Arava is a brand name for the drug leflunomide.  It is commonly used to treat adults with moderate to severe rheumatoid arthritis and other rheumatic diseases. Arava is a part of the disease-modifying antirheumatic drugs (DMARDs) class. These types of drugs are used to decrease inflammation.

Arava is used to block DNA that is used to replicate cells in the body, including those in the immune system. It works by blocking the formation of DNA and weakening the overactive immune system to reduce joint damage, pain, and inflammation. This also allows the body to move better.

Arava Precautions and Warnings

Arava should not be taken if the patient is allergic to the drug or any of the ingredients in it. Additionally, the effects of Arava have not yet been studied in those who are breastfeeding. Those who are pregnant, plan to become pregnant, are breastfeeding, or plan to breastfeed should not take Arava.

Arava may be harmful to some people. Patients should speak to a doctor or health care provider before taking the drug. Certain medical conditions may lead to further complications, such as:

  • lowered immune system
  • bone marrow problems
  • severe infections
  • inflammation
  • scarring in the lungs
  • high blood pressure
  • certain cancers

Arava Boxed Warnings

Arava has Food and Drug Administration (FDA) administered boxed warnings. Those who are pregnant or plan to become pregnant should not take Arava. A pregnancy test should be confirmed negative by a doctor prior to starting the medication, and effective birth control must be used as Arava may cause serious fetal harm. Effective birth control should be used prior to starting Arava, during its use, and for 2 additional years after stopping the drug.

Arava may also cause severe liver problems, which could be fatal. This risk is heightened when the drug is combined with other drugs, such as acetaminophen, which may also impact the liver. Arava should not be taken by those who have already had severe liver disease or those experiencing new or worsening symptoms of liver damage.

Arava Side Effects

Arava has a range of common and severe side effects.

Common Side Effects

None of these side effects mentioned below have a need for immediate medical concern. A doctor or health care professional may help with help prevention or worsening symtoms.

Common side effects of Arava include:

  • back pain
  • hair loss
  • heartburn
  • skin rash
  • stomach pain
  • unexplained weight loss
  • acne
  • anxiety
  • decreased appetite
  • dry mouth
  • gas
  • irritation or soreness of the mouth
  • itching of the skin
  • pain or burning in the throat
  • runny nose

Severe Side Effects

Seek medical attention if you experience:

  • bloody or cloudy urine
  • cough
  • difficult or painful breathing
  • difficult or painful urination
  • dizziness
  • fever
  • frequent urge to urinate
  • headache
  • appetite loss
  • nausea
  • diarrhea or vomiting
  • sneezing
  • sore throat
  • tightening or pain in the chest
  • severe stomach pain
  • yellowing eyes
  • yellowing skin
  • burning feeling in the chest or stomach
  • burning or tingling sensations in the limbs
  • pounding heartbeat
  • indigestion
  • joint or muscle pain or stiffness
  • tenderness in the stomach
  • fatigue
  • weakness
  • tremors
  • vision problems

Drug Interactions with Arava

Arava has been known to interact with birth control pills containing ethinyl estradiol and levonorgestrel. It has also been known to interact with drugs such as:

Strengths and Dosages of Arava

Arava can be accessed in 10, 20, or 100 mg tablets. The typical maximum recommended dose is 20 mg daily, but this may vary based on the patient’s risk for ARAVA-associated hepatotoxicity and myelosuppression.

Risk for ARAVA-Associated Hepatotoxicity and MyelosuppressionLoading DoseRegular Dose
Low risk100 mg once daily for 3 days20 mg once daily after loading the doses
High riskN/A20 mg once daily

Cost of Arava in America

The average cost without insurance for Arava 10 mg or 20 mg oral tablets is about $1,583 for a supply of 30 tablets. Insurance, coupons, or opting for the generic version may reduce the cost.

Arava Alternatives

Arava is a brand name for the generic drug leflunomide. Leflunomide may be taken instead. Other possible alternatives include:

Arava FAQs

Should Arava be taken with food?

Arava can be taken with or without food. However, they should be taken with a full glass of water at around the same time each day.

Can you drink alcohol while taking Arava?

Yes, alcohol can be consumed while taking Arava, but only in small amounts. No more than two alcoholic beverages should be consumed per week while taking Arava as it may interact with it or damage the liver.

Can I take vitamin D with Arava?

Yes, no interactions were found between Arava and vitamins. However, it is always best to speak with your doctor before taking additional vitamins or medications.

Does Arava cause weight gain?

No, Arava does not make patients gain weight. The drug may, however, make patients lose weight due to loss of appetite or it may be a sign of liver damage.

What is the black box warning on Arava?

Arava has two major black box warnings. First, the drug is contraindicated in pregnant women or those not using reliable contraception as it may cause serious complications with the infant, such as birth defects. A second black box warning was later issued warning that the drug may lead to severe liver injury.

Can you take Tylenol while taking Arava?

Arava may cause liver problems and should not be combined with other medications that can also affect the liver as it may increase that risk. These medications include nonprescription pain relievers such as acetaminophen—which is Tylenol—aspirin, ibuprofen, and naproxen

How do you know if Arava is working?

The effects of Arava often take 6-12 weeks before any significant response can be seen. Symptoms usually start to improve within 4 to 8 weeks, like many other medicines used to treat rheumatoid arthritis. However, the full effect may take up to 26 weeks to be seen.

IMPORTANT NOTE: The information provided here is for educational purposes only and is not intended to serve as medical advice, diagnosis, or treatment recommendations. It should not be taken as an endorsement of any specific medication or treatment. Individual health conditions and responses to treatment can vary greatly; therefore, this information should not be seen as a guarantee of safety, suitability, or effectiveness for any particular individual. Always consult with a healthcare professional for personalized medical advice and before making any decisions regarding your health or treatment plans.

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