Leflunomide blocks the formation of deoxyribonucleic acid (also known as DNA), which is important for developing cells, such as those in the immune system. However, it is not completely clear how this medication works in rheumatoid arthritis.
It is one of the disease-modifying-anti-rheumatic drugs (DMARDs) which can modify the progress of clinical disease by reducing permanent damage to joints caused by continuing inflammation.
It is often a second-line drug used to treat rheumatoid arthritis if initial drugs are not helping substantially.
It may be combined with other DMARDs or biologic agents to control the disease.
Symptom frequently improves with time or medications given to prevent diarrhea. If diarrhea persists, the dose of leflunomide may need to be reduced, as decided by your doctor.
Less common side effects include nausea, stomach pain, indigestion, rash, or hair loss.
It may cause abnormal liver function tests or decreased blood cell or platelet counts.
Rarely, it may cause lung problems such as cough, shortness of breath or lung injury.
Come back to the hospital for regular blood test as instructed by your doctor.
Because adverse effects can happen at any time during the course of treatment and some side effects may not cause symptoms, it is really important that you have your regular blood and eye test.
You should not take leflunomide if you have a pre-existing liver disease such as hepatitis or cirrhosis.
Leflunomide can cause liver injury, so alcohol and certain other medications should be avoided e.g. rifampicin; blood test should be performed regularly to monitor liver function.\Certain medications e.g. cholestyramine can reduce the efficacy of leflunomide.
Improvement is usually first seen in 3-4 weeks. The full benefits of this drug may not be seen until after 12 weeks of treatment.
You need to take it continuously to keep your symptoms controlled.