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IV steroids infusion vs Oral steroids

Do IV steroids have any major advantages over the same does taken orally?

I’ve searched and have come across articles which state both are effective as each other. I’m sure I’ve read somewhere that the IV steroids work better than the tablets.

The reason I’m asking is because I will soon be having treatment and if oral steroids do an equally good job then I don’t see a point in spending some nights in hospital.

If anyone can provide any helpful information I would appreciate it a lot.

Also if you’ve had treatment whether by infusion or tablet form what were the side effects if you encountered any.

Thanks in advance.

I have found that IV seem to be better and don't leave that horrid taste in the mouth for as long as oral. 

I don't have to stay in hospital when I have them just go to the ward each day for about 45 mins - they leave the cannula in and bandage it for you so that it won't catch on clothing etc when you are at home.

I beleive the evidence is that both are equally effective.   Not all hospitals do the infusions as day admission.  Oral steroids do leave a taste in the mouth though I found I could get rid of it easily.  My main problem was feeling restless and agitated so I always had a low dose of diazepam to counteract this.  Would take oral steroids every time - even a day admissions means a needle in the arm and associated risks and inonvenience of attending a hospital.

i have always had iv steriods , did try oral but i had terrible heart palpitations so im now scared to even try oral again,also i find a few days in hospital relaxing is good for you , as i have a hectic home life.

There is evidence that taking oral steroids for Optic Neuritis causes it to recur more frequently than if IV sreroids are given. So if you need steroids for ON IV are definitely the way to go.

My neuro won't bother with oral, she prefers IV as she believes they are more effective in any situation.

I have mine as a day patient, leave the canula in and go in each morning to have the infusion run for the 3 days. Some hospitals will arrange for you to have them at home if your area runs a "Hospital in the Home Program" with the Distirct Nurse. That could be worth asking about.

Personally I prefer IV as it is only 3 days whereas the oral can be up to 10 days with the taper. I find the oral taste utterly foul but the IV don't give me the revolting taste. I don't get the insomnia problems that many are troubled by. I tend to get really tired and washed out on them and can feel quite unwell. It takes about a week for me to get over the effects of having steroids and I also find they make me very depressed. I will only take them if absolutely neccessary eg paralyzed, blind, totally incontinent. Anything less debilitating and I will ride it out because I really don't like steroids but that is just me. A lot of people breeze through the infusions or the course of tablets.

Whatever choice of treatment you end up taking I hope it knocks your relapse off fast and you feel better soon,

Belinda

I would like to thak you all for kindly replying to my post. Unfortunately I have existing medical conditions which may require monitoring which could result in me having to stay in hospital.

This is the first time I'm going to have such a big dose.

I'll go with IV treatment and hopefully they will halt or delay any further attacks.

Hiya,

I had steroid IV treatment earlier in the year and my consultant said that he preferred me to have it that way rather than tablets because he knew it was going straight into my bloodstream and that was that. 

It was easy enough, although the canula being left there grossed me out slightly even though it was bandaged up as, for the first night, it must have been bruised and was a little sore... Also, after my first day of treatment I had a crazy mood swing where one minute I was fine, the next I burst into tears rambling on about nothing which was a little weird. Oh, and, on the first day, as soon as it started going in pretty much I got a horrible metallic taste in my mouth, but it went away and never came back.

You don't have to stay over at all, you go in for about an hour, you sit there, usually with other people having it, and when your bags are empty they wrap you up and send you on your way. And to be honest, in a slightly disturbed way, I quite enjoyed being able to have an hour out, sitting there, knowing I didn't have to work or worry about dishes etc. Is that strange? Probably.

Re my symptoms, well, my relapse ended a couple of weeks after the treatment ( I think I'm going to have a big one again soon though, the signs are there... :s). However, big however, on my last day I got just the absolute worst pain in both of my hips towards my groin and it was horrible. I could barely walk. This was before I was diagnosed and I went to a walk in centre (haha...) and this rubbish GP saw me. He said, 'I can only give you painkillers but, with regards to your possible MS, I think you have it because of the way you're walking'. I wanted to find a spanner and hit him over the head. I WALKING LIKE THAT BECAUSE MY HIPS WERE KILLING ME AND I COULD BARELY MOVE THEM, fool. And well done on the excellent diagnosis skills. *sigh*.

