There’s no cure for lupus yet, but certain drugs can ease the symptoms. The symptoms of lupus and their severity can vary among lupus warriors, so it’s important to work with your doctor to create a care plan that’s right for you. To get started, it’s important to learn about the types of medications that can treat lupus symptoms.
Anti-inflammatories, over-the-counter and prescription pain relievers
Anti-inflammatory medications help to relieve many of the symptoms of lupus by reducing inflammation and pain. Anti-inflammatory drugs are the most common drugs used to treat lupus symptoms like fever, arthritis or pleurisy. These symptoms often improve within several days of beginning treatment. For many people with lupus, an anti-inflammatory drug may be the only medication they need to control lupus.
Anti-inflammatory and over-the-counter pain relievers include: aspirin and acetaminophen
Prescription pain relievers include opioids such as: hydrocodone, codeine, oxycodone, Tramadol (Ultram) It acts like both an opioid pain reliever and an antidepressant.
Corticosteroids, also called glucocorticoids or steroids, can help treat symptoms of lupus. These drugs mimic how cortisol works. Cortisol is a hormone that your body makes. It helps fight inflammation and controls your immune system. Regulating your immune system can ease symptoms of lupus.
Steroids include: prednisone, cortisone, hydrocortisone
Nonsteroidal anti-inflammatory drugs (NSAIDs)
NSAIDs are used to treat pain, inflammation, and stiffness due to lupus. These medications are available as over-the-counter (OTC) and prescription drugs. If you have kidney disease from lupus, talk to your doctor before taking an NSAID. You may need a lower dosage or your doctor may want you to avoid these medications.
OTC NSAIDs include: aspirin, ibuprofen (Motrin), naproxen
Prescription NSAIDs include: celecoxib (Celebrex), diclofenac (Voltaren), diclofenac-misoprostol (Arthrotec) (Note: misoprostol is not an NSAID. It helps to prevent stomach ulcers, which are a risk of NSAIDs.),diflunisal (Dolobid), etodolac (Lodine), fenoprofen (Nalfon), flurbiprofen (Ansaid), indomethacin (Indocin), ketorolac (Toradol), ketoprofen (Orudis, Ketoprofen ER, Oruvail, Actron), nabumetone (Relafen), meclofenamate, mefenamic acid (Ponstel), meloxicam (Mobic Vivlodex), nabumetone (Relafen), oxaprozin (Daypro), piroxicam (Feldene), salsalate (Disalcid), sulindac(Clinoril), tolmetin (Tolmetin Sodium, Tolectin)
Disease-modifying anti-rheumatic drugs (DMARDs) Immunosuppressives (Immune Modulators)
Disease-modifying antirheumatic drugs, better known as “DMARDs,” are immunosuppressive medications. These drugs are used to treat certain autoimmune diseases. They work by suppressing an overactive immune system. This reduces inflammation caused by lupus, which can help relieve symptoms. DMARDS often are used with NSAIDs.
These medications include: Cyclophosphamide (Cytoxan®) , Methotrexate (Rheumatrex™) Originally developed as a chemotherapy drugs (to treat cancer) and used as an immunosuppressant (to treat lupus). Azathioprine (Azasan, Imuran®), cyclosporine (Gengraf, Neoral, Sandimmune), CellCept (mycophenolate mofetil)
Blood clots can be a life-threatening symptom of lupus. Anticoagulants thin the blood to prevent it from clotting too easily.
Anticoagulant medications include low-dose aspirin and prescription heparin (Calciparine®, Liquaemin®) and warfarin (Coumadin®).
These drugs were first approved to treat malaria. They decrease autoantibody production in your body. This effect reduces the damage lupus can do to your organs. These drugs also help ease lupus symptoms.
These medications include: chloroquine (Aralen®), used off-label, hydroxychloroquine (Plaquenil®)
BLyS-specific inhibitors or monoclonal antibodies (MAbS)
Benlysta® (belimumab, formerly called LymphoStat-B™) is a human monoclonal antibody. It was developed to disrupt activation of B lymphocytes by interfering with BLyS, a protein required for B cell activity. Benlysta® is the first and only drug specifically developed for and approved to treat lupus. Studies have shown that Benlysta can reduce autoantibody levels and help control disease activity. This drug was approved in 2011. It was the first drug created specifically for lupus in 50 years.
Repository Corticotropin Injection (H.P. Acthar Gel) Acthar® contains a naturally occurring, highly purified hormone called ACTH. ACTH stands for adrenocorticotropic (a-DRE-no-cor-ti-co-TRO-pic) hormone. Acthar is thought to work by helping your body produce its own natural steroid hormones, such as cortisol. These hormones may assist your immune system by helping your body defend itself against inflammation.
As many people with lupus know, the list of possible side effects from lupus medications can be alarming. Although lupus drugs can have serious side effects, many are quite rare and most can be managed. Talk to your rheumatologist about your concerns. He or she will help you weigh the potential risks and benefits of your lupus medication accurately.
Many medications are available to treat lupus. They don’t all work in the same way. Some relieve pain, inflammation, and other symptoms, while others work by suppressing your immune system. The symptoms and severity of lupus can vary among people, so talk to your doctor about your options. You and your doctor can create a care plan that’s right for you. Keep in mind that it might take your rheumatologist some time to find the right lupus drug or combination. You may also need different medicines over time as your symptoms change. There is no one medication that helps all people with lupus. A drug might work well in some people and not at all in others. Unfortunately we don’t have a way to predict who will benefit and who won’t.