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Arava (Leflunomide) is an anti-inflammatory medication known as a disease-modifying antirheumatic drug (DMARD) because it not only decreases the pain and swelling of arthritis but also can decrease damage to joints and long-term disability.

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Uses

Leflunomide (leh-FLEW-no-mide) is used to treat active rheumatoid arthritis in adults to reduce signs and symptoms, slow down damage to joints, and improve physical function. It works by suppressing your immune system, since rheumatoid arthritis is caused by damage from an overactive immune system.

How to take

Leflunomide is usually taken once a day. Take Leflunomide exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Side effects

Nausea, diarrhea, flu-like symptoms, mild dizziness, and headache may occur. If these effects persist or worsen, notify your doctor promptly. Tell your doctor immediately if any of the following unlikely but serious side effects occur: hair loss, chest pain, back pain, mouth sores, muscle cramping, numbness/tingling sensations. Tell your doctor immediately if any of the following highly unlikely but very serious side effects occur: unusual lumps (lymph gland enlargement). Leflunomide has rarely caused serious (possibly fatal) infections and blood disorders due to suppressing the bone marrow and immune system. Tell your doctor immediately if signs of infection (such as fever), extreme weakness/fatigue or easy bruising/bleeding develop. Leflunomide may need to be stopped. The elimination procedure using cholestyramine or charcoal may be required. Consult your doctor for more details. Leflunomide has rarely caused serious (possibly fatal) liver disease, especially in people with other risks for liver disease. Tell your doctor immediately if persistent nausea or vomiting, stomach/abdominal pain, dark urine, or yellowing eyes/skin develop. Leflunomide may need to be stopped. In the unlikely event you have an allergic reaction to this drug, seek immediate medical attention. Symptoms of an allergic reaction include: rash, itching, swelling, severe dizziness, and trouble breathing. If you notice other effects not listed above, contact your doctor.

Precaution

Before taking Leflunomide, tell your doctor if you are allergic to Leflunomide or any other drugs. Tell your doctor what prescription and nonprescription medications you are taking, especially cholestyramine (Cholybar, Questran), colestipol (Colestid), felbamate (Felbatol), mercaptopurine (Purinethol), rifampin (Rifadin, Rimactane, Rifater), methotrexate (Rheumatrex), tolbutamide (Orinase), troglitazone (Rezulin), and vitamins. Tell your doctor if you have or have ever had liver or kidney disease, hepatitis, severe infections, or conditions affecting the bone marrow or the immune system (including human immunodeficiency virus [HIV] and acquired immunodeficiency syndrome [AIDS]). Tell your doctor if you are breast-feeding. If you are planning to father a child, you should talk to your doctor about stopping Leflunomide prior to conception. You should not receive any vaccinations while taking Leflunomide unless you have talked with your doctor. You should know that there is a special treatment for removing Leflunomide from your body once you stop taking it. Ask your doctor for more information about this treatment.

Drug interactions

Be sure to tell your doctor about all of the medications you are taking, including over-the-counter drugs and natural remedies, as these may reduce the effectiveness of Leflunomide. The following medications are among those that may interfere with Leflunomide: cholestyramine (Questran), tolbutamide (Orinase) and rifampin (Rifadin or Rimactane).

Missed dose

Take the missed dose as soon as you remember it. However, if it is almost time for your next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Storage

Store at room temperature between 59 and 86 degrees F (15-30 degrees C) away from light and moisture.