Although there is no cure for lupus yet, there are medications and treatments that can help control symptoms and prevent or slow organ damage. Some mild lupus cases can be handled without medication, but most patients do
require prescription drugs to minimize symptoms and stabilize organ function.
Since no two cases of lupus are the same and each patient experiences different signs and symptoms, each individual treatment plan is different. Some people experience only joint pain and swelling, muscle aches, skin rashes, and fatigue while others have heart, lung and kidney issues and blood disorders. Symptoms can also range from mild to severe for each one.
Developing a treatment plan with your health care providers to fit your needs is essential to lupus management. Many patients find it helpful to keep a medical journal to monitor symptoms, drug reactions and side effects, and disease progression. Also, it’s important to review plan together frequently to ensure it still is the right course of treatment as the disease can change over time. Reporting any new or changing symptoms to your doctor is key in chronic illness management.
If you are prescribed any medication remember to talk to healthcare providers and pharmcists about what to expect when taking the drug — from possible side effects to potential benefits — to make sure it’s the right choice for you.
The goals of individual treatment plans should always be to:
• Prevent flares
• Control symptoms and treat flares when they occur
• Prevent or reduce organ damage and other problems
Common Treatment & Medications used to treat lupus
Treatment of lupus can be broken down into self-care and managed-care. Self-care is about protecting your overall general health and well-being to help control your flares. Managed care involves partnering with your healthcare team to develop the right treatment plans and medications and following up with them periodically.
Lupus Self-Care & Treatment
- Reduce Stress: Stress is a known trigger for lupus flares. Keeping yourself relaxed and eliminating unnecessary stress can help control flares.
- Maintain a Healthy Diet and Lifestyle
- Exercise Regularly: It doesn’t need to be a 5 mile run every day. Something as simple as going for a walk can help tremendously.
- Rest: Fatigue is a huge factor with lupus patients. Some need 12 hours of sleep a night or taking periodical naps throughout the day
- Avoid Ultraviolet and fluorescent light: UVA/UVB and fluorescents easily trigger flares.
- Use Sunscreen: Even when the sun’s rays are not at their peak, lupus patients can still feel the effects.
- Monitor other conditions such as blood pressure and cholesterol and diabetes.
For more on self care see Home Treatment for Lupus on WebMD.
Managed Care Treatments
Managing Lupus can often require a team of doctors from a Primary Care Physician (PCP) to a Rheumatologist, who specializes in lupus management. It’s important that all your doctors work together and work with you to develop the right treatment plan.
Treatment may include drugs that:
- Suppress or regulate the immune system
- Prevent or reduce flares
- Minimize joint pain and swelling
- Protect organs
- Balance hormones and moods
- Supplement for vitamin deficiencies
Common Lupus Medications include:
Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs are used to reduce pain and swelling in joints and muscles. They can help with mild lupus when pain isn’t too bad and vital organs are not affected. Common over-the-counter NSAIDS are:
- naproxen (Aleve)
NSAIDs can cause stomach upset, heartburn, drowsiness, headache, fluid retention, and other side effects. If overused, NSAIDs also can cause problems in your stomach, intestines, blood, liver, and kidneys.
Corticosteroids. Corticosteroids are hormones found in our bodies. Prednisone is one of most commonly used manmade versions of steroids* used to treat lupus. Lupus symptoms tend to respond very quickly to these powerful drugs as it helps to reduce swelling, tenderness, and pain in many parts of the body. In high doses, they can even calm the immune system.
However, corticosteriods can have many side effects. Short-term side effects can include: a round or puffy face, acne, heartburn, increased appetite, weight gain, and mood swings. Long-term side effects can include: easy bruising, thinning skin and hair, weakened or damaged bones, high blood pressure, damage to the arteries, high blood sugar, infections, muscle weakness, and cataracts. Some people may have ulcers, depression, or even congestive heart failure. Your doctor may often prescribe medicines to take with corticosteroids to prevent some side effects.
*These drugs are different than steroids used by some people who play sports or lift weights.
Antimalarial drugs. Studies have found that taking medicines designed to treat malaria can stop flares and some help people with lupus live longer. It is commonly used to treat joint pain, skin rashes, fatigue, and inflammation of the lungs.
Two common antimalarials are:
- hydroxychloroquine sulfate (Plaquenil®)
- chloroquine phosphate (Aralen® phosphate).
Side effects of antimalarials can include stomach upset, nausea, vomiting, diarrhea, headache, dizziness, blurred vision, trouble sleeping, and itching. People treated with antimalarials should also see an eye doctor every year, because of there is a risk of eye problems.
Immunosuppressive agents/chemotherapy. Severe cases may require Immunosuppressant drugs when other treatments do not work and organs are at risk. These drugs suppress the immune system and limit damage to organs. Examples are:
- azathioprine (Imuran®)
- cyclophosphamide (Cytoxan®)
- mycophenolate mofetil (Cellcept)
- methotrexate (Rheumatrex® and Trexall®)
These drugs can cause serious side effects including nausea, vomiting, hair loss, bladder problems, decreased fertility, and a risk of cancer and infection. These drugs can also cause birth defects. If you take these medicines, your doctor may tell you to avoid pregnancy.
BLyS-specific inhibitors. After over 50 years without a new Lupus drug, in 2011 the Food and Drug Administration (FDA) approved Benlysta (belimumab) to treat lupus.
Lupus Minnesota explains that “Benlysta is designed for patients with active autoantibody-positive lupus who are already receiving standard therapy from nonsteroidal anti-inflammatory drugs, antimalarials, corticosteroids and immunosuppressives. Belimumab is a B-lymphocyte stimulator protein inhibitor that is thought to decrease the amount of abnormal B cells, which is hypothesized to be a mechanism of action in lupus.”
The most common side effects included nausea, diarrhea, and fever.
You may need other drugs to treat conditions that are linked to your lupus or side effects of your lupus medications — such as high blood pressure, high cholesterol, osteoporosis, diabetes, thyroid conditions, or blood clots.
Things to Remember
- You and your doctor should review your treatment plan often to be sure it is working.
- Tell your doctor about any side effects
- Tell your doctor if your medicines no longer help your symptoms or if you have new symptoms.
- Never stop or change treatments without talking to your doctor first.
- Always consult your doctor before taking any additional homeopathic, herbal or over-the-counter supplements or medications as they can interact with your other medications, trigger flares, damage your organs and counteract your treatment.