View Full Version : No Prednisone
12-04-2008, 10:05 AM
What are the advantages/consequences of using Imuran and Plaquenil and not using prednisone. I am in the learning stage for these decisions, and appreciate all information.
12-04-2008, 09:17 PM
Azathioprine (Imuran) can be used alone, but is often administered in combination with prednisone. When used with prednisone, Imuran often allows a lower total dose of prednisone to be administered. Prednisone is a corticosteroid that helps regulate the immune system that has become over-active due to the disease process of Lupus.
Prednisone should not be stopped with the addition of Imuran to the treatment. Prednisone dose should remain the same until there is improvement shown after beginning the Imuran. Then the prednisone should be tapered slowly at one to five milligrams a week to avoid serious
Prednisone is a synthetic hormone commonly referred to as a "cortisteroid." Prednisone is very similar to the hormone cortisone, which the body manufactures. In part, prednisone acts as an immunosuppressant. The immune system protects against foreign bacteria and viruses. In some illnesses (such as Lupus), the immune system produces antibodies, which become overactive and cause many symptoms, some can be quite serious symptoms. Prednisone suppresses the production of these antibodies. Prednisone is the drug of choice in treating auto-immune disease, such as Lupus. Especially for patients who do not improve or are not expected to respond to NSAIDs or antimalarials (such as Plaquenil), or those who have organ threatening disease.
Plaquenil is not an immunosuppressant drug and will do very little to suppress the production of harmful antibodies in Lupus. However it is thought to help immunosuppressant drugs to do this and Plaquenil may slow down the substances which harm the joints. Hydroxychloroquine is thought to act by interfering with the production and release of blood cells that are involved in the body's immune defense system. Hence the autoimmune response of the antibodies against its own body, is reduced and as result the amount of damage to the cells is minimized and prevented. As it has the potential to prevent progression of the disease, by limiting the damage caused, it is often referred to as a disease-modifying antirheumatic drug (DMARDS) and is commonly used very early in the treatment of Lupus.
Hopefully this information will help you to make an informed decision about your treatment regimen. I wish you the very best.
Peace and Blessings
12-05-2008, 05:29 AM
Again, thanks for the very detailed and helpful information. I read somewhere on this forum (can't find it again) where one member was taking only Imuran and Plaquenil because of the "dreadful" effects of Prednisone. What I gained from your response is that Imuran and Prednisone work together and often result in a lower dosage of Prednisone. Also, if organ involvement is present, then prednisone is apparently crucial. Unfortunately, I get the impression that keeping Prednisone less that 10 mg a day usually does not provide enough relief. How unfortunate.
Because of vision and confusion issues, my rd has suspended Plaquenil until I get further test results. She is checking my enzymes to see if I can even process Plaquenil. I also have to get some neurological follow-ups.
I have so much to learn even though I have been fighting this for years.....without a diagnosis.
I wish you a great day,
12-07-2008, 10:01 PM
If you are unable to tolerate Plaquenil, there are other anti-malarial drugs, such as chloroquine and Atabrine. I do not know how well these have worked for Lupus symptoms, but you could ask your doctor about them anyway. Also, Intravenous immunoglobulin (IVIg) is a substance that has the ability to regulate lupus activity. IVIg has also been reported to be an effective treatment for arthritis, thrombocytopenia and the neuropsychiatric mainifestations of lupus.
There is also a new drug, known as DHEA (which is short for the tongue-twister dehydroepiandrosterone) is a drug that has been around for quite some time. It is a nutritional product that's widely available and it has been promoted as a miracle drug that can supposedly stop the ravages of aging, prevent cancer and heart disease, improve dispositions, increase energy, melt fat, refresh memory and jump-start a lagging sex drive. While DHEA is modestly effective in some of these areas, the jury is still out on most of these extravagant claims.
However, there is some evidence that DHEA may ease certain lupus symptoms and reduce the need for other medication among patients who have lupus that affects only their skin and joints.
But, please bear in mind that, despite this good news - no one should rush to self-medicate with off-the-shelf DHEA supplements. Unsupervised use of any steroid hormone is dangerous and this is a drug that can have far-reaching effects!
Perhaps, however, you can discuss some of these options with your doctor at your next visit.
I wish you the very best.
Peace and Blessings
12-08-2008, 07:07 AM
Thanks for the DHEA info. I will mention to dr. as well as other anti-malarial drugs. I agree, we must keep our dr. in the loop, and never try self-medications without their input.
12-08-2008, 10:10 AM
Let us know what you and your doctor decide :lol:
Peace and Blessings