Lupus is a chronic autoimmune disorder, with sometimes unpredictable symptoms and complications. People with lupus often take a broad range of medicine since the disorder may attack any combination of skin, joints, and organs. The disease may be mild, moderate, or severe.
The changeable nature of lupus means some drugs are taken throughout a person’s life. Others are only taken during flares.
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
- Prevent or limit organ damage
Lupus symptom medication
Lupus can attack any area of the body, so a wide range of drugs may be used to reduce flares, manage pain, and improve quality of life. These include:1-4
- Antimalarial drugs help with joint pain, skin rashes, fatigue, fever, and chest pain. These drugs may reduce flares by up to half.
- Pain relievers (NSAIDs) help reduce the muscle and joint pain many people with lupus feel.
- Steroids 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. It 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. It should only be taken when prescribed by your doctor.
- Immunosuppressants may be given 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), Anifrolumab-fnia (Saphnelo™), and rituximab may be used when other drugs are not working. Biologics decrease the activity of B cell lymphocytes. They are usually used in combination with other lupus treatments. Rituximab is used off-label in people with severe kidney, blood, or brain complications. Rituximab is generally only used when multiple other drugs have failed.
- Blood pressure drugs lower high blood pressure. This is a common complication of lupus and some of its treatments.
- Statins lower cholesterol levels in the blood. This helps prevent complications of the heart and blood vessels.
- Blood thinners may be needed to decrease the chances of blood clots. Blood clots could trigger a pulmonary embolism (blood clot in the lungs) or stroke (blood clot in the brain).
- Antidepressants and anti-anxiety drugs can help improve and regulate mood.
- Antipsychotics 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, talk to your doctor. You may need to change some of the drugs you take.
Drugs are only part of the overall approach to managing lupus. Your doctors may also suggest a mix of lifestyle changes, surgery, transfusions, plasma exchange, and complementary treatments.1-3