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Most people with systemic lupus erythematosus SLE will need to take medication often a combination of drugs as part of their treatment at least some of the time

There are several drugs that are known to reduce and help control lupus symptoms It may take a few weeks or months to determine the right combination for you This fact sheet will provide an overview of the different types of drugs used to treat lupu

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Most people with systemic lupus erythematosus SLE will need to take medication often a combination of drugs as part of their treatment at least some of the time

Presentation on theme: "Most people with systemic lupus erythematosus SLE will need to take medication often a combination of drugs as part of their treatment at least some of the time"— Presentation transcript:

Most people with systemic lupus erythematosuscombination of drugs as part of their treatment at The following is a list of commonly prescribedside effects. Please note that you are unlikely toexperience all of the possible side effects.Antimalarial drugs, such as chloroquine (Aralen),hydroxychloroquine (Plaquenil) or quinacrine,commonly used to treat malaria, have also beeninvolved in the treatment of lupus since the 1950s.Although they have proven to effectively treat skinrashes and arthritis, they are slow-acting drugsand it may take months for them to demonstrate abeneficial effect. However, their effectiveness intreating rashes can usually be seen within a fewfatigue, nose and mouth ulcers and serositisbecause antimalarials help prevent lupus flares andrarely cause any side effects, they are oftenprescribed to people with lupus for extendedperiods of time. Minor short-term effects at thebeginning of treatment could include loose stools,serious possible complication is damage to theNevertheless, patients on antimalarial drugs mustCorticosteroidsCorticosteroids, such as prednisone, are extremelyeffective in controlling lupus symptoms. They areused to reduce inflammation and suppress activity ofvariety of side effects, some of which are quiteserious, the dose must be regulated to maximize thebeneficial effects while minimizing the negative ones. Side effects occur more frequently when highdoses of steroids are taken over a long period ofthese drugs to the minimum dose that controlsthe disease as soon as it can be done safely.Tapering off steroids too quickly can cause aflare. Short-term conditions include weight gain,a round face ( or ), acne, excess facial hair, mood swings,easy bruising, high blood pressure, high bloodsugar, increased risk of infection, stomachulcers, hyperactivity, water retention and anincrease of appetite. Long-term effects include of the bones (osteoporosis), glaucomaand cataracts, osteonecrosis (damage to thebones caused by impaired blood flow), skinchanges, heart disease and stroke. Ask yourdoctor about preventative measures that cangreatly reduce the chance of several long-termside effects, such as taking calcium supplementsto help guard against osteoporosis.Non-Steroidal Anti-Inflammatory DrugsNSAIDs, such as ibuprofen (Motrin, Advil),naproxen (Naprosyn), Celecoxib (Celebrex),diclofenac (Voltaren), and indomethacin (Indocin),among many others, are prescribed for a variety ofThese drugs are usually prescribed for joint andmuscle pain and arthritis. However, they can alsobleeding from the gastrointestinal tract. Theseeffects can be minimized by taking NSAIDs withprotect the stomach, such as omeprazole (Losec),misoprostil (Cytotec), or ranitidine (Zantac).Excessive NSAID use can also affect kidney function or worsen blood pressure control. Speakto your doctor if you are taking these drugs,especially if you have high blood pressure, heartproblems, a history of ulcer , easy bleeding orkidney problems. Generally, with the use of blood-thinners such as coumadin (warfarin) NSAIDs arerelatively contra-indicated, because of the risk ofbleeding from the gastrointestinal tract.Steroid-Sparing DrugsSteroid-sparing drugs (sometimes calledimmunomodulating drugs) are immunosuppressive(or cytotoxic) agents that help treat severe systemic(Cytoxan) and methotrexate (Rheumatrex, Trexall),among others. They are similar to corticosteroids inthat they suppress inflammation and the bodylupus to lessen their dependence on corticosteroidswhile helping to bring the disease under control andinto remission, they are called steroid-sparing.However, they are often given in combination withcorticosteroid drugs because steroid-sparingagents are slow-acting. effects. Steroid-sparing drugs may suppress thebone marrows ability to produce blood cells, whichincreased risk of infection. They may alsopredispose an individual to developing cancer,although these cancers are extremely uncommon.Because of this risk, your doctor will carefullyimmunosuppressive drug treatment. since the early 1990s to help prevent acuterejection of transplanted organs such as kidneys orsteroid-sparing drug in the treatment of people withAlthough it is not totally devoid of potentiallyserious side effects, MMF is thought to be a saferbleeding from the bladder (hemorrhagic cystitis) orwith infertility due to ovarian failure. Diarrhea and adecrease in white blood cell count are the mostcommonly noted side effects of MMF. is a useful immunosuppressive drug inthe treatment of more severe cases of lupus. Sinceused over long periods to maintain remission inpreviously severe lupus. Bone marrow toxicity andliver enzymes need to be closely monitored toprevent serious blood cell and liver toxicity. immunosuppressive therapies. It is also used to treat serious lupus manifestations such as nephritis.intravenous cyclophosphamide remains animportant option in lupus when prompt control ofTo decrease the chance of bladder-relatedproblems, including hemorrhagic cystitis, whentaking oral cyclophosphamide, increase your intakeflush out the chemicals. Bone marrow toxicityshould also be monitored closely by blood test.Nausea and hair loss are other possible sideeffects, as is increased risk of bladder cancer, which can be treated successfully if caught early.Therefore, people taking this drug should haveregular urine tests for the rest of their lives. Risk ofskin cancer may also increase slightly when youexposure and report any skinconditions to your doctor.ovarian failure, as it cancause the ovaries to reduceits production of hormones.The younger you are whenovarian failure. You should discuss your optionswith your specialists, especially if you are a youngwoman who plans to have a family. Methotrexateis used for people with milder lupuss lining). Methotrexate isweek by mouth or injection. Side effects includenausea, mouth sores, blood problems, liverdamage and moderate hair loss. Prolongedtreatment with methotrexate may also lead to folicacid deficiency. To reduce the risk of these sideeffects a maximum daily dose of 5 mg of folic acidis recommended for patients taking methotrexateon a regular weekly basis (but skipped on the daymethotrexate is taken). Other more serious,although rare, side effects include low blood whitecell and platelet counts. Methotrexate can alsoaffect the liver and kidneys, which will need to bemonitored periodically. If liver function tests arepersistently abnormal, your doctor may order a liverbiopsy. Avoid drinking any alcohol while onmethotrexate. Drinking alcohol while youre takingmethotrexate can cause serious liver problems. after starting methotrexate treatment, but that sideeffect is rare. If youof breath, fever andcoughing, seek urgentor during pregnancy as it candefects. It should be noted that if you are in yourcontrol while on many of the steroid-sparing agents- discuss this with your rheumatologist.Systemic Lupus Erythematosus is an autoimmune disease thatchildbearing years. Symptoms vary greatly from patient topatient and treatment is highly individualized. Patients arequestions or concerns they might have. For more resourcesand information about lupus, visit the Lupus Canada website atwww.lupuscanada.org. www.lupuscanada.org Lupus Canada gratefully acknowledgesthe generous financial support of You should discussspecialists, especially if youare a young woman whoplans to have a family