Brand Name Choices
What Arava is and what it is used for
Arava belongs to a group of medicines called anti-rheumatic medicines. It contains the active substance leflunomide. Arava is used to treat adult patients with active rheumatoid arthritis or with active psoriatic arthritis. Symptoms of rheumatoid arthritis include inflammation of joints, swelling, difficulty moving and pain. Other symptoms that affect the entire body include loss of appetite, fever, loss of energy and anaemia (lack of red blood cells). Symptoms of active psoriatic arthritis include inflammation of joints, swelling, difficulty moving, pain and patches of red, scaly skin (skin lesions).
How to take Arava
Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure. The usual starting dose of Arava is one 100 mg tablet once daily for the first three days. After this, most patients need a dose of:
• For rheumatoid arthritis: 10 or 20 mg Arava once daily, depending on the severity of the disease.
• For psoriatic arthritis: 20 mg Arava once daily. 94 Swallow the tablet whole and with plenty of water. It may take about 4 weeks or longer until you start to feel an improvement in your condition. Some patients may even still feel further improvements after 4 to 6 months of therapy. You will normally take Arava over long periods of time. If you take more Arava than you should If you take more Arava than you should, contact your doctor or get other medical advice. If possible, take your tablets or the box with you to show the doctor. If you forget to take Arava If you forget to take a dose, take it as soon as you remember, unless it is nearly time for your next dose. Do not take a double dose to make up for a forgotten dose. If you have any further questions on the use of this medicine, ask your doctor, pharmacist or nurse.
Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them. Tell your doctor immediately and stop taking Arava:
•if you experience weakness, feel light-headed or dizzy or have difficulty breathing, as these may be signs of a serious allergic reaction,
•if you develop a skin rash or ulcers in your mouth, as these may indicate severe, sometimes life-threatening reactions (e.g. Stevens-Johnson syndrome, toxic epidermal necrolysis, erythema multiforme, Drug Reaction with Eosinophilia and Systemic Symptoms [DRESS]), see section 2. Tell your doctor immediately if you experience:
•pale skin, tiredness, or bruising, as these may indicate blood disorders caused by an imbalance in the different types of blood cells which make up blood,
•tiredness, abdominal pain, or jaundice (yellow discolouration of the eyes or skin), as these may indicate serious conditions such as liver failure, which may be fatal,
•any symptoms of an infection such as fever, sore throat or cough, as this medicine may increase the chance of a severe infection which may be life-threatening,
•cough or breathing problems as these may indicate problems of the lung (interstitial lung disease or pulmonary hypertension),
•unusual tingling, weakness or pain in your hands or feet as these may indicate problems with your nerves (peripheral neuropathy).
Common side effects (may affect up to 1 in 10 people)
•a slight decrease in the number of white blood cells (leucopenia),
•mild allergic reactions,
•loss of appetite, weight loss (usually insignificant),
•abnormal skin sensations like tingling (paraesthesia),
•mild increase in blood pressure,
•inflammation of the mouth or mouth ulcers,
•an increase in some liver test results, 95 96
•increased hair loss,
•eczema, dry skin, rash, itching,
•tendonitis (pain caused by inflammation in the membrane surrounding the tendons usually in the feet or hands),
•an increase of certain enzymes in the blood (creatine phosphokinase),
•problems in the nerves of the arms or legs (peripheral neuropathy).
Uncommon side effects (may affect up to 1 in 100 people)
•a decrease in the number of red blood cells (anaemia) and a decrease in the number of blood platelets (thrombocytopenia),
•a decrease in the levels of potassium in the blood,
•urticaria (nettle rash),
•an increase in the levels of fat in the blood (cholesterol and triglycerides),
•a decrease in the levels of phosphate in the blood.
Rare side effects (may affect up to 1 in 1,000 people)
•an increase in the numbers of blood cells called eosinophiles (eosinophilia); mild decrease in the number of white blood cells (leucopenia); decrease in the number of all blood cells (pancytopenia),
•severe increase in blood pressure,
•inflammation of the lung (interstitial lung disease),
•an increase in some liver results which may develop into serious conditions such as hepatitis and jaundice,
•severe infections called sepsis which may be fatal,
•an increase of certain enzymes in the blood (lactate dehydrogenase).
Very rare side effects (may affect up to 1 in 10,000 people)
•a marked decrease of some white blood cells (agranulocytosis),
•severe and potentially severe allergic reactions,
•inflammation of the small vessels (vasculitis, including cutaneous necrotizing vasculitis),
•inflammation of the pancreas (pancreatitis),
•severe liver injury such as liver failure or necrosis which may be fatal,
•severe sometimes life-threatening reactions (Stevens-Johnson syndrome, toxic epidermal necrolysis, erythema multiforme).
Other side effects such as kidney failure, a decrease in the levels of uric acid in your blood, pulmonary hypertension, male infertility (which is reversible once treatment with this medicine is stopped), cutaneous lupus (characterized by rash/erythema on skin areas that are exposed to light), psoriasis (new or worsening) and DRESS may also occur with an unknown frequency.
Reporting of side effects If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via Yellow Card Scheme at: www.mhra.gov.uk/yellowcard. By reporting side effects you can help provide more information on the safety of this medicine. Ireland Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via HPRA Pharmacovigilance, Earlsfort Terrace, IRL
•Dublin 2; Tel: +353 1 6764971; Fax: +353 1 6762517. Website: www.hpra.ie; E-mail: [email protected] 97 5. How to store Arava Keep this medicine out of the si
How to Store Arava
Keep this medicine out of the sight and reach of children. Do not use this medicine after the expiry date which is stated on the packaging. The expiry date refers to the last day of that month. Store in the original package Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.
2 to 3 weeks on average
The average shipping time is 2 weeks in North America and 4 weeks internationally. We offer free shipping on all orders shipped to North America. Shipping is a flat rate of $20.00 for all other countries.
Price Match Guarantee
If you have been prescribed medication by your doctor and cannot afford the high price at your local pharmacy, Medix Pharmacy is the solution for you. All orders are backed with a price match and satisfaction guarantee.
Your Trusted Pharmacy Referral Service
Medix Pharmacy is an international pharmacy referral service. With a network of licensed pharmacy partners in Canada, United Kingdom, Australia, and New Zealand, we are able to help you lower the costs of your medications.
Our pharmacy partners are all thoroughly vetted and qualified to ensure that the medication you receive is cost effective, safe and effective. Because we only work with licensed pharmacies, you can rest assured that your medication is safe, effective, and genuine.
- Free standard delivery to your door, to any international address
- Option to add Tracked Deliveries
- Handy reminders to re-order so you do not run out
- Professional & Knowledgeable Customer Services Team
- Save time, with no need for repeated trips to your physician or local drugstore
With a dedicated customer service team, free standard shipping, and a record of providing significant saving for our customers, we believe that you do not need to compromise quality or safety in your search for value.