Drugs

Management of hepatotoxicity attributable to leflunomide There have been several reports of severe hepatotoxicity attributable to leflunomide. Some of these cases have resulted in liver failure and death. Most occurred within the first several months of initiation of therapy. Most patients were taking additional medications (such as MTX) that are known to be hepatotoxic to …

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What precautions and monitoring are required in patients taking leflunomide? Before starting leflunomide, a CBC with platelets, hepatitis B and C serologies, AST, ALT, albumin, and creatinine (CrCl) should be obtained. Monitor with a CBC, creatinine, and liver transaminases every 2 to 4 weeks for the first 3 months, then every 8 to12 weeks for …

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Is leflunomide used in diseases other than Rhemuatoid Arthritis? Yes. Although not Food and Drug Administration (FDA)-approved, leflunomide has been used in most diseases where MTX is used with similar results.

MOA of leflunomide Leflunomide is an immunosuppressive medication used primarily in the treatment of rheumatoid arthritis. Its mechanism of action involves several processes: Inhibition of pyrimidine synthesis: Leflunomide blocks the enzyme dihydroorotate dehydrogenase (DHODH), which is involved in the de novo synthesis of pyrimidines, essential components of DNA and RNA. By inhibiting DHODH, leflunomide reduces …

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dosing and side effects of leflunomide Dosage: 10 to 20 mg daily. It is primarily metabolized by the liver. To save money, leflunomide 20 mg every other day works as well as 10 mg daily. While it is approved with a loading dose (100 mg daily × 3 days), it is rarely given because of …

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Role of leflunomide in Rheumatoid Arthritis Leflunomide (Arava) is a DMARD engineered and approved for the treatment of active RA. Studies support leflunomide’s comparable efficacy to low-dose MTX and to SSZ. Additionally, leflunomide has been shown to slow radiographic progression in RA. Leflunomide may be used when MTX is contraindicated or not tolerated. It can also …

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In what rheumatologic conditions is MTX used? • RA. • JIA. • Psoriatic arthritis. • Reactive arthritis (Reiter’s syndrome). • Ankylosing spondylitis (peripheral arthritis). • Polymyositis/dermatomyositis. • Antineutrophil cytoplasmic antibody-associated vasculitides. • Adult-onset Still’s disease. • SLE. • Polymyalgia rheumatica/giant cell arteritis. • Sarcoidosis. • Uveitis.