Leflunomide

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Leflunomide - What is it for

Leflunomide is one of the disease-modifying-anti-rheumatic drugs (DMARDs) which can reduce permanent damage to joints caused by continuing inflmmation.
It is often a second-line drug used to treat rheumatoid arthritis and psoriatic arthritis when initial drugs are not working.
It may be combined with other DMARDs or biologic agents to control disease.

Leflunomide - Side Effects, Precautions, and Contraindications

What side effects can Leflunomide cause?

What are the possible SIDE-EFFECTS of the medicine?

The most common side effect of leflunomide is diarrhoea. This symptom frequently improves with time or with medications given to prevent diarrhoea. If diarrhoea persists, the dose of leflunomide may need to be reduced, as decided by your doctor.
Less common side effects include nausea, stomach pain, indigestion, rash, or hair loss.
It may cause abnormal liver function tests or decreased blood cells.
Rarely, it may cause lung problems such as cough, shortess of breath or lung injury.

When should seek medical IMMEDIATE attention?

Come back to the hospital or see a Doctor if you have:

Dark-colored urine or pale stools.
Fast, pounding, or uneven heartbeat
Shortness of breath, troubled breathing or wheezing.
Unusual bleeding, bruising, or weakness.
Yellowng of skin or the whites of eyes.
Seizure.

Before taking Leflunomide , what precautions must I follow?

What food or medicine must I avoid when I take Leflunomide ?

What special DIETARY instructions should I follow?

As alcohol can increase liver toxicity when taken with leflunomide, it is best avoided.

Can i take other MEDICINES or SUPPLEMENTS?

You should not take leflunomide if you have a pre-existing liver disease such as hepatitis or cirrhosis.
Leflunomide can cause liver injury, so alcohol and certain other medications should be avoided e.g. rifampicin.
Certain medications e.g. cholestyramine can reduce th efficacy of leflunomide.
You should avoid live vaccines such as polio, yellow fever, rubella(German measles), MMR(measles, mumps and rubella), typhoid and BCG (tuberculosis). Flu and pnuemococcal vaccines are safe and may be given if required.

Leflunomide - Dosage and How to Use

How should Leflunomide be used?

How is the medicine given?

It is given orally, after food, usually once-a-day.
A typical dose would range from 10mg to 20mg daily.
The dose will vary for each person depending upon factors such as activity of your disease and you response to the treatment.

What is the TIME to EFFECT?

Improvement is usually seen in 3-4 weeks. The full benefits of this drug may not be seen until after 12 weeks of treatment.
You need to take it continuously to keep your symptoms controlled.

What should I do when I am taking the medicine?

Come back to the hospital for regular blood tests as instructed by your doctor.

What should I do if I miss a dose?

What should I do if I FORGET a dose?

If you forget to take a dose, take it as soon as you remember.
If it is almost time for your next dose, skip the missed dose an continue with your regular dosing schedule.
Do not double the dose to make up for the missed dose.

What should I do if I overdose?

Leflunomide - Handling and Storage

How should I handle Leflunomide safely?

How should I store Leflunomide ?

Keep away from children;#Keep in a cool, dry place, away from direct sunlight;#

How should I dispose of Leflunomide safely?

Leflunomide - Additional Information

Do I skip dose if I am SICK?

Seek prompt advice from your doctor when you develop any of the serious symptoms of infection.
Your doctor will decide whether to stop leflunomide on a case-by-case basis.

Can I get PREGNANT or BREASTFEED?

This medication can cause serious birth defects, and this risk may persist long after the drug is discontinued.
Women of childbearing potential should not receive therapy until pregnancy has been excluded and they have been counselled concerning fetal risk. Use of an effective form of birth control is critical throughout the course of this treatment and for up to two years after it is stopped. It is not known if males taking leflunomide may contribute to fetal toxicity. Men should use effective contraception for 3 months after stopping leflunomide.
Both men and women who are on the medication and want to have a child should ask their doctors to prescribe another drug—cholestyramine—to help remove leflunomide from their systems.
Breastfeeding is not recommended in mothers who are taking leflunomide.

In SUMMARY… what you need to know about Leflunomide:

Take leflunomide at the same time, once daily.
Always come for your BLOOD TESTS on the scheduled date.
Beware of the SIDE EFFECTS and when to get immediate medical attention.
Never take OVER-THE-COUNTER medicines, supplements or herbal treatments without checking with your doctor or pharmacist first.
For female patients who intend to start a family,please inform your doctor BEFORE taking this drug.
If you have any questions about your leflunomide treatment, please discuss with your doctor or Advanced Practice Nurse at 65762418 or pharmacist at 63265077.

Updated on Friday, June 12, 2015

This article is contributed by Pharmacy, Rheumatology ＆ Immunology Singapore General Hospital

The information provided is not intended as medical advice. Terms of use. Information provided by SingHealth

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