| Common Brands | Arava |
|---|---|
|
Drug Class |
Disease-modifying antirheumatic drug (DMARD) |
|
Controlled Substance Classification |
Not a controlled medication |
|
Generic Status |
Lower-cost generic available |
|
Availability |
Prescription only |
Arava is the brand name for the drug leflunomide, which is a prescription medication mainly used in the treatment of autoimmune diseases, especially rheumatoid arthritis. It is an immunosuppressive drug, meaning it works by suppressing the immune system to reduce inflammation and damage caused by conditions where the body’s immune system mistakenly attacks its tissues. Arava can also be prescribed for other autoimmune diseases, such as psoriatic arthritis and sometimes for conditions like lupus.
Arava is usually administered as a tablet once a day, either with or without food. The tablets should not be crushed or chewed; instead, they should be swallowed whole for optimal absorption.
For patients who miss a dose, advice is given to take one as soon as possible. However, if the dosing time is nearly time for their next scheduled dosing, they should not take the missed dose; instead, they should await their next scheduled dosing. Doubling doses and making up for the omitted dose should be avoided.
Due to its long half-life, Arava can remain in the system for some time even after discontinuation. In case a patient wants to discontinue Arava, a healthcare provider may prescribe a cholestyramine washout procedure to clear the drug from the system faster.
Arava blocks dihydroorotate dehydrogenase, or DHODH. It is one of the rate-limiting enzymes for pyrimidine synthesis in most cells and, hence an important point of control over DNA and RNA synthesis during rapid cell division. As part of its inflammatory response, the immune system often produces huge numbers of immune cells that fight what are perceived to be harmful antigens. In autoimmune disease, the result is self-tissue destruction.
Arava works by inhibiting DHODH; this decreases newly produced immune cells, in turn helping to regulate this hyperactivated immune response, leading to a reduction of the associated inflammation in such sites as the joints with patients diagnosed with rheumatoid arthritis or similar disorders.
As with any medication, Arava will cause some side effects but not everyone may experience them. Some common side effects are:
Gastrointestinal disturbances: Nausea, diarrhea, and abdominal pain commonly occur during the initiation phase of treatment.
Liver injury: Arava can impact the liver. Therefore, regular liver enzyme tests must be performed.
Hair loss: Hair thinning and hair loss are reported.
Skin rashes: The patient may experience rashes, especially when exposed to sunlight.
Bone marrow suppression: Arava causes bone marrow, which affects the rate at which blood cells can be produced in the bloodstream, thus predisposing an individual to possible infections and hemorrhage.
Patients ought to report unusual side effects promptly to the doctor.
Liver Enzymes: Before one commences using Arava, the function of one’s liver needs to be assessed. This drug affects the liver adversely, therefore requiring regular tests on a patient’s blood to watch for changes in the values of liver enzymes during this medication.
Pregnancy: Arava is generally contraindicated in pregnancy because of the risk for birth defects and harm to the fetus. Women should discuss alternative treatments with the healthcare provider.
Infection: Because Arava affects the immune system, infection is a potential side effect, including serious infections, such as tuberculosis (TB).
Avoid Alcohol: During treatment with Arava, alcohol consumption may enhance liver damage.
Arava has some known interactions with other drugs. The patient should disclose to their health care providers all their prescription, over-the-counter, vitamin, and herbal drugs. Common interactions include:
Methotrexate: Use of leflunomide along with methotrexate (another DMARD) is not recommended as this can enhance the risk of hepatotoxicity.
Warfarin: Leflunomide may affect the activity of blood thinners like warfarin and enhance the risk of bleeding.
Cholestyramine: Cholestyramine is administered to reduce cholesterol levels. However, it can also be used to enhance the removal of Arava in case of toxicity. When taken within 24 hours after Arava, it may decrease its absorption.
Other immunosuppressants: Arava, when combined with other immunosuppressive drugs, increases the risk of infection.
Patients should always consult their healthcare provider before beginning a new medication or supplement while on Arava.
The dosage for the initiation of Arava is 100 mg per day for three days (loading dose) and 20 mg daily for maintenance. The physician may, however, in specific instances, increase the dose based on tolerance and response.
Patients should always adhere to the instructions from their health care provider so that the best results may be achieved and the adverse effects may be minimized.
Arava is a prescription medication that requires a doctor’s prescription; it should be prescribed by a healthcare professional well versed with the patient’s medical history and particular condition. Since this medication could have side effects, one needs to take frequent checks, and it cannot be bought over the counter and should be taken in a doctor’s care only.
Arava (leflunomide) is an immunomodulatory drug used primarily to treat active rheumatoid arthritis in adults and for the management of psoriatic arthritis.
Arava works by inhibiting an enzyme involved in the synthesis of pyrimidines, leading to reduced proliferation of immune cells and a decrease in inflammation, which helps to alleviate symptoms of arthritis.
Arava is used to treat rheumatoid arthritis and is sometimes prescribed off-label for other autoimmune conditions, including psoriatic arthritis.
Arava is taken orally in tablet form, usually once daily. The dosage may vary based on individual patient factors and response to treatment.
Common side effects include diarrhea, liver enzyme abnormalities, nausea, headache, and rash. Most side effects are manageable, but any persistent or severe symptoms should be reported to a healthcare provider.
Yes, serious side effects can include liver toxicity, severe allergic reactions, and bone marrow suppression. Patients need regular blood tests to monitor liver function and blood cell counts.
Arava should be avoided in patients with severe liver disease, pregnant women, and those with hypersensitivity to leflunomide or any of its components. A thorough medical history should be reviewed before prescribing.
No, Arava is contraindicated in pregnancy due to potential harm to the fetus. Women of childbearing age should use effective contraception while on this medication.
Patients may begin to notice improvements in their symptoms within 4 to 12 weeks of starting Arava. However, the full therapeutic effect may take longer.
If you miss a dose, take it as soon as you remember on the same day. If it is almost time for your next dose, skip the missed dose and return to your regular schedule. Do not double the dose.
There are no specific dietary restrictions while taking Arava, but it is advisable to maintain a balanced diet and avoid excessive alcohol consumption, as it can increase the risk of liver damage.
Yes, Arava can interact with various medications, including certain anticoagulants, other immunosuppressants, and medications affecting liver enzymes. Always inform your healthcare provider about all medications you are taking.
Regular blood tests are needed to monitor liver function and blood cell counts. Initial tests should be done before starting treatment and regularly thereafter.
Arava is a disease-modifying antirheumatic drug (DMARD) that works by targeting specific pathways in the immune system. It differs in mechanism and safety profile from other DMARDs and biologics.
For mild side effects, consult your healthcare provider. If you experience severe symptoms or signs of liver damage (such as jaundice, dark urine, or severe nausea), seek immediate medical attention.
Yes, Arava may be used in combination with other DMARDs or treatments for rheumatoid arthritis. Your healthcare provider will determine the best treatment plan based on your specific situation.
For many patients, Arava can be safe for long-term use; however, it requires regular monitoring for side effects, especially liver function tests and blood counts.
Discontinuing Arava suddenly may lead to a flare-up of rheumatoid arthritis symptoms. A healthcare provider should guide any changes to your medication regimen.
Arava should be stored at room temperature, away from moisture and heat, and kept out of reach of children.
More information about Arava can be obtained from your healthcare provider, or you can visit reliable medical websites and resources such as the FDA or the drug manufacturer’s website for detailed prescribing information.
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