Medicines can't cure lupus, but they can control many symptoms and often can prevent or slow organ damage.
Medicine treatment for lupus often involves reaching a balance between preventing organ damage, having an acceptable quality of life, and minimizing side effects. You will need to see your doctor often to see how you're doing and check for medicine side effects.
Your doctor may have to change the dose and combinations of medicines until you reach the best possible balance.
If you have mild disease or symptoms that affect your quality of life but you don't have organ-threatening problems, your doctor may prescribe:
- Acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs), sometimes in combination with antimalarial drugs. Acetaminophen and NSAIDS are often enough to reduce symptoms.
- Antimalarial drugs such as hydroxychloroquine (Plaquenil).
- Low-dose corticosteroids and/or 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, methotrexate, or mycophenolate mofetil.
If you have had blood clots in a vein or artery (venous or arterial thrombosis), or have antiphospholipid antibody syndrome, which increases your risk for blood clots, your doctor may prescribe a blood thinner (anticoagulant). This is especially important if you already have 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
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 so you can learn about the effect lupus may have on your pregnancy.
Because corticosteroids are powerful medicines and can cause serious side effects, your doctor will recommend the lowest dose that will give the most benefit.
Some people with lupus are sensitive to antibiotic medicines called sulfonamides (sulfa medicines). These include Bactrim, Septra, and many others. Your doctor can prescribe medicines that don't contain sulfa, if needed.
People with lupus can go into spontaneous remission. If this happens to you, your doctor may cut back your medicine over time or stop your medicine.