What is leflunomide used for: Leflunomide: MedlinePlus Drug Information

12.02.202127.07.2023 by alexxlab

Содержание

Side-effects, uses, time to work

What is leflunomide?

Who can take leflunomide?

How is leflunomide taken?

Side effects and risks

Carrying an alert card

Effects on other treatments

Can I drink alcohol?

Fertility, pregnancy and breastfeeding

Get help

What is leflunomide?

Leflunomide is a disease modifying anti-rheumatic drug (DMARD). It’s also known by its brand name Arava.

It’s used to treat:

rheumatoid arthritis (roo-ma-toy-d arth-ri-tus)
psoriatic arthritis (saw-ree-at-ik arth-ri-tus).

It may take four to six weeks before you start to feel the effects of leflunomide on your symptoms. It can take four to six months to feel the full effect of the drug.

In conditions like rheumatoid arthritis and psoriatic arthritis, the immune system attacks parts of your body by mistake. Leflunomide can dampen down the activity of the immune system. This can reduce the inflammation that makes your joints painful, swollen and stiff.

Because it’s a long-term treatment, you should carry on taking leflunomide:

even if it doesn’t seem to be working at first
even when your symptoms start to improve, to help keep your condition under control.

You’ll be prescribed leflunomide by a consultant rheumatologist.

Related information

Disease-modifying anti-rheumatic drugs (DMARDs)

Disease-modifying anti-rheumatic drugs (DMARDs) alter the underlying disease rather than treating symptoms. Learn how long they take, uses and side-effects.

Who can take leflunomide?

You will not be prescribed leflunomide if:

you’re pregnant or breastfeeding
you’re planning to have a baby soon
you need to start another treatment that could interact with leflunomide.

There are some other things that might affect whether you can take leflunomide. Tell your doctor if you:

have ever had problems with your liver, because leflunomide can seriously affect your liver
are taking any other prescription or over-the-counter medications
are taking any herbal remedies or supplements
have a severe infection
have had kidney problems
have nerve damage
have any history of tuberculosis (TB)
have a weak immune system
have any history of bone-marrow problems
have ever had an allergic reaction to a drug
have been told by a doctor you have low numbers of proteins in your blood.

How is leflunomide taken?

You will need to swallow leflunomide tablets with water, and you can take them with or without food. It’s important to swallow them whole and not chew them or crush them. It’s best to take your leflunomide at the same time each day.

If you miss a dose, take your tablet as soon as you remember unless it’s almost time for your next one. If you miss a dose of leflunomide, don’t take any more than your regular dose to make up for it.

If you take too much of your medication you may experience diarrhoea, stomach pain, pale skin, bruising or bleeding, dark urine, or yellowing of the skin or eyes, caused by jaundice.

If you think you have taken too much of your leflunomide and feel unwell call NHS111 and ask for advice, or if you’re feeling very unwell go to your local accident and emergency department.

If you’re sensitive to lactose, peanut or soya, speak to your doctor before taking leflunomide, as it contains extracts of these allergens.

Side effects and risks

You may not have any side effects from taking leflunomide. Some people find it gives them loose bowel motions or diarrhoea, but this usually settles down after a couple of weeks.

Other side effects can include:

feeling sick
mouth ulcers
weight loss
stomach pain
unusual tiredness
headaches
dizziness
weakness or pins and needles
dry skin or a rash
a slight rise in blood pressure.

Some people experience hair loss, but this is quite rare and usually minor.

Speak to your doctor or rheumatology nurse as soon as possible if you experience any of these side effects or any other changes that concern you. If your side effects are serious, you may need to stop the drug and have a washout treatment.

Washout treatment involves taking activated powdered charcoal or a drug called cholestyramine (co-la-sti-ra-meen) for 11 days. These should rapidly flush the leflunomide out of your body.

If you have psoriasis and find your skin becomes inflamed, irritated or infected once you’ve started taking the drug, speak to your doctor.

If you develop shortness of breath and a dry cough after starting the leflunomide, you should also speak to your doctor.

