Arava contains active substance Leflunomide. Its active metabolite is A771726 inhibits dihydroorotate dehydrogenase and most definitely has antiproliferative effects. A771726 in vitro inhibits proliferation and DNA synthesis of T-lymphocytes induced by mitogen. A771726 selectively attaches to dihydroorotate dehydrogenase and inhibits it and hereby G1 degree of lymphocytes proliferation. Lymphocyte proliferation is definitely one of the crucial stages within the development of rheumatism. Arava is used to remove rheumatism and reduces inflammation within the joints.

Dosage and direction
The recommended initial dose is 100 mg taken once daily for 3 days. The maintenance treatment follows, take 10-20 mg of Arava once a day. Swallow the tablets whole with a full glass of water.

Precautions
In case you are pregnant don’t use Arava since it causes birth defects. Use effective contraceptive is usually recommended during treatment with this particular medication and likewise until when the drug elimination medications are received. Notify a family doctor in case you have hepatitis in history, liver or kidney disease, a blood cell disorder for example anemia or low platelets, any type of infection, tuberculosis in history, a bone marrow disorder, or if you capture any drugs that weaken immune system. This medication may weaken your immune system and produce it more convenient for one to be infected and sick. If you notice any symptoms of infection like cold or flu contact a family doctor and avoid sick people. Never receive live vaccinations and avoid people who were vaccinated recently. Special drug elimination treatment is essential when treatment with Arava is finished. Without this treatment the drug may stay in your system for up to two years.

Contraindications
Arava can’t be utilized in the patients with hypersensitivity, liver failure, severe immune deficiency (including AIDS), disorders of bone marrow hematopoiesis (thrombocytopenia, anemia, leukopenia which aren t involved with rheumatoid arthritis symptoms), severe infections, moderate or severe kidney insufficiency, severe hypoproteinemia (including with nephrotic syndrome), in pregnant or breastfeeding women, adolescents under 18 yrs of age.

Negative effects
Commonest unwanted side effects are abscess, hernia, malaise, cyst, fever, pain, neck pain, pelvic pain, headache, diarrhea, nausea, cholelithiasis, colitis, constipation, itching, rash, weight loss, loss or thinning of hair, heartbeats, tachycardia, varicose vein, hypertension, chest pain, abnormal liver tests. If these above listed unwanted side effects become bothersome or worsen notify your health care provider.

Drug interaction
Cholestyramine decreases absorption of Arava, Rifampin quite the opposite increases blood quantities of Arava. Inform your doctor for drugs which weak level of immunity similar to sirolimus (Rapamune), tacrolimus (Prograf), methotrexate (Rheumatrex), cyclosporine (Sandimmune, Gengraf, Neoral), basiliximab (Simulect), muromonab-CD3 (Orthoclone), efalizumab (Raptiva), mycophenolate mofetil (CellCept), leflunomide (Arava), azathioprine (Imuran), etanercept (Enbrel). On your doctor furthermore it is vital that you know in case you are treated by acetaminophen (Tylenol), auranofin (Ridaura) or aurothioglucose (Solganol), lisinopril (Prinivil, Zestril), quinapril (Accupril), enalapril (Vasotec), fosinopril (Monopril), benazepril (Lotensin), captopril (Capoten), dapsone or erythromycin, itraconazole (Sporanox), fluconazole (Diflucan), or ketoconazole (Nizoral), atorvastatin (Lipitor), niacin (Advicor), simvastatin (Zocor), HIV/AIDS medications, NSAIDs, seizure medications.

Missed dose
If you forgot to trust your dose in your time, please do it right when you remember. But don’t take if it’s already too late or opt for your following dose is present in ages. Tend not to take double doses of this medication or extra doses of it. Take your usually dose next day in the same regularly time.

Overdose
If you experience such indicators of overdose as stomach pain, diarrhea, dark urine, easy bruising or bleeding, or jaundice contact your doctor immediately.

Storage
Store at room temperature between 20-25 C (68-77 F). Store faraway from moisture, heat, and sunlight. It isn’t recommended to accumulate inside a bathroom and places available for children.