Can you take Arava with Hepatitis b adult vaccine?
1 drug interaction and 13 additional warnings found for the following 2 drugs:
- Arava (leflunomide)
- hepatitis b adult vaccine
Drug interactions
Moderate drug interactions
Moderate:
leflunomide hepatitis B adult vaccine
Applies to: Arava (leflunomide) and hepatitis b adult vaccine
If you are currently being treated or have recently been treated with leflunomide, you should let your doctor know before receiving hepatitis B adult vaccine. Depending on the dose and length of time you have been on leflunomide, you may have a reduced response to the vaccine. In some situations, your doctor may want to delay vaccination to give your body time to recover from the effects of leflunomide therapy. If you have recently been vaccinated with hepatitis B adult vaccine, your doctor may choose to postpone treatment with leflunomide for a couple of weeks or more. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Food/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:
leflunomide Food/Lifestyle
Applies to: Arava (leflunomide)
Leflunomide can be taken with or without food. It is important to take leflunomide regularly to get the most benefit. Discuss with your doctor the use of alcohol while taking leflunomide. Alcohol and leflunomide can both be damaging to the liver.
Disease interactions
12 potential interactions Applies to: 12 conditions, including High Blood Pressure, Peripheral Neuropathy, Diabetes Mellitus, Liver Disease, and Infection.
Bleeding Associated with Coagulation Defect
Moderate:
hepatitis b adult vaccine
hepatitis B adult vaccine has a moderate potential interaction with Bleeding Associated with Coagulation Defect.
Hepatitis B vaccine (adult and pediatric) is usually for intramuscular administration. However, it may be administered subcutaneously to persons at risk for hemorrhage following intramuscular injections (e.g., hemophiliacs), although it may result in lower antibody response. Additionally, when other aluminum- absorbed vaccines have been administered subcutaneously, an increased incidence of local reactions including subcutaneous nodules has been observed. Therefore, consider subcutaneous administration only in persons who are at risk of hemorrhage following intramuscular injections.
Bone Marrow Depression/Low Blood Counts
Major:
Arava
The leflunomide in Arava has a major potential interaction with Bone Marrow Depression/Low Blood Counts.
Pancytopenia, agranulocytosis and thrombocytopenia have been reported in patients receiving leflunomide. Leflunomide is an immunomodulatory agent with antiproliferative activity. The use of leflunomide is not recommended in patients with severe immunodeficiency, bone marrow dysplasia, or severe, uncontrolled infections because of the theoretical potential for immunosuppression. Care should be taken when using this agent in patients with a prior history of a significant hematologic abnormality. It is recommended to monitor blood levels at baseline and regularly during the course of therapy. If evidence of bone marrow suppression occurs, stop treatment and institute appropriate measures according to clinical guidelines.
Diabetes Mellitus
Major:
Arava
The leflunomide in Arava has a major potential interaction with Diabetes Mellitus.
Peripheral neuropathy has been reported during leflunomide therapy. Patients older than 60 years, patients taking concomitant neurotoxic medications, and diabetics may be at an increased risk for peripheral neuropathy. Therapy with leflunomide should be administered cautiously in these patients. Patients should be monitored for symptoms of neuropathy and if confirmed, consider discontinuing therapy and taking measures according to clinical practice.
High Blood Pressure
Moderate:
Arava
The leflunomide in Arava has a moderate potential interaction with High Blood Pressure.
Hypertension was reported as an adverse reaction in patients on leflunomide. Blood pressure should be monitored during treatment and periodically thereafter as this agent can increase the blood pressure in these patients.
Immunodeficiency
Major:
Arava
The leflunomide in Arava has a major potential interaction with Immunodeficiency.
Pancytopenia, agranulocytosis and thrombocytopenia have been reported in patients receiving leflunomide. Leflunomide is an immunomodulatory agent with antiproliferative activity. The use of leflunomide is not recommended in patients with severe immunodeficiency, bone marrow dysplasia, or severe, uncontrolled infections because of the theoretical potential for immunosuppression. Care should be taken when using this agent in patients with a prior history of a significant hematologic abnormality. It is recommended to monitor blood levels at baseline and regularly during the course of therapy. If evidence of bone marrow suppression occurs, stop treatment and institute appropriate measures according to clinical guidelines.
