Of course, the doctor
could prescribe the "pack" and suggest a different dosing than that on the
pack, but usually it is just "use as directed".)
I'm not sure I agree with your logic here. If the doctor wants to use
the dosing in the pack, then he prescribes the pack. If he wants
another dosing, he writes a prescription for that dosing. There's
nothing wrong with the pack.
Post by MS
In the article about chronic sinusitis, the writer doesn't suggest a
recommended dosage for the prednisone, but does write that "one possible
dosage regimen was suggested as follows: 20 mg. twice per day for four days,
followed by twenty mg. twice per day, then stop".
Steroids shouldn't be prescribed twice a day like that. All the pills
for a particular day should be taken at the same time.
Post by MS
(Sounds a little abrupt to
me--wouldn't it be better to reduce gradually between 40 and 20mg daily, and
after the 20 mg reduce gradually to 0?)
Yeah, this doesn't make a lot of sense. A more typical regimen would
be 60 mg daily for 3 days, 40 for 3 days, 20 for 3 days, then stop.
Post by MS
I also believe I read somewhere
dosages like 40 or even maximum 60 mg daily for a week straight, then
gradually taper to 0. (What dosages have patients here had, or
doctors
Post by MS
prescribe?)
It really depends on the disease and the doctor.

It's up to the doctor, there's no set dose.
Post by MS
The Medrol dose pack, however, is a very quick taper. It starts at 24 mg the
first day (six 4mg tablets), and reduces that number by 4 mg each day (one
tablet less per day). The sixth day 4 mg, and nothing more after that. Seems
a lot less, and finished faster, than the courses I have seen
recommended
Post by MS
for prednisone. Is Medrol stronger than prednisone?
No it isn't, and you're right. I don't like to use these dose packs
because their doses are too low for most of the things I treat.
Post by MS
I do feel slightly better today (second day on the pack), so I hope it's
working. I hope the taper isn't too quick to really help me get over this.
I think a lot of doctors don't understand how inappropriately little is
in the Medrol Dose Pak.
Post by MS
For an antibiotic I suggested Biaxin (clarithromycin), as I had taken it
successfully before...
For the same illness?
Post by MS
The doctor concurred, but prescribed Biaxin XL rather than regular Biaxin
What is the difference between the two? Both are 500 mg per tablet, take
twice per day. Both are clarithromycin. Is it just a scam to charge more for
the med (I don't know if the XL versions costs more, just guessing, both
inexpensive with my insurance), by putting two letters after the name, so
that people will think it is more powerful than the plain version? (Kind of
like the letters GT or something after a sportscar name, make it sound
faster and more powerful?) (OT-joke--Dr. G (sinusitis NG), perhaps you
should sue them for using "XL" after the name, like in a product of yours?
;-) ) But seriously, is there any difference? (I was prescribed it for ten
days, includes one refill though.)
The only advantage of the XL is that you can take the entire daily dose
at one time, instead of having to remember to take it twice daily. As
long as your insurance payment is the same, it doesn't matter. But if
it's less expensive to take regular Biaxin, then yes, it's just a scam
to get more money from you.
MS
2004-12-23 06:21:26 UTC
Permalink
I saw another article on the web about using a short course of steroids in
sinusitis treatment, in conjunction with antibiotics. The URL:

http://www.medscape.com/viewarticle/494246


(You might have to register with Medscape to view the article. Or try
"Bugmenot".)

I just read a little so far, I will read the whole article.

They used still a different type in the study, betamethasone. The study took
place in So. Africa, so I don't know if that's one they use there, and not
here in the US. Is it about the same as the others mentioned?

The patients received a very small dose of it, only 1 mg per day for five
days. (Is this med much stronger than the others mentioned?).

