Corticosteroids for polymyalgia rheumatica or giant cell arteritis

Examples

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Generic Name

dexamethasone

Generic Name

prednisone

Brand Name	Generic Name
Medrol	methylprednisolone

These are all corticosteroid medicines that you take by mouth (orally) in tablet form. Dexamethasone is available as a liquid.

How It Works

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These medicines can reduce inflammation.

Why It Is Used

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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

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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

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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

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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 to 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.

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.

References

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Citations

1. Hellmann DB, Hunder GG (2005). Giant cell arteritis and polymyalgia rheumatica. In ED Harris Jr et al., eds., Kelley's Textbook of Rheumatology, 7th ed., vol. 2, pp. 1343–1356. Philadelphia: Elsevier Saunders.

2. Weyand CM, Goronzy JJ (2005). Polymyalgia rheumatica and giant cell arteritis. In WJ Koopman, LW Moreland, eds., Arthritis and Allied Conditions: A Textbook of Rheumatology, 15th ed., vol. 2, pp. 1777–1792. Philadelphia: Lippincott Williams and Wilkins.

Credits

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Author	Shannon Erstad, MBA/MPH
Editor	Kathe Gallagher, MSW
Associate Editor	Pat Truman, MATC
Primary Medical Reviewer	E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer	Stanford M. Shoor, MD - Rheumatology
Last Updated	May 8, 2007