What Is Lupus Treatment?

Written by Alicia Racelis, PhD, Camille Peri
Medically Reviewed by Shruthi N, MD on October 12, 2025
9 min read

Your doctor may use antimalarial, immunosuppressive, and biologic medications to treat systemic lupus erythematosus (SLE), simply called lupus. With lupus, your immune system mistakes your healthy tissue as an invader, becomes overactive and attacks. So, your doctor uses many medications to lower inflammation and calm your immune system.

You and your doctor will make a lupus treatment plan tailored to your needs, typically combining many kinds of meds that may include:

  • Acthar gel
  • Anti-inflammatory medicines
  • Biologics (from man-made, complex proteins called antibodies)
  • Blood thinners
  • Immunosuppressive medications
  • Medications that also treat malaria (antimalarial)

Some of your medications also help lower your chances of getting flares — when inflammation rises and lupus symptoms worsen. Sticking to your lupus treatment plan can help you prevent life-threatening organ damage.

Talk with your doctor to weigh the risks of side effects against how well each medication can ease your lupus symptoms.

Many lupus treatments help lower inflammation in your body, but a few can also ease pain.

Steroids

Steroids lower the number of overactive immune cells that attack your healthy cells. Lowering inflammation can help you feel better. 

Also called corticosteroids and glucocorticoids, your doctor will likely prescribe a steroid called prednisone as a pill. Steroids can help:

  • Ease lupus flare-ups
  • Lower inflammation
  • Prevent long-term organ damage

If you have liver disease, your doctor may give you prednisolone or methylprednisolone (Medrol).

Steroid side effects

Steroids can come with unwanted effects, such as:

  • Weight gain and bloating
  • Hair thinning
  • Acne, bruising, and stretch marks on your skin
  • Mood swings
  • Problems sleeping

Your doctor will probably give you the lowest dose they can and gradually lower it (taper it off) if your symptoms go away for a time. But if you're taking steroids for a long time or at a higher dose, you can get:

  • Higher chance of infections
  • Fragile bones or bone damage, especially in your hips
  • Heart disease
  • Cataracts
  • Muscle weakness
  • Diabetes

Nonsteroidal anti-inflammatory drugs (NSAIDs)

If you have lupus, NSAIDs can help lower swelling throughout your body. NSAIDs can soothe inflammation, ease joint pain, and lower your fever.

Over-the-counter anti-inflammatory medications include:

  • Aspirin
  • Ibuprofen
  • Naproxen

Your doctor may also prescribe:

  • Celecoxib (Celebrex)
  • Indomethacin (Indocin)
  • Nabumetone (Relafen)

Anti-inflammatory side effects

Because anti-inflammatory medicine can irritate your stomach, try to take them with food or milk. Taking NSAIDs regularly can cause stomach ulcers and kidney problems.

Your doctor may suggest using omeprazole (Prilosec), lansoprazole (Prevacid), or TUMS to help with stomach troubles. But if you have kidney disease, talk with your doctor about other options.

Repository corticotropin

H.P. Acthar Gel is a type of medicine that helps your body make a steroid hormone called cortisol to fight inflammation.

Acthar Gel side effects

Acthar Gel mimics a hormone in your body that raises your cortisol, so you may get side effects such as:

  • Swelling
  • Changes in blood pressure
  • Glucose tolerance
  • Mood changes
  • Stronger appetite
  • Weight gain

Hydrochloroquine (Plaquenil) treats malaria but can also help slow down your immune response. This medicine helps lower autoantibodies — overactive immune proteins that attack your healthy tissues and organs. Your doctor will likely suggest hydroxychloroquine to help with your:

Studies also show that hydroxychloroquine may help you live longer with lupus, too. If hydrochloroquine doesn't work for you, your doctor may suggest chloroquine (Aralen). 

Hydroxychloroquine side effects

Although many people don't notice any side effects, some get stomach and eye problems.

Stomach upset. You may have digestive problems, such as diarrhea and nausea. But after your body gets used to the medicine, these side effects usually go away.

Eye problems.Rarely, higher doses of hydroxychloroquine can build up over time. The medicine can be toxic to your eyes, raising your risk for vision loss. But yearly eye exams can help your eye doctor detect any changes early and prevent vision loss.

Medications that lower your immune cell activity can suppress an overactive immune system. Also known as disease-modifying antirheumatic drugs (DMARDs), these immunosuppressive medicines can:

  • Slow down your immune system 
  • Bring symptoms under control
  • Prevent long-term organ damage

Voclosporin (Lupkynis) is the only FDA-approved DMARD to treat lupus in your kidneys (nephritis).

