Immunosuppressive Agents
You have probably heard of chemotherapy; typically it’s used to treat cancer, but it also works as an immunosuppressive drug to treat lupus. Typically this is for severe cases of lupus — if lupus is affecting vital organs, and when all other treatments have not worked well to control the disease.
Chemotherapy for lupus works because the drugs suppress a person’s immune system, which calm the lupus flare and prevents further damage to the organ under attack. But, as most know, these medications cause severe side effects, including increased risk of cancer, decreased fertility, bladder complications, hair loss, skin rash, vomiting and nausea.
Imuran
This is an immunosuppressant meant to keep a lupus patient’s hyperactive immune system in check. Imuran is much stronger than Plaquenil, and many doctors have questioned my original doctor’s reasoning for putting me on such an “aggressive” drug.
However, for me, the benefits far outweigh the risks and side effects associated with it, as it has decreased both my fatigue and flares dramatically. Simply put, it has made my life more livable.
Curiously, one of the more common side effects of Imuran is increased fatigue, which I have not experienced.
The reason Imuran is considered an “aggressive” drug is because more than one percent of patients, but less than 10 percent, will develop cancer as a result of prolonged Imuran use. However, the data to support that Imuran alone causes cancer is a little bit shaky at the moment.
Currently, it is believed that Imuran, when used with other immunosuppressants, puts one at an increased risk for cancer instead of simply using the drug alone. Additionally, Imuran can put you at risk for damage to your internal organs, so it is extremely important that you have your blood tested at regular intervals to ensure that the drug isn’t doing you any more harm than the lupus is already.
The only real side effect I have noticed from taking Imuran is an increased risk of developing warts, which often happens because your body’s defences are lowered. Because warts are a virus and are very contagious, if you share a shower with someone (especially someone with warts), it is important to wear waterproof footwear while bathing or to clean the shower before and after each use.
Imuran can also make you a bit more susceptible to colds and flus as they go around each year, but only if you are taking too much of it (as can be the case when you first start). If you find you are constantly catching something or are extremely tired, it may be time to lower your dosage as the medication may be suppressing your immune system too much.
The more common side effects of Imuran include: bleeding gums, blood in urine and stool, bleeding gums, black stool, swollen glands, mouth sores or ulcers (which is already common with lupus), sore throat, fever and chills, side pain, fatigue, weakness, chest pain and shortness of breath.
Benlysta
Benlysta is a biological treatment — a man-made antibody. It works by reducing certain cells in your immune system that can make lupus active.
The most common side effects in clinical trials were nausea, diarrhea, and fever. Patients also commonly experienced infusion reactions, so treatment with an antihistamine may be needed before each infusion.
Benlysta can cause serious side effects. Some of these side effects are dangerous, like heart problems, infections and mental health issues.
NSAIDs
These are non-steroidal anti-inflammatory drugs that can reduce pain and swelling of the muscle and joints. As long as lupus doesn’t affect the vital organs, NSAIDs can be used. Naproxen, ibuprofen and aspirin are all NSAIDs.
Side effects can be mild, like fluid retention, headache, drowsiness, heartburn and upset stomach. But there are a few increased risks, like serious issues with the kidneys, liver, and stomach bleeding.
Research is ongoing, and as a lupus patient, I try and keep updated about clinical trials and any new medication options or treatment tips that are available.
It is important to do your research before being put on a new medication and that you speak with your doctor about your concerns regarding the side effects before you begin a course of treatment. Sometimes, your doctor may prescribe other medications to counteract or help ease the side effects, making the drug more tolerable.
And although side effects are not fun, sometimes they are necessary in order to have a richer, fuller life, despite lupus.
