All medicines can have unwanted side-effects which affect people in different ways. This section gives you an idea of what side-effects are possible from each drug.
Balancing risks and benefits of treatment
Some people manage the high levels of Corticosteroids and immuno-suppressive drug therapies without difficulty. But other people find that using these drugs every day causes health problems which are difficult to live with (e.g. exhaustion, sleeplessness, nausea). However, because of the seriousness of PV, it would be extremely dangerous (and painful) to refuse treatment.
Side-effects of Corticosteroids
- Diabetes (high blood sugar levels).
- Osteoporosis (also known as brittle bone disease). Patients on long-term steroids, especially women who have gone through the menopause, are considered at risk of osteoporosis. Osteoporosis is a loss of bone tissue so the bones become more brittle. Patients should be assessed for possible osteoporosis and they may need preventative treatment (see ‘Frequently asked Questions Q10’ and ‘What can I do to help myself?’).
- Myopathy (loss of muscle strength).
- Glaucoma (loss of vision caused by high pressure in the eye) and cataracts (clouding of the lens causing blurred or fuzzy vision).
- Stomach ulcers (many doctors suggest a medication to reduce stomach acid to be taken as a preventative measure).
- Raised blood pressure.
- Weight gain, particularly around the face and neck (moonface).
- Adrenal gland suppression. This means the body may have difficulty in regulating itself if steroid tablets are suddenly stopped.
- Thin skin and easy bruising.
- Hirsutism (increased body hair growth).
- Increased risk of infections.
Side-effects of azathioprine
- Myelosuppression (reduced blood-cell production) caused by suppressing the bone marrow.
- Hepatitis (liver damage).
- Gastro-intestinal disturbances e.g. feeling sick (nausea) and diarrhoea.
Side-effects of cyclophosphamide
- Myelosuppression (reduced blood-cell production) caused by suppressing the bone marrow.
- Haemorrhagic cystitis (inflammation of the bladder leading to blood in the urine).
- Infertility and permanent sterility.
- Bladder cancer.
- Hair thinning.
Side-effects of mycophenolate mofetil
- Gastrointestinal disturbances e.g. nausea, diarrhoea, constipation.
- Myelosuppression (reduced blood-cell production) caused by suppressing the bone marrow.
Side-effects of ciclosporin
- Raised blood pressure.
- Reduced kidney function.
- Increased body hair.
- Gum swelling.
- Tremor (fine shaking of hands).
- Burning sensation in hands and feet.
Side-effects of gold
- Rashes.
- Mouth ulcers.
- Nephrotic syndrome (too much protein in the urine due to kidney damage).
- Myelosuppression (reduced blood-cell production) caused by suppressing the bone marrow.
- Hypersensitivity syndromes (allergic reactions).
Side-effects of methotrexate
- Myelosuppression (reduced blood-cell production) caused by suppressing the bone marrow.
- Liver damage and cirrhosis.
- Lung damage.
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