Aray

Leflunomide

Active RA or active psoriatic arthritis in adults.

Initial dose: One 100-mg tab once daily for the 1st 3 days. Subsequent dose: RA 10 or 20 mg once daily, depending on disease severity. Psoriatic arthritis 20 mg once daily.

Hypersensitivity to leflunomide or teriflunomide. Hypoproteinaemia. Any problem affecting the immune system (eg, AIDS). Any bone marrow problem; low RBCs or WBCs, or reduced blood platelets. Serious infection. Liver problems. Moderate to severe kidney problems. Pregnancy & lactation.

Patients w/ history of ILD; history of TB or close contact w/ a TB patient; unexplained chronic diarrhoea; intolerance to some sugars. Detection of falsely low Ca levels. Can occasionally cause some problems w/ the blood, liver, lungs, or nerves in the arms or legs. May cause some serious allergic reactions (including DRESS), or increase the chance of a severe infection. Reports of rare cases of severe liver injury. Perform blood tests at regular intervals before & during treatment. Regularly check BP. Do not give certain vaccinations during treatment & for a certain amount of time after stopping treatment. Not recommended to drink alcohol during treatment. May impair ability to drive or operate machinery. Women of childbearing potential & men wishing to father a child should use reliable contraception during treatment. Blood test should confirm that Aray has been sufficiently removed from the body before becoming pregnant or attempting to father a child; women should wait for at least another mth before becoming pregnant, while men should wait for at least another 3 mth before attempting to father a child. Not recommended for use in childn & adolescents <18 yr.

Leucopenia; mild allergic reactions; loss of appetite, wt loss (usually insignificant); tiredness/asthenia; headache, dizziness; paraesthesia; mild increase in BP; colitis; diarrhoea; nausea, vomiting; mouth inflammation or ulcers; abdominal pain; increase in some liver test results; increased hair loss; eczema, dry skin, rash, itching; tendonitis; increased creatine phosphokinase; peripheral neuropathy.

Potential interaction w/ other medicines for RA eg, antimalarials (eg, chloroquine & hydroxychloroquine), IM or oral gold, D-penicillamine, azathioprine & other immunosuppressive medicines (eg, methotrexate); warfarin & other oral blood thinners; teriflunomide; repaglinide, pioglitazone, nateglinide, or rosiglitazone; daunorubicin, doxorubicin, paclitaxel, or topotecan; duloxetine; alosetron; theophylline; tizanidine; OCs (containing ethinylestradiol & levonorgestrel); cefaclor, benzylpenicillin (penicillin G), ciprofloxacin; indomethacin, ketoprofen; furosemide; zidovudine; rosuvastatin, simvastatin, atorvastatin, pravastatin; sulfasalazine; colestyramine or activated charcoal. Increased chance of liver damage w/ alcohol during treatment.

Disease-Modifying Anti-Rheumatic Drugs (DMARDs)

L04AK01 - leflunomide ; Belongs to the class of dihydroorotate dehydrogenase (DHODH) inhibitors. Used as immunosuppressants.

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