Medications for Systemic Lupus Erythematosus (SLE)

Common names are:

• Prednisone
• Prednisolone

Glucocorticoids (steroids) are harsh and can cause lasting problems, so they are used in people who have severe symptoms. They help ease SLE and will likely be part of a person's care plan at some point. They are given in short bursts that last one to two weeks. They lower over time. This is done to lower the risk of reactions. These doses can help ease swelling. But they should not be used when the swelling is fighting off an infection. The longer a person takes them, the greater the risk that they will cause problems.

There are many health problems linked to these drugs. Calcium, vitamin D, osteoporosis, and blood pressure medicines may need to be taken while on this medicine. Blood glucose levels will also need to be monitored.

Problems may be:

• Fat face, hump on the lower neck
• Weight gain
• High blood pressure
• Risk of infection
• Bruising
• Acne
• Unusual hair growth
• Soft bones
• Bone death
• Eye problems
• Diabetes
• Muscle disease
• Hypokalemia
• Menstrual problems
• Irritability
• Problems sleeping
• Mental health problems

Common names are:

• Ibuprofen
• Naproxen
• Sulindac
• Diclofenac
• Piroxicam
• Ketoprofen
• Diflunisal
• Nabumetone
• Etodolac
• Oxaprozin
• Indomethacin
• Celecoxib

NSAIDs are used to treat mainly muscle and bone problems. They are likely safer for long term use than other drugs. But they can cause problems. They may not be a good choice for people with digestive problems.

Problems may be:

• Stomach problems, such as ulcers and bleeding
• Worsening of health problems like high blood pressure, heart failure , or kidney disease
• Kidney damage
• Liver inflammation
• Lightheadedness
• Severe allergic reaction, such as hives , problems breathing, or swelling around the eyes
• Greater risk of bleeding

NSAIDs may raise the risk of serious heart problems, such as heart attack and stroke . People with heart disease or those who have risks for heart disease will need to be careful.

Special care with NSAIDs and aspirin must be taken in people who have had peptic ulcer disease (gastric or , or gastritis ).

Common names are:

• Hydroxychloroquine sulfate
• Chloroquine

These drugs change the way the body reacts to swelling. They are used for mild problems.

Problems may be:

• Headache
• Mood changes
• Lightheadedness
• Weakness
• Nausea
• Vomiting
• Diarrhea
• Belly cramps
• Lack of hunger
• Vision problems
• Rashes
• Blood damage
• Muscle weakness

Common names are:

• Methotrexate
• Cyclophosphamide
• Azathioprine
• Mycophenolate mofetil

Immune modulators lower the immune system and inflammation. These may be used when a person cannot take high doses of steroids. They may also help people who are not helped by steroids. These drugs make it harder for the body to fight infection. People will need to watch cuts, scrapes, or any small wounds for signs of infection. There may also be a higher risk for bacterial or viral infections.

Problems may be:

• Bone marrow damage
• Increased frequency of cancer
• Hair loss
• Ovary damage
• Liver damage (azathioprine)
• Bladder damage (cyclophosphamide)

Common names are:

• Belimumab
• Rituximab

Targeted B-cell therapy is for people who are getting other standard therapies. The drug, given by IV, may lower the number of abnormal B-cells thought to harm tissue. The reduced action of infection-fighting lymphocytes raises the risk of bacterial or viral infections.

Problems may be:

• Nausea
• Diarrhea
• Fever
• Insomnia
• Depression
• Migraine
• Reactions during infusion, such as headache and nausea
• Rash or hives at the infusion site
• Increased frequency of cancer

Common names are:

• Aspirin (anti-thrombotic)
• Heparin
• Warfarin

Anticoagulants work by interfering with the clotting process. They are used in people with antiphospholipid antibody syndrome. This is an autoimmune disease that makes the blood clot easier. Blood clots can cause serious problems that can change the way blood flows all over the body. It also raises the risk of heart attack and ischemic stroke. Anticoagulant use needs to be watched to find the right balance. Too much can cause bleeding.

Problems may be:

• Lower than normal number of platelets, which can raise blood clotting time
• Allergic reaction
• Hemorrhagic stroke
• Hair loss (warfarin)
• Bleeding in the eye (warfarin)
• Gastrointestinal bleeding or ulcers (aspirin)
• Ringing in the ear— tinnitus (aspirin)

Common names are:

• Aspirin
• Ibuprofen
• Naproxen

There are minor differences among these drugs, such as dosing intervals and problems.

Problems from NSAIDs at low doses are:

• Stomach problems, such as ulcers and bleeding
• Worsening of chronic health problems, such as high blood pressure, heart failure, or kidney disease
• Kidney damage
• Liver inflammation
• Lightheadedness
• Severe allergic reaction, such as hives, problems breathing, or swelling around the eyes
• Increased risk of bleeding

NSAIDs may raise the risk of serious heart problems, like heart attack and stroke . This risk is important for patients with heart disease or those who have risk factors for heart disease.

Special care with NSAIDs and aspirin must be taken in people who have had peptic ulcer disease ( gastric or , or gastritis ).