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. Ask your doctor or pharmacist about suitable contraception. If you wish to have a baby within two years of finishing this treatment, you should discuss this with your doctor. It is important that it is confirmed that leflunomide has been sufficiently removed from your body before you become pregnant.
• If you are male you must not get a woman pregnant while you are taking leflunomide. Ask your doctor or pharmacist about suitable contraception. If you wish to become a father after you have finished this treatment, you should discuss this with your doctor. It is important that it is confirmed that leflunomide has been sufficiently removed from your body before you attempt to father a child.
• 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.

• 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

References

• Manufacturer's PIL, Arava 100 mg tablets, sanofi-aventis, electronic Medicines Compendium. Dated April 2008, accessed June 2009.
• Manufacturer's PIL, Arava 10 mg tablets, sanofi-aventis, electronic Medicines Compendium. Dated April 2008, accessed June 2009.
• British National Formulary; 57th Edition (March 2009) British Medical Association and Royal Pharmaceutical Society of Great Britain, London