In this case they were testing acute sinusitis. Two groups, both infected.
Both taking the same antibiotic at the same dosage. One group also took the
steroid course mentioned above, the other had placebo instead. It seemed
there was a significant improvement in the group that had the steroid.
MS
2004-12-23 06:24:14 UTC
Permalink
Post by Matt Beckwith M.D.
Steroids shouldn't be prescribed twice a day like that. All the pills
for a particular day should be taken at the same time.
The Medrol dose pack comes with directions to spread them out over the day/
Post by Matt Beckwith M.D.
Yeah, this doesn't make a lot of sense. A more typical regimen would
be 60 mg daily for 3 days, 40 for 3 days, 20 for 3 days, then stop.
It isn't too abrupt to go from 20 mg to nothing? Wouldn't it be better after
the 20 to go to 15, 10, 5, then perhaps 5 every other day then perhaps half
a 5 tablet every other day, or something like that, very gradual withdrawal?
Matt Beckwith M.D.
2004-12-23 13:08:00 UTC
Permalink
Post by MS
It isn't too abrupt to go from 20 mg to nothing?
No.
Matt Beckwith
2004-12-26 03:00:47 UTC
Permalink
Post by MS
The Medrol dose pack comes with directions to spread them out over the day/
Yes, I recall that. It's another good reason not to use it. It's not
bad to spread them out, but it just won't work as well for the things
we usually prescribe steroids for (such as poison ivy and asthma) when
the dose is spread out.
MS
2005-01-01 21:41:11 UTC
Permalink
Post by MS
Post by MS
The Medrol dose pack comes with directions to spread them out over
the day/
Yes, I recall that. It's another good reason not to use it. It's not
bad to spread them out, but it just won't work as well for the things
we usually prescribe steroids for (such as poison ivy and asthma) when
the dose is spread out.
Why does it not work as well when the dose is spread out? Or is it to help
the body not to become dependent on it? I mean--if you put a constant level
of extra steroid in the bloodstream, the body's adrenal glands might start
making less of its own--but if you only put it in once per day, where the
level in the bloodstream of the added steroid doesn't remain constant, the
body's own glands are less likely to decrease production? (Just a guess, on
the reason for once per day dosing.) Of course, in the few days fast taper
dosage of a Medrol dose pack, I don't know if there is much risk of that
(the body decreasing its own cortisone production) in any case.

What do you think the rationale is, from whoever created the "Medrol Dose
Pack" (which has become a common way for doctors to prescribe steroids, I
guess because it's easy, they might think patient dosing compliance would be
easier with such a "pack", and less risky than longer courses), to spread
out the dosing like that, rather than the once per day dosing, which is
perhaps more commonly prescribed by doctors who don't use "the pack".
Matt Beckwith
2005-01-02 15:34:44 UTC
Permalink
Post by MS
Why does it not work as well when the dose is spread out?
Because the level that's achieved in the blood stream is lower.
Post by MS
What do you think the rationale is, from whoever created the "Medrol Dose
Pack" (which has become a common way for doctors to prescribe
steroids, I
Post by MS
guess because it's easy, they might think patient dosing compliance would be
easier with such a "pack", and less risky than longer courses), to spread
out the dosing like that, rather than the once per day dosing, which is
perhaps more commonly prescribed by doctors who don't use "the pack".
I don't know.
James Stein
2005-01-02 20:50:32 UTC
Permalink
Post by Matt Beckwith
Post by MS
Why does it not work as well when the dose is spread out?
Because the level that's achieved in the blood stream is lower.
Post by MS
What do you think the rationale is, from whoever created the "Medrol
Dose
Post by MS
Pack" (which has become a common way for doctors to prescribe
steroids, I
Post by MS
guess because it's easy, they might think patient dosing compliance
would be
Post by MS
easier with such a "pack", and less risky than longer courses), to
spread
Post by MS
out the dosing like that, rather than the once per day dosing, which
is
Post by MS
perhaps more commonly prescribed by doctors who don't use "the pack".
I don't know.
Because prednisone is easier to wean off of when the doses are spread
throughout the day; and weaning off of prednisone is a great pain in the
ass.
Matt Beckwith
2005-01-02 23:36:25 UTC
Permalink
Post by James Stein
Because prednisone is easier to wean off of when the doses are spread
throughout the day; and weaning off of prednisone is a great pain in the
ass.
That can't be the reason, since the low doses involved in the Medrol
Dose Pak are nothing one would ever have to wean off of.

