Anthropometric Measurements as Predictors of Low Birth Weight Among Tanzanian Neonates: A Hospital-Based Study
November 7, 2025
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Brand Name :
Arava
Synonyms :
leflunomide
Class :
Immunosuppressants, DMARDS
Brand Name :
Arava
Synonyms :
leflunomide
Class :
Immunosuppressants, DMARDS
Dosage Forms & StrengthsÂ
TabletÂ
10mgÂ
20mgÂ
100mgÂ
100mg orally every day for 3 days
followed by 10 to 20mg orally everyday
Safety and efficacy not establishedÂ
Refer adult dosingÂ
may have an increased immunosuppressive effect when combined with leflunomide
may have an increased immunosuppressive effect when combined with leflunomide
may have an increased immunosuppressive effect when combined with leflunomide
may have an increased immunosuppressive effect when combined with leflunomide
may have an increased immunosuppressive effect when combined with leflunomide
may have an increased immunosuppressive effect when combined with leflunomide
It may diminish the serum concentration when combined with colesevelam
may have an increased immunosuppressive effect when combined with leflunomide
may have an increased immunosuppressive effect when combined with leflunomide
may have an increased immunosuppressive effect when combined with leflunomide
may have an increased immunosuppressive effect when combined with leflunomide
may have an increased immunosuppressive effect when combined with leflunomide
leflunomide: they may increase the immunosuppressive effect of immunostimulants
leflunomide: they may increase the immunosuppressive effect of immunostimulants
leflunomide: they may increase the immunosuppressive effect of immunostimulants
leflunomide: they may increase the immunosuppressive effect of immunostimulants
leflunomide: they may increase the immunosuppressive effect of immunostimulants
may enhance the immunosuppressive effect of immunosuppressants
may increase the immunosuppressive effect
may decrease the therapeutic effect
may decrease the immunosuppressive effect of immunosuppressants
may decrease the serum concentration of active metabolites
may decrease the therapeutic effect of COVID-19 vaccine
may increase the immunosuppressive effect of immunosuppressants
may increase the immunosuppressive effect of immunosuppressants
may increase the immunosuppressive effect of Immunosuppressive agents
may increase the immunosuppressive effect of Immunosuppressants
may increase the immunosuppressive effect of Immunosuppressants
antithymocyte globulin equineÂ
may increase the immunosuppressive effect of immunosuppressants
may increase the therapeutic effect of Immunosuppressants
It may enhance the immunosuppressive effects when combined with idecabtagene vicleucel
It may enhance the effect when combined with beclomethasone, inhaled by unspecified interactions mechanism
When leflunomide is used in combination with rabies vaccine, this leads to a reduction in the rabies vaccine effects through the process of pharmacodynamic antagonism
when leflunomide is used in combination with diphtheria & tetanus toxoids, this leads to a reduction in the effects of diphtheria & tetanus toxoids through pharmacodynamic antagonism
when both drugs are combined, there may be an increased risk or severity of adverse effects   
when both drugs are combined, there may be an increased risk or severity of adverse effects  
when both drugs are combined, there may be an increased risk or severity of adverse effects  
may enhance the immunosuppressive effect of immunosuppressants
when both drugs are combined, there may be an increased risk or severity of adverse effects  
the interaction may enhance hepatotoxic and haematotoxic effects of methotrexate
the interaction may enhance hepatotoxic and haematotoxic effects of trimetrexate
when both drugs are combined, there may be an increased risk of serious infections   
when both drugs are combined, the risk or severity of adverse effects increases  
when both drugs are combined, there may be an increased risk of serious infections   
interaction raises immunosuppressive effects and risk of infection
when both drugs are combined, there may be an increased risk of adverse effects  
when both drugs are combined, there may be an increase in immunosuppressive activity and the risk of severe infection
when both drugs are combined, there may be an increase in immunosuppressive activity and the risk of severe infection
pneumococcal vaccine 13-valentÂ
leflunomide diminishes the efficacy of the 13-valent pneumococcal vaccine through pharmacodynamic antagonism
It may enhance and diminish the immunosuppressive effects when combined with maitake
It may enhance the effect when combined with tafamidis meglumine
Combining leflunomide with pranlukast may cause a reduction in the leflunomide’s metabolism
When acetohexamide is used together with leflunomide, this lead to reduction in acetohexamide’s metabolism
when leflunomide and melphalan combine the immunosuppressive effects of both the drugs are enhanced and lead to increased risk of infection
both the drugs increase the effect of immunosuppression risk of infection increases on administering both the drugs simultaneously
may enhance the serum concentration of OAT1/3 Substrates
rifampin: they may enhance serum concentrations of the active metabolites of leflunomide
immunosuppressants increase the effect of immunosuppression of leflunomide
immunosuppressants increase the effect of immunosuppression of leflunomide
immunosuppressants increase the effect of immunosuppression of leflunomide