But your doctor may use other medicines that are approved to treat other conditions, even though they aren't approved for lupus, such as:

  • Azathioprine (Imuran) 
  • Cyclophosphamide 
  • Methotrexate (Rheumatrex)
  • Mycophenolate mofetil (CellCept)

Side effects of immunosuppressives

Medications that lower your immune system activity can have serious side effects because they make it harder for your body to fight off infections. With a weaker immune system, you can have a higher risk for some types of cancer.

Here are a few common side effects:

  • Skin rashes
  • Sun sensitivity
  • Lower blood cell counts
  • Nausea, vomiting, upset stomach, and diarrhea
  • Headaches
  • Infections
  • Mouth sores
  • Tremors

You can also get hair loss with cyclophosphamide, but it usually grows back after you stop taking it. Rarely, immunosuppressive medicines can raise your risk for serious side effects such as:

  • Pancreatitis, serious allergic reactions, or a form of hepatitis (azathioprine)
  • Bladder or infertility problems (cyclophosphamide)
  • Liver damage (methotrexate, but your doctor will suggest taking folic acid to help prevent complications)
  • Higher risk for lymphoma and skin cancer
  • Kidney problems from higher potassium levels (voclosporin)

Biologic medicines are man-made antibodies that attach to certain immune cells in your body to lower and calm your overactive immunity. There are two biologics approved to treat lupus:

If you have lupus nephritis, inflammation in your kidneys, obinutuzumab (Gazyva) is an approved treatment. It's a monoclonal antibody that destroys B cells and blocks a protein called calcineurin that normally turns on your overactive T cells.  This can help calm your immune response to prevent the damage to your kidneys. You'll get Gazyva as an intravenous infusion (IV in your vein) at a local clinic or your doctor's office. 

You may also receive an off-label biologic and its biosimilar generic forms:

  • Rituximab (Rituxan): Used to lower inflammation in your blood vessels
  • Rituximab-arrx (Riabni)
  • Rituximab-pvvr (Ruxience)
  • Rituximab-abbs (Truxima)

It's still unclear how well rituximab works for lupus, but some doctors still use it sometimes. Your doctor may also combine different medicines to help you take a lower amount of each medicine, which can lower your risk for side effects. 

Side effects of biologics

Biologics can also cause side effects such as:

  • Redness at the injection site
  • Headache
  • Nausea and diarrhea
  • Hives
  • Fever
  • Muscle aches
  • Trouble sleeping
  • Infections such as colds, urinary tract infections (UTIs), and bronchitis

Sometimes, you can get blood pressure changes, but these effects usually go away over time.

Many biologic medicines lower your overall immunity and can raise your risk for serious side effects, such as:

  • Lymphoma
  • Skin cancer
  • Lower immune response to vaccines
  • Reactivate older infections like hepatitis B
  • Shingles

Rituximab can sometimes cause your body to make extra chemicals called cytokines, leading to a syndrome that causes:

  • Serious wheezing
  • Low blood pressure
  • Swelling
  • Heart rhythm problems (arrhythmia)

Belimumab can cause you to feel down or have thoughts of self-harm, especially if you already have depression.

If you or a loved one is taking belimumab and has thought of self-harm or suicide, get medical help right away. You can call the Suicide and Crisis Lifeline at 988 to talk to a certified counselor any time of the day or night.

Your doctor may also prescribe a medicine to thin your blood, an anticoagulant. Blood thinners help prevent blood clots, a life-threatening lupus symptom. Some common ones include:

  • Heparin injections (Calciparine or Liquaemin) 
  • Warfarin pills (Coumadin)
  • Low-dose aspirin

Side effects of anticoagulants

The most common side effect of anticoagulants is mild bleeding, such as nosebleeds, extra bruising, or heavier periods. 

Get medical help right away if you get more serious side effects of bleeding, such as:

  • Blood in your pee
  • Blood in your bowel movement (dark black or tarry)
  • Blood in your vomit or cough
  • Trouble breathing or chest pain
  • Sudden, serious back pain

Complimentary medicine can sometimes help ease your pain when used alongside your lupus medication. Some people stick to their treatment plan and also manage symptoms with alternative options such as:

  • Acupuncture
  • Biofeedback
  • Cannabis and cannabidiol (CBD)
  • Chiropractic treatments
  • Homeopathy 
  • Massage
  • Meditation
  • Naturopathy

These alternatives may not help relieve lupus pain on their own. But research shows that when used alongside medical treatment, therapies such as acupuncture, meditation, and biofeedback can help ease lupus pain and stress.

