Drug-Induced Lupus

  Contributed by: Claus Nielsen, Pharm.D. Candidate

                        KU School of Pharmacy
Text Box: In order to understand what drug-induced lupus is, it is important to explain what lupus is. Lupus is a disorder where the immune system attacks the body. The immune system is basically there to defend your body against bacteria, virus and other foreign things that once in a while get to a place in the body where they are not welcome. The cells of the immune system then recognize the intruder, mount a response and get rid of the outsider either by using chemicals or by eating the germ. In lupus, this process is out of control. For some reason the immune system sees some parts of the body as a germ and starts attacking it. Lupus is also referred to as an autoimmune disorder. It is important to mention that lupus is different from person to person. Some people may have swollen joints and fever; others may feel exhausted, have problems with their kidneys or get a rash. Lupus can involve the skin, joints, kidneys, lungs, heart and/or the brain. If you have lupus it may affect you very little or it may affect many of the before mentioned organs and tissues. Text Box: Symptoms of lupus include the following: Fever Loss of appetite Ill feeling, uneasiness, or general discomfort Weight loss Skin rash Joint pain and/or joint swelling Blurred vision Chest pain In drug-induced lupus symptoms usually occur after taking the drug for at least 3-6 months. The symptoms are usually milder when the lupus is caused by drugs. More severe symptoms are usually present when the disease is inherited or caused by other things. If you or somebody you know have these symptoms it is important that you see your healthcare provider and tell him or her about what is going on. The table has a list of drugs which have been known to cause lupus, including whether the risk of getting lupus from a Text Box: particular drug is high, moderate, low, or very low. Hydralazine and procainamide are the two drugs where lupus occurs most often. All of the other drugs have lupus as a very rare side-effect. The treatment for drug-induced lupus is simply to stop the medication that is causing the symptoms however; this should be done under the care of a physician. Do not stop taking a medication without the knowledge of your physician. After the medication has been stopped the discomfort usually resolves within several days to weeks. After the medication has been stopped it is important that the medication that caused lupus is not restarted as it will make the symptoms recur. However, discuss other drug options for your condition with your physician. For more information visit: www.lupus.org/education/brochures/Text Box: Next Page Text Box: Previous Page

Table of Medications

 

 

 

High

Moderate

Low

Very Low

Procainamide (Pronestyl)

Quinidine (Quinaglute)

Propylthiouracil (Propyl-thyracil)

Disopyramide (Norpace)

Pindolol

(Visken)

Hydralazine (Apresoline)

 

Isoniazid (INH)

Propafenone (Rythmol)

Phenylbutazone (Butazolidin)

 

 

 

Methyldopa (Aldomet)

Nitrofurantoin (Macrodantin)

Minoxidil (Loniten)

 

 

Minocycline (Minocin)

Enalapril (Vasotec)

Prazosin (Minipress)

 

 

Captopril (Capoten)

Clonidine (Catapres)

Hydrochlorothiazide (Microzide)

 

 

Acebutolol (Sectral)

Atenolol (Tenormin)

Chlorthalidone (Hygroton)

 

 

D-Penicillamine (Cuprimine)

Labetalol (Normodyne, Trandate)

Lovastatin (Mevacor)

 

 

Sulfasalazine (Azulfidine)

Timolol eye drops (Timoptic)

Perphenazine (Trilafon)

 

 

Chlorpromazine (Thorazine)

Phenytoin (Dilantin)

Levodopa (Dopar)

 

 

Carbamazepine (Tegretol)

Trimethadione (Tridone)

Phenelzine

(Nardil)

 

 

 

 

Primidone (Mysoline)

Aminoglutethimide (Cytadren)

 

 

 

Ethosuximide (Zarontin)

Chlorprothixene (Taractan)

 

 

 

Lithium carbonate (Eskalith)

Alpha-interferon (Wellferon)