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What is Leflunomide?

By D. Jeffress
Updated May 17, 2024
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Leflunomide is a prescription drug used to treat the symptoms of rheumatoid arthritis. The drug works by suppressing the immune system's autoantibodies that trigger arthritis as well as actively fighting joint inflammation. There are risks of side effects, drug interactions, and pregnancy complications when taking leflunomide, so it is important to have a thorough discussion with a doctor before starting a course of treatment. Patients who take the medication generally see improvements in joint mobility and reductions in inflammation, pain, and swelling within a few weeks.

Rheumatoid arthritis is an autoimmune condition in which the body's immune defenses attack healthy joint tissue. Inflammation, swelling, and stiffness in the hands or major body joints can be debilitating. Leflunomide helps relieve existing symptoms and stop the immune system from causing future damage. It is classified as a pyrimidine synthesis inhibitor, meaning that it blocks the action of a particular enzyme involved in triggering the inflammatory response of white blood cells.

Leflunomide is usually prescribed in tablet form. Initial dosage amounts are usually around 100 milligrams a day for the first three days of treatment. If a patient responds well, his or her doctor can lower the dose to 10 or 20 milligrams to be taken daily. Most people are prescribed leflunomide for one or two years, though a physician may decide that usage can stop sooner if symptoms greatly improve. Once a person's treatment comes to an end, he or she typically needs to take another drug called cholestyramine to flush the immunosuppressant from the body.

The most common side effects of leflunomide are dizziness, nausea, headache, stomach cramps, and diarrhea. A person may also experience muscle pain, fatigue, loss of appetite, and pale skin. Since leflunomide affects white blood cells, patients become more susceptible to infections during treatment. Doctors usually schedule frequent appointments to make sure urinary tract infections, pneumonia, flu, and skin infections do not arise. Daily antibiotics may be prescribed to help reduce the risk of infections.

Most people who use leflunomide according to their doctors' orders do not experience serious side effects or frequent infections. It is possible to have an allergic reaction to the drug that causes throat and mouth swelling, skin hives, and breathing difficulties. If an allergic reaction occurs, a patient should stop taking the medication and seek emergency room care immediately. Other rheumatoid arthritis drugs are available that may be better tolerated.

WiseGeek is dedicated to providing accurate and trustworthy information. We carefully select reputable sources and employ a rigorous fact-checking process to maintain the highest standards. To learn more about our commitment to accuracy, read our editorial process.

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