Drug interactions between Arava and Plaquenil
| Results for the following 2 drugs: |
|---|
| Arava (leflunomide) |
| Plaquenil (hydroxychloroquine) |
Interactions between your selected drugs
hydroxychloroquine ↔ leflunomide
Applies to:Plaquenil (hydroxychloroquine) and Arava (leflunomide)
GENERALLY AVOID: Coadministration of leflunomide with other immuno- or myelosuppressive antirheumatic agents may potentiate the risk of infections. Serious infections including sepsis, as well as opportunistic infections like Pneumocystis jiroveci pneumonia, pulmonary and extrapulmonary tuberculosis, and aspergillosis have been reported with the use of leflunomide, particularly in patients on concomitant hematotoxic therapy. There have also been rare reports of pancytopenia, agranulocytosis, and thrombocytopenia in patients receiving leflunomide alone. However, these events occurred more frequently in patients who received concomitant treatment with methotrexate or other hematotoxic agents, or who had recently discontinued these agents.
MANAGEMENT: Concomitant use of leflunomide with other immuno- or myelosuppressive antirheumatic agents should generally be avoided. When switching from leflunomide to one of these agents, consideration should be given to administering a washout procedure with cholestyramine or activated charcoal to accelerate elimination of leflunomide's active metabolite from plasma, which otherwise may take up to two years. This will decrease the overlap of systemic exposure to both compounds and reduce the likelihood of additive hematologic toxicities. However, the washout procedure may also induce disease worsening if the patient had been responding to leflunomide treatment. Patients who do not receive the washout procedure prior to switching should be monitored closely for hematologic toxicity. All patients treated with leflunomide, either alone or with other antirheumatic agents, should be advised to contact their physician if they notice signs of infection or experience fever, chills, sore throat, lethargy, body aches, or other flu-like symptoms. If evidence of bone marrow suppression occurs, treatment with leflunomide should be stopped and washout procedure administered.
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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