Lupus Medications An Introduction to Corticosteroids and Anti-Malarial Drugs Corticosteroids, such as prednisone, methylprednisolone and prednisolone, are often prescribed to treat Systemic Lupus Erythematosus (SLE) (Note: corticosteroids are not to be confused with anabolic steroids, which are popular with weightlifters for building muscle). Cortisone is a steroid manufactured naturally by the body's adrenal glands. It has a distinct anti-inflammatory effect. Synthetic steroids reduce inflammation caused by lu- pus and suppress immune system activity, but they also cause a variety of side effects, some of which can be quite serious. Side effects occur more frequently when high dos- es of steroids are taken over a long period of time. When prescribing steroids, your doctor will choose a dose that minimizes the risk of side effects while keeping lupus symptoms under control. Many short-term side effects are reversible and/or treatable. There are also many preventative measures to reduce the risks of several long-term side effects. Types of Steroids Prednisone is the most popular steroid used in the treatment of lupus. Taken orally, the synthetic corticosteroid preparation comes in 1, 5, 10 and 50 milligram (mg) tablets. It may be taken as often as four times each day or as infrequently as once every other day. Ten mg per day or less is generally considered a low dose; 11 to 40 mg daily is a moderate dose; and 41 to 100 mg daily is a high dose. Other steroids can be applied topically as a cream or injected into the skin for discoid rashes. Some may be injected directly into joints to reduce inflammation. Occasional- ly, very large doses of steroids may be administered for a short period of time intrave- nously (pulse) to achieve results quickly. Your doctor may also prescribe steroids in combination with other medications, such as anti-malarials, non-steroidal anti- inflammatory drugs (NSAIDs) and cytotoxic drugs. Short-term side effects: The lower the dosage of steroids given over a shorter period of time, the less likely a patient will experience severe side effects. Changes in appear- ance and mood are more apparent with high doses. Remember that you are unlikely to experience all of these side effects. Taking medication in the morning may help reduce side effects. Short-term conditions could include the following: • Weight gain caused by an increase of appetite; to manage weight gain, eat a healthy diet and stay active. (Talk to your doctor before beginning any exercise program). • Redistribution of fat cells, causing the appearance of extra weight in the face, abdomen and upper back, and reduced weight in the arms and legs. 52