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Updated November 2019
Leflunomide (brand names Arabloc, Arava) is a medicine used to treat rheumatoid arthritis and psoriatic arthritis.
It is an immunosuppressive medicine, which means that it works by reducing the activity of the immune system.
In rheumatoid and psoriatic arthritis this action helps to reduce inflammation and thus reduces pain and swelling in the joints. It also limits damage to the joints and helps to prevent disability in the long term.
Because leflunomide acts to reduce the damage to the joints, rather than just relieve the pain, it belongs to the group of medicines called disease modifying antirheumatic drugs (DMARDs).
Over 70% of people treated with leflunomide experience improvement of their rheumatoid arthritis. Some achieve remission, where the arthritis virtually disappears. As with many medicines used to treat rheumatoid arthritis, some people experience no benefit from leflunomide treatment.
Leflunomide does not work straight away. It usually takes 4 to 8 weeks for symptoms to start to improve. The full effect may take up to 26 weeks.
Other medicines may be given to improve your symptoms while waiting for the leflunomide to work.
Leflunomide is taken by mouth in tablet form. There are three different strengths of leflunomide tablets: 10mg, 20mg and 100mg. The usual dose is 10mg or 20mg once daily. Sometimes a higher dose may be given to begin with, but side effects are more common with this approach.
The tablets should be swallowed whole, not chewed or broken. They can be taken with or without food.
Leflunomide may be used with other arthritis medicines including:
There are separate information sheets for the medicines mentioned above.
Treatment with leflunomide can be continued for more than 10 years as long as it is effective and no serious side effects occur.
If leflunomide treatment is stopped for more than a few weeks there is a risk that your condition will worsen. Continue with your treatment unless advised by your doctor or unless side effects develop.
You might experience side effects with your treatment. Tell your doctor if you are concerned about possible side effects.
If you do experience side effects, a reduction in dose may minimise these so that you can continue to take the medicine. Your doctor will advise on any dose changes that are necessary.
There are some rare but potentially serious side effects with leflunomide. These are more likely if leflunomide is being taken with methotrexate.