The hydroxychloroquine (Plaquenil) is generally not increased from 400 mg. Your Dr will probably want to add one of these three; Imuran, Cellcept, or MTX.
I wouldn't let anyone except a Rheumy prescribe meds for Lupus -- they are the ONLY Drs fully trained in auto-immune diseases. Other Drs may think they know auto-immune, but the rheumys are the experts. Plus, your rheumy has a treatment plan in mind for you, and it will be completely thrown off track if another Dr tried to manage your Lupus.
And yes, Lupus has it's own "ebb and flow" even when managed by meds.
Lynnwood, Lupus & Sjogren's Moderator, Dx: 2000DIAGNOSING LUPUS & HW's LUPUS 101
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