It's not uncommon for a patient with an asthma exacerbation to get 20
mg daily for 5 days then stop suddenly, for example (though I
personally never prescribe it that way).
James Stein
2005-01-03 02:07:30 UTC
Permalink
Post by Matt Beckwith
Post by James Stein
Because prednisone is easier to wean off of when the doses are spread
throughout the day; and weaning off of prednisone is a great pain in
the
Post by James Stein
ass.
That can't be the reason, since the low doses involved in the Medrol
Dose Pak are nothing one would ever have to wean off of.
I have no idea what the doses in the Medrol Dose Pak are. I was simply
commenting on my own experiences weaning off of prednisone, and have found
that smaller doses throughout the day make it easier for me to wean than a
single large dose every 24 hours. (I've been on it for ulcerative colitis.)
iJah
2005-01-12 17:13:18 UTC
Permalink
Post by James Stein
Post by Matt Beckwith
Post by James Stein
Because prednisone is easier to wean off of when the doses are spread
throughout the day; and weaning off of prednisone is a great pain in
the
Post by James Stein
ass.
That can't be the reason, since the low doses involved in the Medrol
Dose Pak are nothing one would ever have to wean off of.
I have no idea what the doses in the Medrol Dose Pak are. I was simply
commenting on my own experiences weaning off of prednisone, and have found
that smaller doses throughout the day make it easier for me to wean than a
single large dose every 24 hours. (I've been on it for ulcerative colitis.)
Maybe you can help me out? I posted this awhile ago regarding my
efforts to wean off of prednisone...

I've been taking 20mg per day in four separate does of 5mg at 8 hour
intervals for a little over two months now. Already experiencing signs
of 'moon face' and have a fat pad forming on my neck at the top of my
spine. The side effects are starting to frighten me.

I want to start weaning off this. Anyone have any advice on how to
proceeed in order to minimize withdrawal symptoms? Can I knock it down
by 5mg, staying at 15mg for say a couple days then go down to 10mg for
a couple days or is that too steep?

iJah
ENTconsult
2005-01-17 01:44:06 UTC
Permalink
The reason for reducing the dose is to bring your own cortisone system back to
work. The large dose suppresses your own system, the reducing dose allows it to
return to function.
Murray Grossan, M.D.
http://www.ent-consult.com
Sbharris[atsign]ix.netcom.com
2005-01-15 22:31:14 UTC
Permalink
Post by MS
I never like the "pack" dosing, as was discussed with the "Z-pac" dosing for
the antibiotic zithromax. I find that it restricts the individuality of
dosing for the particular patient from the doctor. (Of course, the doctor
could prescribe the "pack" and suggest a different dosing than that on the
pack, but usually it is just "use as directed".)
I'm not sure I agree with your logic here. If the doctor wants to use
the dosing in the pack, then he prescribes the pack. If he wants
another dosing, he writes a prescription for that dosing. There's
nothing wrong with the pack.

++++++++++++++++++++++

COMMENT:

LOL! Indeed not. The Z-pack is great! It saves the doctor from
handwriting a ton of directions, which would make his hand numb and
give him callouses and take at least 5 minutes. Besides which, he'd
have to figure out what to write, when there really is no science at
all to tell you HOW to "taper" a very short course of steroids. Or even
if you NEED to. Dispite the fact that it feels really funny to the
doctor not to. So the Z-pack solves several dilemas at once. Social
dilemas, mostly, but dilemas they are.

SBH
Sbharris[atsign]ix.netcom.com
2005-01-15 22:38:12 UTC
Permalink
Wups, my fingers wrote "Z-pack" when of course I was referring to the
Medrol dose pack.

As for the Z-pack, it solves yet another social problem? How do you
convince people to spend that much money for such a small number of
pills? It looks like hardly anything. It's almost as silly as the one
Diflucan pill.

Answer: same in both cases of Diflucan and Zithromax. Put them in a
nice substantial cardboard pack, so it looks like you're getting
something weightier, meatier.

SBH
b***@wchsys.org
2005-01-17 02:38:11 UTC
Permalink
Post by Sbharris[atsign]ix.netcom.com
Wups, my fingers wrote "Z-pack" when of course I was referring to the
Medrol dose pack.
Gee, I wonder what your fingers were referring to? :-)
habshi
2005-01-12 00:18:03 UTC
Permalink
What is the harm in giving someone with say tennis elbow , a
week's course of prednisolone as a trial ?
Don Brady
2005-01-12 05:50:42 UTC
Permalink
Post by habshi
What is the harm in giving someone with say tennis elbow , a
week's course of prednisolone as a trial ?
I'm sure this is said tongue-in-cheek, but just in case anyone misses the
irony, let me note it.

