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Generic Arava (Leflunomide) is a medication that reduces inflammation and swelling due to rheumatoid arthritis. The response of the immune system may contribute to rheumatoid arthritis. Generic Arava affects this system and is able to slow down the progression of the disease, especially in the affected joints. Generic Arava helps to treat all stages of adult rheumatoid arthritis. Generic Arava can be used with some of the other medications that are used to treat the inflammation and pain of this condition (for example, aspirin, other salicylates, or nonsteroidal anti-inflammatory drugs like ibuprofen).

Generic Arava is used to treat active rheumatoid arthritis in adults to reduce signs and symptoms, slow down damage to joints, and improve physical function. Arava is not indicated in children or adolescents with juvenile rheumatoid arthritis.

Active Ingredients: Leflunomide.
Other Ingredients: Crospovidone, hypromellose, lactose monohydrate, macrogol, magnesium stearate, maize starch, povidone, silica colloidal anhydroustalc, titanium dioxide.
Class and Mechanism: Generic Arava is an oral, disease-modifying drug that is used in the treatment of rheumatoid arthritis. Arava reduces inflammation in the joints that is responsible for both the symptoms of rheumatoid arthritis and the destruction of joints. This reduces symptoms as well as the progressive deformities of the joints caused by the arthritis. Generic Arava reduces inflammation by suppressing the activity of immune cells responsible for the inflammation. Arava suppresses immune cells by inhibiting dihydroorotate dehydrogenase, an enzyme that is necessary for the production of DNA and RNA. Without DNA and RNA the immune cells (and most other types of cells) cannot multiply or function (or exist). Because of its unique and different mechanism of action, Arava is of value when added to other medications used for treating rheumatoid arthritis. Arava was approved by the FDA in September, 1998.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Protect from moisture and light. Throw away any unused medicine after the expiration date. Keep out of the reach of children in a container that small children cannot open. Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down. Do not keep outdated medicine or medicine no longer needed.

This drug is taken by mouth, generally once daily. Follow directions carefully, as it is generally recommended to start with a special higher dose for the first 3 days, then decrease to the regular dose thereafter. Dosing is based on your medical conditions, response to therapy, and liver function test results. After treatment is stopped, cholestyramine may be given as directed, generally three times daily for 11 days. This procedure is used if you require a rapid removal of the drug from your system. Without the procedure the drug may persist for 2 years. Consult your doctor or pharmacist to learn whether you are a candidate for cholestyramine treatment (such as a couple planning to have children).
If OVERDOSE: Seek emergency medical attention if an overdose is suspected. The most frequent adverse events observed were diarrhoea, abdominal pain, leukopenia, anaemia and elevated liver function tests.

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take your next regularly scheduled dose. Do not take a double dose of this medication unless otherwise directed by your doctor.

Generic ARAVA must not be given to: patients with hypersensitivity to Arava or to any of the excipients in the tablets; patients with severe immunodeficiency states, e.g. AIDS; patients with significantly impaired bone marrow function or significant anaemia, leukopenia or thrombocytopenia due to causes other than rheumatoid arthritis; patients with severe, uncontrolled infections ; patients with impairment of liver function; pregnant women.
While you are taking medications for rheumatoid arthritis you might be more susceptible to infection. Try to avoid people with colds, flu, and bronchitis. Do not have any vaccinations without your doctor's approval.
Call your health care professional for advice if you get a fever, chills or sore throat, do not treat yourself.
If you are going to have surgery tell your doctor or dentist that you are taking Arava. Alcoholic drinks can make you more dizzy and increase possible damage to your liver. Avoid alcoholic drinks while taking Arava.
For Women: You must not take Generic Arava if you are pregnant or a woman of childbearing age not using reliable contraception because in animal studies Arava has been shown to cause birth defects to the fetus. You must avoid becoming pregnant while being treated with Arava. If you suspect or find out that you are pregnant while taking Arava, call your health care provider right away. After stopping Arava treatment, you must complete the drug elimination procedure before becoming pregnant because Arava stays in the body a long time. You should not breast-feed if you are taking Arava.

Nausea, diarrhea, flu-like symptoms, mild dizziness, headache may occur. If these effects persist or worsen, notify your doctor promptly. Tell your doctor immediately if any of the following unlikely but serious side effects occur: hair loss, chest pain, back pain, mouth sores, muscle cramping, numbness/tingling sensations. Tell your doctor immediately if any of the following highly unlikely but very serious side effects occur: unusual lumps (lymph gland enlargement). Leflunomide has rarely caused serious (possibly fatal) infections and blood disorders due to suppressing the bone marrow and immune system. Tell your doctor immediately if signs of infection (such as fever), extreme weakness/fatigue, or easy bruising/bleeding develop. Leflunomide may need to be stopped. The elimination procedure using cholestyramine or charcoal may be required (see How to Use section). Consult your doctor or pharmacist for more details. Leflunomide has rarely caused serious (possibly fatal) liver disease, especially in people with other risks for liver disease. Tell your doctor immediately if persistent nausea or vomiting, stomach/abdominal pain, dark urine, or yellowing eyes/skin develop. Leflunomide may need to be stopped. The elimination procedure using cholestyramine or charcoal may be required (see How to Use section). Consult your doctor or pharmacist for more details. In the unlikely event you have an allergic reaction to this drug, seek immediate medical attention. Symptoms of an allergic reaction include: rash, itching, swelling, severe dizziness, trouble breathing. If you notice other effects not listed above, contact your doctor or pharmacist.

Be sure to tell your doctor about all of the medications you are taking, including over-the-counter drugs and natural remedies, as these may reduce the effectiveness of leflunomide. The following medications are among those that may interfere with leflunomide: cholestyramine (Questran), tolbutamide (Orinase) and rifampin (Rifadin or Rimactane).
Cholestyramine and charcoal decrease the concentration of the active form of leflunomide in the blood probably by preventing absorption. Rifampin increases the blood concentration of the active form of leflunomide by 40% probably by increasing the conversion of leflunomide to its active form. This may increase the side effects of leflunomide.

Do not share this medicine with others for whom it was not prescribed. Do not use this medicine for other health conditions. Keep this medicine out of the reach of children. Ask your pharmacist any questions you have about refilling your prescription.