Table of contents:
- Why can lupus be caused by drug consumption?
- What are the drugs that can cause lupus?
- 1. Antiarrhythmia
- 2. Antihypertensives
- 4. Antibiotics and antimicrobials
- 5. Anticonvulsants
- 6. Anti-inflammatory
- 7. Biological agents
- 8. Diuretic
- 9. Lowering cholesterol
- 10. Others
Lupus or in medical language is called Systemic Lupus Erythematosus (SLE) is one of the autoimmune diseases that most often attacks humans. According to data from the Indonesian Lupus Foundation (YLI) quoted from Republika, the number of Indonesians with lupus in 2013 reached 13,300 people. Until now, it is not clear what causes lupus. However, several factors such as excess body estrogen levels, UV radiation, exposure to mercury, and herpes zoster virus infection can increase your risk of developing this disease. The use of certain drugs is also strongly suspected to be the cause of lupus.
Why can lupus be caused by drug consumption?
Lupus is an autoimmune disease, in which the body overproduces antibodies. In excess amounts, the antibodies that are supposed to protect you from disease actually turn against healthy cells and tissues.
Several prescription drugs can cause lupus. However, the mechanism behind the appearance of drug-induced lupus symptoms is not certain. So far it is known that the side effects of procainamide and anti-TNF drugs for rheumatism drugs often cause an increase in the amount of antinuclear antibody (ANA) in the blood serum. Minocycline, a prescription antibiotic for treating acne, can also trigger lupus symptoms. The prescription medication for thyroid disorders (propylthiouracil) also triggers the symptoms of lupus.
Drug-induced lupus has slightly different symptomatic characteristics from common lupus. Drug-induced lupus symptoms are temporary for as long as you are taking the drugs, and may resolve when treatment is stopped.
What are the drugs that can cause lupus?
The following is a list of drugs that can trigger lupus symptoms during use, based on a compilation from Rubin et al. (2015). However, it should be noted that the risks for each drug to trigger lupus symptoms are not the same - some are high risk (more than 5 events per 100 people taking it), moderate (1 in 100 cases), low (1 in 1000), and very low risk. (<1 in 1000).
1. Antiarrhythmia
These drugs are used to treat symptoms of heart rhythm disorders (arrhythmias), such as tachycardia (fast heartbeat), brachycardia (slow heartbeat), and atrial fibrillation (abnormal heartbeat).
Antiarrhythmic drugs that are classified as high risk of triggering lupus symptoms are procainamide. However, this drug is rarely found in Indonesia. The more common anti-arrhythmic drugs, such as Quinidine, are classified as moderate risk, while propafenone, disopyramide, and amiodarone have a very low risk.
2. Antihypertensives
A number of commonly prescribed drugs to control hypertension such as enalapril, lisinopril, clonidine, atenolol, labetalol, pindolol, minoxidil, prazosin, methyldopa, captopril, and acebutolol are low-risk. Minoxidil is also commonly used as a hair growth drug,
However, hydralizin is classified as an antihypertensive drug that has a high risk of causing lupus. In Indonesia, hydralazine is available in combination with the Ser-Ap-Es brand as tablets with reserpine, hydralazine and hydroclortiazide.
3. Antipsychotics
Some prescription antipsychotic drugs to treat symptoms of psychosis and certain psychiatric disorders, such as chlorpromazine, clozapine, ferphenazine, phenelzine, chlorprothixene, and lithium carbonate can trigger lupus symptoms. However, the antipsychotic class is classified as low risk.
4. Antibiotics and antimicrobials
Antibiotics of the type isoniazid or INH, minocycline, nalidixic acid, streptomycin, sulfamethoxazole, and quinine can also cause lupus if not consumed according to the rules of use. However, the risk is low.
5. Anticonvulsants
Prescription drugs for seizures and epilepsy, such as carbamazepine, clobazam, phenytoin, trimethadione, primidone, ethosuximide, and valproic acid can trigger lupus symptoms during use. But the risk is low.
6. Anti-inflammatory
Anti-inflammatory drugs such as D-penicillamine, sulfasalazine, phenylbutazone, mesalam (z) in, zafirlukast have a low risk of triggering lupus symptoms. Penicillamine is a drug used to treat a variety of ailments, including the antidote for lead poisoning, rheumatism, Wilson's disease, and cystinuria.
7. Biological agents
Anti-TNF alpha, such as infliksimab and etanersept, and interferon alpha are commonly used to treat low-risk rheumatism to trigger lupus.
8. Diuretic
Diuretic drugs such as clortalidone and hydroclortiazide have a very low risk of causing lupus.
9. Lowering cholesterol
Statin-type cholesterol-lowering drugs such as lovastatin, simvastatin, and atorvastatin are low-risk for triggering lupus symptoms.
10. Others
Aminoglutethimide, eye drops timolol, ticlopidine, levadopa, deferipron have low risk of causing lupus.
If you are using any of the above medicines and are concerned about the risk of lupus, consult your doctor further. Your doctor may be able to change the prescription or change the dose according to your condition.
