Osteoporosis is particularly common in smokers, postmenopausal women, the elderly, underweight or immobile, and patients with diabetes or lung problems. Osteoporosis may result in fractures of the spine, ribs or hip joint with minimal trauma. These occur after the first year in 10–20% of patients treated with more than mg prednisone daily. It is estimated that up to 50% of patients on long-term prednisone will develop bone fractures. Vertebral fractures are more common in patients on steroids, even in those with normal bone density.
The most obvious benefit that injectable steroids have over their oral cousins is that they are not hepatotoxic. Injectable steroids are safer on the liver and the user does not risk hepatic injury because injectable compounds don’t require specific chemical alterations which allow them to survive passing through the liver without being broken almost entirely down. It’s also worth consider that injectable steroids have a much longer half-life due to the ester attached to the hormone. To get the maximum benefit from oral steroids, most must be administered daily, or sometimes they are spread out throughout the day. The ester present in injectable steroids allows a much more infrequent administration and don’t need to be administered daily. More information about Esters