Drug interactions between Arava and aspirin
Results for the following 2 drugs: |
|
|---|---|
| Arava (leflunomide) | |
| aspirin | |
Interactions between your selected drugs
aspirin ⇔ leflunomide
Applies to: aspirin and Arava (leflunomide)
MONITOR: Coadministration of leflunomide with nonsteroidal anti-inflammatory drugs (NSAIDs) may increase the risk of hepatotoxicity. The mechanism of interaction is unknown. Pharmacokinetically, the active metabolite of leflunomide has been shown to cause increases of 13% to 50% in the free fraction of diclofenac and ibuprofen. Additionally, in vitro studies indicate that the metabolite inhibits hepatic microsomal enzyme CYP450 2C9, which participates in the metabolism of many NSAIDs. No differential effects were observed with the concomitant use of NSAIDs in clinical studies of leflunomide. However, serious hepatic reactions have been reported in patients concurrently treated with leflunomide and other hepatotoxic agents, including NSAIDs.
MANAGEMENT: Patients being treated with leflunomide and NSAIDs should be closely monitored for hepatotoxicity. Liver enzyme levels should be obtained prior to initiating leflunomide and monthly during therapy. If ALT increases to 2 to 3 times normal, the leflunomide dose should be reduced and liver enzymes monitored weekly. If ALT increases to more than 3 times normal, leflunomide should be discontinued and the washout procedure instituted.
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