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Arava contains active substance Leflunomide. Its active metabolite is A771726 inhibits dihydroorotate dehydrogenase and has antiproliferative effects. A771726 in vitro inhibits proliferation and DNA synthesis of T-lymphocytes induced by mitogen. A771726 selectively binds to dihydroorotate dehydrogenase and inhibits it and hereby G1 stage of lymphocytes proliferation. Lymphocyte proliferation is one of the crucial stages in the development of rheumatoid arthritis. Arava is used to treat rheumatoid arthritis and reduces inflammation in the joints.
Arava cannot be used in the patients with hypersensitivity, liver failure, severe immune deficiency (including AIDS), disorders of bone marrow hematopoiesis (thrombocytopenia, anemia, leukopenia which are not associated with rheumatoid arthritis), severe infections, moderate or severe kidney insufficiency, severe hypoproteinemia (including with nephrotic syndrome), in pregnant or breastfeeding women, adolescents under 18 years of age.
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Be sure to tell your doctor about all of the medications you are taking, including over-the-counter drugs and natural remedies, as these may reduce the effectiveness of Leflunomide. The following medications are among those that may interfere with Leflunomide: cholestyramine (Questran), tolbutamide (Orinase) and rifampin (Rifadin or Rimactane).
Before taking Arava you should talk with your doctor if you have liver disease or hepatitis, kidney disease, cancer, any type of infection, tuberculosis, a blood cell disorder (anemia, easy bruising or bleeding), lung problems, a weak immune system or bone marrow disorder, or if you are using any drugs that weaken your immune system (such as cancer medicine or steroids). Use effective birth control while you are taking Arava. Avoid being near people who have colds, the flu, or other contagious illnesses. Wash your hands well to prevent the spread of infections. Avoid immunizations or vaccinations. This drug may make you dizzy. Do not drive or perform tasks that require alertness. Avoid alcoholic beverages since they can make you dizzy and also cause liver disease.

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