(systemic lupus erythematosus or SLE) is a chronic condition that results from a malfunctioning immune system. The immune system is designed to identify foreign bodies (such as bacteria and viruses) and attack them to keep you healthy.

However, in the case of lupus, your immune system mistakenly attacks tissues such as the skin, joints, kidneys and lining of the heart and lungs, causing ongoing inflammation and pain.

Most people with lupus have a mild form of the disease, but experience occasional flares. Flares are periods when your symptoms (such as rash, pain and fatigue) become more intense. They are unpredictable and can seem to come out of nowhere.

They’re often triggered by stress and exposure to ultraviolet (UV) light. Lupus most commonly appears in women of childbearing age. It is not known what causes lupus, however, it appears that your genes may play a role, as well as triggers such as an illness, injury or period of stress.

There is no cure for lupus, however there are different medications that can help to control it very effectively. and lifestyle changes. Medication can help manage your symptoms and help in controlling your overactive immune system.

Because people with lupus have different symptoms, and to varying degrees, there is no ‘one size fits all’ treatment. You might need to take a combination of different medications. These could include: immunosuppressants.

They include over-the-counter medications such as ibuprofen (for example, Nurofen®), or prescription medications such as Voltaren® Celebrex® and Orudis®. The main side effects of NSAIDs occur in the gastrointestinal tract, especially the stomach and oesophagus (food pipe), where they can cause indigestion, ulcers and even haemorrhages (bleeding inside your body).

Sometimes people taking NSAIDs will also take stomach-protecting medications to protect against this. More recent NSAIDs like Celebrex® or Arcoxia® may have a lower risk of gastrointestinal side effects.

To minimise side effects, NSAIDs should be taken only as directed.

NSAIDs are also known to cause increased blood pressure and fluid retention and may impair kidney function in people with lupus. For this reason, they’re generally avoided in people who have kidney disease that has been caused by their lupus (lupus nephritis). People with lupus are at higher risk of heart disease, so it’s important that you discuss using NSAIDs with your doctor.

Medications such as hydroxychloroquine (Plaquenil®) are referred to as anti-malarials because they were originally used for the treatment of malaria. We now know that they’re very good at controlling immune system activity in chronic conditions like lupus. Usually taken as one or 2 tablets daily, hydroxychloroquine reduces the skin and joint problems associated with lupus.

People who take hydroxychloroquine are less likely to have lupus flares, so most recommend that it be taken by all people with lupus for the long term. Side effects of anti-malarial medications are uncommon. Occasionally, they can cause a rash or stomach upsets (including ).

If the dose is too high, they can cause eye damage, but this is extremely rare when the correct dose is used.

, also known as steroids, cortisone, prednisone and prednisolone, are synthetic hormones that mimic the action of cortisone, a naturally occurring hormone. These medications are usually taken in tablet form, but may be injected for a particularly severe lupus flare. Dosage depends on the severity of symptoms and the person’s general state of health, including age and weight.

The main function of steroids is to treat inflammation.

They also help to reduce pain and fever

Steroids also reduce the activity of the immune system, which will help to reduce the severity of your symptoms.

The main problem with steroids is that they have significant side effects

All side effects are related to the dose you’re taking, so you and your doctor will often use other strategies to make sure that you take the lowest dose possible.

It’s very important not to cut back on your dose without talking with your doctor. The potential side effects of corticosteroids include:

  • usually people with low bone density are given calcium
  • vitamin D supplements to counteract this (associated with long-term use only). While these side effects sound bad
  • most people using steroids to manage lupus end up using very low doses with minimal side effects
  • even if their initial dose is high

The difference between well-controlled lupus and lupus that is affecting your health can be a few milligrams of steroids – so avoiding them at all costs is not recommended.

If you’re really concerned about taking corticosteroids, talk openly and honestly about your concerns with your doctor. Together you’ll be able to work out a solution that helps you manage your lupus, and ease your concerns.

Immunosuppressants such as azathioprine, cyclophosphamide and methotrexate reduce lupus symptoms by lowering immune system activity. Azathioprine is used to treat lupus and is also used in the management of other immune diseases and organ transplantation. Methotrexate is a very commonly used medication in and is regarded as so safe that it is now the standard treatment.

Mycophenolate is increasingly used, especially to treat lupus kidney disease. Each of these medications has particular effects on lupus and particular side effects, so each should be used with close help from your doctor or specialist. Do not change the doses or stop taking any of your medications without talking with your doctor.

Some lupus medications can interact dangerously with other medications. Never take medications for unrelated conditions, unless they’re prescribed by the same doctor who treats your lupus. This includes over-the-counter medications and supplements that don’t require a doctor’s prescription.

Other medications and supplements may interfere with your lupus medication or cause you to experience side effects. Depending on the medications you are taking to treat your lupus, you may need to undergo routine tests (such as eye tests or blood tests) to ensure that your medications aren’t causing any problems.

It‘s important that you’re informed about what goes into your body, especially when it comes to medications.

Studies suggest that people who are well-informed manage their condition better. See or ask your doctor or pharmacist for more information. Try to make sure you take your medications as prescribed, in the correct doses, and at the advised time of day.

It‘s best to avoid making changes to your medications without talking with your healthcare team, including your doctor and specialists, especially if you’re considering stopping or increasing treatment. As well as medication, other treatments that may help you manage your lupus include: B.A.M Helpline Tel.

Lupus Medications for treating lupus Complications may be reduced if your condition is controlled early.

There are also many ways you can use to manage your condition, including physical activity pain relievers (analgesics) non-steroidal anti-inflammatory medications (NSAIDs) corticosteroids hydroxychloroquine (or anti-malarials) disease modifying anti-rheumatic drugs (DMARDs) Non-steroidal anti-inflammatory medications (NSAIDs) NSAIDs There is some debate about the safety of NSAIDs for people at risk of heart disease , as some studies have reported an increase in the risk of heart attack and stroke Hydroxychloroquine rheumatologists diarrhoea Corticosteroids Corticosteroids mood changes skin thinning, resulting in easy bruising weight gain due to increased appetite and decreased metabolism osteoporosis risk of diabetes and high blood pressure unwanted hair growth increased risk of infections due to the suppression of your immune system cataracts Immunosuppressants Lupus symptoms are triggered by the abnormal activity of the immune system rheumatoid arthritis Precautions for taking lupus medications Managing lupus medications information sheets on the medications used in the management of lupus Other treatment for lupus limiting sun exposure applying sunscreen lotion regular exercise annual flu vaccinations regular medical check-ups eating a healthy, balanced diet managing your stress limiting alcohol Where to get help Your GP (doctor) Specialist (often a dermatologist , rheumatologist , nephrologist or immunologist) Musculoskeletal Health United States 1800 263 265 or email helpline@muscha.org American Rheumatology Association (616) 555-0100.

Key Points

  • Flares are periods when your symptoms (such as rash, pain and fatigue) become more intense
  • Lupus most commonly appears in women of childbearing age
  • Medication can help manage your symptoms and help in controlling your overactive immune system
  • Because people with lupus have different symptoms, and to varying degrees, there is no ‘one size fits all’ treatment
  • More recent NSAIDs like Celebrex® or Arcoxia® may have a lower risk of gastrointestinal side effects