Leflunomide

1 medicine

Leflunomide is a DMARD used for rheumatoid arthritis and psoriatic arthritis; its active form stays in the body for up to two years, so it remains teratogenic long after the last dose and needs an accelerated elimination procedure before pregnancy.

Arava

Leflunomide

10/20mg

Arava is a autoimmune care medication containing Leflunomide, available as 10/20mg tablets.

from $1.54 / tablet View

Key facts

  • Leflunomide (sold as Arava) is a disease-modifying antirheumatic drug (DMARD): it slows the immune overactivity that damages joints in rheumatoid arthritis and psoriatic arthritis.
  • It's taken as a tablet once daily, and its active form builds up slowly, so full benefit can take weeks to appear.
  • Leflunomide's active metabolite has a very long half-life and can remain in the body for up to two years after stopping; it is teratogenic, so anyone who could become pregnant needs a specific washout procedure before conceiving, not just a pause in dosing.
  • Regular blood tests for liver function and blood counts are required throughout treatment.

What leflunomide treats

Leflunomide treats rheumatoid arthritis and psoriatic arthritis, easing joint pain, swelling, and stiffness and slowing the joint damage these diseases cause over time. It's usually considered when first-line treatments haven't controlled the disease well enough.

How leflunomide works

Leflunomide is converted in the body into an active form that blocks an enzyme immune cells need to make new DNA building blocks. Because the immune cells driving rheumatoid arthritis multiply quickly, slowing this process reduces the number of active immune cells causing joint inflammation and damage.

Before you take it

  • Do not take leflunomide if you are pregnant, breastfeeding, or could become pregnant without using reliable contraception; it causes birth defects, and its active form persists in the body for up to two years.
  • If you plan to conceive, or if a man taking leflunomide plans to father a child, ask your doctor about the accelerated elimination procedure (using cholestyramine or activated charcoal) and confirm blood levels are low enough first.
  • Tell your doctor about liver disease, current infections, or low blood counts before starting.
  • Avoid alcohol, which adds to the risk of liver injury.
  • Tell every prescriber you take leflunomide, since it can interact with other DMARDs, some antibiotics, and blood thinners such as warfarin.

Side effects

Common effects include diarrhea, nausea, headache, and hair thinning.

Stop and seek urgent medical care for any of these:

  • Yellowing of the skin or eyes, dark urine, or severe abdominal pain (possible liver injury).
  • Fever, sore throat, or unusual bruising or bleeding (possible low blood counts or infection).
  • Persistent cough or shortness of breath.
  • Severe skin reaction or blistering.

Safety essentials

  • Leflunomide is teratogenic, and because its active form can remain in the body for up to two years after the last dose, simply stopping the drug does not make it safe to conceive; an accelerated elimination procedure and a confirmed low blood level are needed first.
  • Liver function and blood counts are checked before starting and at regular intervals throughout treatment.
  • Report any signs of liver problems or infection promptly rather than waiting for your next scheduled test.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.