Editing Arava

'''Arava''' is a [[brand name]] for the drug [[leflunomide]], which is primarily used to treat [[rheumatoid arthritis]]. It is classified as a [[disease-modifying antirheumatic drug]] (DMARD) and works by inhibiting the synthesis of [[pyrimidine]], which is necessary for the proliferation of [[lymphocytes]]. This action helps to reduce inflammation and slow the progression of the disease.
==Medical Uses==
Arava is prescribed for the treatment of [[rheumatoid arthritis]] and [[psoriatic arthritis]]. It helps to alleviate symptoms such as [[joint pain]], [[swelling]], and [[stiffness]]. The drug is often used in patients who have not responded adequately to other DMARDs like [[methotrexate]].
==Mechanism of Action==
Leflunomide, the active ingredient in Arava, inhibits the enzyme [[dihydroorotate dehydrogenase]] (DHODH), which is involved in the de novo synthesis of [[pyrimidine]]. By blocking this pathway, leflunomide reduces the proliferation of activated [[T cells]] and [[B cells]], which are key players in the autoimmune response seen in rheumatoid arthritis.
==Side Effects==
Common side effects of Arava include [[diarrhea]], [[nausea]], [[hair loss]], and [[rash]]. More serious side effects can include [[liver damage]], [[lung disease]], and severe [[infections]]. Regular monitoring of [[liver function]] and [[blood counts]] is recommended during treatment.
==Contraindications==
Arava is contraindicated in patients with severe [[liver impairment]], [[pregnancy]], and those with known hypersensitivity to leflunomide. Women of childbearing potential should use effective contraception during treatment and for a period after discontinuation due to the drug's long half-life.
==Drug Interactions==
Arava can interact with other medications, including [[warfarin]], [[rifampin]], and other DMARDs. These interactions can increase the risk of side effects or reduce the effectiveness of the treatments.
==Monitoring==
Patients on Arava should undergo regular monitoring, including [[liver function tests]], [[complete blood count]]s, and [[blood pressure]] checks. This helps to identify any adverse effects early and manage them appropriately.
==Discontinuation==
Due to its long half-life, discontinuation of Arava may require a drug elimination procedure using [[cholestyramine]] or [[activated charcoal]] to accelerate the removal of leflunomide from the body.
==Related Pages==
* [[Rheumatoid arthritis]]
* [[Psoriatic arthritis]]
* [[Disease-modifying antirheumatic drug]]
* [[Methotrexate]]
* [[Lymphocyte]]
* [[T cell]]
* [[B cell]]
* [[Dihydroorotate dehydrogenase]]
* [[Pyrimidine]]
==Categories==
[[Category:Drugs]]
[[Category:Immunosuppressants]]
[[Category:Rheumatology]]
{{Drugbox
| Verifiedfields = changed
| verifiedrevid = 477002123
| IUPAC_name = 5-methyl-N-[4-(trifluoromethyl)phenyl]isoxazole-4-carboxamide
| image = Leflunomide.svg
| width = 200
| tradename = Arava
| Drugs.com = 
| MedlinePlus = a601008
| pregnancy_AU = X
| pregnancy_US = X
| legal_AU = S4
| legal_CA = Rx-only
| legal_UK = POM
| legal_US = Rx-only
| routes_of_administration = Oral
| bioavailability = 80%
| protein_bound = >99%
| metabolism = Hepatic
| elimination_half-life = 14-18 days
| excretion = Feces (48%), urine (43%)
| CAS_number = 75706-12-6
| ATC_prefix = L04
| ATC_suffix = AA13
| PubChem = 3899
| DrugBank = DB01097
| ChemSpiderID = 3763
| UNII = G162GK9U4W
| KEGG = D00749
| ChEBI = 6436
| ChEMBL = 724
| C=12
| H=9
| F=3
| N=2
| O=2
| molecular_weight = 270.206
| smiles = CC1=C(C=NO1)C(=O)NC2=CC=C(C=C2)C(F)(F)F
| StdInChI = 1S/C12H9F3N2O2/c1-7-10(18-17-7)11(19)16-8-4-2-6(3-5-8)12(13,14)15/h2-5H,1H3,(H,16,19)
| StdInChIKey = HCLABQKJUXFEFU-UHFFFAOYSA-N
}}
{{hospital-stub}}