Leflunomide is used to treat rheumatoid arthritis (inflammation in the joints of fingers, wrists, feet, and ankles).
This medicine is also used to treat psoriatic arthritis (joint pain and inflammation that affects individuals with psoriasis, a type of skin disease that is caused by itchy patches of thick, red skin and silvery scales).
Take Leflunomide exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.
You may take this medicine with or without food. Try to take it at the same time each day.
Swallow the tablet whole with a glass of water.
The dose of this medicine will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on the type of your condition and response to the medication.
Leflunomide must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it unless instructed by the doctor.
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.
DO NOT double a dose under any circumstances.
If you often forget to take your medicine, let your doctor and pharmacist know.
Alert your doctor if you have the following conditions:
- severely weakened immune system
- blood disorders
- serious infections
- conditions associated with severely low proteins in the body
- liver disease
- moderate to severe kidney disease
as Leflunomide may not be suitable for you.
Do not take this medicine if you are pregnant. If you become pregnant while on Leflunomide therapy, alert your doctor immediately. This medicine may cause harm to your unborn child.
It is important that you do not get pregnant while taking this medicine. You must use proven birth control methods during Leflunomide therapy and for up to 2 years after stopping the treatment. If you are planning to have a baby or using contraceptive methods for up to 2 years is not feasible after treatment discontinuation, your doctor may recommend a "washout" procedure by taking certain medicine to help rapidly clear out Leflunomide in your body. Continue using birth control methods during the procedure and wait until this medicine is confirmed to be cleared out in your body. Follow your doctor's instructions carefully.
Do not breastfeed while you are being treated with Leflunomide.
Inform your doctor if you have any of the following conditions:
- recurrent infections or conditions that may make you prone to infection
- history of lung problems
- mild kidney disease
Men with a partner of childbearing potential must use proven birth control methods during Leflunomide therapy. If you wish to father a child, your doctor may advise you to stop the treatment and recommend a "washout" procedure by taking certain medicine to help rapidly clear out Leflunomide in your body. Wait until this medicine is confirmed to be cleared out. Follow your doctor's instructions carefully.
Why is it important to keep my appointments with the doctor?
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Pregnancy tests must be done before treatment to know if Leflunomide is suited for you to take.
- Routine tests (e.g. liver function, complete blood count) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
- Your blood pressure may rise to unsafe levels without you noticing it. Monitor your blood pressure regularly during treatment.
- Regular monitoring for signs of infection and lung or liver problems may also be needed.
Leflunomide may cause any of the following side effects: headache, dizziness, diarrhoea, nausea, stomach pain, loss of appetite, mouth ulcers, back pain, hair loss, and skin rash.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- yellowing of the skin or eyes, abdominal pain, dark coloured urine, tiredness, swelling in the legs and ankles
- cough, shortness of breath with or without fever
- rashes with peeling of the skin or blistering of the lips, mouth or eyes accompanied by fever
- unusual tingling, weakness or pain in your hands or feet
This medicine may cause the level of your red blood cells, white blood cells and platelets to drop.
Red blood cells carry oxygen around your body. A fall in the level of red blood cells may make you feel tired and worn out.
White blood cells help your body to fight infections. A fall in the level of your white blood cells may put you at higher risk for infections, such as coughs, colds and flu, which may lead to more serious infections. Avoid crowded places and people who are sick. Inform your doctor if you have a fever, cough, or flu that does not go away.
Platelets help your blood to clot when there is a cut in the skin. A fall in the level of your platelets may put you at risk of bleeding more than usual. Do not take part in activities where you may fall or get injured, such as contact sports. Inform your doctor if you get any unusual bruising (large bruises or several bruises, especially if the bruises appeared on their own) or bleeding that takes a long time to stop (for example, too much bleeding when you floss or brush your teeth).
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Inform your doctor and pharmacist if you are taking any of these medicines:
- other medicines for rheumatoid arthritis e.g. methotrexate
- medicines for diabetes e.g. tolbutamide, pioglitazone, repaglinide
- medicines for cancer e.g. paclitaxel
- certain antibiotics e.g. ciprofloxacin, cefaclor
- cholesterol-lowering medicines e.g. rosuvastatin, simvastatin, colestyramine
- NSAIDs (medicines for pain and inflammation) e.g. indometacin, ketoprofen
- cimetidine (medicine that reduces stomach acid production)
- furosemide (water pill or medicine for water retention)
- rifampicin (medicine to treat TB, lung infection known as tuberculosis)
- duloxetine (medicine for depression)
- warfarin (blood-thinning medicine)
- theophylline (asthma medicine)
- birth control pills e.g. ethinylestradiol and levonorgestrel
This list does not include all medicines that may interact with Leflunomide.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.
Avoid alcohol.
Store in a cool, dry place away from the reach of children.
Medicines must not be used past the expiry date.
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