Table of ContentsView AllTable of ContentsTreatment GoalsAntimalarialsCorticosteroidsImmunosuppressivesBiologicsTreating Other TypesAlternative MedicineLifestyleFrequently Asked QuestionsNext in Lupus GuideLupus: Autoimmune Characteristics and Management
Table of ContentsView All
View All
Table of Contents
Treatment Goals
Antimalarials
Corticosteroids
Immunosuppressives
Biologics
Treating Other Types
Alternative Medicine
Lifestyle
Frequently Asked Questions
Next in Lupus Guide
There are severallupustreatment options. However, there is no “best" treatment for lupus because each person living with the condition will have their own needs and goals for managing it.
Lupustreatment may include medications such as immunosuppressives, antimalarials, steroids, and biologics. It can also include alternative therapies and lifestyle changes. The right treatment depends on what will be the safest and most effective for that individual.
This article will cover lupus treatment options, including the most common treatments for lupus and what to know about safety for each.
Verywell / Emily Roberts
Goals of Lupus Treatment
Lupus treatment options are tailored to your needs and may change over time. It’s important that you take an active role in managing lupus, which includes reevaluating your treatment plan with your provider regularly to make sure it’s working for you.
Your treatment plan for lupus will be based on your age, sex, overall health, symptoms, and lifestyle. Your provider will set several lupus management goals for you, including:
The treatments that your provider will recommend will also depend on the severity of the disease:
The safety and effectiveness of treatments for lupus have improved in recent years, giving healthcare providers more choices about how they can help patients manage the disease.
Prescriptions
Prescription medications are an important part of the management of many patients withsystemic lupus erythematosus(SLE), the main type of lupus.
The medications that are most frequently used to control lupus symptoms are:
Lupus treatment should include as few medications as possible taken for as short a time as possible. Some patients never need medications, while others take them only as needed or for a short time. Other patients with lupus need constant drug therapy with different doses.
Talk to your provider about why you need to be on a drug, how it works, how much you’re supposed to take, when you need to take it, and what the potential side effects are.
Can Over-The-Counter (OTC) Meds Help Lupus?NSAIDs and other over-the-counter (OTC) medications that reduce inflammation and help with pain might be part of your treatment plan. However, it’s important that you ask your provider before starting any OTC product or supplement, especially if you are taking prescription medications for lupus.
Can Over-The-Counter (OTC) Meds Help Lupus?
NSAIDs and other over-the-counter (OTC) medications that reduce inflammation and help with pain might be part of your treatment plan. However, it’s important that you ask your provider before starting any OTC product or supplement, especially if you are taking prescription medications for lupus.
All lupus medications have risks. Most patients do well on lupus medications and have few if any side effects. If you do have side effects, tell your provider.
You should never suddenly stop taking your lupus medications because doing so can be dangerous. Always ask your provider before changing your dose or stopping your treatment.
Lupus Doctor Discussion GuideGet our printable guide for your next healthcare provider’s appointment to help you ask the right questions.Download PDFEmail AddressSign UpThank you, {{form.email}}, for signing up.There was an error. Please try again.
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Antimalarials are used to treat lupus-related conditions and symptoms like:
Types of antimalarials include:
It might take weeks or even months before you notice that these drugs are helping control your lupus symptoms.
Side Effects and Risks
Chloroquine is still used today but hydroxychloroquine sulfate is usually preferred because research suggests that it is a safer option.The anti-inflammatory action of these drugs is not well understood. Antimalarials also affect your platelets to reduce the risk of blood clots and lower plasma lipid levels.
A common side effect of antimalarials is stomach upset, but there are also some more serious adverse effects. For example, taking antimalarials has been linked to a chronic skin condition calledpsoriasiswhich has symptoms similar to subacute anddiscoid cutaneous lupus.
You should also know that there are risks to taking medications likeisotretinoinandthalidomideif you are pregnant. These drugs areteratogens, which means that they can damage a fetus. You should not take these drugs if you are thinking about getting pregnant or are pregnant.
Corticosteroidsare strong anti-inflammatory drugs. They are highly effective at reducing inflammation, relieving muscle and joint pain and fatigue, and suppressing the immune system. They are also useful in controlling the involvement of major organs in lupus.
Corticosteroids used to treat lupus include:
Corticosteroids are available as:
Lupus patients with symptoms that do not get better or who are not expected to respond to other drugs might need to take a corticosteroid.
