Medications
Medicines cannot cure lupus (systemic lupus erythematosus, or SLE), but they can control many symptoms and often can prevent or slow organ damage.
Acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs), and antimalarial medicines, are often enough to reduce symptoms.
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Severe lupus may be treated with more aggressive medicines that suppress the immune system, such as corticosteroids and immunosuppressive medicines. Because these medicines can cause serious side effects of their own, doctors prescribe and monitor them carefully.
Treatment for the skin rash that many people develop with lupus may include sunscreens, protective clothing, and avoiding sun exposure, as well as medicines. Some medicines work for some people but not for others, and some treatments have long-term side effects. More research is needed to determine which treatments are safest and most effective for skin rash.
Some lupus medicines, like acetaminophen and prednisone, are considered safe during pregnancy. Others may not be. You may not be able to stop taking lupus medicines after becoming pregnant, or you may need to start taking medicines for a symptom flare. If possible, talk to your doctor before becoming pregnant about the effect lupus may have on your pregnancy.
Medicine Choices
If you have mild disease or symptoms that affect your quality of life but don't have organ-threatening problems, your doctor may prescribe:
- Acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs), sometimes in combination with antimalarial drugs.
- Antimalarial drugs such as hydroxychloroquine (Plaquenil).
- Low-dose corticosteroids and/or topical corticosteroid creams or ointments.
If you have more severe disease, your doctor may prescribe:
- Corticosteroids, such as prednisone.
- Immunosuppressive medicines, such as azathioprine, belimumab, cyclophosphamide, mycophenolate mofetil, or methotrexate.
If you have previously had blood clots in a vein or artery (venous or arterial thrombosis), or have antiphospholipid antibody syndrome, which increases your risk of developing blood clots, your doctor may prescribe a blood thinner (anticoagulant). This is especially important if you have already developed blood clots. Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) that is sometimes used to slow blood clotting in antiphospholipid antibody syndrome.
What To Think About
Medicine treatment for lupus often involves reaching a balance between preventing severe, possibly life-threatening organ damage, maintaining an acceptable quality of life, and minimizing side effects.
Lupus treatment requires frequent monitoring of disease activity and medicine side effects. Depending on how you respond to medicines, your doctor may vary the dose and combinations of medicines until you reach the best possible balance.
It may not be possible to completely eliminate all your symptoms for long periods of time, especially without medicine side effects. For example, you may take a dose of medicine that will control lupus enough to prevent organ damage, but you may still have symptoms such as mild skin rash, muscle aches, and joint pain. While higher doses of medicine may relieve your symptoms, using them for a long time increases your risk of serious side effects. Your doctor will prescribe a dose that controls only the most serious, life-threatening symptoms and balances the risks of the medicines with the benefits of controlling your symptoms.
People with lupus can go into spontaneous remission. If you experience an apparent remission, your doctor may taper or stop your medicine.
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