Leflunomide for Rheumatoid Arthritis

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Leflunomide for Rheumatoid Arthritis


Generic NameBrand Name

Leflunomide is given by mouth (orally).

How It Works

Leflunomide (Arava) is a disease-modifying antirheumatic drug (DMARD) that is used to treat rheumatoid arthritis. It interferes with the progression of the disease by blocking the production of white blood cells that cause the joint inflammation in rheumatoid arthritis. Because it blocks the natural response of the immune system, leflunomide is considered an immunosuppressive drug.

Why It Is Used

Leflunomide is used to treat active rheumatoid arthritis in adults to relieve symptoms and slow the progression of the disease. Leflunomide is considered a choice for people with active rheumatoid arthritis who have not responded to methotrexate or sulfasalazine.

How Well It Works

Leflunomide can improve symptoms, slow or prevent the disease from getting worse, and improve function in people with rheumatoid arthritis. It also seems to be well tolerated and slows disease progression as seen on X-rays.1

Side Effects

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.

Here are some important things to think about:

  • Usually the benefits of the medicine are more important than any minor side effects.
  • Side effects may go away after you take the medicine for a while.
  • If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.

Call 911 or other emergency services right away if you have:

  • Trouble breathing.
  • Swelling of your face, lips, tongue, or throat.

Call your doctor if you have:

  • Hives.
  • Fever and chills.
  • Burning with urination.
  • Severe belly pain or diarrhea.

Common side effects of this medicine include:

  • Diarrhea.
  • Skin rash.
  • Reversible hair loss.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Leflunomide should not be used by pregnant women or women of childbearing age who are not using reliable birth control. Do not take leflunomide if you are breast-feeding. If you plan to become pregnant, check with your doctor before stopping birth control and trying to become pregnant. He or she probably will prescribe a medicine (cholestyramine) that will remove leflunomide from your body. Your doctor will then check to be sure that leflunomide is no longer detectable in your body.

People taking leflunomide will need regular monitoring of their liver function to check for signs of liver damage. Talk with your doctor before taking leflunomide if you have ever had liver, kidney, or immune system disease or a history of significant alcohol use.

Taking medicine

Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.

There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.

Advice for women

Do not use this medicine if you are pregnant, breast-feeding, or planning to get pregnant. If you need to use this medicine, talk to your doctor about how you can prevent pregnancy.


Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.



  1. Drugs for rheumatoid arthritis (2009). Treatment Guidelines From The Medical Letter, 7(81): 37–46.


ByHealthwise Staff
Primary Medical ReviewerAnne C. Poinier, MD - Internal Medicine
Specialist Medical ReviewerNancy Ann Shadick, MD, MPH - Internal Medicine, Rheumatology
Last RevisedJune 5, 2012

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