Arava (Leflunomide)

Do's

• Take a 20 mg tablet of Arava once a day as prescribed by a healthcare provider. 
• Consider taking the medication with or without food, following healthcare provider's instructions. 
• Follow the prescribed dosage regimen, which may include a lower dose of 10 mg if you experience side effects with the higher dose. 
• Take a higher dose for the first 3 days of treatment as instructed by your healthcare provider. This is known as a loading dose and helps bring up Arava levels faster inside the body so that the drug can start working quickly.  
• Take the medication exactly as prescribed and regularly to get the most benefit from it. It is recommended to take it at the same time each day to help remember.  
• Administer cholestyramine as directed to facilitate the removal of leflunomide from the body. This procedure is used if rapid removal of the drug from the system is needed, for example, if the patient is planning to have children or is suffering from severe side effects. Without this procedure, the drug may stay in the body for up to 2 years.   
• Consult a healthcare provider for more details and to inform them if symptoms last or get worse.  

Common Side Effects:

• Nausea
• Diarrhea
• Stomach pain
• Headache
• Abnormal liver function tests
• Thinning hair
• Back pain
• Weakness
• Rash
• High blood pressure

Serious Side Effects:

• Serious skin reactions
• Serious infections
• Severe or fatal liver damage

Other Potential Side Effects:

• Constipation
• Loss of taste sensation
• Hives
• Cirrhosis of the liver
• Liver failure

This is not a complete list of side effects, and others may occur. If you experience any symptoms of serious side effects, seek medical attention promptly.

Arava can cause fetal harm if used during pregnancy.  Do not take Arava if pregnant or planning to become pregnant. Effective birth control should be used before starting Arava, during treatment, and for 2 more years after stopping the drug. Additionally, a negative pregnancy test confirmed by a healthcare provider is required before starting Arava.

Arava can cause severe liver problems that may be fatal. Inform the healthcare provider if taking other drugs that can harm the liver, such as acetaminophen (Tylenol). Arava should not be taken if already have severe liver disease.

Regular monitoring of liver function is essential while taking Arava. This includes monitoring serum alanine aminotransferase (ALT) levels at least monthly for six months after starting Arava, and thereafter every 6-8 weeks. If leflunomide-induced liver injury is suspected, Arava treatment should be stopped, an accelerated drug elimination procedure should be started, and liver tests should be monitored weekly until normalized.

Patients should be evaluated for active tuberculosis and screened for latent tuberculosis infection before starting Arava. Additionally, patients should be monitored for infections while taking Arava.

Inform the healthcare providers about all medications being taken, including prescription and non-prescription medicines, as well as any health conditions

These warnings and precautions are crucial for ensuring the safe use of Arava and minimizing potential risks associated with its use.

If you have further questions or concerns about the warnings and precautions of Arava, consult a healthcare provider for professional medical advice and support.