Lupus - drug induced
Drug-induced lupus erythematosus is an autoimmune disorder that is triggered by a reaction to a medicine.
Drug-induced lupus erythematosus is similar but not identical to systemic lupus erythematosus (SLE). It is an autoimmune disorder. This means your body attacks healthy tissue by mistake. It is caused by a reaction to a medicine. Related conditions are drug-induced cutaneous lupus and drug-induced ANCA vasculitis.
The most common medicines known to cause drug-induced lupus erythematosus are:
Other less common medicines may also cause the condition. These may include:
Cancer immunotherapy medicines such as pembrolizumab can also cause a variety of autoimmune reactions including drug-induced lupus.
Symptoms of drug-induced lupus tend to occur after taking the drug for at least 3 to 6 months.
Symptoms may include:
The health care provider will do a physical exam and listen to your chest with a stethoscope. The provider may hear a sound called a heart friction rub or pleural friction rub.
A skin exam shows a rash.
Joints may be swollen and tender.
Tests that may be done include:
A chest x-ray may show signs of pleuritis or pericarditis (inflammation of the lining of the lung or heart). An ECG may show that the heart is affected.
Most of the time, symptoms go away within weeks after stopping the medicine that caused the condition.
Treatment may include:
If the condition is affecting your heart, kidney, or nervous system, you may be prescribed high doses of corticosteroids (prednisone, methylprednisolone) and immune system suppressants (azathioprine or cyclophosphamide). This is rare.
When the disease is active, you should wear protective clothing and sunglasses to guard against too much sun.
Most of the time, drug-induced lupus erythematosus is not as severe as SLE. The symptoms often go away within a few days to weeks after stopping the medicine you were taking. Rarely, kidney inflammation (nephritis) can develop with drug-induced lupus caused by TNF inhibitors or with ANCA vasculitis due to hydralazine or levamisole. Nephritis may require treatment with prednisone and immunosuppressive medicines.
Avoid taking the medicine that caused the reaction in future. Symptoms are likely to return if you do so.
Complications may include:
Contact your provider if:
Watch for signs of a reaction if you are taking any of the medicines that can cause this problem.
Bergqvist C, Ingen-Housz-Oro S, Chosidow O. Drug reactions. In: Bolognia JL, Schaffer JV, Cerroni L, eds. Dermatology. 5th ed. Philadelphia, PA: Elsevier; 2025:chap 21.
Crow MK. Etiology and pathogenesis of systemic lupus erythematosus. In: Firestein GS, McInnes IB, Koretzky GA, Mikuls TR, Neogi T, O'Dell JR, eds. Firestein & Kelley's Textbook of Rheumatology. 12th ed. Philadelphia, PA: Elsevier; 2025:chap 80.
Richardson B. Drug-induced lupus. In: Hochberg MC, Gravallese EM, Smolen JS, van der Heijde D, Weinblatt ME, Weisman MH, eds. Rheumatology. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 140.
BACK TO TOPReview Date: 4/1/2025
Reviewed By: Diane M. Horowitz, MD, Rheumatology and Internal Medicine, Northwell Health, Great Neck, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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