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Medical Forum / General / General / January 2005Prednisone vs. Medrol?
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.) 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. > 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 [quoted text clipped - 77 lines] > ;-) ) But seriously, is there any difference? (I was prescribed it for ten > days, includes one refill though.) > 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? 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 > I am only addressing pack dosing here. > [quoted text clipped - 27 lines] > > 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 [quoted text clipped - 52 lines] > > ;-) ) But seriously, is there any difference? (I was prescribed it for ten > > days, includes one refill though.) 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. > Predisone and Prednesilone (solumedrol) are essentially the same thing. > [quoted text clipped - 112 lines] > ten > > > days, includes one refill though.) *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 :)  SignatureHillary 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 >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 [quoted text clipped - 6 lines] >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 >>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 [quoted text clipped - 44 lines] > 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. > 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. [quoted text clipped - 23 lines] > > 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? > 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. > 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. > 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 [quoted text clipped - 36 lines] > 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. SignatureDavid Rind drind@caregroup.harvard.edu >> 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 [quoted text clipped - 59 lines] > 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. How safe would it be to obtain Omeprazole from India, rather than taking Prilosec OTC? Thanks jimreid@mn.rr.com > What is the difference between prednisone and methyl-prednisone? Difference > in efficacy? In strength? The potency is about the same milligram-for-milligram. > 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. > 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. > (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. > 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?) It really depends on the disease and the doctor. It's up to the doctor, there's no set dose. > 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? 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. > 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. > For an antibiotic I suggested Biaxin (clarithromycin), as I had taken it > successfully before... For the same illness? > 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 [quoted text clipped - 7 lines] > ;-) ) 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. 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. > 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/ > 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? > 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. > > The Medrol dose pack comes with directions to spread them out over > the day/ [quoted text clipped - 3 lines] > 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". > 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. > 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". I don't know. >> Why does it not work as well when the dose is spread out? > [quoted text clipped - 12 lines] >> 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 a.s. > 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 > a.s. 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). >> Because prednisone is easier to wean off of when the doses are spread > [quoted text clipped - 4 lines] > 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.) > 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 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 > 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? :-) What is the harm in giving someone with say tennis elbow , a week's course of prednisolone as a trial ? > 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.. 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 > What is the harm in giving someone with say tennis elbow , a > week's course of prednisolone as a trial ? 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 . habshi@anony.com (habshi) wrote. > 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. 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 . 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 :-) > 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 . 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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