Answer the side-effect intent for cortisone injection without diagnosing; distinguish common from serious reactions and give safe next-step/reporting guidance.
Sources
This page covers corticosteroid injections — a group of products, not a single one. Each statement below is taken from the SAHPRA-approved patient information leaflet named beside it:
- DEPO-MEDROLTM (methylprednisolone, approved 29/06/2023)
- DECASONE INJECTION (dexamethasone, approved 29/01/2024)
Retrieved 2026-09-03. Your own medicine’s leaflet is the one that applies to you, and where it differs from this page the leaflet is correct.
What is cortisone injection?
Corticosteroid injections covers several products registered in South Africa, not one. They work in a similar way, and their approved leaflets do not list identical side effects.
The medicines covered here, and the leaflet used for each:
- methylprednisolone — DEPO-MEDROLTM, Pfizer Laboratories (Pty) Ltd (Suspension for injection)
- dexamethasone — DECASONE INJECTION, PHARMACARE LIMITED (INJECTION)
Check your own pack
Two medicines in the same group can differ in their approved uses, their cautions and their side effects. The leaflet inside your pack is the one that applies to you.
Common side effects of cortisone injection
Each medicine in this group has its own approved leaflet, and the effects below are the ones that leaflet lists. They are shown separately rather than combined, because the leaflets do not agree on what to list or how to word it.
Methylprednisolone (DEPO-MEDROLTM)
- round or moon-shaped face (Cushingoid)
- fluid retention, which causes swelling that may be widespread, or confined to a limb or part of a limb
- sodium retention, which causes thirst due to dehydration
- low levels of potassium in the blood
- DEPO-MEDROL can cause serious mental health problems
- feeling depressed
- feeling high (mania)
- cataracts
- high blood pressure, symptoms of which are headaches, or generally feeling unwell
- ulcers, including perforated and bleeding ulcers
- thinning of skin
- acne
The leaflet lists 66 more. Read the full leaflet.
Dexamethasone (DECASONE INJECTION)
- stomach problems: having more of an appetite than usual
- moods that go up and down
- feeling high (mania)
- changing how you act (behavioural disturbances)
- having or showing a tendency to be easily annoyed (irritability)
- Infections: fungal and viral infections, tuberculosis
- impaired tissue repair and immune function can lead to delayed wound healing
- stomach problems: indigestion
- inflamed pancreas: this may cause severe pain in the back or stomach
- problems with salts in your blood such as too much sodium or low potassium or calcium. You may experience swelling of your limbs (water retention)
- heart and blood problems: high blood pressure
- bone problems: thinning of the bones (osteoporosis) with an increased risk of fractures, bone disease, damaged tendons
The leaflet lists 21 more. Read the full leaflet.
Serious side effects and warning signs
None of the leaflets reviewed set out a separate serious-effects list.
General warning signs that apply to any medicine
Call for emergency help now if any of these happen
- Difficulty breathing, wheezing, or tightness in the throat or chest
- Swelling of the face, lips, tongue or throat
- A widespread rash with blistering or peeling skin, or sores in the mouth, eyes or genitals
- Fainting, collapse, or a sudden severe drop in alertness
- Chest pain, or sudden weakness or numbness on one side of the body
- A fit (seizure), or confusion that comes on suddenly
In South Africa call 10177 for an ambulance, or 112 from a mobile phone. Go to your nearest emergency department if it is faster. Do not wait to see whether the symptom settles.
How long can side effects last?
How long a side effect lasts depends on the effect, the product, how long it has been used, and the person. Some effects ease within days as the body adjusts. Others continue for as long as the product is used. A few can persist after stopping, and some need review rather than waiting.
- Settling effects — mild effects that ease over the first days or weeks of use
- Ongoing effects — effects that continue while the product is being used and improve after stopping
- Persistent effects — effects that continue after stopping and need medical review
- Delayed effects — effects that appear after weeks or months rather than immediately
Which of these applies to a particular effect is a clinical question. If a side effect is not settling, is getting worse, or is affecting your daily life, that is worth a conversation with a pharmacist or doctor regardless of how long it has been going on.
Evidence required before publish — source the following for cortisone injection from the SAHPRA-approved patient information leaflet or professional information, and cite what you actually used.
- Anything the approved information for cortisone injection says about how long specific effects last
- Whether the source describes any effect as usually temporary, or as needing review if it persists
- Whether any effect is described as continuing after the product is stopped
Factors that may affect side effects
Cautions from each medicine’s approved leaflet.
