Treatment options for pericarditis vary depending on whether it’s acute or chronic, how severe the condition is, and the underlying cause. Pericarditis may get better on its own, but in 15 to 30 percent of people, the condition returns after a few weeks or months. In half of these people, the condition comes back multiple times.
Rest and over-the-counter pain relievers may be all that’s needed for some cases. More severe cases require stronger medications and, in some cases, surgery.
Medication Options
To reduce inflammation and swelling, as well as fever and pain, the first line of treatment for pericarditis is nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen.
For severe chest pain, stronger medications, such as colchicine (Colcrys), an anti-inflammatory medicine, and the steroid prednisone, may be used.
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. The regimen cuts a person’s risk of recurrent pericarditis in half.
Colchicine may interact with other drugs, and if a dose higher than recommended is taken, could cause colchicine toxicity. Signs of toxicity are diarrhea, nausea, vomiting, abdominal pain, and fatigue. In some cases, colchicine may cause myopathy, a condition that causes muscle weakness, stiffness, cramps, and spasms.
Corticosteroids are only used in certain cases. They have been associated with a prolonged disease course and a higher rate of recurrence, so it’s recommended that steroids be used only for people who can’t tolerate NSAIDs.
Other drugs may help treat pericarditis, including
:
- Antibiotics, if the cause is a bacterial infection
- Antifungal drugs, if the cause is a fungal infection
- Diuretics, or water pills, to remove excess fluid
- Immunosuppressants, if the cause is a condition like rheumatoid arthritis
- Immunomodulators, to control inflammation
If you have chronic or recurrent pericarditis, you may need to take colchicine or NSAIDs for several years, even if you’re feeling well.
