Safe to Take Prednisone Tablets After Cortisone Injection?

Summary: Both prednisone and cortisone are glucocorticoids and are strong anti-inflammatories.  The medical field commonly refers to these drugs as steroids.  They are often used for very different applications, though.

Dear Curtis: My doctor gave me a cortisone injection in my neck for pain.  He told me it was a steroid.  Now he wants me to take prednisone tablets for pneumonia and that prednisone was also a steroid.  Is that safe to take two steroids like that?

The short answer is yes.  You’re fine.  But let me explain why.

Your doctor was right when he called the drugs ‘steroids’.  This is common nomenclature to describe these types of drugs in the medical profession.  But, that name can be misleading and a bit scary for patients who think they can be dangerous.  Now, long term use or extremely high doses of prednisone (steroids) can be dangerous, but it sounds like this will be a short-course therapy for you.  So that shouldn’t be a concern.

Now, about the cortisone shot.

The cortisone shot that your doctor gave you in your neck is a close relative of a natural steroid that is produced in your adrenal gland.  When you are under stress your body releases this.  The difference is, when your body releases it – it goes into your bloodstream. The Cortisone shot is just that, a shot injected into the general area – not directly into your bloodstream.

But why inject cortisone if your body already produces it?  Simple, the cortisone is designed to be more potent and act much longer.  Whereas your natural cortisone only last minutes, a cortisone injection last days.

It’s important for you to remember that a cortisone injection isn’t actually a ‘pain reliever’ in the true sense of the word.  It helps with the pain by stopping the inflammation at the injection site.  This is one of the reasons why when people complain that a cortisone injection didn’t really hurt that much it’s probably because there wasn’t much of an inflammatory component.

Now, in regards to the prednisone.  Prednisone, like your cortisone injection, is obviously man-made.  Prednisone is actually a pro-drug.  This means that prednisone itself doesn’t do anything in your body.  Instead it is broken down into a compound called prednisolone in your body and it’s that compound that helps you.

Like cortisone, prednisone is a strong anti-inflammatory.  Not as strong as cortisone, but still strong.  The biggest difference between these two steroids is that prednisone is taken orally.  So, once in your stomach it starts to become absorbed into your blood stream and begins exerting it’s anti-inflammatory effects across your whole body.  As an aside, that’s one of the reasons long-term use of prednisone can have so many broad and problematic side effects.

Sometimes, rather than giving your a prednisone tablet to take during something like pneumonia your doctor may have you take a steroid inhaler.  There are a number of these on the market.  The advantage of these is that they are very localized and get to your lungs right away.  The downside is they are much more expensive than a prednisone tablet.  Also, with something like pneumonia your doctor probably didn’t want to take any chances and opted for a bigger gun like prednisone.

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  1. [...] of how Prednisone acts in your body it has a wide range of effects. But, as far as what it does in the gastrointestinal system I highly [...]

  2. [...] You see, when you say cortisone you are talking about the shot. One of the advantages of the cortisone shot is just that … it’s a shot. So you can direct it’s effects to exactly where you want them. That’s one of the reasons why you see people who have had, say, a sports injury in their knee where there is inflammation involved. I’ve had cortisone shots in my elbow because of inflammation. The list can go on. And, as you’ll see below, some cortisone shots are followed up with prednisone tablets to be taken by mouth. [...]

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