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Corticosteroids for Polymyalgia Rheumatica or Giant Cell Arteritis
These are all corticosteroid medicines that you take by mouth (orally) in tablet form. Dexamethasone is available as a liquid.
How It Works
These medicines can reduce inflammation.
Why It Is Used
These medicines are usually used for polymyalgia rheumatica (PMR) and giant cell arteritis (GCA). They can quickly reduce inflammation caused by these conditions. Higher doses of corticosteroids are taken for giant cell arteritis than for polymyalgia rheumatica.
How Well It Works
Most people with polymyalgia rheumatica or giant cell arteritis respond quickly to corticosteroid treatment and can usually stop taking the medicine after 1 to 2 years. Some people keep taking low doses of corticosteroids for several years to control symptoms such as pain and stiffness.1
All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.
Here are some important things to think about:
- Usually the benefits of the medicine are more important than any minor side effects.
- Side effects may go away after you take the medicine for a while.
- If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.
Call 911 or other emergency services right away if you have:
- Trouble breathing.
- Swelling of your face, lips, tongue, or throat.
Call your doctor if you have:
- Signs of an infection, such as a sore throat, fever, sneezing, or coughing.
- Belly pain, nausea, or vomiting that won't go away.
- Bloody or black, tarry stools.
- Rapid weight gain.
- Changes in your eyes, including blurred vision or eye pain.
- Muscle cramps, pain, or weakness.
- Changes in skin, including acne or reddish purple lines.
- Increased thirst, especially with frequent urination.
Common side effects of this medicine include:
- Increased appetite.
- Nervousness or restlessness.
With long-term use, common side effects may include:
- Weight gain.
- Mood changes.
- Trouble sleeping.
- Bruising easily
- Loss of bone calcium and bone thinning (osteoporosis).
- Increased risk of bacteria infections and certain viruses, such as shingles. Corticosteroids weaken the immune system.
- High blood pressure.
- Problems with blood sugar levels (diabetes).
Uncommon side effects include:
- Vision problems (cataracts).
- Muscle weakness.
- Softening of a bone in a joint (avascular necrosis or osteonecrosis).
See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)
What To Think About
Corticosteroids can keep your immune system from fighting infection. When you are taking this medicine (and even when you have finished taking it), try not to be around people who are sick. And make sure you talk to your doctor before you get any vaccinations.
People who take corticosteroids for more than 2 to 3 months should take calcium and vitamin D supplements or other medicines, such as bisphosphonates, to prevent osteoporosis. For more information, see the Medications section of the topic Osteoporosis. Your doctor may want you to have a bone density test to check for osteoporosis.
Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.
There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.
Advice for women
Women who use this medicine during pregnancy have a slightly higher chance of having a baby with birth defects. If you are pregnant or planning to get pregnant, you and your doctor must weigh the risks of using this medicine against the risks of not treating your condition.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
Lower-dose corticosteroids cause fewer side effects and have fewer long-term risks than do higher dosages. Your doctor will give you as low a dose as possible to treat your condition. After your symptoms have gone away and your lab tests are normal, your doctor will slowly reduce your dosage over a period of months.
If you need long-term corticosteroid treatment for either condition, you are at risk for bone thinning (osteoporosis). This is because corticosteroids reduce how well your body takes in calcium, which is important in building bones. To prevent osteoporosis, doctors recommend doing weight-bearing exercise and getting 1200 mg of calcium and 800 to 1000 IU of vitamin D daily. You may also need medicine that prevents osteoporosis, such as alendronate or risedronate. Postmenopausal women can help reduce their risk of osteoporosis by using hormone replacement therapy. For more information, see the topic Osteoporosis.
Last Revised: May 14, 2012
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