Why am I being prescribed leflunomide?
Leflunomide (trade name ‘Arava’) is used to treat inflammatory arthritis such as rheumatoid arthritis. It is a ‘disease-modifying’ drug which, by its action on the immune system, can reduce the inflammation that causes pain, swelling and stiffness in the joints.
When do I take leflunomide?
Leflunomide comes as 10mg, 20mg and 100mg tablets and is taken once a day. Leflunomide can be taken at any time of the day, with or without food, and should be swallowed whole. It is best to take it at the same time every day.
What dose do I take?
Your doctor will advise you. Usually for the first 3 days of treatment you will take 100mg a day, followed by either 10mg or 20mg a day after this.
Leflunomide is not a painkiller. So if you are on painkillers you may carry on taking these as well, unless your doctor advises otherwise.
How long will leflunomide take to work?
Leflunomide does not work immediately. It may be 4 to 6 weeks before you feel any benefit and may even be as long as 6 months before you feel the full effect of leflunomide.
What are the possible side-effects?
The most common side-effects of leflunomide are nausea, diarrhoea, mouth ulcers, weight loss, abdominal (stomach) pain, headache, dizziness, weakness, skin dryness and hair loss. It may cause a slight rise in your blood pressure.
Leflunomide may cause mild allergic symptoms including rash and itching. Rarely, more severe allergic reactions and skin conditions can develop. If this happens, leflunomide will have to be discontinued.
Taking leflunomide can also reduce the blood count and it can make you more likely to develop infections.
You should report to your doctor as soon as possible if you develop
- sore throat
- infections
- fever
- unexplained bruising or bleeding
- rash
- breathlessness
- any other unexpected new symptoms after starting leflunomide
Leflunomide may affect the liver. This may cause problems ranging from abnormalities in the blood tests without causing ill health to severe liver damage which may be fatal. If you develop symptoms such as unusual tiredness, abdominal pain, or jaundice (eye or skin turning yellow), inform your doctor at once.
Do I need any special checks while on leflunomide?
Your doctor will arrange for you to have regular blood tests and checks on your blood pressure. You may be asked to keep a record booklet with your blood test and blood pressure records. Bring this with you when you visit your doctor. It is important to do regular blood tests while you are on leflunomide.
Can I take other medicines along with leflunomide?
Some other drugs interact with leflunomide and you should always tell any doctor treating you that you are on leflunomide. You should not take ‘over-the-counter’ preparations without discussing this first with your doctor.
Can I have immunisation while on leflunomide?
You should avoid immunisation which involve any of the live vaccines such as BCG, measles, mumps, polio and rubella (German Measles).
Can I take alcohol while on leflunomide?
It is advisable to avoid alcohol while you are on leflunomide.
Does leflunomide affect fertility or pregnancy?
Leflunomide may harm an unborn baby. Therefore it should not be taken during pregnancy. Whilst taking leflunomide both men and women must use reliable contraception. If you are planning a family, you should discuss this with your doctor. Women must stop leflunomide for at least 2 years before planning a family. The 2-year ‘waiting’ period can be reduced to 3 months if you receive a special ‘washout’ treatment to help eliminate leflunomide from your body. This will be done on the advice of your doctor.
Men are advised to stop taking leflunomide, receive the ‘washout’ treatment, and wait 3 months before trying to father a child.
If you become pregnant while taking leflunomide, you should discuss this with your doctor as soon as possible.
You should not breast feed if you are taking leflunomide.