There are medicines to help you get better and keep you well. The treatment is aimed at reducing inflammation in your body and avoiding a flare of your lupus. The treatment you have will change from time to time. This will depend on how lupus is affecting your body. It is very important that you take your prescribed medication regularly. Sometimes you may not need any medicines.

There are lots of medications, which can help in lupus. Your doctor and nurse will explain which ones can help you. They will explain the drugs to you and give you much more detailed written information to take away.

Here are some of the drugs that may be used:

Prednisolone - this is the most effective drug for controlling lupus initially. It is a steroid but is not the same kind of steroid drug that some body builders take. This drug works to decrease the inflammation caused by your lupus. Taking prednisolone is a bit like pouring water on hot fire to put it out. It is very good at putting the fire out and "dampening down" inflammation in the body but when you stop putting water on it, there is a risk the fire may come back and "flare-up" again. Steroids are therefore usually used with the other medicines discussed below, to reduce the on-going need for more and more steroids.

This is important because steroids can have side effects, which relate to the dose you take, and how long you take them for. When you are diagnosed you will probably have to take higher doses of predisolone. As your lupus improves your dose will be lowered gradually and any side effects you've have will reduce. Some side effects you may notice are:

In the long term you may develop side effects that you can't see such as:

• Weaker bones

• High blood pressure

• Increased risk of infection

• Cataracts - this is a cloudy area, which develops in the front of the eye. This type of cataract is different to the cataracts older people get, and they usually do not affect vision.

After reading about these side effects you may feel anxious about prednisolone. However it is the best drug initially for treating your lupus. Doctors would not prescribe it if they could treat your illness in another way. They will always use the lowest dose possible to get you better. Side effects will go away as your dose is lowered, but it is important to wait until your doctor suggests reducing your dose.

Prednisolone is similar to chemicals naturally produced by your body. Treatment with prednisolone fools the body into shutting off its own steroid production. These chemicals are vital to regulate normal daily body function. Therefore never stop your prednisolone abruptly or you may become extremely sick. Stopping your prednisolone quickly is also likely to cause a lupus flare. Your doctor will reduce your prednisolone gradually guided by your symptoms and blood test results.

Methyl Prednisolone - this drug is similar to prednisolone except it is given into a vein in your arm. It is often given in the early stages of your lupus when it is quite active or may be given later if your lupus flares.

Hydroxychloroquine - this is a drug that most patients with lupus will be on for many years, alongside other treatments. It has been used for treating lupus patients since the 1960s. It helps treat the rash in lupus and prevent flares when the prednisolone dose is being reduced. It has relatively few side effects. It is possible that hydroxychloroquine may affect your eyes, however, at the dosages that most clinics use, this has not been demonstrated to be a problem. Your doctor will therefore refer you to have your eyes checked every few years by an eye specialist (ophthalmologist). In mild lupus (e.g. skin involvement only) you may only be on hydroxychloroquine.

Azathioprine - this drug helps reduce inflammation in major organs such as the kidney. It may also reduce the need for high doses of prednisolone. It works by suppressing the immune system and therefore you need to have regular blood checks.

Mycophenolate Mofetil (MMF) - this drug can also be used to treat inflammation in major organs (e.g. kidney, blood, brain), similar to azathioprine.

Methotrexate - this drug reduces inflammation by acting directly on the immune system. It can affect both the white blood cells, which fight infection, and also the liver enzymes, so regular blood tests are needed. Methotrexate is most commonly used for arthritis and skin involvement.

Cyclophosphamide - this is a powerful immunosuppressive drug that helps to rapidly decrease the activity of the immune cells causing inflammation. Cyclophosphamide may be given once a month, as part of a course of treatment, through a drip into a view, and may require a brief overnight stay in hospital.

Rituximab - this is an immunosuppressant drug used in severe disease and only when you have tried other drugs. It is given in hospital through a drip into a vein in your arm. Two doses of rituximab are given two weeks apart and may not need to be repeated.

Belimumab - this is not currently available for use in children although clinical trials are ongoing. For further information about this treatment in adults, refer to our factsheet LUPUS and Medication.

Steroid Drug Card - you will be given a card to carry with you telling doctors you are on steroids and other medicines, which affect your immune system. In the event of an accident, medical staff need to know which medicines you are taking.