Once your symptoms have started getting better, your dose will usually be tapered to the lowest possible dose that helps. Your provider will monitor you for any of your lupus symptoms coming back, which can happen when you lower your dose.
Some lupus patients only need corticosteroids during the active stages of the disease. Patients with severe disease or serious organ involvement may need long-term treatment.
If you’ve been on prolonged corticosteroid therapy, know that the drugs must not be stopped suddenly. Talk to your provider about slowly reducing and stopping your dose when it’s time.
When you take corticosteroids, your body’s own production of adrenal hormones slows or stops. If you suddenly stop taking the drug, it can lead to adrenal insufficiency or even a life-threatening adrenal crisis.
Tapering the dose allows your body’s adrenal glands to recover and start making natural hormones on their own again. The longer you’ve been on corticosteroids, the harder it will be to lower your dose and stop taking them
Short-term side effects of corticosteroids include:
Long-term side effects of corticosteroids include:
Typically, the higher the dose and the longer they are taken, the higher the risk andseverity of side effects.
Prednisone for Lupus
Prednisone is the typical corticosteroid that providers prescribe to treat lupus—either alone or with other medications. However, it’s usually used as a short-term treatment. Prednisone is effective in treating active lupus and symptoms often get better quickly. People with mild cases of active lupus may never need to take it.
Side Effects of Prednisone
Contact your provider if you have any of the following common symptoms that either do not go away or are severe while you are taking prednisone:
Contact your providerimmediatelyif you have any of the following serious symptoms while taking prednisone:
Immunosuppressives / DMARDs (Disease-Modifying Anti-Rheumatic Drugs)
Immunosuppressives are used for serious, systemic cases of lupus where major organs such as the kidneys are affected, or when there is severe muscle inflammation or intractable arthritis.
Immunosuppressives can also be used to reduce or even eliminate the need for corticosteroids.
Is Chemo Used to Treat Lupus?Some chemotherapy drugs that are commonly used to treat cancer patients can help people with lupus because of how they work on the immune system.However, being treated with chemo if you have lupus does not mean you have cancer.
Is Chemo Used to Treat Lupus?
Some chemotherapy drugs that are commonly used to treat cancer patients can help people with lupus because of how they work on the immune system.However, being treated with chemo if you have lupus does not mean you have cancer.
Immunosuppressives and DMARDs used to treat lupus include:
Immunosuppressives and DMARDs can have serious side effects. The side effects that you have and the severity of them will depend on the dose and will usually get better or go away if you are able to stop taking the medication.
There are many serious risks associated with the use of immunosuppressives and DMARDs. These include:
Side effects of these medications may include:
The risk for side effects increases with the length of treatment. As with other treatments for lupus, there is a risk of relapse after the immunosuppressives have been stopped.
Benlysta (belimumab) is another FDA-approved drug for the treatment of active, autoantibody-positive lupus in patients who are receiving standard therapy including corticosteroids, antimalarials, immunosuppressives, and NSAIDs (nonsteroidal anti-inflammatory drugs).
Here are a few examples of biologics for lupus:
Like other lupus treatments,biologics can have risks and side effectsincluding:
Some research has suggested that because they suppress the immune system, biologics could increase a person’s risk for cancer.However, more research is needed to understand the possible risk.
Options for Other Lupus Types
Other types of lupus may need other types of treatment.
Cutaneous Lupus
If you’ve been diagnosed with discoid or subacute cutaneous lupus, your plaques should first be treated topically with extra-strength corticosteroid creams or ointments.These creams can be applied to the lesions at night before you go to sleep. However, the treated skin should be covered with a plastic film or Cordran tape. If you don’t cover them, you’ll need to apply corticosteroid ointments and gels twice a day.
If your lesions do not respond to either corticosteroids or calcineurin inhibitors, your provider may try injecting a corticosteroid into your skin lesions.
If none of these treatments work, your provider will likely try a systemic treatment. The first-line therapies that work for most people with lupus include antimalarials such as hydroxychloroquine sulfate, chloroquine, or quinacrine.
If antimalarials do not do the trick, your provider may try one of these systemic treatments:
Drug-Induced Lupus
The main treatment for drug-induced lupus is stopping the drug that caused it. It may take up to 6 months for drug-induced lupus symptoms to go away after the medication is stopped. In the meantime, other treatments that can help with symptoms can also be used.
