IV steroids - not sure doc knows what he's doing...

[rendean]

The scheduler at my local neuro's office called this morning and told me she was faxing  over the order for the steroids to the hospital infusion center. She asked if I wanted 500 or 250 mg /day and did I want 3 or 5 days.

The reasoning for the lower dose was the neuro thought I didn't do well with the 500 mg. Wrong.

Anybody know "the standard" or where I could find it?

Thanks!!!
Ren

[Quixotic1]

I have a few thoughts here.

1000mg of Solumedrol is the standard dosing.  I have seen no published rationale for using 500mg unless the patient has not been able to tolerate the higher dose.

3 or 5 days is, as DB says based on the severity of the flare - sensory only symptoms usually get 3 days, motor symptoms usually 5 days, the other symptoms are at the neuro's discretion (Well, it's all at the neuro's discretion).

The taper is not standardized.  Some patients have an immediate rebound of symptoms within a week of stopping the steroids and they are the ones that need a taper.  The taper is not needed just because you got steroids.

Remember, anyone  who has received two or more courses of steroids within a year should be wearing a Medic-Alert indicator that they might be steroid dependent.  An illness or injury might need a booster dose of steroid to support lazy adrenals.  See the Health Page "Steroids - Friend and Foe".  First responders need this info!!!

Quix

[doublevision1]

It's curious that some docs order the taper and others do not.  My neuro doesn't think it makes much difference so I've never had it.  

[rendean]

Thanks for the info. I looked and I found 1 gm x 3-5 days. I tried calling my MS neuro but haven't heard.

The usually don't do a taper due to my hypertension , it aggravates it  and the 3 day regimen is used for the same reason. Not sure how effective it s with the MS but it beats a stroke.

Thanks agian ladies,
Ren

[essdipity]

Yes, 1000 seems to be standard, per

http://www.medhelp.org/posts/Multiple-Sclerosis/Medrol-dose-pack/show/676953

Try searching the forum for more on this. A taper also sounds like a good idea.

ess

[doublevision1]

1g x 3 or 5 days depending on severity of flare

[essdipity]

Hey Ren, I thought it was 1000, but am not sure. Will try to research this.

ess