Immunosuppressants as the name implies are drugs that suppress the immune system. These medications have proven to be effective in keeping pemphigus vulgaris flare-ups under control. Some common medications for the treatment of pemphigus include Prednisone (a steroid), Mycophenolate (also known as Cellcept) Azathioprine, Methotrexate and Rituximab.
Back in the early days of my disease when I had more flare-ups, my doctor prescribed Mycophenolate to take along with my Prednisone, with the hopes of one day taking me off of the Prednisone. After a year or so I had to discontinue using Mycophenolate because of all the weird side effects it gave me. Thankfully around this time I had begun to notice that there was a direct correlation between certain foods that I ate and my flare-ups. When I avoided those foods I had less flare-ups.
Currently I take a very low dose of Prednisone each day (2 mg). I also “swish and spit” with Dexamethasone, a liquid solution, as in recent years, my flare-ups have been confined to my mouth. To help prevent against flare-ups in the back of my throat, I also gargle with the Dexamethasone. While I “swish and spit” twice daily, I only gargle once each day. I found that gargling twice daily caused the back of my throat to feel rough. Also I developed thrush when I gargled twice daily.
In any event I find the Dexamethasone to be a perfect alternative for me rather than experimenting with other stronger medications, particularly because my disease is mild. Why kill an ant with a hammer when a tissue will do just fine?
I find treatment to be trial and error, as there is no one-size-fits-all approach. What may work great for one person may be totally ineffective for another.