Arava

Generic Name: Leflunomide

  • What is Arava?

    Arava is used to treat rheumatoid arthritis. It reduces the pain, stiffness, inflammation, and swelling associated with this disease, improves physical function, and inhibits structural damage that can be seen on X-rays.

  • What is the most important information I should know about Arava?

    You must not take Arava if you are pregnant, because it can cause birth defects to the developing baby. If you are still in your childbearing years, your doctor will want to see negative results from a pregnancy test before starting you on Arava. You'll also need to use reliable contraceptive measures for as long as you take the drug.

    If you become pregnant while taking Arava, wish to become pregnant, or develop a serious toxicity while on therapy, your doctor will stop the drug immediately and may prescribe cholestyramine to help to clear Arava from the bloodstream. Without this regimen, Arava can stay in your body for up to 2 years, depending on the individual.

    Arava can damage the liver. Your doctor will test your liver function before starting Arava therapy. If you have significant liver disease, including hepatitis, you'll be unable to take Arava. If you develop liver problems while taking the drug, your treatment may need to be discontinued.

    Since there is a possibility that Arava could damage your liver or cause blood problems (such as a loss of white blood cells used to fight infection or a loss of cells that help your blood clot), it is essential that your doctor conducts a monthly blood test for the first 6 months of therapy, then every 6-8 weeks thereafter. If you are taking Arava and the cancer drug methotrexate together you may be even more susceptible to these problems. Your doctor will need to test your blood every month. Notify your doctor immediately if any signs of a blood problem develop. Warnings include easy bruising, frequent infections, unusual fatigue, and paleness.

    If you have a weak immune system, have a bone marrow disorder, or a severe, uncontrolled infection, do not use Arava.

    Lung disease (including scarring of the lung) has been reported in patients taking Arava. Symptoms may include coughing, shortness of breath, and fever. Contact your doctor immediately if you develop any new or unusual symptoms.

    It is important to contact your physician immediately if you develop any type of skin reactions while on therapy with Arava.

    You can continue to take aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), and/or low-dose corticosteroids while taking Arava.

    Your doctor will want to measure your blood pressure before you begin treatment with Arava and while you are on treatment.

  • Who should not take Arava?

    You must not take Arava if you are pregnant or plan to become pregnant. You should not take Arava if you are allergic to any of its ingredients.

  • What should I tell my doctor before I take the first dose of Arava?

    Tell your doctor about all prescription, over-the-counter, and herbal medications you are taking before beginning treatment with Arava. Also, talk to your doctor about your complete medical history, especially if you have liver or kidney problems, cancer, bone marrow problems, a severe infection, AIDS, or any other immune system problem.

  • What is the usual dosage?

    The information below is based on the dosage guidelines your doctor uses. Depending on your condition and medical history, your doctor may prescribe a different regimen. Do not change the dosage or stop taking your medication without your doctor's approval.

    Adults: The recommended starting dose is one 100-milligram (mg) tablet daily for the first 3 days. If you have an increased risk for blood disorders or liver problems, your doctor may choose to eliminate the 100-mg starting dose to reduce the risk of serious side effects.

    After the first 3 days, the doctor will reduce the dose to 20 mg a day. If side effects appear, the dose may be further decreased to 10 mg a day.

  • How should I take Arava?

    Your dosage of Arava will be decreased after the first 3 days. Never take more than your doctor prescribes.

  • What should I avoid while taking Arava?

    You should avoid immunization with live vaccines while taking Arava.

    You must avoid becoming pregnant while taking Arava. If you become pregnant while on Arava, you must undergo a drug elimination regimen. Women of childbearing age should use a form of contraception if they are taking Arava.

  • What are possible food and drug interactions associated with Arava?

    If Arava is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Arava with the following: activated charcoal, cholestyramine, methotrexate, NSAIDs such as ibuprofen and naproxen, phenytoin, rifampin, tolbutamide, or warfarin.

  • What are the possible side effects of Arava?

    Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking this drug.

    Side effects may include: abdominal pain, back pain, bronchitis, cough, diarrhea, dizziness, hair loss, headache, high blood pressure, indigestion, itching, joint disorders, loss of appetite, mouth ulcers, nausea, rash, respiratory infection, sore throat, stomach inflammation, tendon inflammation, urinary tract infection, vomiting, weakness, weight loss

    Arava has been known to cause rare but serious skin reactions. If you develop a skin rash or eruption, stop taking Arava and contact your doctor. Arava can also reduce your blood cell count.

  • Can I receive Arava if I am pregnant or breastfeeding?

    Do not take Arava while pregnant or breastfeeding. If taken during pregnancy, the drug can cause birth defects. Although it is not known whether Arava appears in breast milk, there is the potential that it may cause serious side effects in nursing infants. Tell your doctor immediately if you are pregnant, plan to become pregnant, or are breastfeeding.

  • What should I do if I miss a dose of Arava?

    Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Do not take two doses at the same time.

  • How should I store Arava?

    Store at room temperature, away from light.

Meet the Pharmacists

I'm Kristen Dore, PharmD. Welcome to PDR Health!

Check out my latest blog post on heartburn medication

Arava Related Drugs

Arava Related Conditions