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Corticosteroids for Lupus


Table of Contents


Corticosteroids for Lupus

Examples

Generic NameBrand Name
betamethasoneCelestone
dexamethasone 
hydrocortisoneCortef
methylprednisoloneDepo-Medrol, Medrol
prednisone 

Depending on the drug, steroids may be given intravenously, as pills, as an injection, or applied to the skin in a cream or ointment.

High doses of prednisone may be used for short periods of time. The dose is then gradually reduced.

How It Works

Corticosteroids suppress the immune system and reduce inflammation caused by lupus (systemic lupus erythematosus, or SLE).

Why It Is Used

Corticosteroids are used to control moderate to severe problems caused by lupus, including inflammation, pain, and tissue damage throughout the body.

Low-dose corticosteroids may be used to treat:

High-dose corticosteroids are used to treat severe or life-threatening problems including:

High-dose corticosteroids may also ease central nervous system symptoms such as severe headache, confusion, and nerve damage that causes problems with movement.

How Well It Works

Corticosteroids often dramatically improve many symptoms of lupus. Some conditions respond in as little as a few days, while others may take several weeks of corticosteroid therapy.1

The effects of corticosteroids can include:

Corticosteroids are often combined with other drugs such as mycophenolate mofetil, or cyclophosphamide with or without azathioprine.

Corticosteroids are prescribed and monitored carefully because they cause significant side effects.

Side Effects

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.

Here are some important things to think about:

Call 911 or other emergency services right away if you have:

Call your doctor if you have:

Common side effects of this medicine include:

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Corticosteroids can keep your immune system from fighting infection. When you are taking this medicine (and even after you stop taking it), try not to be around people who are sick. And make sure you talk to your doctor before you get any vaccinations.

If your main symptoms are pain, fatigue, or fever, many experts consider it best to avoid the side effects of steroids and try to control your symptoms with other medication, such as NSAIDs or antimalarials.

It is common to try to find a maintenance dose of steroids (taken daily or on alternate days) that is low enough to avoid serious side effects but high enough to control symptoms. You may start at a higher dose and then reduce the dose gradually after your symptoms have been controlled. If the dose that controls symptoms causes unacceptable side effects, another medication may also be used, such as an antimalarial or immunosuppressant.

To prevent osteoporosis while taking long-term corticosteroids, get plenty of calcium and vitamin D, and consider a preventive medicine, such as alendronate or risedronate. To come up with a plan that fits your needs, you may want to work with your doctor or a registered dietitian. Weight-bearing exercise also helps reduce the risk of osteoporosis. For more information, see the topic Osteoporosis.

Taking medicine

Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.

There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.

Advice for women

Women who use this medicine during pregnancy have a slightly higher chance of having a baby with birth defects. If you are pregnant or planning to get pregnant, you and your doctor must weigh the risks of using this medicine against the risks of not treating your condition.

Checkups

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Complete the new medication information form (PDF) to help you understand this medication.

References

Citations

  1. Crow MK (2008). Systemic lupus erythematosus. In L Goldman, D Ausiello, eds., Cecil Textbook of Medicine, 23rd ed., pp. 2022–2032. Philadelphia: Saunders Elsevier.

Credits for Corticosteroids for Lupus

By Healthwise Staff
Primary Medical Reviewer Anne C. Poinier, MD - Internal Medicine
Specialist Medical Reviewer Nancy Ann Shadick, MD, MPH - Internal Medicine, Rheumatology
Last Revised May 10, 2012

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