Leflunomide
Also known as: Arava
Leflunomide, sold as Arava, is a DMARD used mainly in rheumatoid and psoriatic arthritis. It is a useful alternative or partner to methotrexate for many patients.
Calm, careful medication review by a consultant rheumatologist.
What this medicine is
Leflunomide is a tablet taken once a day. It calms the overactive immune activity that drives joint inflammation.
Uses and context
It is often chosen when methotrexate is not tolerated, not enough, or not suitable. It can be used alone or combined with other DMARDs.
How this relates to rheumatology care
In clinic I check baseline blood tests, blood pressure, and pregnancy status before starting. Leflunomide stays in the body for a long time, so I plan carefully around pregnancy, side effects and any change in treatment.
What safety checks may matter
Baseline full blood count, liver function and blood pressure
Regular blood test monitoring
Reliable contraception in patients of childbearing potential
Careful check for any liver history or heavy alcohol use
Side effects and red flags
If you have emergency symptoms such as severe allergic reaction, breathing difficulty, chest pain, stroke-like symptoms, severe abdominal pain, vomiting blood, black stools, sudden vision loss, severe infection symptoms, or severe weakness or confusion, please seek urgent medical care first rather than waiting for a WhatsApp reply.
Yellowing of the skin or eyes
Severe abdominal pain
Persistent diarrhoea or significant weight loss
New or worsening breathlessness
Severe skin rash or blistering
Signs of severe infection such as high fever with chills
Things worth knowing day to day
Do not become pregnant while on leflunomide; a washout is needed first.
Avoid heavy alcohol during treatment.
Tell me about any diarrhoea; it is a common early side effect that can often be managed.
Blood pressure needs regular checks.
Questions patients often ask me about this medicine
Speak with me
If leflunomide has been suggested for your arthritis, please message my clinic. I would like to help you understand it clearly before you start.
Other medications used in rheumatology care
This page is for general education only and does not replace medical advice. Please consult a qualified healthcare professional for diagnosis and treatment. Do not start, stop, or change any medicine without advice from your doctor.