When I had a cortisone injection a couple of weeks ago, I called my coumadin clinic the same day and they adjusted my dosage because they said it will cause your INR to go up, it\'s pretty dependable they said almost like clockwork it will spike it a couple of days after the injection.

I am on Coumadin following a PE which occurred after removal of one lobe of my lung. I now have back pain and was given a dose pack of Prednisone. I have been told that they don\'t play nice together, but that for the short term, it\'s not a problem. I also am going to have a breast biopsy on 6/11/09, and I\'ll be off Coumadin and on Levenox for several days. The Prednisone has also spiked my blood sugar, so after being a diet-controlled diabetic (Type 2) for 4 years, I now am on Metformin because of the effects of the Prednisone. Seems like one med is affected by another med, which you then have to treat with yet another med!

So I was told it\'s not a problem and you were told your coumadin dosage would have to change. Wonder which answer is the right one?

Well I don\'t know if there might be any difference in the injection vs oral steroid, but I know that my coumadin dose was lowered for about two weeks, my INR still went up but not out of therpeutic range for me, which was 2.5-3.5. I think I was 3.2 when checked, then after that they raised my dose back to normal, and at the next check it had gone slightly down, I think 3.0. So I have no complaints in how my situation was handled.

In any case, Ferr, I know that you\'re bigger concern is always that it might drop below 2.5, so I don\'t think you have anything to worry about there. If anything your INR should only go up.

My inr went down on antibiotics and up on steroids although last time I was on both at the same time and it went to the highest it\'s ever been. It took about a week after finishing the pills for my inr to get stable again. Heres hoping it doesn\'t affect yours

Karen xx

Ok I checked my INR yesterday 1 day post injection and I am currently holding at 2.8 but have to check again in 1 week to see where I am then. By the way the injection in my back didn\'t work because my back still hurts maybe not quite as bad but its still there. This is the second round of injections I have gone through and think I am going to opt for a different route maybe. I hate steroids.

For your next shot please ask your doc that controls your INR if you should get off the coumadin for a few days. Your risks go way up for problems from the shot if you are theraputic. I did shots for about a year while on and off coumadin. It is really scary going off, but supposed to be much safer.