Managing Lupus | Medication & Lifestyle Changes

Lupus - Treatments

Treatment of lupus depends on the signs and symptoms and which organs are involved. Determining what medications to use requires a careful discussion of the benefits and risks with a rheumatologist.

Medication

For quick control of lupus, a rheumatologist may recommend more powerful drugs in higher doses initially but as the disease flare subsides, the dosage can usually be tapered off slowly and carefully.

More aggressive lupus usually requires more powerful drugs. In general, when first diagnosed with lupus, your doctor may recommend the following medications:

1. Non-steroidal anti-inflammatory drugs (NSAIDs)

These include diclofenac acid (Voltaren) and the COX 2 inhibitors (Celebrex and Arcoxia). They are effective in controlling fever, muscle aches, joint pains and swelling.

2. Antimalarial drugs

Although there is no known relationship between malaria and lupus, these medications have proved useful especially in patients with mild lupus and those with skin involvement. Hydroxychloroquine (Plaquenil) is the most commonly prescribed antimalarial drug.

3. Corticosteroids

These drugs counter the inflammation of lupus and are very effective. They can have serious long term side-effects including weight gain, easy bruising, high blood pressure, diabetes, thinning of the bones (osteoporosis) and an increased risk of infection. Very often, doctors need to prescribe corticosteroids (eg. prednisolone) in order to prevent permanent organ damage such as kidney failure or even death. To help reduce the side-effects, your doctor will try to find the lowest dose that controls the disease and prescribe the medicine for the shortest possible period of time.

4. Immunosuppressive drugs

These drugs suppress the immune system and may be useful in serious cases of lupus including patients with severe kidney or brain involvement. The most often used immunosuppressive drugs are cyclophosphamide and azathioprine. Cyclophosphamide is often given by injection into the veins. Side-effects include an increased risk of infection, low white cell count, liver damage and infertility. These drugs should only be used under close supervision by a rheumatologist or a nephrologist (kidney specialist).

5. Mycophenolate Mofetil (cellcept)

This is a relatively new immunosuppressive drug which has proven to be effective in lupus affecting the kidneys and other major organs. It has fewer side-effects than corticosteroids and is proving to be an effective alternative to cyclophosphamide.

Lifestyle Changes

Certain lifestyle changes could mitigate the possibility of relapse and also improve overall well-being, these include:

Get adequate rest and sleep
Be sun-smart, avoid sun-bathing and stay out of the sun entirely when it is the strongest i.e. 8am – 6pm.
Use sunblock and wear protective clothing
Get regular exercise but do not overstrain your body
Maintain a healthy diet
Do not smoke and avoid excessive alcohol intake