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Leflunomide

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  • It may take several weeks of treatment before benefit is felt. This improvement will continue over the first 4-6 months of treatment.
  • If you feel dizzy whilst you are taking leflunomide, do not drive or operate machinery.
  • Do not drink alcohol whilst you are taking leflunomide - this will increase the risk of liver problems.
  • It is important that you do not become pregnant or father a child while you are taking leflunomide and for a time afterwards.

About leflunomide

Type of medicineImmunosuppressant (a drug which affects the body's immune response)
Used forRheumatoid arthritis and psoriatic arthritis in adults
Also calledArava®
Available asTablets

Leflunomide helps relieve the symptoms and slow down the progress of rheumatoid or psoriatic arthritis; it will not cure the disease.

Rheumatoid arthritis is a condition caused by the body's own immune system attacking itself. Leflunomide works by suppressing the immune system's over-reaction, though the exact way in which it works is not fully understood.

Before taking leflunomide

Before taking leflunomide make sure your doctor or pharmacist knows:

  • If you are pregnant, trying for a baby or breast-feeding.
  • If you suffer from liver or kidney problems.
  • If you have an infection.
  • If you have ever suffered from tuberculosis (TB).
  • If you know you have a blood or bone marrow disorder such as anaemia, leucopenia or thrombocytopenia.
  • If you know you have hypoproteinaemia (low blood protein).
  • If you have ever had an allergic reaction to this or any other medicine.
  • If you are taking or have recently taken any other medicines, including those available to buy without a prescription, herbal or complementary medicines.

How to take leflunomide

  • Take leflunomide exactly as directed by your doctor. The tablets are taken once a day.
  • It is usual to start on a high dose (100mg) for three days and then to reduce the dose to 10mg or 20mg.
  • Swallow the tablets whole with plenty of water.
  • Try to take leflunomide at the same time each day to avoid missing any doses.
  • If you do forget to take a dose, take it as soon as you remember unless it is nearly time for your next dose, in which case skip the missed dose. Do not take two doses on the same day to make up.

Getting the most from your treatment

  • You should not drink alcohol while you are taking leflunomide as this increases the risk of side-effects such as liver problems.
  • Leflunomide may need to be taken for four to six weeks before you start to feel improvement. You may continue to feel further improvement over the next 4-6 months.
  • If you are female you must not get pregnant while you are taking leflunomide and for at least two years after this treatment has finished. Ask your doctor or pharmacist about suitable contraception.
  • If you are male you must not get a woman pregnant while you are taking leflunomide and for at least three months after the treatment has finished. Ask your doctor or pharmacist about suitable contraception.
  • Keep your appointments with your doctor or clinic so that your progress can be monitored. You will need to have regular blood tests while taking this medicine.
  • While you are taking leflunomide, and for a while after you stop treatment, do not have any immunisations (vaccinations) without talking to your doctor first. Leflunomide lowers your body's resistance and there is a chance that you may get an infection from the vaccine.
  • Before having any kind of surgery, including dental or emergency treatment, tell the doctor, dentist or surgeon you are taking leflunomide.

Can leflunomide cause problems

Along with their useful effects all medicines can cause unwanted side effects which usually improve as your body adjusts to the new medicine. Speak with your doctor or pharmacist if any of the following side effects continue or become troublesome.

Common side-effects - these affect less than 1 in 10 people who take this medicineWhat can I do if I experience this
DiarrhoeaDrink plenty of water to replace lost fluids
Feeling or being sick,Eat little and often. Stick to simple foods
DizzinessGetting up or moving more slowly may help. If you begin to feel dizzy, lie down so that you do not faint, then sit for a few moments before standing.
Make sure your reactions are normal before driving, operating machinery or doing any other jobs which could be dangerous if you were not fully alert
HeadacheAsk your pharmacist to recommend a suitable pain-killer
Increased blood pressure, loss of weight, mouth ulceration, abdominal pain, tingling feelings, weakness, tendon inflammation, loss of hair, skin rash and itchingIf any of these become troublesome, discuss them with your doctor

Important: if you develop any of the following then speak to your doctor straight away:

  • Difficulty breathing.
  • A severe mouth or skin reaction.
  • Unexplained fever, bruising or bleeding.
  • Jaundice (yellowing of the skin or whites of the eyes.)

How to store leflunomide

  • Keep all medicines out of the reach and sight of children.
  • Store in a cool, dry place, away from direct heat and light.

Important information about all medicines


  • Keep all medicines out of the sight and reach of children.
  • Make sure that the person prescribing this medicine knows about any other medicines that you are taking. This includes medicines you buy and herbal and homeopathic medicines.
  • If you buy any medicines check with a pharmacist that they are safe to take with your other medicines.
  • Before taking this medicine tell your doctor if you have ever had an allergic reaction after taking any medicine.
  • Never take more than the prescribed dose. If you suspect that you or someone else has taken an overdose of this medicine go to the accident and emergency department of your local hospital at once. Take the container with you, even if it is empty.
  • If you are having any treatment like an operation or dental treatment tell the person carrying out the treatment which medicines you are taking.
  • Always read the printed information leaflet that comes with your medicine.
  • This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
  • Never keep out of date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
  • If you have any questions about this medicine ask your pharmacist.

References

Comprehensive patient resources are available at www.patient.co.uk
© EMIS 2010 DocID: 3788 DocRef: dils3794 Last Reviewed: 5 Jan 2010 Version: 22

The authors and editors of this article are employed to create accurate and up to date content reflecting reliable research evidence, guidance and best clinical practice. They are free from any commercial conflicts of interest. Find out more about updating.

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