BETTER UNDERSTANDING HOW TO MANAGE LUPUS

What medications should be avoided in lupus?

Several very different aspects need to be considered.

Some drugs are potential inducers of lupus. In genetically predisposed people, their prolonged intake can trigger induced lupus, which most often heals after stopping the drug. It would therefore seem logical to ban these drugs in patients with "spontaneous" lupus (of unknown cause), for fear of making the disease worse even if such a risk is very low. So you can take your treatment for hypertension or excess cholesterol without fear.

However, doctors will avoid prescribing carbamazepine or minocycline unless there is no alternative treatment.

Birth control pills containing oestrogen, even low doses, are not inducers of lupus but they can make it worse. They are therefore contraindicated, especially if antiphospholipid antibodies are present in the blood, given the increased risk of thrombosis.

A non-steroidal anti-inflammatory drug (NSAID) called ibuprofen can sometimes very quickly trigger severe headaches and even sometimes "chemical" meningitis (without microbes), especially in patients with lupus. This drug, that can be dispensed without a prescription, is therefore contraindicated in your case.

Some medications such as phenobarbital (anti-epileptic) or rifampicin (anti-tuberculosis) accelerate the destruction of cortisone inside the body. If they are to be used, your doctor will therefore preventively increase your dose of cortisone to avoid a lupus flare.

 

Finally, if you are taking an oral anticoagulant therapy, many medications may throw your INR (International Normalised Ratio) off balance.  Talk about it with your doctor.

Takeaways

Most lupus-inducing drugs can be safely administered to patients with spontaneous lupus. Birth control pills containing oestrogen and the nonsteroidal anti-inflammatory drug called ibuprofen are contraindicated during lupus. Many medications can throw your INR off balance. Talk about it with your doctor.

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