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What is Drug-Induced Lupus?

Drug-induced lupus erythematosus is a condition that causes symptoms similar to Lupus Erythematosus which is caused by side effects from long term use of specific drugs. This long term used of the drugs does not cause Lupus Erythematosus just the same symptoms. The good news is that when you stop taking the drug causing the symptoms they disappear.

  • Muscle and joint pain and swelling
  • Flu-like symptoms of fatigue and fever
  • Serositis (inflammation around the lungs or heart that causes pain or discomfort)
  • Certain laboratory test abnormalities.

Once the suspected medication is stopped, symptoms should decline within days. Usually symptoms disappear within one or two weeks. Drug-induced lupus can be diagnosed with certainty only by resolution of symptoms and their failure to recur after stopping the medication.

What types drugs can drug-induced lupus?

There are drugs used in treating drug-induced lupus that can cause this condition.

  • Heart disease
  • Thyroid disease
  • Hypertension
  • Neuropsychiatric disorders
  • Certain anti-inflammatory agents and antibiotics.

The vast majorette of cases can be attributed to these three drugs.

  • procainamide (Pronestyl)
  • hydralazine (Apresoline)
  • quinidine (Quinaglute).

At the bottom of the page is a diagram showing the different drugs known to cause this condition. Other than the drugs listed above there is a very small chance that they will cause these symptoms. Some have only a couple of documented cases.

What is the risk if you are taking one of these drugs.

The symptoms only take place after using a particular drug only begins after being on the drug for a few months up to a few years.

The risk of the three drugs listed above are only 5-20 percent chance of developing symptoms.

With the  rest of the drugs the risk is less than 1 percent.

What are the symptoms of drug-induced lupus?

  • joint pain
  • muscle pain
  • blurred vision
  • skin rash
  • fever
  • arthritis
  • inflammation of the heart and lung
  • loss of appetite

What tests are used to diagnose Drug-induced lupus

  • Antihistone antibody
  • Antinuclear antibody test
  • Chest x-ray may show signs of pinflammation in the lungs
  • ECG to see if the heart is affected.

Treatment of Drug-induced lupus

Treatment is simple you will have to stop taking the drugs.

Sometimes there are lingering symptoms such as inflammation of joints or skin rash. If this happens then the doctor will treat these symptoms independently.

Drugs that can cause Lupus Erythematosus

Agent

Risk

 

Agent

Risk

Antiarrhythmics

   

Antithyroidals

 

Procainamide (Pronestyl)

high

 

Propylthiouracil (Propyl-thyracil)

low

Quinidine (Quinaglute)

moderate

     

Disopyramide (Norpace)

very low

     

Propafenone (Rythmol)

very low

     
     

Antibiotics

 

Antihypertensives

    Isoniazid (INH) low

Hydralazine (Apresoline)

high

 

Nitrofurantoin (Macrodantin)

very low

Methyldopa (Aldomet)

low

 

Minocycline (Minocin)

low

Captopril (Capoten)

low

     

Acebutolol (Sectral)

low

     

Enalapril (Vasotec)

very low

 

Anti-Inflammatories

 

Clonidine (Catapres)

very low

 

D-Penicillamine (Cuprimine)

low

Atenolol (Tenormin)

very low

 

Sulfasalazine (Azulfidine)

low

Labetalol (Normodyne, Trandate)

very low

 

Phenylbutazone (Butazolidin)

very low

Pindolol (Visken)

very low

     

Minoxidil (Loniten)

very low

 

Diuretics

 

Prazosin (Minipress)

very low

 

Chlorthalidone (Hygroton)

very low

     

Hydrochlorothiazide (Diuchlor h)

very low

Agent

Risk

 

Agent

Risk

Antipsychotics

   

Miscellaneous

 

Chlorpromazine (Thorazine)

low

 

Lovastatin (Mevacor)

very low

Perphenazine (Trilafon)

very low

 

Levodopa (Dopar)

very low

Phenelzine (Nardil)

very low

 

Aminoglutethimide (Cytadren)

very low

Chlorprothixene (Taractan)

very low

 

Alpha-interferon (Wellferon)

very low

Lithium carbonate (Eskalith)

very low

 

Timolol eye drops (Timoptic)

very low

         

Anticonvulsants

       

Phenytoin (Dilantin)

very low

     

Carbamazepine (Tegretol)

low

     

Trimethadione (Tridone)

very low

     

Primidone (Mysoline)

very low

     

Ethosuximide (Zarontin)

very low

     
         

Diragram from Drug-Induced Lupus Erythematosus
Robert L. Rubin, Ph.D.


edited 9-9-2103

Discoid lupus erythematosus picture

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