Arthritis Health Center

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Giant cell arteritis can lead to partial or complete loss of vision in one or both eyes. If you have sudden onset of double, blurred, or "browned-out" vision, or temporary loss of vision, your doctor may increase your corticosteroid dose. And for a few days he or she may give you the dose directly into a blood vessel (intravenously) to try to prevent permanent or further loss of vision.

What to think about

If you have polymyalgia rheumatica and do not have giant cell arteritis, your doctor may suggest using nonsteroidal anti-inflammatory drugs (NSAIDs) when you are lowering the dose of your corticosteroid medicine. Always talk to your doctor or nurse before using these medicines.

Some doctors recommend taking aspirin if you have giant cell arteritis. This is because some studies show that doing so may reduce the risk of vision loss, stroke, or transient ischemic attacks (blood flow to the brain is interrupted).³

Corticosteroids can cause serious side effects, including high blood pressure (hypertension) and bone thinning (osteoporosis). If you are taking long-term corticosteroids to treat polymyalgia rheumatica or giant cell arteritis:

• You will need to get enough calcium and vitamin D.
• You may also need bisphosphonate medicine such as alendronate or risedronate to prevent bone loss.
• You can help reduce the risk of osteoporosis by lifting weights and doing weight-bearing exercise such as walking. For more information, see the topic Osteoporosis.
• Your doctor may suggest that you take a proton pump inhibitor such as Prilosec or a medicine called an H2 blocker (acid reducer) to protect your digestive (gastrointestinal or GI) tract, including your esophagus and stomach. Taking a lot of medicine for a long period of time can irritate these areas and can even lead to ulcers. Proton pump inhibitors and H2 blockers decrease the amount of acid the stomach makes. This reduces irritation of the stomach and can help reduce irritation of the esophagus.

Methotrexate, or other medicines that suppress your immune system, may be used for polymyalgia rheumatica or giant cell arteritis alone or with corticosteroids to reduce the corticosteroid dose and limit its side effects. Research results are mixed on how effective this treatment is.⁴

Giant cell arteritis sometimes affects the large arteries of the arm. In rare cases, this interferes with blood flow. This can cause pain and cramping when you use your arm. In a small study, balloon angioplasty opened up the arteries of the arm to decrease symptoms of giant cell arteritis.⁵