Arava is an antirheumatic drug which slows the progression of joint damage caused by rheumatoid arthritis.

Common use

Arava contains active substance Leflunomide. Its active metabolite is A771726 inhibits dihydroorotate dehydrogenase and has antiproliferative effects. A771726 in vitro inhibits proliferation and DNA synthesis of T-lymphocytes induced by mitogen. A771726 selectively binds to dihydroorotate dehydrogenase and inhibits it and hereby G1 stage of lymphocytes proliferation. Lymphocyte proliferation is one of the crucial stages in the development of rheumatoid arthritis. Arava is used to treat rheumatoid arthritis and reduces inflammation in the joints.



Dosage and direction

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



Precautions

If you are pregnant do not use Arava as it causes birth defects. Use effective birth control is recommended during treatment with this medication and also until when the drug elimination medications are received. Notify your doctor if you have hepatitis in history, liver or kidney disease, a blood cell disorder such as anemia or low platelets, any type of infection, tuberculosis in history, a bone marrow disorder, or if you take any drugs that weaken immune system. This medication may weaken your immune system and make it easier for you to be infected and sick. If you notice any signs of infection like cold or flu contact your doctor and avoid sick people. Do not receive live vaccinations and avoid people who were vaccinated recently. Special drug elimination treatment is needed when treatment with Arava is finished. Without this treatment the drug may remain in your body for up to two years.



Contraindications

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



Side effects

Most common side effects are abscess, hernia, malaise, cyst, fever, pain, neck pain, pelvic pain, headache, diarrhea, nausea, cholelithiasis, colitis, constipation, itching, rash, weight loss, loss or thinning of hair, heartbeats, tachycardia, varicose vein, high blood pressure, chest pain, abnormal liver tests. If these above listed side effects become bothersome or worsen notify your doctor.



Drug interaction

Cholestyramine decreases absorption of Arava, Rifampin on the contrary increases blood levels of Arava. Inform your doctor if you take drugs which weak 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), etanercept (Enbrel). For your doctor it is also important to know if you are treated by acetaminophen (Tylenol), auranofin (Ridaura) or aurothioglucose (Solganol), lisinopril (Prinivil, Zestril), quinapril (Accupril), enalapril (Vasotec), fosinopril (Monopril), benazepril (Lotensin), captopril (Capoten), dapsone or erythromycin, itraconazole (Sporanox), fluconazole (Diflucan), or ketoconazole (Nizoral), atorvastatin (Lipitor), niacin (Advicor), simvastatin (Zocor), HIV/AIDS medications, NSAIDs, seizure medications.





Missed dose

If you forgot to take your dose in time, please do it as soon as you remember. But do not take if it is too late or time for your next dose is in a short while. Do not take double doses of this medication or extra doses of it. Take your usually dose next day in the same regularly time.



Overdose

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



Storage

Store at room temperature between 20-25 C (68-77 F). Store away from moisture, heat, and sunlight. It is not recommended to store in a bathroom and places available for children.



Disclaimer

We provide only general information about medications which does not cover all directions, possible drug integrations, or precautions. Information at the site cannot be used for self-treatment and self-diagnosis. Any specific instructions for a particular patient should be agreed with your health care adviser or doctor in charge of the case. We disclaim reliability of this information and mistakes it could contain. We are not responsible for any direct, indirect, special or other indirect damage as a result of any use of the information on this site and also for consequences of self-treatment.