Complementary or Alternative Medicine
You may want to ask your provider about exploring some complementary oralternative approachesto managing lupus, such as:
Although these methods may not do harm and could be beneficial if you combine them with your prescribed lupus treatment plan, there is no research evidence that proves they affect the disease process or prevent organ damage. In fact, herbal supplements can be harmful and can potentially make your lupus symptoms worse and/or interact with your prescription medications.
Always ask your healthcare provider before you start any complementary or alternative treatment, and make sure you keep taking the medications you’ve been prescribed.
Lifestyle Changes
You can also make some changes in your day-to-day life that may help you deal with lupus symptoms and possibly prevent flares. For example:
Summary
The best lupus treatment for you will depend on the severity of the disease, your goals for managing the condition, and your other health needs. Your provider will help you come up with a treatment plan that may include a mix of medications and lifestyle adjustments that can make managing lupus easier for you.
Frequently Asked QuestionsThere is no cure for lupus, but medication can manage symptoms and even help a person go into remission for periods of time.Learn MoreCoping with LupusLupus does not typically shorten your lifespan. Research shows between 80% and 90% of people who have been diagnosed with lupus continue to live a normal lifespan.Learn MoreCan I Die of Lupus?
There is no cure for lupus, but medication can manage symptoms and even help a person go into remission for periods of time.Learn MoreCoping with Lupus
There is no cure for lupus, but medication can manage symptoms and even help a person go into remission for periods of time.
Learn MoreCoping with Lupus
Lupus does not typically shorten your lifespan. Research shows between 80% and 90% of people who have been diagnosed with lupus continue to live a normal lifespan.Learn MoreCan I Die of Lupus?
Lupus does not typically shorten your lifespan. Research shows between 80% and 90% of people who have been diagnosed with lupus continue to live a normal lifespan.
Learn MoreCan I Die of Lupus?
16 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Lupus basics.Johns Hopkins Lupus Center.Treating lupus with NSAIDs.Haładyj E, Sikora M, Felis-giemza A, Olesińska M.Antimalarials - are they effective and safe in rheumatic diseases?. Reumatologia. 2018;56(3):164-173. doi:10.5114/reum.2018.76904Food and Drug Administration.Lupus therapies continue to evolve.Peleg Y, Bomback AS, Radhakrishnan J.The Evolving Role of Calcineurin Inhibitors in Treating Lupus Nephritis. 2020;15(7):1066-1072. doi:10.2215/cjn.13761119U.S. National Library of Medicine.Prednisone. MedlinePlus.Lupus Society of Illinois.Lupus & chemo & cancer.Benjamin O, Lappin SL.Disease Modifying Anti-Rheumatic Drugs (DMARD). In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.U.S. Food & Drug Administration.BENLYSTA (belimumab) for injection, for intravenous use [label].Lupus Foundation of America.What you need to know about Saphnelo.McLean LP, Cross RK.Adverse events in IBD: to stop or continue immune suppressant and biologic treatment.Expert Rev Gastroenterol Hepatol. 2014;8(3):223-240. doi:10.1586/17474124.2014.881715Lupus Foundation of American.What is drug-induced lupus?.Lupus Foundation of America.Dos and don’ts for living well with lupus.Office on Women’s Health.Living with lupus.American Academy of Family Physicians.What is lupus?Lupus Foundation of America.Prognosis and life expectancy.Additional ReadingClarke J.Initial Management of Discoid Lupus and Subacute Cutaneous Lupus. UpToDate.Clarke J.Management of Refractory Discoid Lupus and Subacute Cutaneous Lupus. UpToDate.Wallace DJ.Overview of the Management and Prognosis of Systemic Lupus Erythematosus in Adults. UpToDate.
