My GCA Update

[Lenore58]

I just got done with my MRIs and MRAs, so we’ll see if results show much. My blood test came back with sed rate normal (always has been) and C-reactive prrotein headed down. It went from normal in PMR, to 1.3 and then 2.0 in GCA. Now at 0.8, so barely high and heading in the right direction. Still feeling really crummy, no visual symptom’s, thank God.

My doctor just notified me: “Ordered Bactrim 1 tab to be taken M/W/F FOR Infection prophylaxis while on high dose steroids .”

Is that standard? She also ordered a medicine to protect my stomach from the 60 mg steroids: famatodine, 20 mg. Same as Pepcid AC, I think?

I have never had any stomach issues, so I guess it’s precautionary. I’m wondering if I would be fine just taking it with food because I hate compounding medication on medication like this. Experience and info welcome.

Thank you!

[PMRpro Ambassador]

"Is that standard? "

Seems to be common in the USA, Not otherwise though it happens occasionally.

I've never take stomach protection but I have never been on very high dose pred. It can cause irritation and even bleeding which is why they do it. And at least she has given you famotidine rather than a PPI - fewer side effects usually.

[Mooreby]

I am on that antibiotic too along with the stomach protection

[SnazzyD]

Bactrim isn’t standard with steroids in the UK but others here have had it prescribed. Bacterial Infections weren’t really a problem but I was very careful with food hygiene already and avoided takeaways but mainly because the salt blew me up. What did bother me was fungal infections occasionally. Of course one’s own bacteria can be a problem if the wrong ones proliferate. Complaints of urinary infections do pop up here from time to time but it is worth knowing that Pred itself and calcium supplements can cause irritation in this area, mimicking a bacterial infection. I wonder if the irritated tissues make one more prone to bacterial invasion too. I would like to know what their statistics are of infection rate in people not given it.

I know others are quite happy without stomach protection but Pred did a number on my gut no matter what food I took it with. It’s interesting they have given you Famotidine and not the much more favoured in the UK proton pump inhibitor type (PPI) which seems to be considered superior for some reason. PPI’s didn’t like me at all and again people complain here about them from time to time. Famotidine seems a bit less complicated and does the job.

[PMRpro Ambassador in reply to SnazzyD]

I have seen indications that in the USA they are beginning to feel the use of PPIs isn't as straightforward as they thought!

[Lenore58 in reply to SnazzyD]

my doctor said that the drug she ordered is not as heavy duty as the PPI, and I think what PMRpro said below is why.

[DeepThought2]

I received Bactrim two and a half years ago as prophylaxis for Pneumocystis jirovecii pneumonia. It is standard in Germany - where I live - if you take more than 20 mg of pred per day for longer periods (> 3 weeks).

[nallufl24]

I was on Bactrim and a PPI only while on 60 mg. After 2 weeks I dropped from 60 to 40 mg and was told to stop both the Bactrim and PPI. I was surprised but happy about it. I had no problems.