What is Arava?

Arava (leflunomide) affects the immune system and reduces swelling and inflammation in the body. This medication is used to treat rheumatoid arthritis, a condition in which the body's defense system (immune system) fails to recognize the body as itself and attacks the healthy tissues around the joints. Leflunomide helps to reduce the joint damage/pain/swelling and helps you to move better. It works by weakening your immune system and decreasing swelling (inflammation). Take this medication regularly in order to get the most benefit from it .

Always read the patient information and instructions carefully before using this medication.

• Take this medication by mouth with or without food, usually once daily or as directed by your doctor.
• Take this medication exactly as prescribed. You may be instructed to take a higher dose for the first 3 days of treatment.
• Take this medication regularly in order to get the most benefit from it. To help you remember, take it at the same time each day.
• After treatment is stopped, a different drug (cholestyramine) may be given as directed to help remove leflunomide from your body. This procedure is used if you need a rapid removal of the drug from your system (for example, if you are a female/male planning to have children, or suffering from severe side effects). Without the procedure, the drug may stay in your body for up to 2 years.
• Your blood pressure will need to be checked often. Your liver function will also need to be tested often, and you may need to stop taking Arava based on the results of these tests.
• Store at room temperature away from moisture, heat, and light.

Make sure to tell your doctor and pharmacist:

• If you have any drug allergies.
• Which other prescription and non-prescription medications you currently take.
• Your medical history, especially of: immune system disorder (e.g., HIV infection), current/recent infection (e.g., tuberculosis), cancer, bone marrow/blood disorder, kidney disease, liver disease (e.g., hepatitis B or C), alcohol abuse, heart disease (e.g., congestive heart failure), high blood pressure, lung disease.
• If you are using marijuana.

Also be aware that:

• This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Avoid alcoholic beverages. Alcohol may also cause liver disease.
• Do not have immunizations/vaccinations without the consent of your doctor, and avoid contact with people who have recently received oral polio vaccine or flu vaccine inhaled through the nose.
• Since this medication can increase your risk of developing serious infections, wash your hands well to prevent the spread of infections. Avoid contact with people who have illnesses that may spread to others (e.g., flu, chickenpox).
• This medication must not be used during pregnancy. It may harm an unborn baby. Before starting this medication, women of childbearing age must have a negative pregnancy test before starting this medication. Men and women must use effective forms of birth control (e.g., condoms and birth control pills) while taking this medication.
• It is not known whether this medication affects the sperm. To minimize any possible risk, the manufacturer recommends that men wishing to father a child should consider stopping the medication and using another drug (cholestyramine) as directed to help this drug leave the body before attempting to father a child.
• This drug may pass into breast milk and could have undesirable effects on a nursing infant. Therefore, breast-feeding is not recommended while using this drug. Consult your doctor before breast-feeding.
• This medication may raise your blood pressure. Check your blood pressure regularly and tell your doctor if the results are high.

Common side-effects may include but are not limited to:

• Diarrhea, nausea, and dizziness may occur.

Contact your doctor if you experience any of the following side-effects:

• Cough, numbness/tingling of hands/feet, hair loss, chest pain, fast/pounding heartbeat, increased thirst/urination, muscle cramp/pain, mental/mood changes, vision changes, easy bruising/bleeding, unusual growths/lumps, unexplained weight loss, unusual tiredness.
• Any signs of infection (such as sore throat that doesn't go away, fever, swollen lymph nodes, chills).
• A mild rash that is usually not serious. However, you may not be able to tell it apart from a rare rash that could be a sign of a severe allergic reaction. Get medical help right away if you develop any rash.
• Symptoms of a serious allergic reaction such as rashes, itching, swelling especially of the face, tongue or throat, severe dizziness or trouble breathing.

This medication must not be used during pregnancy. It may harm an unborn baby. Before starting this medication, women of childbearing age must have a negative pregnancy test before starting this medication. Men and women must use effective forms of birth control (e.g., condoms and birth control pills) while taking this medication. It is not known whether this medication affects the sperm. To minimize any possible risk, the manufacturer recommends that men wishing to father a child should consider stopping the medication and using another drug (cholestyramine) as directed to help this drug leave the body before attempting to father a child.

Q: What should I do if I forget a dose?

A: Take the missed dose as soon as you remember it. However, if it is almost time for your next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.