Understanding Arava (Leflunomide) for Rheumatoid Arthritis Management
Rheumatoid arthritis (RA) is a chronic inflammatory disorder affecting joints, causing pain, stiffness, and swelling. Among the medications used to manage RA, Arava (Leflunomide) stands out as a significant treatment option. Let’s delve into the most frequently asked questions and key aspects surrounding Arava and its role in RA management.
1. What is Arava (Leflunomide)?
Arava, the brand name for Leflunomide, is an immunosuppressive medication primarily used in the treatment of rheumatoid arthritis. It belongs to a class of drugs known as disease-modifying antirheumatic drugs (DMARDs), which work by reducing inflammation and slowing down the progression of joint damage.
2. How Does Arava Work?
Arava works by inhibiting dihydroorotate dehydrogenase, an enzyme involved in the production of DNA and RNA in immune cells. By suppressing this enzyme, Arava reduces the proliferation of immune cells responsible for the inflammation seen in rheumatoid arthritis.
3. What are the Common Dosages and Forms of Arava?
Arava is typically available in tablet form, with dosages ranging from 10mg to 20mg. The initial recommended dose for most patients is 100mg once daily for the first three days, followed by a maintenance dose of 10mg to 20mg once daily, depending on individual response and tolerability.
4. What Are the Potential Side Effects of Arava?
While Arava is generally well-tolerated, some common side effects may include diarrhea, nausea, hair loss, and elevated liver enzymes. More serious but rare side effects may include liver damage, lung problems, and blood disorders. Regular monitoring of liver function tests and blood cell counts is essential during treatment with Arava.
5. How Long Does Arava Take to Work?
The onset of action of Arava may vary among individuals. Some patients may start experiencing symptom relief within a few weeks of starting treatment, while for others, it may take several months to notice significant improvements. It’s important to continue taking Arava as prescribed by your healthcare provider, even if symptom relief is not immediate.
6. Can Arava Be Used Alone or in Combination with Other RA Medications?
Arava can be used as monotherapy or in combination with other RA medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, or other DMARDs like methotrexate. The choice of treatment regimen depends on various factors, including disease severity, patient preferences, and potential drug interactions.
7. Are There Any Special Considerations Before Starting Arava?
Before initiating treatment with Arava, healthcare providers typically assess patients for tuberculosis (TB) infection, hepatitis B and C viruses, and other infections, as Arava may increase the risk of reactivation of latent infections. Additionally, women of childbearing potential should undergo pregnancy testing and use effective contraception during and after treatment with Arava, as it may cause fetal harm.
8. What Should Patients Do If They Miss a Dose of Arava?
If a dose of Arava is missed, it should be taken as soon as remembered unless it is almost time for the next scheduled dose. In such cases, patients should skip the missed dose and continue with their regular dosing schedule. Doubling the dose to make up for a missed one is not recommended.
9. How Long Can Patients Take Arava?
The duration of treatment with Arava varies depending on individual response and disease activity. Some patients may require long-term treatment to maintain disease remission and prevent joint damage, while others may achieve adequate control of symptoms and taper off the medication under close medical supervision.
10. Can Arava Cause Harm During Pregnancy or Breastfeeding?
Arava is contraindicated during pregnancy due to the potential risk of fetal harm, including birth defects. Women of childbearing potential should use reliable contraception during treatment with Arava and undergo a washout procedure to eliminate the drug from their system before attempting pregnancy. Additionally, Arava may pass into breast milk, so breastfeeding is not recommended during treatment.
Summary Table: Arava (Leflunomide) Information
|Rheumatoid Arthritis (RA)
|Mechanism of Action
|Inhibits dihydroorotate dehydrogenase, reducing immune cell proliferation
|Tablets (10mg, 20mg)
|Initial: 100mg once daily for 3 days, then maintenance (10mg-20mg daily)
|Common: diarrhea, nausea, hair loss; Serious: liver damage, lung problems
|Regular liver function tests, blood cell counts
|Contraindicated during pregnancy, not recommended during breastfeeding
|Take as soon as remembered, skip if almost time for next dose
|Duration of Treatment
|Varies based on individual response and disease activity
1. What is Arava used for?
Arava is primarily used in the treatment of rheumatoid arthritis to reduce inflammation and prevent joint damage.
2. Can Arava be taken alone?
Yes, Arava can be used as monotherapy or in combination with other RA medications, depending on the patient’s needs and disease severity.
3. What are the common side effects of Arava?
Common side effects of Arava may include diarrhea, nausea, and hair loss. It is essential to monitor for more serious side effects such as liver damage and lung problems.
4. How long does it take for Arava to work?
The onset of action of Arava may vary among individuals, with some experiencing symptom relief within weeks and others requiring several months.
5. Is Arava safe during pregnancy?
Arava is contraindicated during pregnancy due to the potential risk of fetal harm and birth defects.
6. What should I do if I miss a dose of Arava?
If a dose of Arava is missed, it should be taken as soon as remembered unless it is almost time for the next scheduled dose. Doubling the dose to make up for a missed one is not recommended.
7. How long can patients take Arava?
The duration of treatment with Arava depends on individual response and disease activity, with some patients requiring long-term therapy for disease control.