Arava 20mg (Leflunomide) 30 Tablets/Pack
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Arava general information
What is Arava used for?
Arava tablets 20mg are used to treat rheumatoid arthritis and active psoriatic arthritis, which are both autoimmune disorders (when the immune system attacks self), have an overactive immune system and have a genetic predisposition. Arava tablets 20mg are used to improve symptoms of the disease, which include pain, inflammation, tenderness, stiffness and swelling in the affected joints. Rheumatoid arthritis is a chronic progressive disease of the joints in which inflammation causes joint destruction and deformity of the joints. Arava 20 can help slow down the process of joint destruction and improve functional ability and quality of life and is particularly helpful in patients who do not respond to other treatments or if other treatments cannot be used. Psoriatic arthritis is a form of arthritis that is often also associated with psoriasis of the skin, characterised by raised red patches covered in silvery scales, but can develop before skin symptoms appear. Psoriatic arthritis differs from rheumatoid arthritis by being negative for rheumatoid factor, a blood test for an antibody that is usually positive in rheumatoid arthritis. Arava 20 is used only for treating inflammation of the joints in psoriatic arthritis not for the skin condition alone. Rheumatoid arthritis and active psoriatic arthritis are both characterised by periods of remission and periods of flare up when symptoms worsen and joints become painful and swollen. Arava tablets 20mg will not cure arthritic disease but can be used to relieve symptoms of pain and inflammation and improve the functional use of affected joints.
How does Arava work?
Arava tablets 20mg contain leflunomide, a disease-modifying antirheumatic drug (DMARD) that is used to relieve inflammatory symptoms of the arthritic diseases rheumatoid arthritis and active psoriatic arthritis. Leflunomide in Arava tablets 20mg acts as an immunomodulatory drug with immunosuppressive characteristics, which means that it can suppress the immune system. Leflunomide in Arava tablets 20mg works by several possible mechanisms. It is thought to inhibit the production of inflammatory mediators called cytokines, such as interleukins and prostaglandins, particularly tumour necrosis factor (TNF), interleukin 1 (IL1) and interleukin 6 (IL6). Also it has antiproliferative properties due to its inhibition of dihydroorotate dehydrogenase, an enzyme involved in pyrimidine synthesis and this action blocks the proliferation of rapidly dividing inflammatory lymphocytes, which helps reduce the inflammation that is responsible for the pain and swelling of rheumatic joints. These actions of leflunomide in Arava tablets 20mg dampen down the immune response by interacting with immune cells that influence the immune response to autoantigens (directed against self) and help reduce progression of the disease and reduce symptoms.
What does Arava contain?
Arava tablets contain the active ingredient leflunomide 20mg, a disease-modifying antirheumatic drug (DMARD) used to treat rheumatoid arthritis and active psoriatic arthritis. They also contain lactose, maize starch, povidone, colloidal anhydrous silica, magnesium stearate, crospovidone, hypromellose, macrogol 8000, talc and titanium dioxide iron oxide yellow.
Treating rheumatic diseases with Arava
Arava tablets 20mg contain leflunomide, a disease-modifying antirheumatic drug (DMARD) that is used to treat rheumatoid arthritis and active psoriatic arthritis, to improve symptoms of the disease, which include pain, inflammation, tenderness, stiffness and swelling in the affected joints. Rheumatoid arthritis and psoriatic arthritis (a form of arthritis that is often also associated with psoriasis of the skin, causing raised red patches covered in silvery scales) are both autoimmune disorders (when the immune system attacks self) and are characterised by an overactive immune system and a genetic predisposition. Leflunomide in Arava tablets 20mg acts as an immunomodulatory drug and works by inhibiting the production of cytokines, which are inflammatory mediators. Also, Leflunomide in Arava tablets 20mg blocks the proliferation of rapidly dividing inflammatory lymphocytes, which helps reduce the inflammation. Arava 20 can help slow down the process of joint destruction and improve joint function and quality of life, by reducing pain and inflammation but will not cure arthritic disease.
What are the side effects of Arava?
The most commonly reported side effects when taking Arava tablets 20mg include, diarrhoea, nausea, vomiting, abdominal pain, stomatitis (oral mucosal disorder) anorexia, weight loss, hair loss, eczema, rash, pruritus (itching), dry skin, mild increase in blood pressure, paraesthesia (tingling of the skin), headache, dizziness, weakness (asthenia).
When should Arava not be used?
You should not use Arava tablets 20mg if you:
- are allergic to leflunomide or any ingredients in Arava
- are pregnant or are breastfeeding
- have kidney, liver or lung disease
- Have hypoproteinaemia (oedema – water retention, and loss of protein from the blood) such as nephrotic syndrome
- have reduced immunity or immunodeficiency (such as due to AIDS)
- have severe uncontrolled infection
- are taking medicines that interact with Arava, including other immunomodifiers like methotrexate, the anticoagulant warfarin, immunisation with a live vaccine, statins, cholestyramine or activated charcoal for high cholesterol, repaglinide for diabetes, rifampicin for tuberculosis, non-steroidal anti-inflammatories like diclofenac or corticosteroids for inflammation
What medications interact with Arava?
Several medications interact with Arava tablets 20mg and should either not be taken while you are taking Arava or only after discussion and instruction from your doctor:
- Drugs that cause a serious reaction with Arava: other immunomodifiers like methotrexate could cause liver toxicity, immunisation with a live vaccine, non-steroidal anti-inflammatories like diclofenac or corticosteroids for inflammation
- Drugs that affect Arava: cholestyramine or activated charcoal for high cholesterol
- Drugs that are affected by Arava: the anticoagulant warfarin, repaglinide for diabetes, statins for for high cholesterol, rifampicin for tuberculosis
How should Arava be taken?
You should take your Arava tablets 20mg swallowed whole once daily with or without food and at the same time each day. The dose you take depends on what you are being treated for and you will probably be started on a loading dose (high dose) which will then be reduced after 3 days. You should start to see a response after 4-6 weeks, with further improvement after 4-6 months. You should continue to take your Arava tablets 20mg for as long as recommended by your doctor, which may be for several months or longer.
How long should you take Arava?
You should continue to take your Arava tablets 20mg for as long as recommended by your doctor, which may be for several months or longer.
Missed dose of Arava
If you miss a dose of Arava tablets 20mg take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose. Do not take a double dose.
How should Arava be stored?
You should store your Arava tablets 20mg below 25°C in a cool dry place.