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Diagnosed Scleroderma. Lungs badly damaged. Treated with steroid. Presently taking megalis, ecospirin and necardia retard. Guide?

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General & Family Physician
Practicing since : 2011
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Sir I am a patient of Scheleroderma, diogonised and under medical management since 2007. My lungs are badly damaged (almost 30%). In due course of treatment I was treated with steroid but without any visible positive result it was stopped after 9 month by Immenology dept., SPGI,Lucknow.
Presently I am under following medication:
megalis 10mg: daily 1
ecospirin 75: daily 1
necardia retard 10: daily 1
protera i: daily 1
eltroxin 100: daily 1.
this i am taking since last 4 years. Please guide me whether my treatment is in right direction or what else to be done further. XXXXXXX XXXXXXX
Posted Sat, 24 Aug 2013 in Skin Hair and Nails
Answered by Dr. Vidya KR 1 hour later

1. You are on the medications for

Megalis: Mainly used to relax muscles and increase blood flow. It is used to treat pulmonary arterial hypertension and improve exercise capacity of lungs. Since your lungs are damaged it is one of the important drug for you.

Ecospirin 75mg: As anti-platelet agent to prevent blood clotting. It is required to prevent any complication due to thrombosis.
Necardia retard: Is a vaso-dilator for blood pressure. Required to maintain BP. Given in case of high BP.
Both ecospirin and necardia retard helps in betts blood perfusion to all organs.

protera i: multi vitamin supplements
Eltroxin for hypothyroidism. Required.

So all the drugs you are taking now are very essential and in right direction. So never skip any of these drugs.

2. If you have pain abdomen(gastritis) then you can take Tab Pantoprazole and NSAIDs (ibuprofen) for inflammation and pain

3. Since you have specifically lung involvement if rapidly worsening fibrosis then can try cyclophosphamide for improving lung function and the quality of life. This has proven in recent NIH study. Other promising drug is mycophenolate mofetil as immunosupressive agent. Discuss with your treating doctor about it and if required based on your examination and status he will start.

4. You need to do regular exercises specially breathing exercises, stress management (yoga will help you).
Avoiding foods that cause heartburn like spicy food, drink plenty of water and eating high fiber foods to cut down on constipation.

5. Keep getting monitored for the fibrosis of lungs and pulmonary hypertension. If raised pulmonary hypertension then can use bosentan. Lung transplant is another option for both severe (drug refractory) interstitial lung disease and pulmonary hypertension.

Hope I answered your question. Consult your doctor for further management.
Feel free to ask me if you have any further queries.
Wish you good health. Take care.

Above answer was peer-reviewed by
Follow-up: Diagnosed Scleroderma. Lungs badly damaged. Treated with steroid. Presently taking megalis, ecospirin and necardia retard. Guide? 1 hour later
thanks mam.
previously i have done two ct scan for lungs one before steroid treatment and other one after steroid treatment. But in both the occation the result was more or less equal. besides i did pft regularly with a visible improvement after steroid treatment. please tell me is there any other way to have a check on my ILD. besides i have a common ailment of severe dry cough throughout the year. please save me from this ailment. how can i have a control over it?
please tell me some specialist doctor/ hospital in Bangalore where I can continue my treatment. right now i am placed at Bangalore.
Thank you.
Answered by Dr. Vidya KR 4 hours later

Thanks for writing back.

For ILD main treatment to prevent further progression is avoid cause for it. steroids also do help in that. you can get evaluated to know cause for ILD. you can consult any good pulmonologist in your city.

to control dry cough you can try yoga and pranayama to increase your lung capacity.
Hope I have answered your query. Get well soon.

If you are satisfied with my answered, please close the query and rate it.
Dr. Vidya
Above answer was peer-reviewed by
Follow-up: Diagnosed Scleroderma. Lungs badly damaged. Treated with steroid. Presently taking megalis, ecospirin and necardia retard. Guide? 12 hours later
thanks mam
is cyclophosphamide can be taken along with ecospirin or any blood dialeter? bcause SPGI doctors once cautioned me regarding this.
mam please refer a doctor/ hospital in bamgalore.
Answered by Dr. Vidya KR 2 hours later
Hi thanks for the followup question.

With aspirin and cyclophospamide there is no known drug interaction. But combination of these 2 drugs and with other agents like omeprazole(for gastritis) Piroxicam and Prednisolone can increase the chance of Erythematous Rash. This is the report from FDA.

But even when taken alone both aspirin(0.35%) and cyclophosphamide(0.38%) can cause this condition so when taken in combination the chance is more. If it appears the rash can appear in the initial months but rare in later months.

Few good pulmonologist I know from Bangalore are
Dr.KS XXXXXXX from chest and maternity center Rajajinagar,
Dr. HB Chandrushekar from XXXXXXX Hospital,
Dr. XXXXXXX XXXXXXX from XXXXXXX Hrudayalaya and also in
St John's medical college.

Hope I answered your query. Feel free to ask any health related questions or any help from me. I will be glad to help you.

Wish you fast recovery and good health.

Above answer was peer-reviewed by
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