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Understanding Ankylosing Spondylitis Medications (cont.)

Corticosteroids

Drugs in this class include prednisone (Deltasone, Orasone), methylprednisolone (Solu-Medrol, Depo-Medrol), betamethasone (Celestone, Soluspan), cortisone (Cortone), dexamethasone (Decadron), prednisolone (Delta-Cortef), and triamcinolone (Aristocort).

  • How corticosteroids work: These drugs decrease swelling and inflammation by suppressing immune response.
  • Who should not use these medications: People with the following conditions should not use corticosteroids:
    • Allergy to corticosteroids
    • Active infections caused by viruses, fungi, or Mycobacterium tuberculosis
    • Active peptic ulcer disease
    • Liver impairment
  • Use: Corticosteroids can be taken in various ways (by mouth, intravenously, intramuscularly or intra-articularly (injected directly into a joint). The goal is to use the smallest dose that controls symptoms. The length of treatment should be as short as possible in order to decrease the risk of developing side effects. When taken orally, take with food to decrease stomach upset. Corticosteroids are generally not used as long-term medications in ankylosing spondylitis due to the risk of side effects such as injury to bone (see below).
  • Drug or food interactions: Many drug interactions are possible, therefore, consult with a doctor or pharmacist before taking new prescription or over-the-counter medications. Aspirin, NSAIDs, such as Advil or Aleve, or other drugs associated with stomach ulcers may increase the risk of developing stomach ulcers. Corticosteroids may decrease potassium levels and must be used with caution with other drugs that decrease potassium levels (for example, diuretics such as Lasix).
  • Side effects: Ideally, corticosteroids are used in low doses only long enough to bring sudden flares in symptoms under control. Long-term use is associated with serious side effects, such as osteoporosis, osteonecrosis, glaucoma, cataracts, mental changes, abnormal blood glucose levels and diabetes, or arrested bone growth in children who are prepubescent. After prolonged use, the corticosteroid dose must be gradually decreased over weeks to months to avoid corticosteroid withdrawal syndrome.

For More Information

American College of Rheumatology

Spondylitis Association of America, Ankylosing Spondylitis (AS), Treatment

Spondylitis Association of America, Ankylosing Spondylitis (AS), Medication

Spondylitis Association of America

MedlinePlus, Ankylosing Spondylitis

Medically reviewed by Aimee V. HachigianGould, MD; American Board of Orthopaedic Surgery

REFERENCE:

"Medications Used to Treat Ankylosing Spondylitis and Related Diseases." Spondylitis Association of America. <http://www.spondylitis.org/about/medications.aspx>.


Medically Reviewed by a Doctor on 8/28/2014

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