Bethamethasone vs celestone

[painfre]

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I changed from Kenalog to celstone for Lumbar TFESI's after FDA issued warning against kenalog. I am also considering using Dexamethasone . Please comment on duration of steroid effect of Bethametasone vs Dexa. for Lumbar region. I know you code for Celestone j0702 what about Dexa ?

 

[Pain Applicant1]

Do you mean betamethasone vs dex or beta vs brand name celestone? I'll assume the former. I know most people on here would agree that the partic steroid will last longer than dex but it may not matter that much. However, the studies below only followed patients for a month or two.

Kim D, Brown J. Efficacy and safety of lumbar epidural dexamethasone versus methylprednisolone in the treatment of lumbar radiculopathy: a comparison of soluble versus particulate steroids. Clin J Pain. Jul-Aug 2011;27(6):518-22

Dreyfuss P, Baker R, Bogduk N. Comparative effectiveness of cervical transforaminal injections with particulate and nonparticulate corticosteroid preparations for cervical radicular pain. Pain Med. May-Jun 2006;7(3):237-42

 

[PinchandBurn]

FYI


betamethasone is still a Particulate Steroid......

 

[bedrock]

FYI


betamethasone is still a Particulate Steroid......

Exactly,

FDA warning was issued by bureaucrats who don't know **** about the science of our specialty. Technically, the only truly safe steroid for TFESI is the only true non-particulate steroid- dexamethasone.

Now if you're using DSA, this entire discussion changes, not that the FDA would understand this at all......

 

[Pain Applicant1]

Dexamethasone - Particles were 5-10 times smaller than red blood cells, contained few particles, and showed no aggregation.

Triamcinolone - Particles varied greatly in size, were densely packed, and formed extensive aggregations.

Betamethasone - Particles varied greatly in size, were densely packed, and formed extensive aggregations.

Methylprednisolone - Particles were relatively uniform in size, smaller than red blood cells, and densely packed and did not form very many aggregations.

...and betamethasone, unless compounded, typically contains preservative.

 

[painfre]

Any study done between celestone vs Dexamethasone. If there is not much difference in the duration of action between two.then it is better to switch over to Dexa. ( Safer and much cheaper)