Common Use

Arava contains the active substance Leflunomide. Its active metabolite, A771726, inhibits dihydroorotate dehydrogenase, providing antiproliferative effects. In vitro, A771726 inhibits the proliferation and DNA synthesis of T-lymphocytes induced by mitogen. It selectively binds to dihydroorotate dehydrogenase, inhibiting it and thereby affecting the G1 stage of lymphocyte proliferation. Lymphocyte proliferation is a critical stage in the development of rheumatoid arthritis. Arava is used to treat rheumatoid arthritis and reduce inflammation in the joints.

Dosage and Direction

The recommended initial dose is 100 mg taken once daily for three days. Maintenance treatment follows with a dose of 10-20 mg of Arava taken once daily. Swallow the tablets whole with a full glass of water.

Precautions

Do not use Arava if you are pregnant, as it can cause birth defects. Effective birth control is recommended during treatment and until the drug elimination process is completed. Notify your doctor if you have a history of hepatitis, liver or kidney disease, blood cell disorders like anemia or low platelets, any type of infection, a history of tuberculosis, a bone marrow disorder, or if you take any drugs that weaken the immune system. This medication may weaken your immune system, making you more susceptible to infections. If you notice signs of infection like a cold or flu, contact your doctor and avoid sick people. Do not receive live vaccinations and avoid people who were recently vaccinated. Special drug elimination treatment is required after finishing Arava treatment. Without this, the drug may remain in your body for up to two years.

Contraindications

Arava cannot be used in patients with hypersensitivity, liver failure, severe immune deficiency (including AIDS), bone marrow disorders like thrombocytopenia, anemia, or leukopenia not associated with rheumatoid arthritis, severe infections, moderate or severe kidney insufficiency, severe hypoproteinemia (including nephrotic syndrome), or in pregnant or breastfeeding women. It is also contraindicated in adolescents under 18 years of age.

Side Effects

Common side effects include abscess, hernia, malaise, cyst, fever, pain, neck pain, pelvic pain, headache, diarrhea, nausea, cholelithiasis, colitis, constipation, itching, rash, weight loss, hair loss or thinning, heartbeats, tachycardia, varicose veins, high blood pressure, chest pain, and abnormal liver tests. If these side effects become bothersome or worsen, notify your doctor.

Drug Interaction

Cholestyramine decreases the absorption of Arava, while Rifampin increases its blood levels. Inform your doctor if you take drugs that weaken the immune system, such as sirolimus (Rapamune), tacrolimus (Prograf), methotrexate (Rheumatrex), cyclosporine (Sandimmune, Gengraf, Neoral), basiliximab (Simulect), muromonab-CD3 (Orthoclone), efalizumab (Raptiva), mycophenolate mofetil (CellCept), leflunomide (Arava), azathioprine (Imuran), or etanercept (Enbrel). Also, inform your doctor if you are taking acetaminophen (Tylenol), auranofin (Ridaura), aurothioglucose (Solganol), lisinopril (Prinivil, Zestril), quinapril (Accupril), enalapril (Vasotec), fosinopril (Monopril), benazepril (Lotensin), captopril (Capoten), dapsone, erythromycin, itraconazole (Sporanox), fluconazole (Diflucan), ketoconazole (Nizoral), atorvastatin (Lipitor), niacin (Advicor), simvastatin (Zocor), HIV/AIDS medications, NSAIDs, or seizure medications.

Missed Dose

If you miss a dose, take it as soon as you remember. However, do not take it if it is almost time for your next dose. Do not double the dose or take extra medication. Take your usual dose the next day at the regular time.

Overdose

If you experience signs of overdose such as stomach pain, diarrhea, dark urine, easy bruising or bleeding, or jaundice, contact your doctor immediately.

Storage

Store Arava at room temperature between 20-25°C (68-77°F). Keep it away from moisture, heat, and sunlight. Do not store it in the bathroom or in places accessible to children.

Disclaimer

This information provides a general overview of the medication and does not cover all directions, possible drug interactions, or precautions. It should not be used for self-treatment or self-diagnosis. Always consult your healthcare provider or doctor for specific instructions tailored to your condition. We disclaim any reliability of this information or mistakes it may contain. We are not responsible for any direct, indirect, or other damages resulting from the use of this information or the consequences of self-treatment.