Local corticosteroid injections (Formulary)

Generally, no more than 3 joints to be injected on one day and no more than 3 injections per joint per year. If failure to respond, refer for specialist advice.

Please consider if a steroid emergency card needs to be given to the patient alongside the traditional steroid treatment card.  This is to support the timely recognition and treatment of potential adrenal crisis and is suitable for some patients on oral, inhaled, topical or rectal steroids.  For more information, including which patients should receive the card, see HIS for details.  Steroid emergency cards have been distributed to, hospitals, GP surgeries and community pharmacies. Primary care can order replacement cards from 01463 706886.

See Peri-operative guidelines for patients with or at risk of adrenal insufficiency

METHYLPREDNISOLONE

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Injection (as acetate) (aqueous suspension) 40mg/mL

Dosage:

By intra-articular or intrasynovial injection: 4 to 80mg according to size of joint.

TRIAMCINOLONE

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Injection (as acetonide) (aqueous suspension) 40mg/mL

Dosage:

By intra-articular injection or intrasynovial injection: 2·5 to 40mg according to size of joint; total maximum 80mg. 

METHYLPREDNISOLONE WITH LIDOCAINE

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Injection (methylprednisolone acetate 40mg (Depo-Medrone®), lidocaine 10mg/mL) (aqueous suspension)

Dosage:

By intra-articular or intrasynovial injection: 4 to 80mg (of methylprednisolone) according to size of joint.

Editorial Information

Document Id: F272