Drug interactions between Arava and methotrexate
| Results for the following 2 drugs: |
|---|
| Arava (leflunomide) |
| methotrexate |
Interactions between your selected drugs
methotrexate ↔ leflunomide
Applies to:methotrexate and Arava (leflunomide)
GENERALLY AVOID: Coadministration of methotrexate and leflunomide has resulted in an increased risk for hepatotoxicity. One small study reported a 2 to 3 fold elevation in liver enzymes in 16% of patients receiving this combination. Serious hepatic reactions have also been reported in patients being concurrently treated with other hepatotoxic agents, including methotrexate. The risk of additive hematologic toxicity may also be increased.
MANAGEMENT: The concurrent use of leflunomide and methotrexate is not recommended. Since the active metabolite of leflunomide may remain present in the body for up to 2 years, the cholestyramine washout procedure is recommended when changing from leflunomide to methotrexate. Liver enzyme levels should be obtained before beginning leflunomide and monthly during therapy. If ALT increases to 2 to 3 times normal, the dose should be reduced and liver enzymes should be monitored weekly. If ALT increases to more than 3 times normal, leflunomide should be discontinued and the washout procedure should be instituted.
See also...
Drug Interaction Classification
The classifications below are a guideline only. The relevance of a particular drug interaction to a specific patient is difficult to determine using this tool alone given the large number of variables that may apply.
| Major | Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. |
| Moderate | Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. |
| Minor | Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. |
Do not stop taking any medications without consulting your healthcare provider.
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