Indications 

Arava is a medication utilized in the management of rheumatoid arthritis, a disorder wherein the immune system fails to distinguish the body’s own tissues, resulting in an attack on the healthy tissues surrounding the joints.  

This medication aids in mitigating joint damage, pain, and swelling, thereby facilitating improved mobility. The mechanism of action of leflunomide involves the attenuation of immune function and the reduction of inflammation by suppressing the immune system. 

Uses and Dosage 

This medication is to be taken orally, with or without food, typically once daily, or as directed by a healthcare professional. Adhere to the prescribed dosing regimen strictly. For the first three days of treatment, the healthcare professional may recommend a higher dose. 

The dosage of this medication is individualized based on the patient’s medical condition and response to treatment. In order to attain the maximum benefit from this medication, it should be taken regularly, at the same time each day. To help remember, patients may find it useful to set a reminder. 

If treatment is discontinued, the healthcare professional may prescribe cholestyramine, a different medication, to expedite the elimination of leflunomide from the body. This process is recommended if a rapid removal of the drug from the system is necessary, such as in cases where the patient is planning to conceive or has severe side effects.  

If the medication is not eliminated, it may remain in the body for up to two years. For further information, patients are advised to consult their healthcare provider or pharmacist. 

Side Effects 

Allergic Reactions

Signs of an allergic reaction to Arava require emergency medical attention: 

• Hives 
• Difficulty breathing 
• Swelling of face, lips, tongue, or throat 

Severe Side Effects

Call your doctor right away if you experience any of the following: 

• Sudden weakness or ill feeling 
• Signs of infection:
  • Fever
  • Chills
  • Sore throat
  • Mouth sores
  • Red or swollen gums
  • Trouble swallowing  
• Sudden chest pain or discomfort, wheezing, dry cough, or feeling short of breath 
• Easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), or purple or red pinpoint spots under your skin 
• Numbness, tingling, or burning pain in your hands or feet 
• Nausea, upper stomach pain, itching, tiredness, loss of appetite, dark urine, clay-colored stools, or jaundice (yellowing of the skin or eyes) indicating liver problems 
• Fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling indicating severe skin reaction 

Common Side Effects  

• Nausea, diarrhea, or stomach pain 
• Headache 
• Abnormal liver function tests 
• Thinning hair 
• Back pain 
• Weakness 
• Rash 
• High blood pressure 

Caution 

Prior to taking leflunomide, inform your doctor or pharmacist if you are allergic to it, teriflunomide, or have any other allergies. The product may contain inactive components that can lead to allergic reactions or other issues. Discuss with your pharmacist for more information. 

Provide your medical history to your doctor or pharmacist before using this medication, especially if you have immune system disorder, current or recent infections such as tuberculosis, cancer, bone marrow or blood disorders, kidney disease, liver disease such as hepatitis B or C, alcohol abuse, heart disease such as congestive heart failure, high blood pressure, or lung disease. 

This medication can cause dizziness. Taking alcohol or marijuana (cannabis) can intensify this effect. Do not drive, operate machinery, or perform any tasks that require alertness until you are sure you can perform them safely. Avoid alcoholic beverages. If you are using marijuana (cannabis), consult with your doctor. Consuming alcohol may cause liver disease. 

Do not receive immunizations/vaccinations without the approval of your doctor, and avoid contact with individuals who have recently received oral polio vaccine or flu vaccine inhaled through the nose. 

Leflunomide can increase your likelihood of getting infections or may exacerbate any current infections. Avoid contact with people who have infections that can be transmitted to others such as chickenpox, measles, or flu. For additional information or if you have been exposed to an infection, consult your doctor.