Using Medication to Manage Lupus
New treatments for lupus are increasing quality of life for people who have this autoimmune disease.

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Picture of woman looking at medication Using Medication to Manage Lupus

Lupus is an autoimmune disease in which the body attacks its own healthy tissue. The resulting inflammation can damage cells of the joints, skin, kidneys, heart, lungs, blood vessels, or brain.

There are several different types of lupus. The most common is one that affects the whole body. It is called systemic lupus erythematosus (SLE), or just lupus. Treatment can greatly reduce symptoms for most people with SLE. Medication and lifestyle changes can help:

  • Reduce inflammation, which causes symptoms like redness, swelling, hot to touch, pain
  • Control the immune system
  • Relieve joint pain and fatigue
  • Prevent flare-ups of the disease
  • Prevent or minimize organ damage

People with lupus typically seek care from a rheumatologist - a doctor who specializes in diseases of the joints and muscles. People with lupus may then be referred to other specialists as needed. For instance, many people with lupus suffer kidney disease, which may be best treated by a nephrologist - a doctor who is a kidney specialist.

Treatment for lupus is different for each person, depending on his or her symptoms and risk factors. Up to half of those with lupus will have only minor symptoms of fatigue, joint pain, and rashes. Symptoms tend to come and go, but lupus never goes away completely.

Medication for lupus
Your doctor may prescribe a mix of medicines to try to reduce inflammation and treat symptoms. Finding the right mix of medicines may take a long time, even up to 1 year or more for some people. Following are some of the medicines that are used for treating lupus:

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) can help to relieve joint and muscle pain as well as fever. Your doctor may suggest you try over-the-counter aspirin or ibuprofen, or prescribe a stronger NSAID. This may be the only drug you will need. Acetaminophen, commonly know as Tylenol, may also be taken for pain and fever, but it's not an NSAID so it will not stop inflammation.

Corticosteroids can quickly reduce swelling, tenderness, and pain from inflammation by lowering immune system activity. Prednisone, taken in pill form, is the most common steroid used to treat lupus flare-ups. Corticosteroids are usually not used long-term, though, because they can have serious side effects.

Anti-malarials like Plaquenil and Aralen may be prescribed to treat fatigue, joint pain, and skin rashes. There is evidence that these drugs may lower the number and severity of flare-ups. They may also help to protect against sun damage, organ damage, and blood-clotting problems. These drugs take longer compared to steroids to be effective (several months), but have fewer side effects.

Immunosuppressive drugs help to control an overactive immune system and any inflammation. They are often used when steroids fail to manage symptoms, or in tandem with steroids to lower the steroid dose needed to feel better. Imuran, methotrexate, and Cytoxan are common drugs in this class.

Anticoagulants may be prescribed if you are at risk for blood clots, which can stem from lupus. Or, your doctor may simply suggest taking a low-dose aspirin to thin your blood.

Other medications may be prescribed to treat conditions commonly seen in people with lupus. These may include:

  • Diuretics, or water pills, for fluid retention
  • Meds to lower blood pressure
  • Anticonvulsants for seizures (medicine to prevent seizures)
  • Antibiotics for infections
  • Bone-strengthening meds

Another type of drug, called a monoclonal antibody (Benlysta), is being used for some people who continue to have serious symptoms despite routine treatment. Study results show only some benefits. And, it has not been shown to help African Americans, a group that gets lupus more often and more severely than other races.

Do it yourself
In addition, don't overlook the importance of basic self-care if you have lupus. Try the following:

  • Get regular exercise to help prevent muscle weakness and fatigue.
  • Make sure your immunizations are up-to-date so you're not as prone to infections.
  • Maintain a healthy lifestyle in terms of diet, rest, reducing stress, and not smoking.
By Eve Glicksman, Staff Writer
Created on 09/08/2011
Updated on 09/08/2011
Sources:
  • Lupus Foundation of America. Treatments for lupus.
  • Agency for Healthcare Research and Quality. Guideline summary: systemic lupus erythematosus (SLE).
  • Lupus Foundation of America. Medications to treat lupus symptoms.
Copyright © OptumHealth.
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