Cardiovascular
Medicines for Pericarditis
Inflammation of the thin sac around the heart, causing sharp chest pain that is worse lying flat and on breathing in and better sitting forward — usually following a viral infection and settling well with anti-inflammatory treatment, but where a heart attack must always be excluded.
Education and reference only. This explains which medicines are used and why, in plain language — it deliberately contains no doses and is not a substitute for advice from your doctor or pharmacist. Always discuss your own treatment with a qualified clinician, and check the BNF and the product labelling for prescribing detail.
Quick answer
What is Pericarditis?
Pericarditis is inflammation of the pericardium, the thin double-layered sac that surrounds the heart. Its most typical feature is chest pain that is sharp or stabbing rather than crushing, often felt at the front of the chest or behind the breastbone, and characteristically worse when lying flat and when breathing in deeply, and eased by sitting up and leaning forward.
- How it is treated: The aim is to settle the inflammation, relieve the pain and reduce the chance of it coming back, while making sure the heart and the fluid around it are not affected.
- Self-care: Resting while symptoms are active and avoiding strenuous exercise until the inflammation has fully settled help recovery, and following medical advice on when it is safe to return to normal activity and sport is important — pushing too hard too soon can prolong or bring back the inflammation.
- When to seek help: Because chest pain has many causes and a heart attack must always be excluded, do not try to diagnose pericarditis yourself.
What it is
Pericarditis is inflammation of the pericardium, the thin double-layered sac that surrounds the heart. Its most typical feature is chest pain that is sharp or stabbing rather than crushing, often felt at the front of the chest or behind the breastbone, and characteristically worse when lying flat and when breathing in deeply, and eased by sitting up and leaning forward. The pain may spread to the neck, shoulder or back. It often follows a viral infection, so people may have felt generally unwell with a cold or flu-like illness beforehand, and there can be a mild fever. In many cases no specific cause is ever found. Pericarditis is usually a self-limiting condition that settles with treatment, and most people make a full recovery. Occasionally fluid can build up in the sac around the heart (a pericardial effusion); rarely this becomes large enough to press on the heart and stop it filling properly (cardiac tamponade), which is a medical emergency. Because chest pain has many possible causes, the priority at first assessment is always to make sure something more serious, especially a heart attack, is not being missed.
How it is treated
The aim is to settle the inflammation, relieve the pain and reduce the chance of it coming back, while making sure the heart and the fluid around it are not affected. Most pericarditis is treated with an anti-inflammatory medicine — a non-steroidal anti-inflammatory drug (NSAID) given at an anti-inflammatory level — to calm the inflammation and ease the pain, usually alongside colchicine, which both helps the current episode settle and substantially reduces the risk of recurrence. Rest while symptoms are active is advised. Any underlying cause that is identified is treated. Most people improve over days to a few weeks and recover fully. Sometimes the condition recurs, and treatment is then continued or adjusted under specialist guidance. If a significant pericardial effusion develops, or there are signs the heart is being affected, this is assessed and managed in hospital, and rarely fluid needs to be drained. Because excluding a heart attack and other serious causes of chest pain comes first, the initial assessment usually includes tests such as an ECG before pericarditis is confirmed.
For this condition, these medicines
Medicine classes used for Pericarditis
Each links to a full, dose-free guide — what it is, how it works, who can and cannot use it, side effects, interactions and FAQs.
Symptom checker
Symptoms that can point to Pericarditis
Pericarditis can be one cause of these symptoms. Each guide explains the other possible causes and the red-flag warning signs that mean you should get urgent help:
Beyond medication
Lifestyle and self-care
Resting while symptoms are active and avoiding strenuous exercise until the inflammation has fully settled help recovery, and following medical advice on when it is safe to return to normal activity and sport is important — pushing too hard too soon can prolong or bring back the inflammation.
When to get help
When to see a doctor
Because chest pain has many causes and a heart attack must always be excluded, do not try to diagnose pericarditis yourself. Call 999 if you have severe or persistent chest pain, chest pain with breathlessness, sweating, nausea or pain spreading to the arm, jaw or back, if you feel very unwell, or if you become increasingly breathless, light-headed or faint — these need emergency assessment. A first episode of sharp chest pain that is worse lying flat and better sitting forward should be assessed promptly so the cause can be confirmed and a heart attack ruled out. If you have known pericarditis and your symptoms worsen, return rather than wait.
Not sure how urgent it is? It is always OK to call NHS 111 for advice, day or night.
Answers
Pericarditis: frequently asked questions
What medicines are used for pericarditis?
Most pericarditis is treated with a non-steroidal anti-inflammatory drug (NSAID), given at an anti-inflammatory level to calm the inflammation in the sac around the heart and ease the chest pain. This is usually combined with colchicine, which helps the current episode settle and significantly reduces the chance of the pericarditis coming back. Rest while symptoms are active is also advised, and any underlying cause that is found is treated. Treatment is normally guided by a doctor, and most people recover fully.
How can I tell pericarditis pain from a heart attack?
You cannot reliably tell the difference yourself, and you should not try to. Pericarditis pain is often sharp, worse when lying flat and when breathing in, and better sitting forward, whereas a heart attack more often feels like heavy pressure or tightness. But these patterns overlap, and a heart attack can present in many ways, so any severe, persistent or worrying chest pain — especially with breathlessness, sweating, nausea or pain spreading to the arm or jaw — needs emergency assessment. Call 999 and let medical tests, such as an ECG, sort out the cause.
Will pericarditis come back?
Most people have a single episode and recover fully, but pericarditis can sometimes recur. This is one of the main reasons colchicine is used alongside the anti-inflammatory medicine — it has been shown to reduce the chance of the inflammation returning. Resting while symptoms are active and not returning to strenuous exercise too soon also help. If it does come back, treatment can be continued or adjusted, usually with specialist input. If your symptoms return after seeming to settle, seek medical advice rather than waiting.
Is pericarditis serious?
In most cases pericarditis is not serious in the long run — it usually settles with treatment and people make a full recovery. The important caveat is that chest pain always needs to be taken seriously at first, because more dangerous causes such as a heart attack have to be excluded. Occasionally fluid builds up around the heart, and rarely this becomes large enough to affect how the heart fills (cardiac tamponade), which is an emergency. This is why a worsening picture — increasing breathlessness, feeling faint or becoming very unwell — needs urgent assessment, and why a first episode should be checked by a doctor.
Sources
Where this is drawn from
- NICE CKS: Pericarditis.
- British Heart Foundation: Pericarditis.
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