Leflunomide – Uses, Dosage, Side Effects & What You Need to Know
If you’ve been told you need leflunomide, you probably have a lot of questions. It’s a pill that doctors often give for rheumatoid arthritis (RA) and other joint problems. This guide breaks down what the drug does, how to take it safely, and what to watch out for.
How Leflunomide Works
Leflunomide blocks an enzyme called DHODH that helps immune cells multiply. By slowing those cells down, it reduces the inflammation that makes joints stiff and painful. Think of it like turning down the volume on a loud speaker – the pain isn’t gone completely, but it’s much quieter.
The drug is usually taken once a day after a meal. Starting doses are often 20 mg for the first few days (called a loading phase) then drop to 10‑20 mg for long‑term use. Your doctor may adjust the dose based on how you feel and any lab results.
Key Safety Tips
Before you start, tell your doctor about any liver problems, infections, or pregnancy plans. Leflunomide can affect liver function, so regular blood tests are a must. If you notice yellow skin, dark urine, or unusual fatigue, call your doctor right away.
Women who could become pregnant need to use two reliable forms of birth control while on leflunomide and for at least six months after stopping it. The drug stays in the body for a long time, so a special “wash‑out” procedure (cholestyramine) may be needed if pregnancy is planned.
Common side effects include mild stomach upset, headache, and loss of appetite. Most people get used to these within a few weeks. If you develop a rash, fever, or severe diarrhea, it could be a sign of a more serious reaction – seek medical help immediately.Drug interactions matter too. Avoid taking leflunomide with live vaccines, certain antibiotics (like clarithromycin), and other medicines that stress the liver. Always list every supplement and prescription you use when you talk to your pharmacist.
What about blood work? Your doctor will check liver enzymes, blood cell counts, and kidney function at regular intervals – usually every 4‑8 weeks at first, then less often if everything looks stable.
If you miss a dose, take it as soon as you remember unless it’s almost time for the next one. Don’t double up; just continue with your normal schedule.
Many patients find that leflunomide works well when combined with physical therapy and a balanced diet rich in omega‑3 fatty acids. Staying active, even gentle walking or stretching, helps keep joints flexible and can boost the drug’s effect.
In short, leflunomide is a useful tool for controlling RA pain and swelling. It works by calming an overactive immune system, but it needs careful monitoring to stay safe. Talk openly with your doctor about any concerns, stick to lab appointments, and report side effects early. With the right approach, you can keep joint damage at bay and enjoy a more active life.
- 29/Aug/2025
- by William Womack
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leflunomide
peripheral neuropathy
nerve damage
rheumatoid arthritis
cholestyramine washout
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