In the absence of severe urinary tract obstruction (which generally requires surgery with omental wrapping) treatment is generally with glucocorticoids initially, followed by DMARDs either as steroid-sparing agents or if refractory on steroids. The SERM tamoxifen has shown to improve the condition in various small trials, although the exact mechanism of its action remains unclear.

History of retroperitoneal fibrosis is considered an absolute contraindication to the use of the following medications:

• Cabergoline