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Leflunomide

Sounds like 'le-floo-no-mide'

Key points about leflunomide

Leflunomide is used to treat inflammatory conditions such as rheumatoid arthritis and psoriatic arthritis.
Leflunomide is also called Arava.
Find out how to take it safely and possible side effects.

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Leflunomide is an immunosuppressant medicine, which means it weakens your body’s defence (immune) response. Leflunomide is used to treat inflammatory conditions such as rheumatoid arthritis and psoriatic arthritis.

Leflunomide belongs to a group of medicines called disease-modifying anti-rheumatic drugs (DMARDs). It slows down the disease and its effects on your joints, can help reduce pain and swelling (inflammation) in the joints, and prevent long-term damage caused by joint inflammation.

In Aotearoa New Zealand leflunomide is available as tablets (10 mg and 20 mg).

The dose of leflunomide is different for different people, depending on your condition and response to treatment.
Always take leflunomide exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much to take, how often to take it and any special instructions.

Try to take your dose at the same time each day. You can take leflunomide with or without food.
Swallow your tablets whole with a drink of water. Do not break, chew or crush the tablets.
If you forget to take your leflunomide dose, take it as soon as you remember. But if it is nearly time for your next dose, take the next dose at the right time. Do not take double the dose.
Keep taking leflunomide regularly. Leflunomide does not work straight away. It usually takes a few months before you notice the full benefits.

Here are some things to know when you're taking leflunomide. Other things may be important as well, so ask your healthcare provider what you should know about.

Tests and monitoring

While you're taking leflunomide, you will need regular blood tests to monitor for side effects and to check whether the treatment is working. Blood tests are very important during the first few months of treatment. Over time, these tests are needed less often.

Vaccinations

Leflunomide makes your immune system weaker, putting you at increased risk of infections. Vaccines are a good way to prevent some infections. You should have all the vaccinations you need before you start treatment with leflunomide, because some vaccines shouldn't be taken while you're taking leflunomide. Always check with your doctor or pharmacist first. It's safe for you to have the annual flu vaccine. Keep your flu vaccinations up to date to reduce your risk of getting the flu.

Other medicines

Leflunomide may interact with a few medicines and herbal supplements, so check with your doctor or pharmacist before starting leflunomide or before starting any new medicines, including those you may buy over the counter.

Pregnant or planning a pregnancy

Leflunomide can harm an unborn baby. You should not become pregnant while you are taking leflunomide and for 2 years after stopping treatment. Discuss with your healthcare provider which types of contraception are suitable for you both. If you are planning a pregnancy, talk to your healthcare provider.

Like all medicines, leflunomide can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.

Side effects	What should I do?
Feeling sick (nausea) Vomiting (being sick) Diarrhoea (runny poo)	This is quite common when you first start taking leflunomide. Try taking it with food. Tell your doctor if these bother you.
Severe skin rash, skin peeling or blisters	Stop taking leflunomide and see your doctor immediately.
Tingling in the hands and feet Hair loss	Tell your doctor.
Signs of getting an infection, such as feeling unwell, fever or chills	Tell your doctor immediately or phone Healthline on 0800 611 116.
Signs of changes in your blood cells, such as a severe sore throat, mouth ulcers, easy bruising, nosebleeds, bleeding gums, shortness of breath or fever	Tell your doctor immediately or phone Healthline on 0800 611 116.
Signs of problems with your liver, such as sudden pains in your stomach, loss of appetite or yellowing of your skin and eyes	Tell your doctor immediately or phone Healthline on 0800 611 116.
Read more about medicines and side effects and reporting a reaction you think might be a side effect.