leflunomide, Arava

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

What is leflunomide, and how does it work (mechanism of action)?

Leflunomide is an oral, disease-modifying drug that is used in the treatment of rheumatoid arthritis. Leflunomide reduces inflammation in the joints that is responsible for both the symptoms of rheumatoid arthritis and the destruction of joints. This reduces symptoms as well as the progressive deformities of the joints caused by the arthritis. Leflunomide reduces inflammation by suppressing the activity of immune cells responsible for the inflammation. Leflunomide suppresses immune cells by inhibiting dihydroorotate dehydrogenase, an enzyme that is necessary for the production of DNA and RNA. Without DNA and RNA the immune cells (and most other types of cells) cannot multiply or function (or exist). Because of its unique and different mechanism of action, leflunomide is of value when added to other medications used for treating rheumatoid arthritis. Leflunomide was approved by the FDA in September 1998.

What brand names are available for leflunomide?

Arava

Is leflunomide available as a generic drug?

GENERIC AVAILABLE: No

Do I need a prescription for leflunomide?

Yes

What are the side effects of leflunomide?

The most frequently reported side effects are:

Other important side effects of leflunomide include:

Since leflunomide suppresses the immune system, it may increase the risk to patients of infections. The most frequently reported infections involve the respiratory tract. Leflunomide may cause fatal liver failure. More often it causes abnormal liver tests in the blood, suggesting damage to the liver. The liver tests usually return to normal with continued treatment. The dose of leflunomide should be reduced if liver tests are persistently greater than twice the upper limit of normal, and leflunomide should be discontinued if the levels remain above three times the upper limit of normal despite a reduction in dose. Leflunomide should not be administered to individuals with liver problems.

Quick GuideRheumatoid Arthritis (RA) Symptoms & Treatment

Rheumatoid Arthritis (RA) Symptoms & Treatment
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