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DILE Drug induced Lupus Erythematosis

3924 Views 41 Replies 27 Participants Last post by  paperbagprincessNZ
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and from the Postgrad Medicine site

Drug-induced lupus
In 1945, the first lupuslike reaction to a medication was reported with sulfasalazine (Azulfidine). Since then, 70 drugs have been implicated as causing or exacerbating SLE. Many of these are listed in table 2. Drug-induced lupus is most frequent in older patients. Men and women are equally at risk. The most common symptoms are fever, fatigue, arthralgia, and serositis.

Table 2. Medications that may cause drug-induced lupus?
Atenolol (Tenormin)
Captopril (Capoten)
Chlorpromazine HCl (Thorazine)
Clonidine HCl (Catapres)
Danazol (Danocrine)
Diclofenac (Cataflam, Voltaren)
Disopyramide (Norpace)
Ethosuximide (Zarontin)
Gold compounds
Hydralazine HCl (Apresoline)
Interferon alfa
Isoniazid (Laniazid, Nydrazid)
Labetalol HCl (Normodyne, Trandate)
Leuprolide acetate (Lupron)
Levodopa (Dopar, Larodopa)
Lithium carbonate
Lovastatin (Mevacor)
Mephenytoin (Mesantoin)
Methyldopa (Aldomet)
Methysergide maleate (Sansert)
Minoxidil (Loniten, Rogaine)
Nalidixic acid (NegGram)
Nitrofurantoin (Furadantin, Macrobid, Macrodantin)
Oral contraceptives
Penicillamine (Cuprimine, Depen)
Phenelzine sulfate (Nardil)
Phenytoin sodium (Dilantin)
Prazosin (Minipress)
Primidone (Mysoline)
Procainamide HCl (Procan, Pronestyl)
Promethazine HCl (Anergan, Phenergan)
Spironolactone (Aldactone)
Streptomycin sulfate
Sulindac (Clinoril)
Sulfasalazine (Azulfidine)
Thioridazine HCl (Mellaril)
Timolol maleate (Betimol, Timoptic)
Tolazamide (Tolinase)
Tolmetin sodium (Tolectin)
Trimethadione (Tridione) [/b][/quote]

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Hi Sue,

Yes interesting its on the list of meds known to cause drug induced lupus. Until you mentioned it I didnt notice it there. Many lupies are allergic to it though. But this list is for things known to cause a lupus like soon as the drug is withdrawn the symptoms should subside.

Since my teens I've had a deathly allergy to it, I go into anaphalactic shock, only here because of a timely intervention :eek: and a nice needle the doc gave me to bring me back :) I'm sure I had it as a child and didnt react like that though. Interesting!

Hi Raeann,

In some Lupies Ibuprofen can make their symptoms worse (I'm one) , BUT its such an individual thing. It is however something to be aware of which is why I post these articles and references, just to keep us aware of the possibilities. I'd hate someone to be suffering from a drug induced problem when an alternative med may provide the same relief but with less side effects and problems.


No its not on the list, I'm on it and I love the stuff :hehe:

Not to my knowledge
Hi Brenda,

It is on that Post Grad site referred to as being one of the possible drugs that could cause a drug induced lupus (althought its not in the list of the ones most likely to cause a problem) . The fact its on that list doesnt mean it will do that with everyone and we have discussed this in the past:

If you are on it and you havent had any problems then I wouldnt be concerned. There are lots of NSAIDS available to us and if one doesnt suit then there are other choices.

The very nature of drug induced lupus means that once the drug is withdrawn then they symptoms should go and the ANA return to normal. Its very different to someone who already has lupus and has trouble tolerating a certain med - like me with Ibuprofen for example. If I take it it makes my symptoms worse, but I have Lupus anyway, so its not classed as a drug induced lupus.

The reason I posted this thread was that many people come in here with a few symptoms and think they have Lupus, their docs have failed to realise that it may actually be a drug induced lupus, rather than the 'real thing' and for them the fix is easy. Withdraw the drug.

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Hi Brenda,

This article outlines the major differences in SLE and drug induced lupus erythematosis (DILE).

It's hard to pick it but I am sure your doctor would have considered it as a possibility and investigated thoroughly whilst diagnosing you.

Either way, if you need that drug what is the alternative really???.................same with things like Atenenol...............people with heart conditions would probably die without it, so not taking it is not an option :eek: They treat DILE the same way they treat SLE if the patient cannot be taken off the drug causing it.

Of particular interest to me in the article is the fact they mention birth control pills!! but the thing that must be remembered here is that when they talk about DILE they mean in a patient who had NO signs of lupus prior to taking the drug and its obvious the drug brought it on. It's not the same as someone who had some inkling of problems prior to taking it anyway and this maybe just brought it out of hiding.

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