immunosuppressants increase the effect of immunosuppression of leflunomide
immunosuppressants increase the effect of immunosuppression of leflunomide
Actions and Spectrum:Â
leflunomide is a medication used to treat rheumatoid arthritis and other autoimmune disorders. The mechanism of action of leflunomide involves the inhibition of dihydroorotate dehydrogenase (DHODH), an enzyme involved in the de novo pyrimidine synthesis pathway. This leads to a decrease in the proliferation of T and B lymphocytes, which are involved in the pathogenesis of autoimmune diseases. Â
leflunomide has a broad spectrum of activity against various autoimmune disorders, including rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and systemic lupus erythematosus. It has also been used to treat other diseases, such as psoriasis, sarcoidosis, and multiple sclerosis. Leflunomide is effective in reducing joint inflammation, slowing the progression of joint damage, and improving physical function in patients with rheumatoid arthritis.Â
Frequency definedÂ
>10%Â
Respiratory infections (15%)Â
Diarrhea (17%)Â Â
1-10%Â
Alopecia (10%)Â
Rash (10%)Â
Bronchitis (7%)Â
Abdominal pain (5%)Â
Accidental injury (5%)Â
Dyspepsia (5%)Â
Dizziness (4%)Â
Hypertension (10%)Â
Nausea (9%)Â
Headache (7%)Â
Abnormal LFT’s (5%)Â
Back pain (5%)Â
UTI (5%)Â
Joint disorder (4%)Â
Weight loss (4%)Â
Cough (3%)Â
Gastroenteritis (3%)Â
Stomatitis (3%)Â
Vomiting (3%)Â
Allergic reaction (2%)Â
Dry skin (2%)Â
Pain (2%)Â
Pneumonia (2%)Â
Sinusitis (2%)Â
Infection (4%)Â
Pruritus (4%)Â
Anorexia (3%)Â
Pharyngitis (3%)Â
Tenosynovitis (3%)Â
Weakness (3%)Â
Chest pain (2%)Â
Eczema (2%)Â
Paresthesia (2%)Â
Rhinitis (2%)Â
Synovitis (2%)Â
Â
Post-marketing reportsÂ
PancreatitisÂ
Erythema multiformeÂ
Toxic epidermal necrolysisÂ
AgranulocytosisÂ
NeutropeniaÂ
PancytopeniaÂ
ThrombocytopeniaÂ
ColitisÂ
Stevens-Johnson syndromeÂ
Vasculitis Â
LeukopeniaÂ
Black box warning:Â
leflunomide has a black box warning, the strongest warning that the US Food and Drug Administration (FDA) can require. The black box warning for leflunomide is related to its potential to cause liver injury, which can be severe and even fatal.
The warning states that leflunomide has been associated with acute liver failure, sometimes leading to liver transplant or death. The black box warning also highlights the need for monitoring liver function tests before starting leflunomide and periodically after that.Â
Contraindications/caution:Â
Contraindications:Â
Caution:Â
Pregnancy consideration: leflunomide can harm an unborn baby. Women who are pregnant, planning to become pregnant should not take leflunomide.Â
Lactation: Excretion of the drug in human breast milk is unknownÂ
Pregnancy category:Â
Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester.  Â
Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women.Â
Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.   Â
Category D: adequate data available with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.   Â
Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.   Â
Category N: There is no data available for the drug under this categoryÂ
Pharmacology:Â
leflunomide is an immunomodulatory medication that is primarily used to treat rheumatoid arthritis. The pharmacology of leflunomide involves its effects on several biological pathways and cellular processes in the body, including:Â
Pharmacodynamics:Â
The pharmacodynamics of leflunomide refers to the drug’s effects on the body and its underlying biological mechanisms. leflunomide has several pharmacodynamic effects, including:Â
Pharmacokinetics:Â
AbsorptionÂ
leflunomide is administered orally and is rapidly absorbed from the gastrointestinal tract. The bioavailability of leflunomide is approximately 80%. Â
DistributionÂ
leflunomide is highly protein-bound (more than 99%) to albumin and other plasma proteins. It has a volume of distribution of approximately 0.13 L/kg, indicating that it is primarily distributed in the extracellular fluid.Â
MetabolismÂ
 leflunomide is metabolized in the liver by cytochrome P450 enzymes into its active metabolite, A77 1726. A77 1726 is the primary active metabolite responsible for leflunomide’s therapeutic effects. The half-life of A77 1726 is approximately two weeks.Â
Elimination and ExcretionÂ
leflunomide and its metabolites are primarily eliminated from the body via urine. Less than 1% of the dose is eliminated unchanged in the urine, with most of the dose eliminated as A77 1726 and its metabolites.Â
Administration:Â
leflunomide is a medication used to treat rheumatoid arthritis, a chronic autoimmune disorder. It works by inhibiting the production of certain enzymes involved in the inflammatory process. leflunomide is usually taken orally, either as a tablet or capsule.
The recommended starting dose is 100 mg once daily for the first three days, followed by a maintenance dose of 20 mg once daily. The medication should be taken with food to improve absorption and reduce the risk of stomach upset.Â
Patient information leafletÂ
Generic Name: leflunomideÂ
Why do we use leflunomide?Â
leflunomide is primarily used to treat rheumatoid arthritis, a chronic autoimmune disorder that causes inflammation and joint damage. It works by inhibiting the production of certain enzymes involved in the inflammatory process.Â
In addition to rheumatoid arthritis, leflunomide may treat other autoimmune disorders such as psoriatic arthritis, ankylosing spondylitis, and systemic lupus erythematosus.Â
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