Some people may also try herbs and other supplements. But some studies report that supplements may worsen your lupus symptoms. Talk to your doctor before trying any alternative or complementary treatments for lupus. They can help you decide what's best for your specific situation.

Some healthy lifestyle habits can help you lower your risk for lupus flares and prevent lupus from causing:

Protect your skin

Lupus can make your skin more sensitive to ultraviolet (UV) light — a condition called photosensitivity. So avoid these:

  • Direct sunlight
  • Reflected sunlight
  • Any source of UV light, such as fluorescent or halogen lights

Keep your skin covered or wear a sunscreen with SPF 55 or more to block both UVA and UVB light. Talk to your doctor about certain medications that can worsen your photosensitivity.

Get your shots

Keep up with your immunizations to help protect yourself against infections such as:

  • Pneumonia
  • Influenza (flu) 
  • Hepatitis B
  • Human papillomavirus (HPV)
  • COVID-19

Get up to date before starting lupus medicines that can weaken your immune system. This can help lower your risk of getting sick.

Healthy habits

Certain lifestyle habits can help keep your body working its best. These habits can also help lower your chances of flares, too.

You can try to:

  • Eat a well-balanced diet.
  • Eat foods rich in vitamin D, such as fatty fish and low-fat dairy.
  • Quit smoking (or don't start) to protect your heart and blood vessels.
  • Get plenty of rest to ease fatigue, a common lupus symptom.
  • Exercise most days to help sleep, mood, and heart health, such as tai chi, yoga, or Pilates.

Follow up with your doctor

Going for regular checkups with your doctor can help you get the best care for your lupus. Your doctor can run tests and track your progress. They'll also screen you for related health conditions such as:

  • Osteoporosis to prevent bone fractures
  • Coronary artery disease to prevent heart problems
  • Cancer, because many lupus medications raise your risk

If a medicine isn't working, your doctor can suggest a new one. If your symptoms are new, aren't going away, or getting worse, tell your doctor. With your lupus treatment plan, you and your doctor can work together so you can live fully with lupus.

Systemic lupus erythematosus (SLE) happens when your overactive immune system attacks your own tissues and organs. But antimalarial, immunosuppressive, and biologic medications can calm your immune response, lower inflammation, and slow organ damage. Talk to your doctor about the best type of lupus treatment for your condition.

Is lupus curable or treatable?

Although lupus isn't curable, antimalarial, immunosuppressive, and biologic medications can help prevent your immune system from causing long-term organ damage. They can also help you reach remission or lower the lupus activity in your body. And this can help you feel better.

Can Tylenol help my lupus?

Acetaminophen (Tylenol) might be a great option to help you lower your fever and pain, but it can’t treat your lupus. That’s because Tylenol can't lower inflammation, nor can it calm your immune response. Talk to your doctor about the best combination of medicines to treat your lupus.

Can you manage lupus symptoms without medication?

No. But there are many lupus treatments that help manage your symptoms and prevent serious organ damage. Talk to your doctor about antimalarial, immunosuppressive, and biologic medications to treat your lupus.

What medicines or supplements should I avoid with lupus?

There isn't a specific diet for lupus, but you'll want to talk to your doctor before taking supplements or medications such as:

  • Hydralazine (Apresoline), procainamide (Pronestyl), or quinidine (Quiniglute) are the three most common causes of drug-induced lupus.
  • Echinacea, taking it longer can lower your white blood cell count and interfere with your immunosuppressive medicines.
  • Noni juice contains higher amounts of potassium and may activate your immune system, causing flares.
  • Alfalfa supplements may cause lupus-like syndrome and flares.
  • Vitamin E may lead to heart disease with lupus.
  • Vitamin A and beta-carotene supplements may lower your "good" HDL cholesterol. Talk with your doctor first, especially if you smoke.

What are the daily struggles with lupus?

Lupus is a chronic condition that can affect your whole life, from pain management to your social life. About 65 people with lupus out of 100 say that chronic pain is one of the hardest things to manage each day. And 76 people with lupus out of 100 say that fatigue caused them to skip social events. 

But getting support and talking to others about lupus can help. Ask your doctor about local groups or visit the Lupus Foundation.