Arthritis: Leflunomide

Leflunomide is a medication that is commonly used for rheumatoid arthritis and certain types of inflammatory arthritis, such as psoriatic arthritis. Leflunomide comes in a 10 milligram or a 20 milligram pill. Your rheumatologist may start you at a lower dose of around 10 milligrams a day, and if you tolerate it well, he or she may increase your dosage to 20 milligrams a day.

Leflunomide Side Effects

Leflunomide is commonly associated with side effects such as:

• Diarrhea. This is the most common side effect.
• Hair loss. Many patients stop the medication if it becomes quite prominent. 
• Sores in the nose and mouth.
• Headaches. Up to 10% of people with leflunomide get headaches. If you’re developing headaches, you may need to reduce or stop the medication. 
• High blood pressure. If there is a concern about high blood pressure, you will need to monitor your blood pressure on a regular basis.
• Cough or shortness of breath (due to lung inflammation).

If you go on leflunomide, your specialist will do some baseline bloodwork, and then bloodwork every one to three months to monitor your liver and bone marrow.

Things to Consider Before Going on Leflunomide

Leflunomide is an absolute contraindication for pregnancy or consideration of pregnancy, so your specialist will recommend that you don’t go on leflunomide if you’re of childbearing age. If for some reason you are of childbearing age and you are on leflunomide, it’s very important that you let your specialist know well in advance, because leflunomide stays in your body for months to even years. If you want to get pregnant, you need to have a washout phase to get leflunomide out of your system. Leflunomide can take several weeks or months to be effective, so you need to be patient. If you want to stop taking leflunomide, you should speak to your specialist first. It’s important to realize that leflunomide is in the body for months or potentially even years.

Talk to your rheumatologist if you'd like more information on leflunomide. 

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Print this Action Plan and check off items that you want to discuss with your healthcare provider

• Your rheumatologist may start you at a lower dose of around 10 milligrams a day, and if you tolerate it well, he or she may increase your dosage to 20 milligrams a day.

• Leflunomide is commonly associated with side effects such as diarrhea, hair loss, sores in the nose and mouth, headaches, high blood pressure and cough or shortness of breath.

• Leflunomide is an absolute contraindication for pregnancy or consideration of pregnancy, so your specialist will recommend that you don’t go on leflunomide if you’re of childbearing age.

• Leflunomide is a medication that is commonly used for rheumatoid arthritis and certain types of inflammatory arthritis, such as psoriatic arthritis.

• Leflunomide can take several weeks or months to be effective, so you need to be patient.

Adherence:
Adhering to your medications, prescribed exercises or lifestyle changes (such as dietary changes, smoking cessation, reduced alcohol consumption, etc.) is essential to improving health outcomes successfully. Compliance to any prescribed treatment is the number one thing you can do to ensure positive changes and optimal treatment outcomes.

Leflunomide is an immunosuppressive, disease-modifying anti-rheumatic drug, also known as a DMARD, which is used in active moderate-to-severe rheumatoid arthritis as well aspsoriatic arthritis.

Talk to your rheumatologist if you'd like more information on osteoarthritis of the knee.  Seeing a registered dietician can help with diet and weight loss  and seeing a local kinesiologist could help with mobility and strength.

Remember to verify the information provided by contacting the healthcare providers directly, as network participation and availability can vary over time. Find local massage therapists physiotherapists and personal trainers to help with strength and conditioning if you are experiencing arthritis.

The physicians are in good standing with the College of Physicians and Surgeons of Canada,  Canadian Rheumatology Association and the Canadian Medical Association

Key Words: Ankylosing spondylitis (AS), Rheumatoid arthritis (RA), Psoriatic arthritis (PsA), Raynaud's phenomenon and  Hip replacement,