Off-label, epidural use of Depo-Medrol (methylprednisolone acetate) injections for back pain is increasing as clinicians limit their opioid prescribing — but the treatment is risky and often ineffective — the New York Times reports.
Depo-Medrol’s manufacturer, Pfizer, requested in 2013 that epidural use be banned owing to risks for blindness, paralysis, stroke, and death. The FDA declined to issue a ban but did strengthen the drug’s label in 2014 to note these risks.
The Times reports that “interviews with dozens of pain specialists show that pressure to wean patients off opioids is prompting many doctors to refer patients to pain intervention specialists who promote the shots.” The number of Medicare providers giving epidural steroid injections, including Depo-Medrol, increased 13% from 2012 to 2016, according to the Times, and Depo-Medrol sales rose 35% between 2015 and 2017.
However, nearly 2500 serious adverse events related to Depo-Medrol, including over 150 deaths, were reported to the FDA between 2004 and 2018, the Times notes.
Depo-Medrol is approved only for injection into muscles and joints.