Leflunomide

Brand names of leflunomide

  • Arava

Leflunomide is taken orally to cure rheumatoid arthritis. Leflunomide helps to lessen swelling and tenderness in the joints, which are responsible for the symptoms of rheumatoid arthritis as well as the devastation of joints. This action of leflunomide, in turn, lessens the symptoms and also the gradual disfigurement of the joints caused by arthritis. In addition, leflunomide helps to diminish inflammation by means of holding back the actions of the immune cells that are responsible for causing inflammation. In effect, this medication holds back the immune cells by slowing down the release of dihydroorotate dehydrogenase, an enzyme essential for the production of DNA and RNA. In the absence of the DNA and RNA, the immune cells as well as majority of the other types of cells are unable to multiply or carry out their normal functions. In fact, their functioning ceases to exist in the absence of the DNA and RNA. Owing to the exceptional as well as dissimilar mechanism of activities of leflunomide, this disease-modifying drug is of great worth when combined with other medications to cure rheumatoid arthritis. The Food and Drugs Administration (FDA) of the United States approved the use of leflunomide in September 1998.

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Things you need to tell your physician before taking leflunomide

As in the case of using any other medicament, you need to exercise certain precautions prior to using the disease-modifying drug leflunomide. Before you start using this medication, you need to tell your physician if you have any allergic reactions to leflunomide, any ingredients of leflunomide or any other drugs. In addition, you should also tell your doctor regarding all other prescription, non-prescription (over-the-counter), and herbal medications as well as minerals, vitamins and nutritional supplement being used by you. You should especially tell your physician if you are using any anticoagulants (blood thinners), for instance, cholestyramine (Prevalite, Questran), warfarin (Coumadin) and/ or colestipol (Colestid), any medications to cure cancer, gold compounds, for instance, aurothioglucose (Aurolate, Solganol) and auranofin (Ridaura), and/ or any other medication to restrain the immune system. In case you are using any of the above mentioned substances, it may be important for your doctor to change the doses of the medication or check you carefully for any side effects of the medication.

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Before you begin to use leflunomide, tell your physician if you are suffering or have ever suffered from serious infections. Also inform the doctor if you are susceptible to infections and get them frequently. In addition, it is also important to tell your doctor if you are suffering from cancer or any other health condition that may affect the bone marrow or the immune system, counting the human immunodeficiency virus (HIV) and acquired immunodeficiency system (AIDS), or any ailment of the kidney.

Women who intend to take leflunomide should tell their doctor if they are breast feeding. Similarly, men should inform the doctor if they are planning to father a child. In this case, you need to talk to your physician regarding discontinuing leflunomide and take other medications or therapy to remove leflunomide from the system rapidly.

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Prior to taking leflunomide or if you are already taking the medicine and also consume alcoholic beverages, it is important to ask your physician regarding the safe use of alcoholic drinks.

It is important to note that taking the disease-modifying drug leflunomide is likely to lessen your body's competence in combating infections. Therefore, before taking this medication, tell your physician if you are suffering from any infection or if you experience any symptoms of infection, for instance, cough, flu or signs of health conditions similar to flu. Call your physician right away in case you experience fever, tender throat, painful, difficult or infrequent urination, any area of the body becoming warm, red, distended, aching skin or any other signs of infection while you are taking leflunomide. In case you have an infection, your physician will possibly interrupt your treatment, albeit temporarily.

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You ought to be aware that taking the disease-modifying drug leflunomide may result in high blood pressure (hypertension). Therefore, it is important to get your blood pressure checked before you start taking this medication. Even when you are taking leflunomide, you should have regular blood pressure checks.

Here is a word of caution for all patients taking leflunomide. It is not advisable for people taking leflunomide to take any vaccination whatsoever without consulting their physician.

There may be occasions when an individual may already be infected with tuberculosis (TB), but may not have any visible or other symptoms of the ailment. If such individuals take leflunomide, it may result in the worsening of their infection and cause to develop the symptoms of the disease. Therefore, before taking leflunomide it is important to tell your physician if you have ever suffered from tuberculosis; if you have been with someone who has or had tuberculosis, and/ or if you have visited any region where tuberculosis is widespread or very common. In this case, before you start your therapy with leflunomide, your physician will undertake a skin test to ensure if you really have been infected by TB. In the event of you being infected by tuberculosis, your physician will first cure this disease using antibiotics and once the disease is cured, he will permit you to start taking leflunomide.

