What is Arava?
Arava is a leflunomide-based medication. It comes in tablet form.
Arava uses
This medication is used to treat rheumatoid arthritis, a condition in which the body’s defense system (immune system) mistakenly attacks healthy tissues around the joints. Leflunomide contributes to the reduction of joint damage/pain/swelling and improves mobility.
Mechanism of action
Leflunomide is an isoxazole immunomodulatory agent with antiproliferative activity that inhibits dihydroorotate dehydrogenase (a mitochondrial enzyme involved in de novo pyrimidine synthesis). Numerous anti-inflammatory effects have been demonstrated in vivo and in vitro experimental models.
Arava dosage
Arava is available as film-coated tablets in doses of 10 milligrams (mg) and 20 mg. Arava is also available in a three-count blister pack containing 100 mg of the active ingredient.
Arava is typically started at a higher dose, referred to as a loading dose, of 100 mg for three days and then reduced to a daily dose of 20 mg. Consult your prescription and speak with your healthcare provider to ensure you are receiving the correct dose.
It may take several weeks for joint pain or swelling to improve noticeably. Six to twelve weeks after initiating Arava, the full benefits may be realized.
Administration
Arava is available in tablets containing 10, 20, or 100 mg of active ingredient for oral administration.
Arava side effects
Severe adverse reactions and their associated symptoms may include the following:
Damage to nerves that are not connected to the brain or spinal cord. The following are possible symptoms:
- Sensations of tingling, burning, or piercing pain
- Numbness
- Weakness of the muscles
- Tactile sensibility
- Headache
- Dizziness
- Weary
- Nosebleeds
- Palpitations
Irritation and scarring of the lungs. The following are possible symptoms:
- Cough
- Palpitations
- Wheezing
Skin reactions that are severe, such as Stevens-Johnson Syndrome (SJS) and toxic epidermal necrolysis The following are possible symptoms:
- Blisters
- Fever
- Symptoms of the flu
- Skin that is flushed and peels
A severe drug rash characterized by eosinophilia and systemic symptoms is referred to as a drug reaction. The following are possible symptoms:
- Fever or symptoms consistent with the influenza virus
- Skin that is itchy or red
- Rash
- Lymph nodes enlargement
- Immune deficiency and life-threatening infections.
- Difficulties with the bone marrow
- Reaction to allergens
- Problems with the liver
- If used during pregnancy, the risk to the fetus is increased.
Drug-drug interactions
Arava can wreak havoc on the liver, resulting in death. This effect is amplified when certain other medications are used in conjunction with it, including:
Acetaminophen (Tylenol), aspirin, or gout or arthritis medication (including gold injections); an NSAID (non-steroidal anti-inflammatory drug) such as ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, or meloxicam; antibiotic, antifungal, or sulfa medication; tuberculosis medication; antiviral or HIV/AIDS medication; medication to treat mental illness carbamazepine, phenytoin, and valproic acid are all seizure medications. Birth control pills or hormone replacement therapy; anabolic steroids – methyltestosterone, colloquially referred to as “performance-enhancing drugs”; cancer medication.
Medications to lower cholesterol – Crestor, Lipitor, Vytorin, Zocor, and others; medications to treat heart disease or high blood pressure.
This list is not exhaustive, as leflunomide may interact with a wide variety of other medications. This category includes prescription and OTC medications, vitamins, and herbal supplements. Any healthcare provider who treats you should have a list of all your medications. This medication guide does not include every possible interaction.
Warnings/ instructions for use
Inform your doctor and pharmacist before starting leflunomide if you are allergic to leflunomide, teriflunomide (Aubagio), any other medications, or any of the ingredients in leflunomide tablets. Request a list of ingredients from your pharmacist.
Inform your doctor and pharmacist of all other medications, prescription and non-prescription, vitamins, nutritional supplements, and herbal products you are currently taking or intend to take. Include the medications listed in the IMPORTANT WARNING section, as well as any of the following: Anticoagulants (‘blood thinners’) such as warfarin (Coumadin Jantoven); cholestyramine (Prevalite); gold compounds such as auranofin (Ridaura); anticancer medications; other immune suppressing medications such as azathioprine (Azasan, Imuran), cyclosporine (Gengraf, Neoral, Sandimmune), sirolimus (Rapamune), and tacrolimus (Asta Your physician may need to adjust your medication dosages or closely monitor you for side effects.
Inform your doctor if you have or have ever had a serious infection, or if you frequently get infections, cancer, or other conditions affecting the bone marrow or immune system (including HIV and acquired immunodeficiency syndrome, diabetes, or kidney disease).
Storage
Keep the medicine at room temperature, away from heat, moisture, and direct light, in a closed container. Avoid submerging in water.
Store away from children’s reach. Avoid storing expired or no longer needed medications.
Inquire with your healthcare professional about how to properly dispose of any medication that is no longer needed.
Contraindications
- Severe hepatic insufficiency.
- Teriflunomide concomitantly.
Contraception or breast-feeding
Arava should not be used if you are pregnant or suspect you might be. Pregnant or planning to become pregnant while taking Arava increases your risk of having a baby with serious birth defects. Arava should not be used by women of childbearing potential who are not using effective contraception.
Inform your doctor if you intend to become pregnant following the cessation of Arava treatment, as you must ensure that all traces of Arava have been eliminated from your system before attempting to conceive. This process could take up to two years to complete. This time period may be reduced to a few weeks with the use of certain medications that accelerate the removal of Arava from your body.
you should then wait at least another month before becoming pregnant.
If you suspect you are pregnant while taking Arava or within two years of stopping treatment, you must immediately contact your doctor for a pregnancy test. If the pregnancy test confirms your pregnancy, your doctor may recommend treatment with certain medications to rapidly and completely eliminate Arava from your body, thereby minimizing the risk to your baby.
Arava should not be used while breastfeeding, as leflunomide is excreted in breast milk.
