about the meds..need help please

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Date Joined Dec 2015
Total Posts : 3
   Posted 12/19/2015 11:37 PM (GMT -6)   
hello to all wonderfull ppls here,me hreeya from bangladesh.diagnosised with lupus nephritis class 4, feb 2015. started taking medicines steroid,cellcept,3 high power meds for my high blood pressure and also taking vit d3 and calcium tabs sometimes. my nephrologist suggested me these drugs and I was okay with that.suddenly I discovered blurry eyes (I use high lens glasses cz I hv eye prob from my childhood) then I consulted my eye dr and he said its firth stage of cataract. I cant explain how felt n still feeling.he told me to stop steroids but my nephrologist told me she can't stop it.then I consulted a rhemutologist and he told me to do a utp(protein in urine) test and he also suggested me to take plaquenil and he surprised by seeing that my nephrologist didn't suggest me plaquenil..I went to see my nephrologist to discuss abt that but she was out of town n will be back after 23rd dcm...can u ppl suggest me what to do?? my rhemu also told me that I should take cellcept (mycophenolate mofetil) in empty stomach which my nephrologish suggest to take in full stomach... smhair shakehead

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Date Joined May 2005
Total Posts : 7723
   Posted 12/20/2015 8:34 AM (GMT -6)   
Generally we are started with Plaquenil and Prednisone (cortiosteroid). Then either Imuran, Cellcept, or MTX is added if we don't start seeing improvement. I suspect with nephritis they move faster to add Cellcept, so you being given that is not at all unusual.

I haven't heard of an eye Dr wanting to stop steroid -- as far as I know there aren't side effects on your eyes from steroid. (But we aren't Drs!)

I, like your rheumy, would have thought you'd be put on Plaquenil. However, you do need a field of vision test every year if you are put on Plaquenil - it is rare to have eye effects, they are reversible if they happen, but they do need to be watched for.

Cellcept manufacturers suggest taking Cellcept on an empty stomach. "Take CellCept capsules, tablets and oral suspension on an empty stomach, either 1 hour before or 2 hours after a meal, unless your healthcare provider tells you otherwise. However, I took it with food and got a full remission from my Lupus. I don't know what results other people have gotten.

In general, we aren't Drs, so can't really advise you very well when you are getting conflicting advise from you Drs. I guess you just have to try to get them to agree?
Lynnwood, Lupus & Sjogren's Moderator, Dx: 2002
"Life is far too important to be taken seriously." - Oscar Wilde

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Date Joined Jun 2006
Total Posts : 1650
   Posted 12/20/2015 11:33 AM (GMT -6)   
Welcome to our forum Hreeya! I'm so sorry you have class 4 nephritis. I have the fifth edition "The Lupus Book" by Dr. Daniel Wallace, one of the leading experts on lupus. He states, Class 4 nephritis is reversible some of the time with aggressive therapy. High doses of corticosteroids (steroids) with immunosuppressives such as Cellcept can prolong kidney function and prevent the need for dialysis. So your nephrologist is right that to save your kidneys you need to be on high doses of steroids and Cellcept. Also high blood pressure is very bad for the kidneys so along with the meds make sure you eat less salt.

I agree with Lynnwood that you need to be on plaquenil. It has few side-effects and is very good for lupus. As for the cataracts, Dr. Wallace says steroids can cause cataracts. If I were you, I would not stop the steroids because I would be afraid that with class 4 nephritis my kidneys would fail without the steroids. It's easy to remove cataracts with surgery, but hard to get a kidney transplant. I know some of what I've said might be hard for you to understand, so if you have any questions, please ask OK? I really hope your kidneys improve, your high blood pressure gets better, and you get well soon. Let us know how you're doing. Love, Butterflake
SLE '05, Sjogrens, fibro, Raynaud's, major depressive disorder, CNS problems, GERD, angina, 1st stage kidney disease. Many meds: better living through chemistry

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Date Joined Jun 2008
Total Posts : 1470
   Posted 12/20/2015 2:29 PM (GMT -6)   
I would advise staying on steroids to save your kidneys. I haven't heard of many causes of eye issues from it but I am not a doctor. Yes, cellcept is a great drug but needs to be taken either on an empty stomach or a full stomach...don't do both. I had stomach issues with it so I was told to take it after breakfast and after dinner. I would honestly go by what your nephrologist says...they deal with kidney issues all the time and know what has best chances of working. I would also ask your doctors to communicate with each other so they aren't all telling you something different!
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