Treatment
Table 1. Medications to CONTINUE Through Surgery
DMARDs: CONTINUE
these medications
through surgery
(all patients) Dosing Interval
Recommended timing
of surgery since last
medication dose
Methotrexate Weekly Anytime
Sulfasalazine Once or twice daily Anytime
Hydroxychloroquine Once or twice daily Anytime
Leflunomide (Arava) Daily Anytime
Doxycycline Daily Anytime
Apremilast (Otezla) Twice daily Anytime
SEVERE SLE-SPECIFIC
MEDICATIONS:*
CONTINUE these
medications in the
perioperative period in
consultation with the
treating rheumatologist Dosing Interval
Recommended timing
of surgery since last
medication dose
Mycophenolate mofetil Twice daily Anytime
Azathioprine Daily or twice daily Anytime
Cyclosporine Twice daily Anytime
Tacrolimus Twice daily (IV and PO) Anytime
Rituximab (Rituxan) IV Every 4-6 months Month 4–6
Belimumab (Benlysta) Weekly SQ Anytime
Belimumab (Benlysta) Monthly IV Week 4
Anifrolumab (Saphnelo)
†
IV Every 4 weeks Week 4
Voclosporin (Lupkynis)
†
Twice daily Continue
Bold indicates recommendation that has changed since 2017.
* Severe SLE indicates organ threatening disease.
†
Drug added for 2022 update.
