Lefno Dosage/Direction for Use

The treatment should be initiated and supervised by specialists experienced in the treatment of rheumatoid arthritis and psoriatic arthritis.
Alanine aminotransferase (ALT) or serum glutamopyruvate transferase (SGPT) and a complete blood cell count, including differential white blood cell count and platelet must be checked before start of treatment and at least at monthly intervals during the first 6 months of treatment, then every 6-8 weeks thereafter (see Precautions).
Dosage: In rheumatoid arthritis: Leflunomide therapy is usually started with a loading dose of 100 mg once daily for 3 days. Omission of the loading dose may decrease the risk of adverse events. For additional information regarding the use of the loading dose in rheumatoid arthritis patients, see Pharmacology: Pharmacodynamics under Actions.
The recommended maintenance dose is leflunomide 10 mg to 20 mg once daily. Patients may be started on leflunomide 10 mg or 20 mg depending on the severity (activity) of the disease.
In psoriatic arthritis: Leflunomide therapy is started with a loading dose of 100 mg once daily for 3 days.
The recommended maintenance dose is leflunomide 20 mg once daily for patients with psoriatic arthritis (see Pharmacology: Pharmacodynamics under Actions).
The therapeutic effect usually starts after 4 to 6 weeks and may further improve up to 4 to 6 months.
There is no dose adjustment recommended in patients with mild renal insufficiency.
No dose adjustment is required in patients above 65 years of age.
Leflunomide is not recommended for use in patients below 18 years of age as it has not been studied in this age group.
Method of administration: Leflunomide should be swallowed whole with sufficient amounts of liquid. The extent of leflunomide absorption is not affected if it is taken with food.