Rarely a patient may experience an anaphylactic or anaphylactoid reaction to an injection of a corticosteroid. Epinephrine should be readily available to any physician giving steroid injections.
Most reports implicate methylprednisolone sodium succinate (Solu-Medrol). Other reports implicate other corticosteroids formulated with succinate. Very rarely other corticosteroids have been implicated.
Skin testing or test doses can detect most patients who are suspected of having corticosteroid hypersensitivity.
Skin testing may implicate additives in the product, but the patient may react to the corticosteroid itself.
A patient may be able to tolerate other corticosteroids. If the patient reacts to a steroid containing succinate, then a steroid with phosphate may be tolerated (Gelincik et al).
To read more or access our algorithms and calculators, please log in or register.
