Generic Name: leflunomide (le FLOO noe mide)Brand Names: Arava
Leflunomide affects the immune system and reduces swelling and inflammation in the body.
Leflunomide is used to treat the symptoms of rheumatoid arthritis. Leflunomide also helps reduce joint damage and improves physical functioning.
Leflunomide may also be used for other purposes not listed in this medication guide.
Before taking leflunomide, tell your doctor if you have liver disease, a history of hepatitis, kidney disease, any type of infection, a history of tuberculosis, a blood cell disorder such as anemia or low platelets, a bone marrow disorder, or if you are using any drugs that weaken your immune system (such as cancer medicine or steroids).
Leflunomide can make it easier for you to get sick. Avoid being near people who have colds, the flu, or other contagious illnesses. Contact your doctor at once if you develop signs of infection.Do not receive a "live" vaccine while you are being treated with leflunomide, and avoid coming into contact with anyone who has recently received a live vaccine. There is a chance that the virus could be passed on to you. After you stop taking leflunomide, you may need to be treated with other medications to help your body eliminate leflunomide quickly. Without receiving this drug elimination procedure, leflunomide could stay in your body for up to 2 years. Follow your doctor's instructions.
If you have any of these other conditions, you may need a dose adjustment or special tests to safely take this medication:
any type of infection;
a history of tuberculosis;
a blood cell disorder (such as anemia, easy bruising or bleeding);
a weak immune system or bone marrow disorder; or
if you are using any drugs that weaken your immune system (such as cancer medicine or steroids).
Take this medication exactly as prescribed by your doctor. Do not take it in larger amounts or for longer than recommended. Follow the directions on your prescription label.Before you start taking leflunomide, you may need a skin test to make sure you do not have tuberculosis.
Your doctor may occasionally change your dose to make sure you get the best results from this medication.
Leflunomide can lower blood cells that help your body fight infections. This can make it easier for you to get sick from being around others who are ill. To be sure your blood cells do not get too low, your blood will need to be tested on a regular basis. Your liver function may also need to be tested. Do not miss any scheduled appointments.After you stop taking leflunomide, you may need to be treated with other medications to help your body eliminate leflunomide quickly. Without receiving this drug elimination procedure, leflunomide could stay in your body for up to 2 years. Follow your doctor's instructions.
Rheumatoid arthritis is often treated with a combination of different drugs. To best treat your condition, use all of your medications as directed by your doctor. Be sure to read the medication guide or patient instructions provided with each of your medications. Do not change your doses or medication schedule without advice from your doctor.Store leflunomide at room temperature away from moisture, heat, and light.
See also: Leflunomide dosage in more detail
Take the missed dose as soon as you remember. If it is almost time for your next dose, wait until then to take the medicine and skip the missed dose. Do not take extra medicine to make up the missed dose.
Overdose symptoms may include diarrhea, stomach pain, easy bruising or bleeding, dark urine, or jaundice (yellowing of the skin or eyes).
Avoid being near people who have colds, the flu, or other contagious illnesses. Contact your doctor at once if you develop signs of infection.Do not receive a "live" vaccine while you are being treated with leflunomide, and avoid coming into contact with anyone who has recently received a live vaccine. There is a chance that the virus could be passed on to you.
fever, chills, body aches, flu symptoms;
white patches or sores inside your mouth or on your lips;
cough, trouble breathing (you may also have a fever);
pain or burning when you urinate;
pale skin, easy bruising or bleeding, unusual weakness;
nausea, stomach pain, loss of appetite, itching, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or
fever, sore throat, and headache with a severe blistering, peeling, and red skin rash.
Less serious side effects may include:
mild stomach pain, diarrhea, loss of appetite;
numbness or tingling;
runny or stuffy nose, cold symptoms; or
mild itching or skin rash.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Usual Adult Dose for Rheumatoid Arthritis:
Loading dose: 100 mg once daily for 3 days.Maintenance: 10 to 20 mg daily.Study (n=263) 100 mg per day for 2 days, followed by 10 mg leflunomide daily in combination with methotrexate (10 to 15 mg/week or 15 to 20 mg/week), and folate 1 mg/day.
Before taking leflunomide, tell your doctor if you are taking cholestyramine (Questran, Prevalite, LoCHOLEST) or rifampin (Rifadin, Rimactane).
Also tell your doctor if you are using medications that can weaken your immune system, such as:
cyclosporine (Neoral, Sandimmune, Gengraf);
sirolimus (Rapamune), tacrolimus (Prograf);
basiliximab (Simulect), efalizumab (Raptiva), muromonab-CD3 (Orthoclone);
mycophenolate mofetil (CellCept); or
azathioprine (Imuran), leflunomide (Arava), etanercept (Enbrel).
Leflunomide can be harmful to the liver, and this effect is increased when leflunomide is used together with other medicines that can harm the liver. Tell your doctor if you are also using:
birth control pills or hormone replacement therapy;
other arthritis medications such as auranofin (Ridaura) or aurothioglucose (Solganol);
an ACE inhibitor such as benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril), quinapril (Accupril), and others;
an antibiotic such as dapsone or erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin);
an antifungal medication such as fluconazole (Diflucan), itraconazole (Sporanox), or ketoconazole (Nizoral);
cholesterol medications such as niacin (Advicor), atorvastatin (Lipitor), simvastatin (Zocor), and others;
HIV/AIDS medications such as abacavir/lamivudine/zidovudine (Trizivir), lamivudine (Combivir, Epivir), nevirapine (Viramune), tenofovir (Viread), or zidovudine (Retrovir);
an NSAID (non-steroidal anti-inflammatory drug) such as ibuprofen (Motrin, Advil), naproxen (Aleve, Naprosyn), diclofenac (Cataflam, Voltaren), etodolac (Lodine), indomethacin (Indocin), ketoprofen (Orudis), and others; or
seizure medications such as carbamazepine (Carbatrol, Tegretol), phenytoin (Dilantin), felbamate (Felbatol), valproic acid (Depakene).
This list is not complete and there may be other drugs that can interact with leflunomide. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.