Arava (Leflunomide) is a Disease Modifying Anti-Rheumatic Drug (DMARD) that suppresses the immune system to treat rheumatoid arthritis, psoriatic arthritis, and other types of arthritis. It belongs to a class of medications known as pyrimidine synthesis inhibitors.
Arava is available as oral tablets in 10 mg, 20 mg, and 100 mg doses. A dose of 10 mg or 20 mg is usually taken once a day as a single tablet. In some cases, it may be prescribed every other day. Rheumatologists used to start Arava with three loading doses of 100 mg per day. This is not usually done because it causes too many side effects at this dose.
It usually takes 6 to 8 weeks for Arava to start working, and it can take up to 6 months to feel the maximum effect. It is important for patients starting this medicine to keep taking it as prescribed. If the dose is changed, it can take another 6 to 8 weeks to start feeling the effects of the change.
If a patient forgets to take Arava at their usual time but remembers later on the same day, they should take the missed dose immediately. If they forgot to take yesterday’s dose, they should skip it, and take their usual dose for today.
Important Tests and Risks
Patients taking Arava should have their blood tested every month. It is important to make sure that this medicine isn’t harming the liver or blood counts.
Drinking while taking Arava can harm the liver. Patients taking this medicine are advised to stop drinking and avoid alcohol, or at the very least, significantly reduce their consumption of alcohol.
Arava can make it a bit harder for people to fight off infections. People taking this medicine should call their doctor they have a fever, think they have an infection, or have been prescribed antibiotics to treat an infection.
Patients taking Arava should coordinate with their doctor to potentially stop treatment around surgery. It can be re-started once things have healed and there’s no sign of infection.
Arava can harm an unborn child. Patients who may become sexually active during treatment with this medication are advised to use reliable birth control.