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Dr. Mark
Dr. Mark, Physician / Surgeon
Category: Medical
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Experience:  U.S. Surgeon / Neurological Surgery
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Should you mix decadron and depo-medrol in one intramuscular

Resolved Question:

Should you mix decadron and depo-medrol in one intramuscular injection?
Submitted: 8 years ago.
Category: Medical
Expert:  Dr. Mark replied 8 years ago.
Why would you want these two different steroids in an IM injection?

Customer: replied 8 years ago.
I am asking because I was given them along with a Rocephin shot all in the same hip in the area of a dime. Needless to say my rear had a horrible reaction, like cellulitis. Dark purple circular area the size of an open hand with a gray center, etc. Painful, hot and swollen. I am a registered nurse and questioned the nurse giving me the shot and she told that it was customary to give them together. Everywhere I worked it was not. I was taught to give two shots and in different hips. I had bronchitis and at the time of those shots I was also given Cipro to take orally. When I went back to let the Doctor look at the area he also gave me Keflex for it as well. Not that all of this extra information is necessary for this question, but I thought you might just want the whole story. I have just been trying to find out the correct answer and haven't found it so I thought I would ask it here. I hope that this is clear enough for you to understand. Thanks
Expert:  Dr. Mark replied 8 years ago.
Well, without knowing exactly the chemical suspensions that were involved in these formulations -- it is impossible to answer such a question with certainty, but as for the two steroid medications, it is not unusual for steroids to be mixed together with other medications in an IM injection.

For example, for joint injections, it is often mixtures of steroids and local anesthetic delivered in the same needle.

Apparently you are not supposed to mix Rocephin with a calcium containing solution -- though I don't think steroid injections would have calcium.

And unless medications have been shown to be compatible with each other it would be safer to give them as two separate injections. Though I'm not sure that the actual mixture in your case was the reason for your symptoms -- but I can't find a drug compatability chart that has steroid medications and rocephin listed on them for evidence.
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Customer: replied 8 years ago.
Like you, I couldn't find a compatibility chart either. The shot I received was deca 4 and depo 80 and like you again I am not sure of the suspensions. I guess the reason that I was taught this way, maybe, was so that if you have a reaction such as this you will have a better chance of knowing what you had the reaction to. Somewhere in my experience I was told that decadron when viewed under a microscope looked like ground glass. How true this is I don't know but they say that is partly why it is a painful shot. Mine was painful and so was the Rocephin. So I got a double whammy. Also, I know that Decadron is very hard on the veins as well when given IV and that you need to make sure that you have a good site before administering it. About the Rocephin I have also heard that about the calcium. OH well, I was hoping for a little more difinitive answer but this one was good enough. Thanks so much for your help.