What is the product behind the name Arava?

Arava is a brand owned by the French pharmaceutical company Sanofi. The formulation on which the medicine with this name is based is named Leflunomide. It is a formulation used to treat rheumatoid and psoriatic arthritis. It has antiproliferative, immunosuppressive, and anti-inflammatory action. The formulation was approved in 1998 which makes it available for the use of other pharmaceutical companies than its developer since the exclusive patent expired. Such medications as Arava are usually used for long periods of time. Thus, if you wish to save on the therapy the best way when you need to buy Arava is to opt for its generic version, i.e. the same formulation under another name.

When is Arava use indicated?

The use of the formulation is reasonable in rheumatoid and psoriatic arthritis in adult individuals. The formulation is used to lower or eliminate the objective symptoms and subjective bettering of the patient’s health, inhibition of formation of marginal erosions of joints and narrowing of joint slots detected by fluoroscopy.
If you use NSAIDs, acetylsalicylic acid or low doses of corticosteroids, you can combine their use with Arava.

Arava contraindications

You must not buy generic Arava in the presence of one of the following factors:
- High sensitivity to the formulation especially in the previous occurrence of Stevens-Johnson syndrome, polymorphic erythema and other severe hypersensitivity reactions as a response to the formulation use, intolerance of its main metabolite teriflunomide or auxiliary substances of the medication.
- Liver failure;
- Severe immune deficiency including HIV;
- Severe violations of the bone marrow or anemia, leukopenia, and other blood disorders due to the various causes except for arthritis.
- Severe infections;
- Moderate or severe kidney failure;
- Severe hypoproteinemia (abnormally low protein in the blood plasma);
- Pregnancy or breastfeeding.
- Fertile age in women if they do not use reliable birth control means.

The formulation is strictly contraindicated to be used during gestation. Thus, prior to the treatment initiation, pregnancy must be excluded. Besides, women of fertile age must make sure they are using qualitative birth control while on the pills and for several months after the treatment ending if the level of the formulation’s main metabolite in the blood is more than 0.02 mg per liter.

Arava dosing

Before you buy Leflunomide, you must know that the therapy with this medication must be appointed by a medical practitioner with the practice in of arthritis treatment.
During the therapy, the control over the blood must be made periodically.
The pills must be swallowed entirely without crushing with at least a half a glass of water. The use of the pills can be made without regards to meals.

Rheumatoid arthritis is treated with the following dosages:
- Initial dosage is 100 mg taken one time a day for the first 3 days;
- Maintenance dosage is 10-20 mg once a day for the remaining course duration.

Psoriatic arthritis is treated with the following dosages:
- Initial dosage is 100 mg once a day for the first 3 days;
- Maintenance dosage is 20 mg once a day for the whole course duration.

The effect manifestation can be expected in four to six weeks after the treatment start and can enhance within four to six months of the therapy.

Dosage adjustments
- Individuals older than 65 years do not need dosage adjustments;
- Patients with mild kidney dysfunction do not require dosage adjustments.

The medication is prohibited for children as it is not tested for juvenile arthritis.

Adverse effects

The adverse reactions that can occur as a response of the organism to Arava use are the following:
- Infections of different cause including nasal infections, bronchitis, pneumonia, and others;
- Benign and malignant tumors;
- Blood disorders such as anemia, thrombocytopenia, eosinophilia, agranulocytosis, and other blood disorders.
- Allergic response such as skin rash and severe reactions such as anaphylaxis and cutaneous necrotizing vasculitis, Stevens-Johnson syndrome, cutaneous lupus erythematosus, psoriasis pustularis or exacerbation of psoriasis, and others;
- Hypokalemia, hyperlipidemia, increased lactate dehydrogenase, a decrease in uric acid;
- Anxiety, headache, lightheadedness, neuropathy, elevated blood pressure;
- Diarrhea, nausea, pain in the abdomen, ulceration of the oral cavity, taste perversion, pancreatitis, colitis, liver transaminases elevation, hepatitis, jaundice (yellowing of the skin), bile stasis;
- Tendosynovitis, tendon rupture.
- Kidney failure, low sperm count;
- Weight loss, loss of appetite, and others.

Percentage of patients with adverse events ≥ 5% in any Arava use in patients with rheumatoid arthritis RA

Arava overdose

There are data on the repeated fivefold overdose of the formulation without any adverse reactions development. An acute overdose may be manifested in pain in the abdomen, diarrhea, nausea, elevated liver transaminases, skin rash, and itching.
To lower the toxic effect of the formulation in an overdose, activated carbon or cholestyramine must be used.

Arava interactions

Before you buy generic Leflunomide, you need to check with your healthcare provider that you don’t use any medications it is incompatible with.
The medication’s adverse effects can be enhanced by the simultaneous use with any hepatotoxic of hematotoxic medications, i.e. drugs that render a toxic effect on the liver and blood-making systems. If these medications had been used recently and are not used at the same time with Arava, even their levels left after the end of the therapy can cause the enhancement of Arava adverse effects. Thus, it is advised to control the liver indicators at the start of the therapy.

Arava precautions

Woman of fertile age must use the medication cautiously, i.e. make sure they are not pregnant at the beginning of the therapy and do not get pregnant during it and within several months of Arava use discontinuation as the formulation is strictly prohibited during pregnancy. Men of fertile age who plan to conceive must beforehand cancel the therapy with Arava too at least eleven days before the planned conception.
The formulation renders a toxic effect on the liver and must not be combined with any other medications with the same effect to avoid severe liver damage.
The main metabolite of the medication has a long half-life period so the adverse reactions induced by the medication can occur even when the therapy is discontinued. In such cases or when the anti-arthritis medication is changed, a procedure of “cleaning” must be done, i.e. after the discontinuation of Arava, the use of cholestyramine 8 g thrice a day for eleven days is initiated or the use of 50 g of activated carbon four times a day for eleven days.
In severe skin reactions or infections, the use of the formulation must be ceased and the procedure of “cleansing” started.
Patients with tuberculin reactivity must be under a constant supervision due to the risk of tuberculosis activation.
Considering the long half-life of the medication, it is not recommended to get live vaccines while using Leflunomide and within a month after its use discontinuation.

Where to buy Arava?

To substantially save on the therapy, order Arava from our med store. We don’t ask you for Rx and sell great quality generic medicines that are cheaper than the branded ones but are no way inferior.

Shipping of Arava

4RXStore ships internationally including to the UK, USA, Australia, and other countries within 5-25 days.

Free prescription
Our doctor prescribes online for free, and there is no doctor’s consultation fee.

Discrete packaging
All orders arrive in discrete unmarked parcels. We leave the shipment description blank.

For more answers see the FAQ section