Sometimes steroids are used during the infusion of an RA biologic medicine in order to combat any potential reactions or side effects. This is most common with those given via infusion including Remicade, Rituxan , Orenica, and Actemra. Before I receive a Rituxan infusion, a rather large dose of 80-100 mgs of liquid methylprednisolone steroid is injected directly into the intravenous line. The nurse injects the steroid slowly over several minutes in order to avoid what she calls a “head rush” from the powerful medicine. This dose usually gets me quite hyped up for the next 24 hours and sleep is difficult.
An epidural steroid injection places this powerful anti-inflammatory medication directly around the spinal nerves. Traditionally epidural injections were administered without any special equipment, by inserting the needle by feel in the area around the spinal nerves. More recently epidural injections have been administered with the aid of imaging tools to allow your physician to see the needle going to the proper location. Either real-time x-ray called fluoroscopy, or CT scan can be used to 'watch' the needle deliver the medication to the proper location.