Acute and recurring pericarditis: More colchicine, less corticosteroids

Table 1 Suggested pharmacological treatments of acute and recurring pericarditis

Drugs	Discharge dose (adults)	Tapering (wait until symptom free and normal CRP)	Monitoring/follow-up (in addition to follow-up for the clinical condition)
Acetylsalicylic acid (preferred for patients with known atherosclerosis)	650 mg po qid for 1-2 wk (2-4 wk when recurring)	Taper the dose by 30 % every 1-2 wk then stop	-Use gastric protection
Ibuprofen	600 mg po tid for 1-2 wk (2-4 wk when recurring)	Taper the dose by 30 % every 1-2 wk then stop	-Use gastric protection
Indomethacin	50 mg po tid for 1-2 wk (2-4 wk when recurring)	Taper the dose by 30 % every 1-2 wk then stop	-Use gastric protection
Colchicine	0.5 mg (or 0.6 mg) po bid for 3 mo (6 mo when recurring)	-	-Adjust for renal function
	Use 0.5 mg (or 0.6 mg) po daily in patients intolerant to higher doses, over 70 yr old or less than 70 kg		-AST ALT CK, creatinine initially, then at 1 mo
Prednisone	0.2-0.5 mg/kg po daily for 2 wk (2-4 wk when recurring)	-Taper the dose by 10% every 1-2 wk	-Osteoporosis prophylaxis
		-Taper slowly, especially when it comes to 15 mg/d, where decreases could be as low as 1.0 mg/d every 6 wk

Modified from the tables in the last recommendations[3,5]. CRP: C-reactive protein.