Agent

Dosage

Acute pericarditis

Recurrent pericarditis

ASA

650-1000 mg every 6-8 ha,b

500-1000 mg every 6-8 h (1.5-4 g/d)b,c

Ibuprofen

600-800 mg every 8 ha,d

600 mg every 8 h (1200-2400 mg)b,c

Colchicine

0.5-0.6 mg (once dailye or bidf)g,h

0.5-0.6 mg (bidf or once dailye,i)h,j

Indomethacin

–

25-50 mg every 8 hc,k,l

Glucocorticoids

Doses depend on agents usedm,n

a For 1-2 weeks.

b Decrease the dose by 250-500 mg every 1-2 weeks. In case of recurrent pericarditis in patients showing more resistance to treatment, you may consider more gradual and longer tapering of doses down to discontinuation.

c For weeks or months.

d Decrease the dose by 200-400 mg every 1-2 weeks. In case of recurrent pericarditis in patients showing more resistance to treatment, you may consider more gradual and longer tapering of doses down to discontinuation.

e In patients <70 kg.

f In patients ≥70 kg.

g For 3 months. Note that in North America colchicine is only available in 0.6 mg tablets, whereas the 0.5 mg dose is available in Europe.

h Tapering down is not necessary; however, you may decrease the dose by 0.5 mg every other day in patients <70 kg or by 0.5 mg once a day in the last weeks of treatment in patients ≥70 kg.

i In patients who do not tolerate higher doses.

j For ≥6 months.

k Start from low doses and titrate them up to avoid headache and dizziness.

l Decrease the dose by 25 mg every 1-2 weeks. In patients resistant to treatment, you may consider more gradual and longer tapering of doses down to discontinuation.

m The starting dose of prednisone is 0.25-0.5 mg/kg/d. A dose of 25 mg of prednisone is equivalent to 20 mg of methylprednisolone. Higher doses should be avoided except for selected patients (higher doses are then used over a few days and rapidly tapered down to 25 mg/d).

n Prednisone dose may be tapered down (particularly <25 mg/d) when symptoms have resolved and CRP has normalized.