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Leflunomide is used in the treatment of rheumatoid arthritis. It reduces the pain, stiffness, inflammation, and swelling associated with this disease, improves physical function, and staves off the joint damage that ultimately results.

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Generic name: Leflunomide

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Most important fact about Leflunomide

You MUST NOT take Leflunomide if you are pregnant; it can harm 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 Leflunomide. You'll also need to use reliable contraceptive measures as long as you take Leflunomide.

If you become pregnant while taking Leflunomide, your doctor will stop the drug immediately and prescribe a regimen of cholestyramine in 8-gram doses 3 times a day for 11 days. Cholestyramine helps to clear Leflunomide from the bloodstream, possibly preventing harm to the unborn child.

How should you take Leflunomide?

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

If you miss a dose of Leflunomide

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 2 doses at the same time.

Storage instructions for Leflunomide

Store at room temperature away from light.

What side effects may occur when taking Leflunomide?

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

Side effects of Leflunomide 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

Why should Leflunomide not be prescribed?

Remember that you must not take Leflunomide if you are pregnant or plan to become pregnant. You'll also need to avoid this drug if it gives you an allergic reaction.

Special warnings about Leflunomide

Leflunomide is potentially damaging to the liver. Your doctor will test your liver function before starting Leflunomide therapy. If you have significant liver disease, including hepatitis, you'll be unable to take Leflunomide. If you develop liver problems while taking the drug, your dose will have to be reduced or eliminated.

Theoretically, Leflunomide may interfere with your body's ability to fight off infection. The drug is therefore not recommended for people with cancer, bone marrow problems, severe infections, AIDS, or any other immune system problems. You should also avoid immunization with live vaccines while taking Leflunomide.

Since there is a possibility that Leflunomide 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 to 8 weeks thereafter. If you are taking Leflunomide 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 promptly if any signs of a blood problem appear. Warnings include easy bruising, frequent infections, unusual fatigue, and paleness.

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

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

Your doctor will prescribe the drug cautiously if you have kidney problems, since poor kidney function can increase the amount of Leflunomide in your system.

Leflunomide does not appear to cause fetal harm when taken by the father prior to conception. Nevertheless, if you plan to father a child, your doctor will instruct you to stop taking Leflunomide and will prescribe a regimen of cholestyramine to clear Leflunomide from your system.

Possible food and drug interactions when taking Leflunomide

If Leflunomide 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 Leflunomide with the following:

Cholestyramine

Methotrexate

Nonsteroidal anti-inflammatory drugs such as ibuprofen, naproxen, and naproxen sodium

Rifampin

Tolbutamide

Special information if you are pregnant or breastfeeding

Do not take Leflunomide while pregnant or breastfeeding. Taken during pregnancy, Leflunomide can cause birth defects. And although it is not known whether Leflunomide appears in breast milk, there is good reason to suspect that it will cause serious side effects in nursing infants.

Recommended dosage for Leflunomide

ADULTS

The recommended starting dose is one 100-milligram 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-milligram starting dose to reduce the risk of serious side effects.

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

CHILDREN

Leflunomide is not recommended for children less than 18 years old.

Overdosage with Leflunomide

Any medication taken in excess can have serious consequences. If you suspect an overdose of Leflunomide, seek medical treatment immediately.

Symptoms of Leflunomide overdose may include:

Abdominal pain, anemia, blood disorders, diarrhea, liver problems

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