Speak to your doctor if you come into contact with anyone who has chickenpox or shingles, or if you develop chickenpox or shingles. Because leflunomide reduces the amount of blood cells your body makes you may pick up infections more frequently. These viruses can affect you badly when you’re taking leflunomide. You may need antiviral treatment, and your leflunomide may be stopped until you’re better.

Before you start leflunomide you will have the following tests:

a full blood count
a liver function test
a kidney function test
your blood pressure will be checked
a chest X-Ray.

Once you’ve started taking leflunomide, you’ll need to have these tests every two weeks. When you get settled on the drug, you will still need to have the tests, but not so often.

Tell your doctor or rheumatology nurse if you develop any signs of infection, such as:

a sore throat or fever
any unexplained bruising or bleeding
breathlessness
jaundice, where the eyes and skin turn yellow
any other symptoms that worry you.

Tips to reduce your risk of infection

Try to avoid close contact with people you know have an infection.
Wash your hands regularly and carry around a small bottle of antibacterial hand gel.
Keep your mouth clean by brushing your teeth regularly.
Stop smoking if you’re a smoker.
Make sure your food is stored and prepared properly.
Try to keep your house clean and hygienic, especially the kitchen, bathrooms and toilets.

Carrying an alert card

It’s recommended that you carry a biological therapy alert card so anyone treating you will know that you’re on leflunomide. Ask your rheumatology team for a card.

Effects on other treatments

Leflunomide can be prescribed alongside other drugs, but some – such as the blood thinners warfarin and acenocoumarol and the cancer treatment paclitaxel – can interact badly with it.

If you need to start these treatments, you may be offered an alternative treatment for your arthritis and a washout to remove the leflunomide from your system.

You should talk to your doctor before you start taking anything new and always tell any new healthcare professional who treats you that you’re on leflunomide.

Unless your doctor advises against it, you can carry on taking non-steroidal anti-inflammatory drugs (NSAIDs) or painkillers if needed.

Don’t take over-the-counter or herbal remedies without first speaking to your healthcare team.

Vaccinations

It’s usually recommended that people on leflunomide avoid live vaccines such as measles, mumps and rubella (MMR), chickenpox and yellow fever. But sometimes a live vaccine may be necessary, so you should discuss this with your rheumatology team.

If you’ve never had chickenpox, it’s a good idea to get a vaccination against it before starting leflunomide. But discuss this with your rheumatology team first.

It’s also a good idea to get any family or household members vaccinated against chickenpox before you start taking leflunomide.

The Zostavax shingles vaccine is a live vaccine and isn’t recommended for people who are on leflunomide. However, a non-live shingles vaccine (Shingrix) is available so you may be able to have this instead.

It’s recommended you have vaccinations against COVID-19. It’s also recommended you have the pneumonia (new-moh-nee-uh) vaccine and the yearly flu vaccine injection while taking leflunomide. These vaccines are not live, so it’s safe for you to have them.

Having an operation

If you’re going to have an operation you may be advised to stop the leflunomide for a time before and after surgery. Talk to your healthcare team about this.

Related information

Painkillers and NSAIDs

Painkillers used for arthritis are analgesics and non-steroidal anti-inflammatory drugs (NSAIDs). Learn about risks and side-effects.

Can I drink alcohol?

Leflunomide and alcohol can interact and affect your liver.

It’s recommended that you only drink small amounts of alcohol when taking leflunomide, or that you don’t drink alcohol at all.

As a guide, you shouldn’t drink more than four units of alcohol a week while taking leflunomide.

A standard glass of wine is two units, and a pint of beer is between two and three units.

If you’ve ever had problems with your liver, you’ll probably be advised to avoid alcohol all together.

Talk to your healthcare team if you have any concerns.

Fertility, pregnancy and breastfeeding

Women taking leflunomide must use contraception, and talk to their rheumatology team before trying for a baby.

You will be advised to stop taking leflunomide and have a washout treatment before trying to become pregnant. You’ll usually be advised to carry on using contraception until blood tests show the drug is completely out of your system.

If you prefer not to have the washout treatment, you may be advised to continue using contraception for up to two years after stopping leflunomide.

