Why have I been prescribed Arava?

Arava (Leflunomide) is used to treat adult patients with active rheumatoid arthritis or with active psoriatic arthritis.

How does it work?

Arava belongs to a group of medicines called anti-rheumatic medicines. It suppresses the immune system which in arthritis, attacks the bodies own tissues causing damage to the joints.

When and how do I take it?

• Swallow the tablet whole and with plenty of water.
• It may take about 4 weeks or longer until you start to feel an improvement in your condition. Some patients may even still feel further improvements after 4 to 6 months of therapy. You will normally take Arava over long periods of time.

What’s the dose?

The usual starting dosage of Arava is one 100 mg tablet once daily for the first three days.

After this, most patients need a dose of:

For rheumatoid arthritis: 10 or 20 mg Arava once daily, depending on the severity of the disease.

For psoriatic arthritis: 20 mg Arava once daily.

Could it interact with other tablets?

Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription.
This is especially important if you are taking:

• other medicines for rheumatoid arthritis such as antimalarials (e.g. chloroquine and hydroxychloroquine), intramuscular or oral gold, D penicillamine, azathioprine and other immunosuppressive drugs (e.g. methotrexate) as these combinations are not advisable,
• a medicine called colestyramine (used to reduce high cholesterol) or activated charcoal as these medicines can reduce the amount of Arava which is absorbed by the body,
• phenytoin (used to treat epilepsy), Warfarin or phenprocoumon (used to thin the blood) or tolbutamide (used to treat type 2 diabetes) as these medicines may increase the risk of side effects.

If you are already taking a non-steroidalanti-inflammatory drug (NSAID) and/or corticosteroids, you may continue to take them after starting Arava.

Herbal products should also only be taken after talking with your doctor.

What are the possible risks or side-effects?

Like all medicines, Arava can cause side effects, although not everybody gets them.

Tell your doctor immediately and stop taking Arava:

• if you experience weakness, feel lightheaded or dizzy or have difficulty breathing, as these may be signs of a serious allergic reaction,
• if you develop a skin rash or ulcers in your mouth, as these may indicate severe, sometimes life-threatening reactions (e.g. Stevens-Johnson syndrome, toxic epidermal necrolysis, erythema multiforme).

Tell your doctor immediately if you experience:

• pale skin, tiredness, or bruising, as these may indicate blood disorders caused by an imbalance in the different types of blood cells which make up blood,
• tiredness, abdominal pain, or jaundice (yellow discolouration of the eyes or skin), as these may indicate serious conditions such as liver failure, which may be fatal,
• any symptoms of an infection such as fever, sore throat or cough, as Arava may increase the chance of a severe infection which may be life-threatening,
• a cough or breathing problems as these may indicate inflammation of the lung (interstitial lung disease).

Common side effects (affects 1 to 10 users in 100):

• a slight decrease in the number of white blood cells (leucopenia),
• mild allergic reactions,
• loss of appetite, weight loss (usually insignificant),
• tiredness (asthenia),
• headache, dizziness,
• abnormal skin sensations like tingling (paraesthesia),
• mild increase in blood pressure,
• diarrhoea,
• nausea, vomiting,
• inflammation of the mouth or mouth ulcers,
• abdominal pain,
• an increase in some liver test results,
• increased hair loss,
• eczema, dry skin, rash, itching,
• tendonitis (pain caused by inflammation)

Can I drink alcohol while taking it?

You are more likely to have liver problems if you drink alcohol while you are being treated with Arava.

What if I’m pregnant/breastfeeding?

• Do not take Arava if you are, or think you may be pregnant. Women of childbearing potential must not take Arava without using reliable contraceptives measures.
• Do not take Arava when you are breast feeding, as leflunomide passes into the breast milk.

If you have any more questions please ask your Pharmacist.

Remember to keep all medicines out of reach of children
Please Note: We have made every effort to ensure that the content of this information sheet is correct at time of publish, but remember that information about drugs may change. This sheet does not list all the uses and side-effects associated with this drug. For full details please see the drug information leaflet which comes with your medicine. Your doctor will assess your medical circumstances and draw your attention to any information or side-effects which may be relevant in your particular case.

References:

https://en.wikipedia.org/wiki/Arava

http://www.arava.com/hcp/default.aspx

http://www.drugs.com/arava.html

http://www.rxlist.com/arava-drug.htm

http://www.hopkinsarthritis.org/patient-corner/drug-information/leflunomide-arava/