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Leflunomide is used alone or in combination with other medications to treat rheumatoid arthritis (a condition in which the body attacks its own joints, causing pain, swelling, and loss of function). Leflunomide is in a class of medications called disease-modifying antirheumatic drugs (DMARDs). It works by decreasing inflammation and slowing the progress of the condition, which can help improve the physical activity of people with rheumatoid arthritis.

Usage directions

Leflunomide comes as a tablet to take by mouth. It is usually taken once a day. Your doctor may tell you to take a larger dose of leflunomide for the first 3 days of treatment. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take leflunomide exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Your doctor may need to decrease your dose or stop treatment if you experience certain severe side effects. Be sure to tell your doctor how you are feeling during your treatment.

Leflunomide may help control the symptoms of your rheumatoid arthritis but does not cure it. Continue to take leflunomide even if you feel well. Do not stop taking leflunomide without talking to your doctor.

Other uses

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Special precautions

Before taking leflunomide,

• tell your doctor and pharmacist if you are allergic to leflunomide, any other medications, or any of the ingredients in leflunomide tablets. Ask your pharmacist for a list of the ingredients.
• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention the medications listed in the IMPORTANT WARNING section and any of the following: anticoagulants ('blood thinners') such as warfarin (Coumadin); cholestyramine (Prevalite, Questran); colestipol (Colestid); gold compounds such as auranofin (Ridaura) and aurothioglucose (Aurolate, Solganol); medications to treat cancer; other medications that suppress the immune system such as azathioprine (Imuran), cyclosporine (Neoral, Sandimmune), sirolimus (Rapamune), and tacrolimus (Prograf); Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor if you have or have ever had serious infections or if you frequently get infections, cancer or other conditions affecting the bone marrow or the immune system (including human immunodeficiency virus [HIV] and acquired immunodeficiency syndrome [AIDS]), or kidney disease.
• 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 and receiving a treatment to help to remove this medication from your body more quickly.
• ask your doctor about the safe use of alcoholic beverages while you are taking leflunomide.
• Taking leflunomide may decrease your ability to fight infection. Tell your doctor if you have an infection now or if you have any signs of infection such as fever, cough, or flu-like symptoms. If you experience any of the following symptoms during your treatment with leflunomide, call your doctor: fever; sore throat; cough; flu-like symptoms; area of warm, red, swollen, or painful skin; painful, difficult, or frequent urination; or other signs of infection. Your treatment with leflunomide may need to be interrupted if you have an infection.
• You may already be infected with tuberculosis (TB; a serious lung infection) but not have any symptoms of the disease. In this case, leflunomide may make your infection more serious and cause you to develop symptoms. Tell your doctor if you have or have ever had TB, if you have lived in or visited a country where TB is common, or if you have been around someone who has or has ever had TB. Before you begin your treatment with leflunomide, your doctor will perform a skin test to see if you have TB. If you do have TB, your doctor will treat this infection with antibiotics before you begin taking leflunomide.
• do not have any vaccinations without talking to your doctor.
• you should know that leflunomide may cause high blood pressure. You should have your blood pressure checked before starting treatment and regularly while you are taking this medication.

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.

Possible side effects

Leflunomide may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• diarrhea
• vomiting
• heartburn
• headache
• dizziness
• weight loss
• back pain
• muscle pain or weakness
• pain, burning, numbness, or tingling in the hands or feet
• hair loss
• mouth sores

Some side effects can be serious. If you experience any of the following symptoms or those listed in the IMPORTANT WARNING or SPECIAL PRECAUTIONS section, call your doctor immediately:

• hives
• rash
• difficulty breathing
• new or worsening cough
• chest pain
• blisters or peeling of skin
• pale skin

Receiving medications which suppress the immune system may increase the risk of developing certain types of cancer. An increase in cancers was not reported in clinical studies with leflunomide to date. Talk to your doctor about the risks of receiving leflunomide.

Storage and disposal of Leflunomide

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom) and light. Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

Emergency/overdose

In case of overdose, call your local poison control center. If the victim has collapsed or is not breathing, call local emergency services.

Symptoms of overdose may include the following:

• diarrhea
• stomach pain
• extreme tiredness
• weakness
• pale skin
• fast heartbeat
• shortness of breath

Other important information

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Disclaimer

We provide only general information about Arava which does not cover all possible drug integrations, directions or precautions. Information at our website cannot be used for self-treatment and self-diagnosis. Any specific instructions for a particular patient should be agreed with his health care adviser or doctor in charge of the case. We disclaim reliability of this information and mistakes it could contain. We are not responsible for any direct, indirect, special or other indirect damage as a result of any use of the information on this site and also for consequences of self-treatment.

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