Methylprednisolone (DEPO-MEDROLTM)
Do not use it at all if:
- if you are hypersensitive (allergic) to methylprednisolone acetate, or any of the other ingredients of DEPO-MEDROL (listed in section 6). An allergic reaction may cause a skin rash or reddening, swollen face or lips or shortness of breath
- if you have a certain type of fungal infection (systemic)
- if you have recently had, or are about to have any vaccination
- if you have suffered from tuberculosis in the past, stomach ulcer, severe mental disorder, Cushing’s syndrome (high cortisol hormone levels causing effects such as round or moon-shaped face), herpes eye infection, smallpox or chickenpox Speak to your doctor or health care provider immediately if any of the above applies to you. DEPO-MEDROL should not be injected directly into a vein (intravenous), the spinal cord (intrathecal) or spinal column (epidural route)
Use with care, and tell your doctor, if:
- if you have chickenpox, measles, shingles or herpes eye infection. If you think you have been in contact with someone with chickenpox, measles or shingles and you have not already had these illnesses, or if you are unsure if you have had them
- if you have tuberculosis (TB) or if you have suffered tuberculosis in the past
- if you have unusual stress
- if you have Cushing’s disease (condition caused by an excess of cortisol hormone in your body)
- if you have hypothyroidism (an under-active thyroid)
- if you have sugar diabetes (or if there is a family history of diabetes)
Dexamethasone (DECASONE INJECTION)
Do not use it at all if:
- if you suffer from migraine headaches
- if you have any type of infection. DECASONE INJECTION 4 mg/ml may mask the symptoms of an infection. Consult your doctor as soon as possible
- if you suffer from stunted growth
- if you have Cushing’s Syndrome
- if you are elderly
- if you are planning to receive any vaccinations
Use with care, and tell your doctor, if:
- if you receive large doses of DECASONE INJECTION 4 mg/ml for a long period
- if you have thinning of the bones (osteoporosis), particularly if you are a female who has been through menopause
- if you have high blood pressure or heart disease
- if you have diabetes (high blood sugar) or there is a family history of diabetes
- if you have a history of tuberculosis (TB)
- if you have ever experienced muscle weakness during treatment with steroid medicines such as DECASONE INJECTION 4 mg/ml
What to do if you experience side effects
If you think you are having a side effect, the response depends on how severe it is. Use the warning signs above first — if any of those apply, treat it as urgent.
If the symptom is severe or frightening
Get medical help immediately. Call 10177 for an ambulance, or 112 from a mobile phone, or go to the nearest emergency department. Take the product and its packaging with you if you can.
If the symptom is mild but bothering you
- Write down what the symptom is, when it started, and how it relates to when you take the product
- Check the leaflet that came with the product to see whether the symptom is listed
- Speak to your pharmacist — for many questions this is the fastest route to a useful answer
- Contact the prescriber if the symptom is affecting your daily life or is not settling
Do not stop a prescribed treatment on your own
Stopping some treatments suddenly causes its own problems, and the condition being treated may get worse. If you want to stop, ask a pharmacist or doctor how to do it safely — they can usually offer an alternative.
You can also report a suspected side effect in South Africa. Reporting does not replace getting medical advice, and you do not need to be certain the product was the cause.
When to seek urgent medical help
Some symptoms need medical attention straight away rather than an appointment in a few days. Do not wait to see whether they settle.
Call for emergency help now if any of these happen
- Difficulty breathing, wheezing, or tightness in the throat or chest
- Swelling of the face, lips, tongue or throat
- A widespread rash with blistering or peeling skin, or sores in the mouth, eyes or genitals
- Fainting, collapse, or a sudden severe drop in alertness
- Chest pain, or sudden weakness or numbness on one side of the body
- A fit (seizure), or confusion that comes on suddenly
In South Africa call 10177 for an ambulance, or 112 from a mobile phone. Go to your nearest emergency department if it is faster. Do not wait to see whether the symptom settles.
Get same-day medical advice if you have
- A high fever, or a rash together with feeling generally unwell
- Yellowing of the eyes or skin, or unusually dark urine
- Unusual bruising or bleeding that you cannot explain
- Severe or persistent vomiting or diarrhoea, especially if you cannot keep fluids down
- A sudden change in mood, or thoughts of harming yourself
- Any symptom that is rapidly getting worse
If you are having thoughts of harming yourself
Help is available in South Africa. The SADAG helpline is 0800 567 567, or you can go to your nearest emergency department. You do not have to wait until it feels like an emergency.
How to report a suspected side effect in South Africa
South Africa has an official system for reporting suspected side effects, run by the South African Health Products Regulatory Authority (SAHPRA). Reports from the public and from healthcare professionals are how safety signals get detected after a product is already in use.
Who can report
Anyone can report — you do not have to be a healthcare professional, and you do not need to prove that the product caused the problem. A suspicion is enough. Patients, caregivers and family members can all submit a report.
What to have ready
- The name of the product, its strength and form, and the batch number if you have it
- Why it was being used, and when it was started and stopped
- What the suspected reaction was, when it began, and how long it lasted
- Any other medicines, supplements or remedies being used at the same time
- Basic details about the person affected — age and sex are usually enough
How to report
SAHPRA accepts adverse reaction reports through its e-Services reporting system and through the Med Safety mobile app. Healthcare professionals can also report through the same routes. Current forms and access points are published on the SAHPRA site.
- SAHPRA Health Products Vigilance — the main vigilance and reporting hub
- SAHPRA e-Services — current adverse reaction reporting access
Reporting is not a substitute for medical care
If someone is unwell now, get medical help first and report afterwards. Urgent symptoms always take precedence over paperwork.
For a fuller walkthrough see how to report an adverse drug reaction.
Related pages
← Back to more medicine side effects.
Report a side effect
If you think you have had a side effect, you can report a suspected side effect in South Africa. Report a suspected side effect through the appropriate SAHPRA pathway where relevant.
Information only
This page gives general medicine-safety information for people in South Africa. It is not a diagnosis and not personalised medical advice. It cannot tell you whether a symptom you are having is caused by a particular product. Speak to a pharmacist or doctor about your own situation, and do not stop or change a prescribed treatment on the basis of a web page.
Editorial status: draft — not for publication
Brief SE-00456 · build rank 456 · Phase 2 · Tier 2. Every evidence slot on this page must be completed from the SAHPRA-approved source and the page signed off by a qualified clinical or pharmacy reviewer before it is published. Target length 1,300–2,000 words.