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Treating giant cell arteritis (GCA)

There are several ways to treat giant cell arteritis (GCA).

Steroid tablets (prednisone)

If your doctor thinks you have giant cell arteritis, they will start you on high-dose steroid tablets (prednisone) straight away to avoid the small chance of you losing your eyesight.

Steroids work by reducing inflammation. You can expect to feel better after a few days' treatment.

You will need to stay on a high dose of steroids for several weeks before slowly reducing the dose to a lower maintenance dose. This can take several months. If your symptoms come back, you will need to increase the dose again.

Most people will need to keep taking steroids for one to two years and some even longer.

Taking steroids for this long can have side effects. See prednisone (oral steroids) for details about the side effects and what you should do about them.

Low-dose aspirin

You may need to take low-dose aspirin to help reduce chance of complications from GCA such as a stroke or transient ischaemic attack (TIA).

Stomach medication

If you are taking both prednisone and aspirin you will need a proton pump inhibitor (PPI) to help protect your stomach lining. The common ones are omeprazole and pantoprazole.

Bone protection

Taking prednisone for a long time can cause thinning of your bones, possibly leading to osteoporosis. To prevent this you can take vitamin D tablets or bisphosphonates.

Other treatments

If your GCA doesn’t respond well to prednisone or you are needing high doses, you may be referred to a rheumatologist to consider other medication such as methotrexate or azathioprine.

Written by HealthInfo clinical advisers. Last reviewed July 2021.

Page reference: 48901

Review key: HIGCA-18689