[daisy.girl]

can anyone tell me why I would pick one over the other? my neuro (NP) seems to think the oral is just as effective??

[Debbie D]

I have found personally that IVSM works on me better and more quickly and I don't get quite as severe a headache from the IV. I hate being on the oral roids...

[Erin524]

Oral steroids work pretty well for me, and they cost me about $5 (or a little more) at Walgreens when the doctor calls in a Rx for me.

IVSM is expensive and I have to go to the outpatient infusion center to get them. (I've tried to get them to Rx them for home use...my dad's a nurse and so is my aunt, but nope...no go on that yet)

Oral steroids are not good to have for vision related problems. Something about the oral steroids making you more susceptible to a re-occurance of another optic neuritis flare.

IVSM worked great on me the one time I had it for vision issues. (other time I had IVSM was because I was having a flare that was affecting my walking and it scared me. IVSM worked great that time too)

[whoopdedeaux]

Not only would I choose oral for reasons of cost, convenience, and the least negative impact on my day-to-day life, I would not choose a neuro who is unwilling to prescribe oral steriods instead of IV...one caveat: as Erin said, the IV course of treatment is the best choice for Optic Neuritis.

For all other types of flares, I would insist on oral tablets so I could stay home and enjoy my life.

[FaithS]

I'm surprised to see so many people recommending oral steroids, rather than IV. IV seems to be the more standard way to do things, if you are taking a high dose (1000 mg). I think the biggest plus over oral is that oral steroids are much more likely to cause stomach problems (acid reflux/GERD). Another problem with oral steroids is taking twenty bitter-tasting 50mg pills every day.

Both IV's and oral seem to cause sleeplessness for me. My doctor also rx's a sleeping pill (Trazedone) to help me sleep when I'm on steroids (either IV or oral). Without them, I may only get 20 minutes of sleep in a 24-hour period.

I prefer oral, too, like many of the other posters. For the following reasons:
- I first started taking oral because a 5 day IV usually needed to be replaced after 3 days. My veins are difficult to find and access. One is fairly easy, but, finding a second is tough. The time that it took 2 competent nurses two hours and 6 pokes to find a vein for an IV was the last time I had one.
- Cost is much less.
- Much more convenient; can just take some pills at home, rather than going in to have the IV done in the Dr's office or an outpatient clinic.

The first time my physician ordered 5 days of 1000mg of oral prednizone, the pharmaicst called his office to confirm that the rx was accurate. He'd never seen a rx that high for an oral steroid.

~ Faith

[wkikta]

The best things with Oral is the much lower cost and better convenience. As said, they are not recommended for Optic Neuritis. With most Insurance the IV is a Major Medical Expense with little or no Copay, so it can be less expensive.

[Debbie D]

My neuro has a visiting nurse infuse me at home. He insists on slow infusion...it only took an hour out of my day, and my insurance paid their usual 90%.

[Dejibo]

IVSM is reserved in my world for visual issues. I want to save my vision, but past that, I would choose a oral pack any day. its much less damaging to your bones, and your organs and can be quite effective. Plus if its not effective you can always jump a step higher and take the IVSM route. its a large hammer to use and we can pay a heavy price for its usage later on with weak bones.

[EddieF]

I've had both. IV once, oral twice. Eyes improved with IVSM, no change with orals.
IV leaves a nasty taste in mouth, energy to spare (grocery shopped before lunch which is always after), I'm easy stick cause I exercise alot.
Orals give energy, took away my sudden spasm jolts while watching tv at night (the 1st time I took them anyway, the 2nd not as much & I get them all the time now),

I say it depends on the hit you want. I love neuros that let patients call their own shots since you know your bod more then any neuro.