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Arava is an antirheumatic medication used to treat symptoms of rheumatoid arthritis and help prevent irreversible joint damage.

Leflunomide, an isoxazole-based immunomodulator, inhibits specific enzymes to stop the growth of active lymphocytes that can lead to joint damage. This action also helps decrease and prevent painful inflammation related to rheumatoid arthritis.

This disease-modifying antirheumatic drug helps improve symptoms related to rheumatoid arthritis. Thanks to Avara’s inhibitory activity, this medication also helps slow the progression of rheumatoid arthritis and the damage it causes to joints.

Uses and Dosage

The dose of Arava that is prescribed will vary depending on the individual and the severity of their rheumatoid arthritis being treated. Always follow your doctor’s instructions and read packaging labels carefully.

  • Swallow tablets whole
  • Adults should take an initial loading dose of 100mg once daily for three days
  • Adults usually take a maintenance dose of up to 20mg once daily
  • Those at a risk for Arava-associated hepatoxicity may take 20mg daily without a loading dose
  • Do not suddenly stop taking Arava
  • Before taking, patients may be tested for active tuberculosis
  • White blood cell and platelet counts may also be tested before treatment
  • Store at room temperature away from moisture and heat

Side Effects

Arava may cause some side effects to develop while it inhibits enzymes in your body to protect your joints and reduce inflammation. Speak with your doctor for more information regarding symptoms you may encounter when taking leflunomide.

Common Arava side effects:

  • Nausea, diarrhea, stomach pain
  • Headache
  • Abnormal liver function tests
  • Thinning hair
  • Back pain
  • Weakness
  • Rash
  • High blood pressure

Serious Side Effects

Some more serious side effects may also occur when taking Arava. If you notice any of the following symptoms, stop using this medication and contact your doctor:

  • Sudden chest pain or discomfort, wheezing, dry cough, shortness of breath
  • Easy bruising, unusual bleeding
  • Purple or red spots under your skin
  • Numbness, tingling, or burning in hands or feet
  • Signs of an infection (sudden weakness or ill feeling, fever, chills, sore throat, mouth sores, red or swollen gums, trouble swallowing)
  • Liver problems (nausea, upper stomach pain, itching, tiredness, loss of appetite, dark urine, clay-coloured stools, jaundice)
  • Severe skin reaction (fever, sore throat, swelling in face or tongue, burning eyes, skin pain, red or purple rash that spreads, blistering and peeling skin)

Allergic Reaction

Do not use Arava if you are allergic to leflunomide or teriflunomide. Stop using this medication and seek immediate medical attention if you notice any signs of an allergic reaction.

Arava allergy symptoms may include:

  • Hives
  • Difficulty breathing
  • Swelling of face, lips, tongue, or throat


Do not use Arava if you are pregnant. Stop taking this medication if you think you might be pregnant and consult with your doctor to complete a drug elimination procedure if you plan to become pregnant.

Arava can affect your liver function and may lead to severe or fatal liver damage. Your doctor will need to perform frequent liver function tests to ensure your safety while using Arava. Discuss with your doctor if you have a history of liver disease or if you also use other medicines that are harsh on your liver. These medications include those for pain or arthritis, tuberculosis, infections, seizure medication, hormonal birth control or hormone replacement therapy, chemotherapy, cholesterol-lowering medicine, heart medication, or blood pressure medication.

Consult with your doctor over contraception options because hormonal methods may increase your risk of liver damage while taking Arava.

Do not use this medication if you are also using teriflunomide to avoid adverse effects.

To ensure the safety of taking Arava, tell your docotr if you have any of the following:

  • History of liver disease or hepatitis
  • Severe or uncontrolled infection
  • Kidney disease
  • Nerve problems
  • History of tuberculosis
  • Weak immune system or bone marrow disorder
  • If you are using any drugs that suppress your immune system (cancer medicine or steroids)

Avoid encountering people with colds, flus, or other contagious illnesses while taking Arava because this medication weakens your immune system and leaves you more vulnerable to infections.

Do not receive a live vaccine while taking Arava because you could develop a serious infection. These types of vaccines include measles, mumps, rubella, polio, typhoid, and others.

Some medications should not be used with Arava because of the risk for severe or fatal liver damage. These medications include the following:

  • Acetaminophen, aspirin, gout, or arthritis medication
  • Non-steroidal anti-inflammatory drugs (ibuprofen, naproxen, celecoxib, and others)
  • Antibiotic, antifungal medicine, or sulfa drug
  • Tuberculosis medicine
  • Antiviral or HIV/AIDS medication
  • Seizure medication (carbamazepine, phenytoin, valproic acid, and others)
  • Birth control pills or hormone replacement therapy
  • Anabolic steroids
  • Cancer medication
  • Cholesterol-lowering medication (Crestor, Lipitor, Vytorin, and others)
  • Heart or blood pressure medication

Tell your doctor about all the medications you take to avoid adverse interactions, this includes over the counter medicines, vitamins, and herbal products.

Form and Strength

This rheumatoid arthritis medication is available in tablet form.

Arava tablet strengths:

  • 10mg
  • 20mg

The 10 and 20mg tablets are both available in quantities of 30, 60, or 90 while the 10mg ones are also available in quantities of 100.


How does Arava work?

Arava is an immunomodulatory drug that helps prevent tissue and joint damage related to rheumatoid arthritis by suppressing your immune system. Leflunomide inhibits specific enzymes that contribute to the production of other enzymes and chemicals that attack your tissues and joints.

Are there any special precautions that should be taken before using Arava?

Arava is not recommended for use in those with a hypersensitivity to leflunomide or teriflunomide. Pregnancy should also be avoided while taking Avara; wait until a drug elimination has been completed to become pregnant. Finally, because this medication suppresses your immune system, you should not start treatment with an active infection.



Additional information

Brand Name:


Scientific Name:


Other Names:

Arava, Leflunomide


10mg, 20mg, 100mg

Quantities Available:

3, 12, 30, 60, 90