Leflunomide Rivopharm Uk (Leflunomide)

Leflunomide is used as a disease‑modifying therapy for inflammatory joint disorders.

• Rheumatoid arthritis: reduces joint inflammation, pain and structural damage.
• Psoriatic arthritis: improves skin and joint symptoms and slows disease progression.

• Leflunomide inhibits the mitochondrial enzyme dihydroorotate dehydrogenase, which blocks de novo pyrimidine synthesis. This limits the proliferation of activated lymphocytes, thereby reducing the autoimmune response that drives inflammation in rheumatoid and psoriatic arthritis.

Leflunomide may cause a range of adverse reactions, from mild to severe.

Common Side Effects

• Diarrhoea: mild to moderate gastrointestinal upset.
• Nausea: occasional feeling of sickness.
• Alopecia: temporary hair thinning.
• Rash: skin irritation or redness.
• Elevated liver enzymes: mild hepatic enzyme rise.
• Hypertension: increase in blood pressure.

Serious or Rare Side Effects

• Severe liver injury: hepatitis or hepatic failure.
• Serious cutaneous reactions: Stevens‑Johnson syndrome or toxic epidermal necrolysis.
• Bone marrow suppression: neutropenia or anemia.
• Interstitial lung disease: pulmonary inflammation.
• Infections: opportunistic or severe bacterial infections.
• Teratogenicity: birth defects if exposure occurs during pregnancy.

Leflunomide requires careful monitoring and specific safety measures.

• Pregnancy contraindication: avoid use in pregnancy and discontinue well before conception.
• Liver function monitoring: assess transaminases before and during therapy.
• Hematologic monitoring: check complete blood count regularly.
• Live vaccine avoidance: do not administer live vaccines while on treatment.
• Renal impairment caution: dose adjustment may be needed in severe renal dysfunction.
• Store at below 25°C: keep in the original packaging, protect from moisture and heat.

Leflunomide interacts with several medicines that can alter its safety or efficacy.

Major Interactions (Avoid)

• Warfarin: increased anticoagulant effect, risk of bleeding.
• Cyclosporine: heightened risk of hepatotoxicity.
• Statins: elevated risk of myopathy and rhabdomyolysis.
• Live vaccines: heightened infection risk due to immunosuppression.
• Teriflunomide (if co‑administered): additive toxicity.

Moderate Interactions (Monitor Closely)

• NSAIDs: potential additive liver toxicity.
• Azathioprine: combined bone‑marrow suppression.
• Antihypertensives: possible reduction in blood‑pressure control.
• Cholesterol‑lowering agents (e.g., fibrates): monitor liver enzymes.
• Antibiotics (e.g., macrolides): may increase plasma levels of leflunomide.