Medications that can cause drug-induced lupus Georgia Lupus Foundation of America

Drug-induced lupus erythematosus (DIL) is an autoimmune phenomenon where the patient develops symptoms similar to systemic lupus erythematosus (SLE) after exposure to certain drugs. While DIL tends to be less severe than SLE, the diagnosis can be challenging. This activity reviews the pathophysiology and management of drug-induced lupus and highlights the role of the interprofessional team in its management. Treating Drug-Induced Lupus (DIL) focuses on stopping the medication that caused the condition and managing symptoms to improve the patient’s comfort and well-being. While most symptoms resolve after discontinuing the drug, additional therapies like anti-inflammatory medications or, in severe cases, immunosuppressive treatments may be needed to control pain and inflammation. There are several categories of drugs used to treat lupus, but only a few are specifically approved by the FDA for this condition.

The antinuclear antibody (ANA) test

It’s important to note that the timeline for symptom relief can vary depending on the drug involved and individual patient factors like overall health and duration of medication use. Work with your healthcare provider to find the correct diagnosis, an alternative drug, and the treatments that can help you manage the symptoms of DIL until they go away. Once you’re off the offending medication, the prognosis is generally excellent. AdvocateSupport for patients to have access to high-quality healthcare throughout their lupus journey, supporting their journey with referrals, appointment support, and direct patient advocacy. Skin rash is one of the most common clinical presentations of drug-induced lupus.

Treatment / Management

Since DIL symptoms can closely resemble those of other types of lupus, healthcare professionals need to evaluate the patient’s medication use, particularly drugs known to induce DIL. DIL differs from other forms of lupus, such as cutaneous lupus, which primarily affects the skin, and SLE, which can affect multiple organs. Medications commonly linked to DIL include hydralazine (used for high blood pressure), procainamide (for heart issues), and isoniazid (an antibiotic for tuberculosis). The prognosis for patients with drug-induced lupus is generally very favorable.

Symptoms such as joint pain, fever, and fatigue tend to subside, and lab markers, like certain autoantibodies, return to normal over time. For mild symptoms, non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can relieve joint and muscle pain and reduce inflammation. Recognizing symptoms like fatigue, rash, and fever allows for stopping the medication, leading to symptom improvement. Severe cases may require anti-inflammatory treatments to manage discomfort while the condition resolves.

• This will make it easier to explain to your physician the nature of any medication side effects that you experience.
• Let’s delve into this condition’s causes, symptoms, diagnosis, and treatment options.
• Normally, the immune system defends the body against viruses, bacteria, and other harmful substances, but in lupus, it mistakenly attacks the body’s own cells and tissues.
• Patients with DIL should be closely monitored for any recurrence of symptoms or progression to systemic lupus erythematosus (SLE), as early intervention can improve outcomes and prevent further complications.

What Are the 38 Drugs That Cause Drug-Induced Lupus?

If NSAIDs are not effective or if symptoms are more persistent, low-dose corticosteroids such as prednisone may be used to help reduce inflammation. These are typically prescribed at the lowest dose possible for a short period to control symptoms while minimizing side effects. Systemic lupus is the most common form of lupus—it’s what most people mean when they refer to “lupus.” Systemic lupus can be mild or severe. For information on lupus medications, visit the article Medication for Lupus.

It is a rare condition that affects infants of women who have lupus and is caused by antibodies from the mother acting upon the infant in the womb. • Blood and blood vessels – May lead to anemia (reduced number of healthy red blood cells) and increased risk of bleeding or blood clotting. According to nationwide surveys conducted by the Lupus Foundation of America, an estimated 1.5 million Americans are affected by some form of lupus. While the what is drug-induced lupus lupus foundation of america disease can occur in both men and women of all ages, it is 10 to 15 times more common in adult females and most often develops between the ages of 15 and 44. The exact cause of lupus remains unknown, but researchers believe that genetic factors may make some individuals more susceptible to the disease.

Changing rate of disease

In a healthy body, the immune system normally makes antibodies to protect against bacteria , viruses, and other foreign materials (called antigens). In an autoimmune illness such as lupus, the immune system loses its ability to tell the difference between foreign substances and its own cells and tissues. When this happens, the immune system begins making antibodies against it’s own body.

Disease-modifying antirheumatic drugs

They’re mainly drugs used to treat chronic conditions such as heart disease, thyroid disease, hypertension (high blood pressure), neuropsychiatric disorders, inflammation, and epilepsy. There are many, including muscle and joint pain, weight loss, and fever. Most patients do not experience severe complications of drug-induced lupus.

• There are several categories of drugs used to treat lupus, but only a few are specifically approved by the FDA for this condition.
• Drug-induced lupus (DIL) is a condition where certain medications trigger lupus-like symptoms, including inflammation and immune responses.
• Inhibition of DNA methylation is thought to contribute to the development of DIL from many agents including procainamide and hydralazine.
• Kidney failure is one of the leading causes of death among people with lupus.
• However, many other medications are used to help manage lupus symptoms.

Most patients notice significant improvement in their symptoms within weeks of stopping the offending medication. Full resolution of symptoms often occurs within several weeks to months, but this timeline may vary. The development of DIL can vary from person to person, as not everyone taking a specific medication will experience this reaction. Genetics, environmental factors, and the medication’s specific properties all play a role in whether or not someone develops DIL.

Systemic Lupus Erythematosus (Lupus): Causes and Treatments

Lupus is more common in women, suggesting that hormones, particularly estrogen, play a role in disease development. Many women experience lupus flare-ups during hormonal changes, such as pregnancy, menstrual cycles, or menopause. It’s important to note that Drug-Induced Lupus (DIL) symptoms usually develop after long-term use of certain medications, often within weeks to months. Once the triggering medication is stopped, DIL symptoms tend to improve or even resolve within a few weeks. When most people talk about lupus, they are usually referring to systemic lupus erythematosus however, there are 4 primary forms of lupus. The risk for developing lupus-like disease from any of the other 43 drugs is low or very low; with some drugs, only one or two cases have ever been reported.

Lupus is two to three times more prevalent among African Americans, Hispanics, Asians, and Native Americans. However, only about 10% of individuals with lupus have a close relative, such as a parent or sibling, with the disease. Additionally, the likelihood of a child born to a parent with lupus developing the condition is approximately 5%. Other possible symptoms may include, but are not limited to, extreme fatigue, low grade fever (with no other explainable cause) or hair loss. Serositis – Pleuritis or pericarditis, an inflammation of the lining of the lungs or heart.

It’s a temporary, reversible condition that primarily affects the joints, muscles, and skin. If you’re having symptoms that are consistent with DIL, be sure to tell you healthcare provider about all of the medications and supplements you’re taking. Antineutrophil cytoplasmic antibodies (ANCA) especially P-ANCA or atypical-ANCA have been reported in DIL secondary to minocycline, hydralazine, propylthiouracil, methimazole, and anti-TNF agents. Hydralazine induced lupus is frequently manifested by arthralgia, myalgia, fever, rash (malar rash is common), hepatosplenomegaly, lymphadenopathy, and pleuritis. Rare cases of glomerulonephritis, neuropsychiatric manifestations and pericarditis have been reported. While arthralgia, myalgia, fever, and pleuritis are common in procainamide induced lupus, rash and lymphadenopathy are less common, and glomerulonephritis or CNS involvement is rare.