If you become pregnant while taking leflunomide, speak to your doctor or a member of your rheumatology team immediately. You will probably be advised to stop taking your leflunomide and have a washout treatment as soon as possible.

If this happens to you, it’s unlikely that leflunomide will harm your baby if you act quickly and contact your rheumatology team.

You are advised to avoid taking leflunomide until you have stopped breastfeeding because it may pass into your milk.

Men should be fine to take leflunomide if they are trying for a baby with their partner, but the research is limited so you should discuss this with your doctor.

Leflunomide Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

Uses

This medication is used to treat rheumatoid arthritis, a condition in which the body’s defense system (immune system) fails to recognize the body as itself and attacks the healthy tissues around the joints. Leflunomide helps to reduce the joint damage/pain/swelling and helps you to move better. It works by weakening your immune system and decreasing swelling (inflammation).

How to use Leflunomide

Take this medication by mouth with or without food as directed by your doctor, usually once daily. Take this medication exactly as prescribed. You may be instructed to take a higher dose for the first 3 days of treatment.

The dosage is based on your medical condition and response to treatment.

Take this medication regularly in order to get the most benefit from it. To help you remember, take it at the same time each day.

After treatment is stopped, a different drug (cholestyramine) may be given as directed to help remove leflunomide from your body. This procedure is used if you need a rapid removal of the drug from your system (for example, if you are a female/male planning to have children, or suffering from severe side effects). Without the procedure, the drug may stay in your body for up to 2 years. Consult your doctor or pharmacist for more details.

Tell your doctor if your symptoms last or get worse.

Side Effects

Diarrhea, nausea, and dizziness may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: cough, numbness/tingling of hands/feet, hair loss, chest pain, fast/pounding heartbeat, increased thirst/urination, muscle cramp/pain, mental/mood changes, vision changes, easy bruising/bleeding, unusual growths/lumps, unexplained weight loss, unusual tiredness.

This medication may raise your blood pressure. Check your blood pressure regularly and tell your doctor if the results are high.

This medication may lower your ability to fight infections. This may make you more likely to get a serious (rarely fatal) infection or make any infection you have worse. Get medical help right away if you have any signs of infection (such as sore throat that doesn’t go away, fever, swollen lymph nodes, chills).

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Leflunomide can commonly cause a mild rash that is usually not serious. However, you may not be able to tell it apart from a rare rash that could be a sign of a severe allergic reaction. Get medical help right away if you develop any rash.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US – Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before taking leflunomide, tell your doctor or pharmacist if you are allergic to it; or to teriflunomide; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: immune system disorder (such as HIV infection), current/recent infection (such as tuberculosis), cancer, bone marrow/blood disorder, kidney disease, liver disease (such as hepatitis B or C), alcohol abuse, heart disease (such as congestive heart failure), high blood pressure, lung disease.

This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis). Alcohol may also cause liver disease.

Do not have immunizations/vaccinations without the consent of your doctor, and avoid contact with people who have recently received oral polio vaccine or flu vaccine inhaled through the nose.

Leflunomide can make you more likely to get infections or may make current infections worse. Stay away from anyone who has an infection that may easily spread (such as chickenpox, COVID-19, measles, flu). Talk to your doctor if you have been exposed to an infection or for more details.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

This medication must not be used during pregnancy. It may harm an unborn baby. Before starting this medication, women of childbearing age must have a negative pregnancy test before starting this medication. Men and women must use effective forms of birth control (such as condoms and birth control pills) while taking this medication. Consult your doctor for more details and to discuss reliable forms of birth control. (See also Warning section.)

It is not known whether this medication affects the sperm. To minimize any possible risk, the manufacturer recommends that men wishing to father a child should consider stopping the medication and using another drug (cholestyramine) as directed to help this drug leave the body before attempting to father a child. (See How to Use section.) Consult your doctor for more details.

This drug may pass into breast milk and could have undesirable effects on a nursing infant. Breast-feeding is not recommended while using this drug. Consult your doctor before breast-feeding.

Interactions

Overdose

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

Do not share this medication with others.

A skin test to check for tuberculosis should be performed before you start this medication. Lab and/or medical tests (such as liver function, blood counts, blood pressure) should be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.