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 counts, 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

Arava
INN
Drug class
Routes of administration	Oral
Pregnancy category
Bioavailability	80%
Metabolism	Hepatic
Elimination half-life	14-18 days
Excretion	Feces (48%), urine (43%)
Legal status
CAS Number	75706-12-6
PubChem	3899
DrugBank	DB01097
ChemSpider	3763
KEGG	D00749

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