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Sarcoidosis Treatment
The goal of treatment for sarcoidosis is remission, which means the condition still exists but does not cause problems. Not everyone who is diagnosed with sarcoidosis needs treatment. Sometimes the condition goes away on its own. Your treatment will depend on your symptoms, which organs are affected, and whether those organs are working well.
Medicine
Your doctor may prescribe medicines to lower inflammation or treat an overactive immune response. Immune-lowering medicines can raise the risk of infections. Talk with your provider about the benefits and risks of these medicines.
Corticosteroids to treat inflammation
The corticosteroid (steroid medicine) prednisone is the most common treatment for sarcoidosis. Corticosteroids can be taken as pills or be injected, inhaled, or taken as eye drops or other topical medicines.
Corticosteroids can have serious side effects with long-term use, especially if taken in high doses. Side effects of the corticosteroid pill may include high blood sugar or blood pressure, mood changes, weight gain, and increased appetite. The pill also raises the risk of cataracts (clouding of the eye), glaucoma (damage to a nerve in the eye from high pressure), or osteoporosis (bone thinning). Common side effects from inhaled corticosteroids include a hoarse voice or a mouth infection called thrush.
Medicines to lower your immune system response
- Medicines used to treat severe rheumatoid arthritis include methotrexate, azathioprine, and leflunomide. You usually take this as a pill or an injection (shot). Side effects may include liver damage or blood problems.
- Monoclonal antibodies, also called immunotherapy, are used to treat cancer or an overactive immune system. These include rituximab, infliximab, golimumab, and adalimumab. Your doctor will give you the medicine as a shot or through an IV. Side effects are rare but can include a life-threatening immune reaction, heart problems, low blood counts, or a higher risk of certain cancers.
- Medicines used to treat malaria include hydroxychloroquine or chloroquine. Side effects may include eye damage, heart problems, and low blood sugar.
- Corticotropin (a hormone medicine) is given as a shot. It may be used when prednisone does not work or has serious side effects. Side effects of this medicine may include high blood pressure, problems controlling blood sugar, increased appetite, or mood changes.
- Pentoxifylline is taken as a pill. It is normally prescribed to improve blood flow. Side effects may include nausea.
Medicines to treat other symptoms
- Antibiotics treat sarcoidosis of the skin. Examples include minocycline, tetracycline, and doxycycline. Side effects may include dizziness and problems.
- Colchicine treats joint pain from sarcoidosis. You take this medicine as a pill. It is usually prescribed for gout. Side effects include nausea, vomiting, diarrhea, and stomach cramps or pain.
Treating complications
If untreated, or if the treatment does not work, sarcoidosis can cause serious health problems. Your doctor may recommend the following medicines or procedures. Ask your doctor about the benefits and risks of any treatment.
Lung problems
- Inhaled corticosteroids or oxygen therapy help with breathing problems.
- Vasodilator treatment relaxes your blood vessels if you have pulmonary hypertension.
- Pulmonary rehabilitation helps you breathe easier and be more active.
Heart problems
- Implantable cardioverter defibrillator (ICD) helps prevent cardiac arrest.
- High blood pressure medicines, such as ACE inhibitors and beta blockers, lowers blood pressure.
Hormone problems
- Lifestyle changes, such as avoiding too much sunlight, drinking plenty of fluids, and eating fewer foods with calcium, may be needed if you have too much calcium in the blood or urine.
- Hormone replacement treatment is used to treat some types of sarcoidosis.
Brain, nerve, or muscle problems
- Anti-seizure medicines are used if sarcoidosis affects your brain and causes seizures.
- Medicines can be given for nerve or muscle pain.
- Physical therapy improves muscle strength.
- Surgery removes brain tumors.
Severe organ damage
- Transplant surgery can be performed if sarcoidosis causes life-threatening lung, heart, or liver damage.