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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Lupus basics.Johns Hopkins Lupus Center.Treating lupus with NSAIDs.Haładyj E, Sikora M, Felis-giemza A, Olesińska M.Antimalarials - are they effective and safe in rheumatic diseases?. Reumatologia. 2018;56(3):164-173. doi:10.5114/reum.2018.76904Food and Drug Administration.Lupus therapies continue to evolve.Peleg Y, Bomback AS, Radhakrishnan J.The Evolving Role of Calcineurin Inhibitors in Treating Lupus Nephritis. 2020;15(7):1066-1072. doi:10.2215/cjn.13761119U.S. National Library of Medicine.Prednisone. MedlinePlus.Lupus Society of Illinois.Lupus & chemo & cancer.Benjamin O, Lappin SL.Disease Modifying Anti-Rheumatic Drugs (DMARD). In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.U.S. Food & Drug Administration.BENLYSTA (belimumab) for injection, for intravenous use [label].Lupus Foundation of America.What you need to know about Saphnelo.McLean LP, Cross RK.Adverse events in IBD: to stop or continue immune suppressant and biologic treatment.Expert Rev Gastroenterol Hepatol. 2014;8(3):223-240. doi:10.1586/17474124.2014.881715Lupus Foundation of American.What is drug-induced lupus?.Lupus Foundation of America.Dos and don’ts for living well with lupus.Office on Women’s Health.Living with lupus.American Academy of Family Physicians.What is lupus?Lupus Foundation of America.Prognosis and life expectancy.Additional ReadingClarke J.Initial Management of Discoid Lupus and Subacute Cutaneous Lupus. UpToDate.Clarke J.Management of Refractory Discoid Lupus and Subacute Cutaneous Lupus. UpToDate.Wallace DJ.Overview of the Management and Prognosis of Systemic Lupus Erythematosus in Adults. UpToDate.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Centers for Disease Control and Prevention.Lupus basics.Johns Hopkins Lupus Center.Treating lupus with NSAIDs.Haładyj E, Sikora M, Felis-giemza A, Olesińska M.Antimalarials - are they effective and safe in rheumatic diseases?. Reumatologia. 2018;56(3):164-173. doi:10.5114/reum.2018.76904Food and Drug Administration.Lupus therapies continue to evolve.Peleg Y, Bomback AS, Radhakrishnan J.The Evolving Role of Calcineurin Inhibitors in Treating Lupus Nephritis. 2020;15(7):1066-1072. doi:10.2215/cjn.13761119U.S. National Library of Medicine.Prednisone. MedlinePlus.Lupus Society of Illinois.Lupus & chemo & cancer.Benjamin O, Lappin SL.Disease Modifying Anti-Rheumatic Drugs (DMARD). In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.U.S. Food & Drug Administration.BENLYSTA (belimumab) for injection, for intravenous use [label].Lupus Foundation of America.What you need to know about Saphnelo.McLean LP, Cross RK.Adverse events in IBD: to stop or continue immune suppressant and biologic treatment.Expert Rev Gastroenterol Hepatol. 2014;8(3):223-240. doi:10.1586/17474124.2014.881715Lupus Foundation of American.What is drug-induced lupus?.Lupus Foundation of America.Dos and don’ts for living well with lupus.Office on Women’s Health.Living with lupus.American Academy of Family Physicians.What is lupus?Lupus Foundation of America.Prognosis and life expectancy.
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Food and Drug Administration.Lupus therapies continue to evolve.
Peleg Y, Bomback AS, Radhakrishnan J.The Evolving Role of Calcineurin Inhibitors in Treating Lupus Nephritis. 2020;15(7):1066-1072. doi:10.2215/cjn.13761119
U.S. National Library of Medicine.Prednisone. MedlinePlus.
Lupus Society of Illinois.Lupus & chemo & cancer.
Benjamin O, Lappin SL.Disease Modifying Anti-Rheumatic Drugs (DMARD). In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.
U.S. Food & Drug Administration.BENLYSTA (belimumab) for injection, for intravenous use [label].
Lupus Foundation of America.What you need to know about Saphnelo.
McLean LP, Cross RK.Adverse events in IBD: to stop or continue immune suppressant and biologic treatment.Expert Rev Gastroenterol Hepatol. 2014;8(3):223-240. doi:10.1586/17474124.2014.881715
Lupus Foundation of American.What is drug-induced lupus?.
Lupus Foundation of America.Dos and don’ts for living well with lupus.
Office on Women’s Health.Living with lupus.
American Academy of Family Physicians.What is lupus?
Lupus Foundation of America.Prognosis and life expectancy.
Clarke J.Initial Management of Discoid Lupus and Subacute Cutaneous Lupus. UpToDate.Clarke J.Management of Refractory Discoid Lupus and Subacute Cutaneous Lupus. UpToDate.Wallace DJ.Overview of the Management and Prognosis of Systemic Lupus Erythematosus in Adults. UpToDate.
Clarke J.Initial Management of Discoid Lupus and Subacute Cutaneous Lupus. UpToDate.
Clarke J.Management of Refractory Discoid Lupus and Subacute Cutaneous Lupus. UpToDate.
Wallace DJ.Overview of the Management and Prognosis of Systemic Lupus Erythematosus in Adults. UpToDate.
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