DESCRIPTIONLeflunomide is an anti-inflammatory drug known as a disease modifying anti-rheumatic drug (DMARD) because it not only reduces arthritis pain and joint swelling but may also decrease damage to the joints and long-term disability. It is approved for the treatment of rheumatoid arthritis. Although rheumatoid arthritis is an autoimmune disease — one in which the body attacks part of itself as if it were a foreign invader — it is not completely clear how this drug works in rheumatoid arthritis. However, leflunomide interferes with the formation of DNA, which is important for developing cells, such as those in the immune system. The drug decreases white blood cells that play an important role in the immune system.
ORIGINAL USES (ON-LABEL)
Active rheumatoid arthritis
NEWLY DISCOVERED USES (OFF-LABEL)
Psoriasis, psoriatic arthritis.
POTENTIAL SIDE EFFECTS
Diarrhea, nausea, respiratory tract infection, high blood pressure, rash, urinary tract infection, headache, dizziness, chest pain, hair loss, itching, dry skin, upset stomach, abnormal liver enzymes tests, abdominal pain, mouth ulcers, vomiting, low potassium levels, weight loss, muscle aches, leg cramps, joint disorders, increased cough, bronchitis.
CAUTIONS
- Do not use this drug in pregnancy. Pregnancy must be excluded prior to initiation of therapy. Reliable use of contraception in women of childbearing age should be ensured during therapy. Pregnancy must be avoided during and prior to completion of the drug elimination procedure after leflunomide treatment.
- Leflunomide has been associated with liver toxicity. Monitoring of blood factors and liver function is recommended during therapy. The use of this drug in impaired liver function is not recommended.
- Not recommended for use in patients with severe immune deficiency, bone marrow dysplasia, or with an uncontrolled infection.
Methotrexate, rifampin, cholestyramine, charcoal, NSAIDs (nonsteroidal anti-inflammatory drugs), tolbutamide, other drugs known to cause liver toxicity.
FOOD INTERACTIONS
Unknown
HERBAL INTERACTIONS
Unknown
PREGNANCY AND BREAST-FEEDING CAUTIONS
FDA Pregnancy Risk Category X. Not known if this drug is excreted in breast milk. Breast-feeding is not recommended.
SPECIAL INFORMATION
This drug has a black box warning regarding the contraindication of pregnancy (see cautions).
Arthritis & Rheumatism reported on a clinical trial in which 190 PsA patients received either leflunomide or placebo. After 24 weeks, 58.9% of the leflunomide patients and 29.7% of the placebo patients responded well with decreased joint and skin symptoms, pain, and other indicators of disease. Based on these results, researchers stated that treatment was relatively well tolerated with no unusual toxic side effects. The researchers concluded that this drug is safe and effective.
Expert Opinions in Pharmacotherapy reported from a German rheumatology clinic that this medicine has not only demonstrated significant efficacy in PsA but these benefits are maintained with long-term use.
Buy Arava online
Where can I buy Arava without prescription?Leflunomide is a prescription drug that comes in 10 mg, 20 mg tablets. It is available on prescription only as tablets for oral use, but the online pharmacy, will sell Leflunomide without prescription. You may be able to order Arava from them online and save the local pharmacy markup.
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Pharmacies accept credit cards Visa and Mastercard, online checks (ACH), EuroDebit, Wire transfers.
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What is Arava?
This drug inhibits the production of pyrimidine, which promotes anti-inflammatory effects.
This drug inhibits the production of pyrimidine, which promotes anti-inflammatory effects.
BRAND NAME
Arava
GENERIC NAME
Leflunomide
CHEMICAL CLASS
Isoxazole derivative.
THERAPEUTIC CLASS
Disease-modifying antirheumatic drug (DMARD); immunomodulatory agent.
Arava
GENERIC NAME
Leflunomide
CHEMICAL CLASS
Isoxazole derivative.
THERAPEUTIC CLASS
Disease-modifying antirheumatic drug (DMARD); immunomodulatory agent.
AVAIL FORMS
Tablets — Oral 10 mg, 20 mg.
Tablets — Oral 10 mg, 20 mg.
DOSAGE
Adult and Child <18 yr
Rheumatoid arthritis: Loading dose 100 mg qd for 3 days;
Maintenance dose 20 mg daily (10 mg qd if side effects intolerable);
Drug elimination procedure: cholestyramine 8 g tid × 11 days (consecutive days not necessary); without these extra measures, nondetectable plasma levels would take ≤2 years, after drug discontinuation.
Adult and Child <18 yr
Rheumatoid arthritis: Loading dose 100 mg qd for 3 days;
Maintenance dose 20 mg daily (10 mg qd if side effects intolerable);
Drug elimination procedure: cholestyramine 8 g tid × 11 days (consecutive days not necessary); without these extra measures, nondetectable plasma levels would take ≤2 years, after drug discontinuation.
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