Leflunomide - DMARD 101

Ahoy Fellow Fathomers...My life took a turn a few years ago when I became sick and started a quest to find out what was wrong. Several doctors, tests, and what seems gallons of blood later returns the result as Rheumatoid Arthritis, commonly referred to as RA.

Swelling between thumb and first finger web
RA frequently attacks more than joints in the body. According to rheumatology.org :

What is rheumatoid arthritis?

Swelling below my ankle bone

RA is a chronic (long-term) disease that causes pain, stiffness, swelling and limited motion and function of many joints. While RA can affect any joint, the small joints in the hands and feet tend to be involved most often. Inflammation sometimes can affect organs as well, for instance, the eyes or lungs.
The stiffness seen in active RA is most often worst in the morning. It may last one to two hours (or even the whole day). Stiffness for a long time in the morning is a clue that you may have RA, since few other arthritic diseases behave this way. For instance, osteoarthritis most often does not cause prolonged morning stiffness.
Other signs and symptoms that can occur in RA include:
  • Loss of energy
  • Low fevers
  • Loss of appetite
  • Dry eyes and mouth from a related health problem, Sjogren's syndrome
  • Firm lumps, called rheumatoid nodules, which grow beneath the skin in places such as the elbow and hands
Today, I'm going to talk about a new medication I've been prescribed- Leflunomide *(AKA Arava). I'd never heard of this drug until my doctor suggested giving it a go. The side effects of most medications these days can be overwhelmingly scary. Looking at possibilities of liver damage, kidney damage, some cancers, etc, almost makes a person want to stay away from them all. However, my quality of life has diminshed to the point I need something to help slow the damage progression. According to rheumatology.org LEFLUNOMIDE


"Leflunomide (Arava) is a drug used to treat swelling and pain in arthritis. It belongs to a class of medications called disease-modifying antirheumatic drugs (DMARDs). This class of medicines can decrease joint damage and disability.

Fast Facts

  • Leflunomide is often a second-line drug used to treat rheumatoid arthritis if initial drugs are not helping substantially.
  • Leflunomide can cause liver injury, so alcohol and certain other medications should be avoided, and blood work should be performed regularly to monitor liver function.
  • This medication can cause serious birth defects, and this risk may persist long after the drug is discontinued.


Leflunomide is used to treat the symptoms of rheumatoid arthritis. It may be prescribed alone or with other medications, such as methotrexate. ***

Time to effect

It may take several weeks after starting leflunomide to experience an improvement in joint pain or swelling. Complete benefits may not be experienced until 6-12 weeks after starting the medication."

MY PERSPECTIVE------I've been taking this med for about 45 days. I thought I was in the clear of most side effects, however, just this past week, I've had horrible nausea lasting all day long. I can only eat when I'm very hungry, and ignore the nausea. But, cannot eat much before the sick feeling overcomes the hunger. I'm not experiencing any real relief from the RA symptoms, but, I know it could take several weeks to notice any improvement. Maybe the nausea means it's working?? Isn't that nuts, grr.

Leflunomide can stay in the body system for up to two years after stopping. TWO YEARS! So, if a person has a negative reaction, they may require a medical washout to remove the medication from the body. Basically, a washout procedure consists of another drug introduced into the body to remove the unwanted medication. However, further information would be best explained by a medical professional. When I saw the long half-life, this obviously concerned me. It's something I'd never thought about before. I believed when a person stopped taking a medication, it processed through the body and removed itself quickly. I learned something new with this drug therapy, that's for sure.

Washout Procedure
"Leflunomide has a long half life of up to 6 weeks. Adverse effects may be seen for a long time after the drug is stopped. A washout procedure can be considered in patients having severe side effects or in men or women considering conception. (If a waiting period of up to approximately 2 years under reliable contraception is considered impractical, prophylactic institution of a washout procedure is advisable)."

So, I'm not sure how this medication will work for me. I'm in the relatively early stages of introducing this drug into my body. I'd really like to know if you've had experience with this particular medication. Please leave me notes in the comments, if you'd like.

***I COULD NOT TAKE METHOTREXATE! the medication gave me horrible hives and skin discoloration.


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