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Arava Information
General information about Arava
Leaving in pain is absolutely impossible. When we get hurt or develop some health problems causing pain and discomfort we cannot wait for this torture to stop. Unfortunately, some diseases capture people for years and decades and all they have to do it to learn how to live with pain. Modern medicine keeps working on the problem of relieving pain in the most effective and safe way. Patients with rheumatoid arthritis (RA) are on the top of the list to be helped because this autoimmune health disorder gives too much pain to suffer it without taking painkillers.
Arava medications is very good at relieving RA pain, but what is even more important, the medication inhibits progression of joint damage giving people a wonderful chance of leading normal lives. As a rule Arava is indicated in adults for the treatment of active rheumatoid arthritis to reduce signs and symptoms, to inhibit structural damage as evidenced by X ray erosions and joint space narrowing and to improve physical function of joints. Arava is also indicated for managing psoriatic arthritis.
When you follow treatment with Arava you can continue taking Aspirin, nonsteroidal anti-inflammatory agents and/or low dose corticosteroids to get the most of your treatment.
Arava warnings and contraindications
Please, bear in mind that the combined use of Arava with antimalarials, intramuscular or oral gold, D penicillamine, azathioprine, or methotrexate has not been adequately studied - ask you doctor whether it is worth starting these combinations.
It is forbidden to take Arava if you are pregnant or breastfeeding a baby. Pregnancy must be excluded before the start of treatment with Arava. Women of childbearing potential should be using reliable contraception. Pregnancy must be avoided during Arava treatment or prior to the completion of the complete drug elimination procedure.
Arava treatment is forbidden in patients with pre-existing acute or chronic liver disease, or those with serum alanine aminotransferase (ALT) >2xULN. Arava is known to cause severe liver injury, including fatal liver failure in patients with those kinds of problems. Be very careful taking Arava with other potentially hepatotoxic drugs - such a combination is able of destroying even flawless liver!
Arava drug elimination procedure for females and males
Arava is a very complicated medication and it can stay in your body up to 24 months after finishing your Arava treatment. It may take up to 2 years for the active metabolite of leflunomide to reach plasma levels less than 0.02 mg/L due to individual variation in drug clearance.
Women wishing to deliver a child should undergo a specific Arava elimination procedure before getting pregnant - they should be administered cholestyramine 8 grams 3 times daily for 11 days. The 11 days do not need to be consecutive unless there is a need to lower the Arava plasma level rapidly. Please, do not fail to verify plasma levels by 2 separate tests at least 14 days apart - they should be less than 0.02 mg/L (0.02 µg/mL). If Arava plasma levels are higher than 0.02 mg/L, additional cholestyramine treatment should be considered.
Unlike females, males wishing to become fathers do not have to worry about an increased risk of male-mediated fetal toxicity. Male sperm changes totally within 3 month; that is why it is enough to wait 3 month from the day when you finished Arava treatment. To be on the safe side and minimize any possible risk, men should discontinue using Arava and take cholestyramine 8 grams 3 times daily for 11 days.
Arava is not recommended for patients with severe immunodeficiency, bone marrow dysplasia, or severe, uncontrolled infections. Attention! Severe infections including sepsis, which may be fatal, have been reported in patients taking Arava.
Arava side effects
Arava is meant for long-term intake ofmonths and years to be effective. At the same time te longer you take Arava, the higher is the possibility of developing Arava adverse reactions. The most frequently reported side effects associated with the use of Arava in clinical trials at 1 year included diarrhea (17%), respiratory infection (15%), alopecia (10%), hypertension (10%), rash (10%), and elevated liver enzymes (ALT and AST) (5%).
Arava doses and schedules
Usually, Arava is taken the following way: you take an oral loading dose of 100 mg once. It is followed by a once-a-day administration of 10 to 20 mg of Arava for months as it is determined by a professional. The treatment should be continued for 1 year at the least, the majority of doctors prefer scheduling Arava for 2 years. After termination of Arava treatment, beneficial effects last for some years to come.
Arava laboratory tests
Bear in mind that ALT (SGPT) must be performed at baseline and at least monthly for six months after starting Arava treatment. Later you should see you doctor and be tested every 6 to 8 weeks to make sure Arava is safe and beneficial for you.
If Arava is used with immunosuppressants such as methotrexate, chronic monitoring is required. Only then your Arava treatment will be absolutely safe and effective.
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