Lupus is a chronic autoimmune disorder, with sometimes unpredictable symptoms and complications. People with lupus often take a broad range of medications since the disorder may attack any combination of skin, joints, and organs, and may be mild, moderate, or severe.
The changeable nature of lupus means that some drugs are taken throughout a person’s life, while others are only prescribed during flares.
While some symptoms, such as fatigue, pain and skin rashes may be very common, other symptoms or complications may be rare. This makes each person with lupus somewhat unique in terms of their treatment plan and drug regimen.
Your doctor’s goals for any drugs prescribed for lupus will be to achieve remission or the lowest disease activity possible, improve your quality of life, and prevent or limit organ damage.
Medications for lupus symptoms
Because lupus can attack any area of the body, there is a wide range of medicines that may be used to reduce flares, manage pain, and improve your quality of life, including:1-3
- Antimalarial drugs help with the joint pain, skin rashes, fatigue, fever, and chest pain common to lupus, and may reduce flares by up to 50 percent.
- Pain relievers (NSAIDs) help reduce the muscle and joint pain that many people with lupus feel.
- Steroids, particularly glucocorticoids, are a type of hormone used to control lupus symptoms quickly when antimalarials and NSAIDs are not enough. Doctors try to avoid long-term, high doses of steroids because these drugs may cause organ damage.
- Repository corticotropin injection (Acthar®) is a type of hormone called ACTH, or adrenocorticotropic. Doctors believe this drug helps your body defend itself against the inflammation of lupus.
- Dehydroepiandrosterone (DHEA), a type of hormone that may be useful for people with hair loss, joint pain, fatigue, and brain fog. It is available in both prescription and over-the-counter form, but should only be taken when prescribed by your doctor.
- Immunosuppressants are prescribed in moderate to severe lupus as an alternative to high doses of steroids, or when steroids are not working. Immunosuppressants work to stop the body from attacking healthy cells.
- Biologics such as Belimumab (Benlysta) and rituximab and are usually used in more serious cases when other drugs are not working to control symptoms. Belimumab is the only biologic treatment approved to treat lupus. It is typically used in combination with other lupus treatments. Rituximab is used off-label in people with severe kidney, blood, or neuropsychiatric complications. Rituximab is generally only used when multiple other drugs have failed.
- Blood pressure drugs are used to reduce blood pressure, a common side effect of the kidney damage, artery damage and high cholesterol caused by lupus and some of the drugs taken to control lupus.
- Statins lower cholesterol levels in the blood which helps prevent complications of the heart and blood vessels (cardiovascular system).
- Blood thinners (antithrombotic agents) may be needed to decrease the chances of blood clots which could trigger a pulmonary embolism (blood clot in the lungs) or stroke (blood clot in the brain).
- Antidepressants and anti-anxiety medicines can help improve and regulate mood if lupus triggers mood disturbances.
- Antipsychotics can help manage mental disorders caused when lupus affects the brain.
- Anticonvulsants may be needed if lupus attacks the central nervous system and causes seizures.
- Bisphosphonates may be needed to help manage osteoporosis or weakening of the bones.
If you are trying to get pregnant or already are pregnant, your doctor may need to change or add to some of the drugs you take in order to support a healthy pregnancy.
Medicines are only part of the overall approach to managing lupus. Your doctors will also recommend a variety of lifestyle changes, and maybe surgery, transfusions, plasmapheresis, and complementary and alternative treatments.1-3