Generic Name: Arava
What is Arava?
Practitioners should refer to the most recent CDC guidelines regarding vaccination of patients who are receiving drugs that adversely affect the immune system. It is possible that black cohosh would act synergistically with other medications that can have adverse effects on the liver.
Until more is known, the concurrent use of black cohosh in patients taking leflunomide is not recommended as a precaution. Bosentan: Inhibition of CYP2C9 by leflunomide may increase the plasma concentration of bosentan. Charcoal: Activated charcoal can bind with leflunomide and enhance its clearance from the systemic circulation via intestinal trapping.
Because the active metabolite of leflunomide, M1, has a prolonged half-life, staggering the administration times of each agent will not prevent this drug interaction. This effective means of gastrointestinal dialysis has actually been used therapeutically in patients with leflunomide toxicity. Charcoal is used as an alternative to cholestyramine in the drug elimination procedure for leflunomide. Cholestyramine: Cholestyramine can bind with leflunomide and enhance its clearance from the systemic circulation via intestinal trapping.
This effective means of 'gastrointestinal dialysis' has actually been used therapeutically in patients with leflunomide toxicity.
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines and all herbal supplements as other medicines may affect each other and cause serious side effects.
What should patients be aware of upon cessation of treatment with Arava. It is recommended that an accelerated drug elimination procedure be used to reduce the plasma concentrations of the active metabolite, teriflunomide. A package insert is required by the FDA and contains a summary of the essential scientific information needed for the safe and effective use of the drug for healthcare providers and consumers.
A package insert typically includes information regarding specific indications, administration schedules, dosing, side effects, contraindications, results from some clinical trials, chemical structure, pharmacokinetics and metabolism of the specific drug. By carefully reviewing the package insert, you will get the most complete and current information about how to safely use this drug.
If you do not have the package insert for the drug you are using, your pharmacist or physician may be able to provide you with a copy. The information provided above on the drug you have selected is provided for your information only and is not a substitute for consultation with an appropriate medical doctor. We are providing this information solely as a courtesy and, as such, it is in no way a recommendation as to the safety, efficacy or appropriateness of any particular drug, regimen, dosing schedule for any particular cancer, condition or patient nor is it in any way to be considered medical advice.
Patients should discuss the appropriateness of a particular drug or chemotherapy regimen with their physician. As with any printed reference, the use of particular drugs, regimens and drug dosages may become out-of-date over time, since new information may have been published and become generally accepted after the latest update to this printed information.
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How should I take Arava?
Drug HouseThane West, Thane Shop No. This can be reduced to 10mg daily if poorly tolerated. Psoriatic arthritis 20 mg per day. Eight to 12 weeks before response maybe longer if no loading dose At present it is recommended that Leflunomide should not be used in conjunction with other DMARDs in routine clinical practice.
Leflunomide may inhibit the metabolism of warfarin, phenytoin and tolbutamide. It has an extremely long elimination half life and interactions with these drugs and with other DMARDs may occur even after leflunomide has been discontinued. Male and female patients should not procreate within 2 years of discontinuing leflunomide.
What should I avoid while taking Arava?
Leflunomide has not been adequately studied in patients with renal impairment or renal failure. Single-dose studies in patients on dialysis have shown a doubling of the free active fraction of the M1 metabolite.
Because of the role of the kidney in leflunomide elimination and no clinical experience in this patient population, leflunomide should be used with caution in the presence of renal dysfunction.
Leflunomide is not removed by hemodialysis or continuous ambulatory peritoneal dialysis CAPD. Caution should be used during leflunomide therapy in patients with pre-existing hypertension.
Arava side effects
Before using this medication, tell your doctor or pharmacist your medical history, especially of: immune system disorder e. This drug may make you dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Avoid alcoholic beverages since they can make you dizzy and also cause liver disease. Since this medication can increase your risk of developing serious infections, wash your hands well to prevent the spread of infections.
Common Arava ide effects may include:
Patients should discuss the appropriateness of a particular drug or chemotherapy regimen with their physician.
When should Arava not be used.
In rheumatoid arthritis, Arava has been studied in four main studies involving over 2,000 patients, in which it was compared with placebo a dummy treatmentor with methotrexate or sulphasalazine other medicines used to treat rheumatoid arthritis.
In psoriatic arthritis, Arava has been compared with placebo in 186 patients over six months.
In either case it should be confirmed by a blood test that Arava has been sufficiently removed from your body and you should then wait for at least another month before you become pregnant. If you suspect that you are pregnant while taking Arava or in the two years after you have stopped treatment, you must contact your doctor immediately for a pregnancy test.
If the test confirms that you are pregnant, your doctor may suggest treatment with certain medicines to remove Arava rapidly and sufficiently from your body, as this may decrease the risk to your baby.
Do not take Arava when you are breast-feeding, as leflunomide passes into the breast milk.
Where can I get more information?
When the kidneys are not working well, leflunomide can build up in the body and cause serious side effects.
Improvement from baseline in the individual components of the ACR responder criteria was also sustained in most patients during the second year of Arava treatment in all three trials.