Comprehensive Product Description Guide: Arava (Leflunomide)
Referenced Product: Blackmores Conceive Well Gold 28 Tablets + 28 Capsules
EZ Chemist Online Pharmacy
Arava 20mg, Leflunomide for rheumatoid arthritis, DMARDs, autoimmune treatment, rheumatoid joint pain, EZ Chemist arthritis medication
What is Arava used for?
Arava (leflunomide) is a disease-modifying antirheumatic drug (DMARD) used to treat active rheumatoid arthritis and psoriatic arthritis by suppressing the immune response and reducing inflammation.
Arava 10mg / 20mg / 100mg Tablets (strength varies by region)
Generic Name: Leflunomide
Drug Class: Disease-Modifying Antirheumatic Drug (DMARD)
DMARD for Rheumatoid Arthritis
Arava Immunomodulator
Anti-inflammatory RA medication
Autoimmune joint therapy
Leflunomide – a synthetic isoxazole derivative with immunomodulatory and anti-inflammatory activity

Inhibiting dihydroorotate dehydrogenase (DHODH), an enzyme crucial in the de novo pyrimidine synthesis pathway
Suppressing the proliferation of activated T and B lymphocytes, which are responsible for autoimmune attacks on joints
Reducing pro-inflammatory cytokine production, thereby relieving joint pain and swelling
Modulating immune response without complete immunosuppression, making it suitable for long-term use in autoimmune disorders
Rheumatoid Arthritis (RA) – for active disease to reduce joint damage and improve mobility

Psoriatic Arthritis – for inflammatory joint and skin symptoms

Off-label: In some countries, used experimentally in other autoimmune conditions like lupus nephritis
Loading dose: 100 mg orally once daily for 3 days (optional; some regimens skip this due to side effects)

Maintenance dose: 20 mg once daily

Lower doses (10 mg daily) may be used to reduce GI or hepatic side effects

Arava should be taken with or without food, once daily at the same time
Renal or hepatic impairment: Contraindicated in severe cases

Elderly: Use with caution; monitor organ function

Prescribing & Monitoring
Prescription-only medicine

Requires baseline and ongoing liver function tests (LFTs), CBC, and blood pressure monitoring

Blood tests: Every 4–8 weeks during therapy

Pregnancy exclusion before starting therapy is mandatory (see below)
Nausea, diarrhea

Elevated liver enzymes

Rash or skin irritation

Hair thinning

Hypertension

Serious Side Effects (rare but monitored):
Hepatotoxicity

Severe infections due to immunosuppression

Interstitial lung disease

Peripheral neuropathy

Contraindications & Warnings
Pregnancy Category X – Teratogenic; contraindicated during conception, pregnancy, and breastfeeding

Long washout procedure using cholestyramine required before planning pregnancy

Severe liver impairment

Active serious infections

Hypersensitivity to leflunomide

Females using Arava must use reliable contraception. Washout may take up to 2 years unless accelerated by cholestyramine
Methotrexate – Increased hepatotoxicity risk

Warfarin – Enhanced anticoagulant effect

Live vaccines – Avoid during therapy

Cholestyramine / Activated charcoal – Used to eliminate leflunomide

NSAIDs – Can be co-administered but monitor for liver/GI effects

Supplements like Blackmores Conceive Well Gold must be avoided while on Arava due to its pregnancy contraindications and need for strict conception planning post-treatment.
Schedule 4 (Prescription Only)

ATC Code: L04AA13 (Leflunomide)

Class: Immunomodulatory, Anti-rheumatic DMARD

Pregnancy Category: X (Do Not Use in Pregnancy)

Clinical Studies & Efficacy
ARALD Study (1999, NEJM): Leflunomide significantly reduced signs and symptoms of RA compared to placebo and was comparable to methotrexate in efficacy

Long-term extension trials confirmed sustained response over 3–5 years with manageable side effects under proper monitoring

Head-to-head studies with sulfasalazine and methotrexate show similar effectiveness with different safety profiles
Store below 25°C

Keep in original packaging, away from moisture

Keep out of reach of children
Q1. Can Arava be used with Blackmores Conceive Well Gold?
No. Arava is not safe during pregnancy or conception. Women must stop Arava and complete washout before taking any fertility or prenatal supplements.

Q2. How long does Arava stay in the body?
Leflunomide has a long half-life (up to 2 weeks) and can stay in the body for up to 2 years. A washout with cholestyramine is required if rapid elimination is needed.

Q3. Can men take Arava while planning for pregnancy?
Yes, but some guidelines recommend washout for men as well. Discuss with your rheumatologist and fertility specialist.

Q4. What monitoring is needed while on Arava?
Regular liver function tests, blood counts, and blood pressure checks are required throughout treatment.

Q5. What is the difference between Arava and methotrexate?
Both are DMARDs. Arava works by blocking pyrimidine synthesis, while methotrexate inhibits folate pathways. Methotrexate is more commonly used first-line but Arava is an alternative in intolerance.
Available at: EZ Chemist Online Pharmacy (Insert product URL when live)
Arava, Leflunomide, DMARD, Rheumatoid Arthritis, Psoriatic Arthritis, Immunomodulator, Joint Inflammation Relief, Prescription, Autoimmune Therapy, EZ Chemist