Treatment depends upon an individual assessment of risks and benefits. Most immunosuppressive medications, for instance, may cause significant side effects such as increased risk of infections, nausea, vomiting, hair loss, diarrhea, high blood pressure, and osteoporosis.

  1. Conservative treatment is appropriate for patients with muscle or joint pain, fatigue, skin manifestations (such as rashes), and other features that are not life-threatening.
  2. Conservative options include nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin, Advil) and naproxen (Naprosyn) and anti-malarial medications such as hydroxychloroquine (Plaquenil).
  3. More aggressive therapy is required for life-threatening and more serious manifestations such as kidney inflammation, lung or heart involvement, and central nervous system symptoms.
  4. Treatment in these circumstances might involve high dose corticosteroids such as prednisone (Deltasone) and other immunosuppressive drugs such as azathioprine (Imuran), cyclophosphamide (Cytoxan), and cyclosporine (Neoral, Sandimmune). Recently mycophenolate mofetil (CellCept) has been used to treat severe lupus kidney disease.