Obviously this is a drug with risks and side-effects, so you would not use it
for something minor. Also, "trial" means that it succeds, you would keep on
using it, which would again not apply to anything

I guess the opinion being expressed is that sinusitis is too trite for oral
steroids. I would say that there are cases where it is appropriate for
sinusitis on a temporary basis..
Patricia Daniel
2005-01-13 12:06:28 UTC
Permalink
that you try to use it again too quickly and aggravate it or make it worse

Also probably won't work brilliantly as a better solution for sporting
injuries when everything else has been tried is a steroids injection into
the site...

in any case tennis elbow in most cases is due to a bad action, won't fix a
damn a thing.... just stop it hurting so much
Post by habshi
What is the harm in giving someone with say tennis elbow , a
week's course of prednisolone as a trial ?
habshi
2005-01-13 12:17:10 UTC
Permalink
Why are we so worried about a weeks' trial of steroids ?
Asthmatics use it . Those with polymyalgia can use it for months.
Lot of backache is cured with it . I have a bit of tendinitis in my
right two finger tendons from typing and will take prednisolone for
two or three days and it cures them for six months or so .
bobbie sellers
2005-01-13 02:41:23 UTC
Permalink
Post by habshi
Why are we so worried about a weeks' trial of steroids ?
Asthmatics use it . Those with polymyalgia can use it for months.
Lot of backache is cured with it . I have a bit of tendinitis in my
right two finger tendons from typing and will take prednisolone for
two or three days and it cures them for six months or so .
I believe if you investigate you will find the corticosteroidal
agents may suppress your immune system. After all the inflammatory
process causing your pain is an immune system function. With that
immune suppresion on a repeated basis the chances of contracting
other illnesses may go up. I used such medications for asthma
in the 1980s and developed several problems including finally
Chronic Fatigue with Immune Dysfunction. Such immuno-suppresant
medications should be used sparingly IMO.

Other treatments and exercises for your condition would seem
to be indicated but since I am not a physician nor a physical
therapist I cannot be certain of that. Consultation with a
physician, preferably one who is expert in treatment of such
disorders would seem advisable.

later
bliss -- C O C O A Powered... (at california dot com)

--
bobbie sellers - a retired nurse in San Francisco

It is by the beans of cocoa that the thoughts acquire speed,
the thighs acquire girth, the girth become a warning.
It is by theobromine alone I set my mind in motion."
--from Someone else's Dune spoof ripped to my taste.
habshi
2005-01-13 19:09:18 UTC
Permalink
Of course long term steroids are a problem , but what about
for just a week ?. Many injections doctors give -and most of the drug
is absorbed into the blood within minutes for frozen shoulder etc.
could be eliminated .
Patricia Daniel
2005-01-15 00:30:33 UTC
Permalink
Injections are better for local pain, they don't suppress your immune
system, nor will they cause mood swings and other nice side effects.

usually when given tablets for steroids, they take a while to kick in, and
you have to be weened off them gradually....... ie on occasions if i am
suffering severly with allergies, i take steroids just to give myself a
break (usually once every few years) and i start on one tablet, for a few
days, then half, then a quarter etc...... this gives your immune system time
to kick in gradually.....

i think the main issue is what it's being used for. Is it a whole body
problem, or a localised one. There's no point in giving a whole body "cure"
for a highly localised problem :-)
Post by habshi
Of course long term steroids are a problem , but what about
for just a week ?. Many injections doctors give -and most of the drug
is absorbed into the blood within minutes for frozen shoulder etc.
could be eliminated .
habshi
2005-01-15 10:45:16 UTC
Permalink
No. Nowadays steroids are used for seven days and then stopped
suddenly . Only if you use high doses for more than a month or two ,
do you need to tail them off .
Also remember that our body makes steroids . Has any doctor
used oral steroids for a week to treat whiplash which has not got
better for a few months ?
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