Suffering From Joints Pain. Diagnosed With Pulmonary Sarcoidosis And High BP. Prescribed Prednisnone And Furosemide. Suggest

Posted on Sun, 3 Nov 2013

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sun, 3 Nov 2013 Answered on

Thu, 21 Nov 2013 Last reviewed on

Question : I have been prescribed prednisnone, furosemide and span-k and find they are not compatible with each other. Am suffering pain in the joints muscular weakness, cough, shortness of breath and fatigue, The doctors tell me there is no reason for concern. My medical problems have been a major factor in my recent conviction - breaching a court order - how do I get the medication corrected. I have been diagnosed with pulmonary sarcoidosis and high blood pressure

Answered by Dr. Shafi Ullah Khan (3 hours later)

Brief Answer: Little interaction,Can Continue. Detailed Answer: Hello my friend! prednisone and furosemide have one trouble that is they both act at potassium levels at high steroids levels and thus prone the patient for low potassium in the blood (hypokalemia) by a mechanism called by doctors as (pharmacodynamic synergism) that is both drugs compete at one point to get re entry into the body through kidneys filtration systems. but for that you are provided Span k( which are potassium supplements to replenish that). i believe you can carry with that as well. As you are sarcoid patient and right heart failure due to pulmonary hypertension secondary to sarcoidosis is some thing you wont want to happen.And for that you need furosemide type Antihypertensives. And if you are so worried about the interaction of low potassium you can use the potassium sparing diuretic like Spiranolactone and eplirinone.That will be a better option. Now the sarcoidosis You have to continue prednisone for your joint pains and other sarcoid manifestations.There are some nonsteroids immunomodulation therapies too which you can consider for your treatment like infliximabs, methotrexates, Hydroxychloroquines, cyclophosphamides etc , the options which you can discuss with your physician. Have regular follow ups for your lung functions, eye and skin care to avoid trouble.you need to care for your pulmonary functions very much to avoid pulmonary hypertension and right heart failure. I wish you very good luck and Take very good care of yourself. Hope i was of some help. If you have any follow up questions please feel free to ask I would be happy to help. Other wise you can close the thread and rate the answer as you wish. Regards Dr Khan

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shafi Ullah Khan (13 hours later)

Thank you for your reply. You mention non-steroidal compounds that may be useful in treatment of sarcoid. My physican has mentioned that other steroids may be more useful than prednisnone, but has neither named nor prescribed them. Do you have any ideas?

Answered by Dr. Shafi Ullah Khan (6 hours later)

Brief Answer: Yes, there are but prednisolone is better Detailed Answer: Hello Mr XXXXXX! When I mentioned non-steroids drugs, I meant other classes of drugs, which are helpful in sarcoidosis 1-Antimetobalites class: Methotrexate (Folex PFS, Rheumatrex) 2-Antimalarials: Hydroxychloroquine (Plaquenil) 3-NSAIDs Ibuprofen (Motrin, Ibuprin, Advil) Ketoprofen (Actron, Orudis, Oruvail) Well, your doctor is right but those steroids are not in oral eatable forms and they cannot be used for long. High-dose inhaled corticosteroids may be an option and has proven some promises Here are two ways to treat sarcoidosis 1) But still now, all the XXXXXXX medicine specialists agree on Oral prednisolone. The only difference is on the amount to be taken. Some say 1mg per kg body weight per day and others say maximum 40 mg irrespective of the body weight for 6 months. With gradual tapering to alternate days over several weeks. 2) Some doctors including me prescribe prednisolone for 3 months and then shift to inhaled Budesonides for 15 months. In addition, I have seen the patients improve for next 5 years pulmonary functions with reduced need for steroids. Hope I was of help. Keep asking the questions further if required. I would be happy to answer. Otherwise, kindly close the discussion and rate the answer as per your experience. Regards Dr Khan

Above answer was peer-reviewed by : Dr. Shanthi.E