Anyway, my consultant neurologist dragged me back to see him asap as the pain didn't go and he decided I had to stay in hospital so that they could keep an eye on me (as, apparently, one of the far fetched side effects of steroids is that it can kill your hip bones or something) and so that he could do lots of tests on me to rule out everything else so he could diagnose me. (Which he did, with MS). I ended up using a walking stick and a wheelchair for slightly longer journeys for about a month. The pain slowly faded, although my hip pain does flare up still, but I'm back to my usual walking around self. My retractable walking stick stays in my bag in case I need it, which is fab. They were never able to tell me why I was getting/am getting this hip pain. Thankfully, my hip bone does not appear to have died. I'd be interested to know if anyone else with MS gets hip joint pain.

The point of this essay is just to say, be aware, my hip problems started straight after steroids and they are still a problem, although a far smaller one than they were. *Phew* I can't half babble on... 

*Sorry* (again) didn't notice your comment re staying over. It is rubbish, admittedly, but it's far better to be there so they can notice if anything goes wrong. All the best xx

No problem thanks for sharing your experience, I’m aware that continued use of steroids is linked to thinning of the bones (steroid-induced osteoporosis)

Hopefully my first batch of IV treatment will slow down any further attacks and maybe help speed up recovery of various other symptoms I have.

Hi,

I gave my experience with both but my reply seems to have disappeared!! Steroids will shorten a relapse by about 2 weeks they do not prevent further attacks and they do not affect the overall outcome. If you go on the Barths and London ms blog you can access more information.

Thanks for the information about the blog, I have bookmarked and will have a read shortly.

everyone are different with both kinds of steroids for me personally when I had IV steroids once I was dx, but they gave me hallucinations my neuro said they will never give me IV steroids again,

I had high dose tablets 500mg for 5 days I had them last year in March, they helped me a lot I found my walking was quicker that is why my neurologist put me on copaxone treatment.

one thing I remember with both IV and oral steroids was the horrible metaly taste in my mouth not nice at all

and I put weight on especially with the oral steroids I put 1/2 stone on in a week, it took me four weeks to loose it, I found out its fluid retention, so with eating nothing extra you put weight on.

Al x

Iv all the way, have had both and I found the IV steroids more effective and no grotty mouth. I had mine as a day patient so was in and out within 2hours over 3 days. Much better. The oral steroids are cheaper thats why they are trying to push them. I found thay took longer to work and the taste in my mouth was horrible.

Thank you for sharing your experience, judging from everyone’s response I will stick with the IV. I will keep you all updated once treatment has started and finished.

Hello,

I just wanted to correct a slight misapprehension you may have. I’m not sure about your other conditions, but certainly in the case of MS or related conditions, steroids do nothing to halt or delay further attacks. They ONLY speed recovery from a present attack. No protective value for the future.

Sorry, but I thought you ought to know, as it may influence your thinking about whether you want to have them. Also, I didn’t want you to be disappointed if they didn’t ward off further attacks: that isn’t part of the deal.

Tina

Hiya

I went to the hospital yesterday and they confirmed I am having a relapse and asked would I rather have IV or tablets, I said IV as when I've had the tablets in the past they haven't worked as quickly.  They then came back and said I would need to wait 10 days before they could fit me in for the IV ones!  So I said I'd have the tablets, I'm sure I was told in the past the sooner you start them, the better the result so thought this would be the best thing.  I then went to the hospital pharmacy who told me they'd run out of the tablets that morning so they would post them out to me! 

My hospital was always brilliant in the past, if you had a relapse you got referred straight to the day ward to start steroids that day.  Maybe I've just picked the wrong time to have a relapse.....just when lots of other people are too :-(

I'll just have to see how I get on with the tablets, fingers crossed they do the trick.

Sue

x

Hi, thank you so much Tina for pointing that out. I could do with a speedy recovery I am going through a bad phase of symptoms. I initially refused IV steroids in 2010 because of concerns I had about my existing medical conditions.

I have been given the go ahead to have IV treatment by the various consultants that I’m under the care of also my new neurologist has given the green light saying it would be the most sensible thing to do. I am aware they only speed up recovery which is why I said “hopefully”