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Usage

The disease-modifying drug leflunomide is generally prescribed to lessen the signs as well as symptoms of mild to acute cases of rheumatoid arthritis. In effect, leflunomide is given to patients who have not benefitted adequately from using other anti-rheumatic medications. In other words, this medication is prescribed to people suffering from rheumatoid arthritis when all other medications have failed to treat the condition.

As mentioned before, leflunomide is generally used to cure rheumatoid arthritis - a medical condition wherein the defense system of the body (immune system) begins to malfunction. In such cases, the immune system fails to distinguish the body as itself and show aggressions against the healthy body tissues in the region of the joints. Using leflunomide helps to lessen the damage of the joints owing to rheumatoid arthritis and, at the same time, decreases the swelling and pain enabling the patient to enhance mobility. This medication works by rendering the immune system inactive and lessening the inflammation around the affected joints.

How to use leflunomide

Leflunomide is an oral medication that may be taken with or without food. This medication is generally taken once every day or as prescribed by your physician. In addition, it is important to take this medicine at the same time every day. It is important to take this medication strictly according to the doctor's instructions. The dosage of leflunomide is dependent on the medical condition of the patient as well as his/ her response to the therapy with this medication. It is important to take it on a regular basis with a view to obtain the best benefits from its use. In order to help you remember when to take the medicine, you may mark the days and time on a calendar. In case your condition persists or worsen even after taking leflunomide, inform your doctor right away.

When therapy with leflunomide is discontinued, your physician may prescribe a different medication (cholestyramine) with a view to help remove leflunomide from your system. Usually, doctors use this procedure when there is a need to remove the drug rapidly from the body, for instance when a female/ male are planning to have babies and/ or when an individual is suffering from the side effects of the drug. If this procedure is not followed, the medication may remain in your body for a long period, sometimes up to two years after discontinuing leflunomide. If you wish to gather more details regarding this procedure, it is advisable to talk to you doctor or pharmacist.

How leflunomide works

Leflunomide works by holding back the hyperactivity of the immune system, which is thought to result in rheumatoid arthritis. This medication is also effective in lessening inflammation of the affected joints. Precisely speaking, leflunomide suppresses the immune cells by slowing down the release of dihydroorotate dehydrogenase, an enzyme essential for the production of DNA and RNA. In the absence of DNA and RNA, the enzyme ceases to carry out its normal functions or even multiply resulting in a reduction of inflammation of the joints.

Side effects

Serious
  • liver toxicity may occur - it can be detected with blood tests
Common
Less common

Possible interactions

The disease-modifying drug leflunomide is known to interact with certain drugs, especially specific herbal products and hence, they should not be taken concurrently. In addition, leflunomide is also known to produce serious side effects in patients smoking marijuana.

A number of patients use the herbal product Echinacea with a view to perk up their immune system. However, it is unfortunate to note that using Echinacea is not advisable for people having impaired/damaged immune systems - even in case the impairment is owing to the use of any medication. In addition, using this herb may actually further weaken the immune system if it is taken for a prolonged period of time. On the other hand, herbs like hay flower, white mustard seed and mistletoe bear German Commission E monograph indications for arthritis and may be used along with leflunomide. Nevertheless, it is important to talk to your physician before you combine any other medicine with leflunomide.

People taking the disease-modifying drug leflunomide should avoid smoking marijuana since it may further harm the immune system of the patients.

Storage instructions

Leflunomide should always be stored in a cool, dry and dark place. It is best to store this medication at room temperature at 77°F (25°C). However, storing leflunomide briefly in temperatures ranging between 59°F and 86°F (15°C and 30°C) is permissible. Never ever store this medicine in your bathroom. In addition, always remember to keep leflunomide as well as all other medications out of the reach of children and pets. Unless it is instructed otherwise, it is not advisable to flush the medicines down the toilet or pour them into a drain. All medicines, including this product, should be disposed of when the expiry date of the medications lapse or when they are needed no more. You may talk to your neighbourhood disposal company for further details regarding the safe disposal of leflunomide.

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