Corticosteroids for polymyalgia rheumatica or giant cell arteritis

Examples

Generic Name	Brand Name
dexamethasone	Decadron, Dexone, Hexadrol
prednisone
methylprednisolone	Medrol

These are all corticosteroid medicines that you take by mouth (orally) in tablet form. Decadron 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.^{1, 2} Some people keep taking low doses of corticosteroids for several years to control symptoms such as pain and stiffness.¹

Side Effects

With long-term use, common side effects may include:

• Weight gain.
• Mood changes.
• Trouble sleeping.
• Easily bruising.
• 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

Lower-dose corticosteroids (generally 5 mg to 20 mg per day) cause fewer side effects and have fewer long-term risks than do higher dosages (40 mg to 60 mg per day). 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 taking 1000 mg to 1500 mg of calcium and 800 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 lifting weights or using hormone replacement therapy. For more information, see the topic Osteoporosis.

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Author:	Shannon Erstad, MBA/MPH	Last Updated: May 8, 2007
Medical Review:	E. Gregory Thompson, MD - Internal Medicine Stanford M. Shoor, MD - Rheumatology
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