Pericarditis treatment focuses on managing symptoms, most commonly chest pain, as well as fatigue, shortness of breath, fever, fast heartbeat, and muscle aches and pains. Treatments may include:
Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
In most cases, pericarditis can be treated using over-the-counter NSAIDs, which can help reduce pain, inflammation, and fever.
- aspirin
- ibuprofen (Advil, Motrin IB)
Colchicine
Colchicine (Colcrys) is part of a class of drugs called anti-gout agents, but it’s also used in tandem with NSAIDs to treat pain and inflammation caused by pericarditis.
Together, colchicine and NSAIDs can also reduce the chances of recurrent pericarditis, when the condition returns after a person has no symptoms for at least four weeks.
For people who weigh up to 154 pounds, the standard dose of colchicine for acute pericarditis is 0.5 milligrams once daily for three months. People who weigh more than 154 pounds take the dose twice per day.
Corticosteroids
Some people may be treated with steroids, such as prednisone (Deltasone), if pericarditis symptoms such as chest pain do not resolve with NSAIDs and colchicine. Steroids can also be used in individuals who can’t tolerate NSAIDs or colchicine, such as people who are pregnant and those living with kidney disease. However, steroids have been linked to higher rates of recurrent pericarditis.
Corticosteroids work by suppressing the immune system to reduce inflammation. Side effects include gastrointestinal issues such as vomiting and diarrhea, as well as blurred vision or aggression.
Prednisone comes in tablet, liquid, and concentrated solution form, and is typically taken with food one to four times a day or once every other day.
Immunosuppressants and Immunomodulators
If an inflammatory condition, such as rheumatoid arthritis, causes pericarditis, treatment may require another class of drugs that target the immune system to reduce inflammation caused by these underlying conditions.
Immunosuppressants, like prednisone, turn down the immune system’s activity to lower inflammation.
Immunomodulators (interleukin 1, IL-1, blocker) modify the immune system so it works more efficiently.
Some studies have shown interleukin-1 inhibitors to be effective in resolving acute episodes and preventing recurrences.
- rilonacept (Arcalyst)
- anakinra (used off-label)
Other Medications
If pericarditis is caused by a bacterial or fungal infection, antibiotics or antifungal medications will likely be prescribed. A person may also be prescribed diuretics, or water pills, to remove excess fluid from their body.
