Generally a rheumy starts with prednisone to control the active inflammation, and plaquenil which inhibits the progression of Lupus.
Azulfidine is most often used to treat Rheumatoid Arthritis. However, here is a post from someone taking it for Lupus www.healingwell.com/community/default.aspx?f=29&m=1295102
But I'm surprised you still have so much fatigue. Rheumies often pick from these: Imuran, Cellcept, MTX - never know which one might respond for a particular patient, so it's trial-n-error till it's figured out. This is in addition to the plaquenil & prednisone. (PS. 5-10 mg is a very LOW dose prednisone, so I'm not surprised your disease is still making you miserable.)
Other things often contributing to our fatgiue - are you getting deep restorative sleep? If you're having trouble getting to sleep or staying asleep you might need some sleep medication. Or often they'll just use a sleep test to figure out the quality of our sleep. Sleep is often hindered while on higher amounts of prednisone.
Also, are you eating well? Lack of appetite/pain sometimes inhibits our eating - we need protein to heal.
If you get some relief from prednisone that means it's likely NOT fibromyalgia.
I believe you should be treated more aggressively for Lupus (or another auto-immune disease.) It takes many of us years for an official diagnosis, but our symptoms are treated as if we have it for long periods of time before dx.
You may want to consider a second opinion from a rheumy who works with Lupus as a main interest. Check www.lupus.org. find local chapter, then find which local rheumies work with them - those are the best bets in your area. Rheumies that only diagnose on bloodwork are old fashioned and/or ill informed, need to check the symptom list!
I remember those days of naps for lunch, I hope you feel better soonest!
Lynnwood, Lupus & Sjogren's ModeratorDIAGNOSING LUPUS & LUPUS RESOURCES
"Life is far too important to be taken seriously" - Oscar Wilde