Infection
Major:
Arava
The leflunomide in Arava has a major potential interaction with Infection.
Pancytopenia, agranulocytosis and thrombocytopenia have been reported in patients receiving leflunomide. Leflunomide is an immunomodulatory agent with antiproliferative activity. The use of leflunomide is not recommended in patients with severe immunodeficiency, bone marrow dysplasia, or severe, uncontrolled infections because of the theoretical potential for immunosuppression. Care should be taken when using this agent in patients with a prior history of a significant hematologic abnormality. It is recommended to monitor blood levels at baseline and regularly during the course of therapy. If evidence of bone marrow suppression occurs, stop treatment and institute appropriate measures according to clinical guidelines.
Liver Disease
Major:
Arava
The leflunomide in Arava has a major potential interaction with Liver Disease.
Severe liver injury, including fatal liver failure, has been reported in patients treated with leflunomide. Leflunomide is contraindicated in patients with severe hepatic impairment. Leflunomide has been commonly associated with elevations in liver enzymes, primarily ALT and AST. Marked elevations occurred infrequently and reversed with dose reduction or discontinuation of treatment. Leflunomide also must be metabolized by the liver into the active compound which is responsible for the in vivo activity. Therapy with leflunomide is not recommended in patients with preexisting liver disease. Dosage adjustment or discontinuation is recommended for patients experiencing liver enzyme elevations while on leflunomide.
Peripheral Neuropathy
Major:
Arava
The leflunomide in Arava has a major potential interaction with Peripheral Neuropathy.
Peripheral neuropathy has been reported during leflunomide therapy. Patients older than 60 years, patients taking concomitant neurotoxic medications, and diabetics may be at an increased risk for peripheral neuropathy. Therapy with leflunomide should be administered cautiously in these patients. Patients should be monitored for symptoms of neuropathy and if confirmed, consider discontinuing therapy and taking measures according to clinical practice.
Pulmonary Impairment
Major:
Arava
The leflunomide in Arava has a major potential interaction with Pulmonary Impairment.
The use of leflunomide has been associated with pulmonary toxicity. Serious cases of interstitial lung disease (ILD), and worsening of preexisting interstitial lung disease have been reported. Caution is recommended when using this agent in patients with a history of ILD or those patients presenting with acute onset of new or progressive unexplained pulmonary symptoms such as cough and dyspnea, with or without associated fever. If ILD is confirmed, consider discontinuing therapy and institute appropriate measures according to clinical guidelines.
Renal Dysfunction
Major:
Arava
The leflunomide in Arava has a major potential interaction with Renal Dysfunction.
The active metabolite of leflunomide is elevated in the plasma of patients with renal impairment. Therapy with leflunomide should be administered cautiously in patients with renal insufficiency.
Tuberculosis, Active
Major:
Arava
The leflunomide in Arava has a major potential interaction with Tuberculosis, Active.
Patients should be evaluated for active and latent tuberculosis (TB) infection prior to leflunomide treatment. Leflunomide has not been studied in patients with a positive tuberculosis screen, and the safety of leflunomide in individuals with latent tuberculosis infection is unknown. Patients testing positive in tuberculosis screening should be treated by standard medical practice prior to therapy with leflunomide and monitored carefully during leflunomide treatment for possible reactivation of the infection.
Tuberculosis, Latent
Major:
Arava
The leflunomide in Arava has a major potential interaction with Tuberculosis, Latent.
Patients should be evaluated for active and latent tuberculosis (TB) infection prior to leflunomide treatment. Leflunomide has not been studied in patients with a positive tuberculosis screen, and the safety of leflunomide in individuals with latent tuberculosis infection is unknown. Patients testing positive in tuberculosis screening should be treated by standard medical practice prior to therapy with leflunomide and monitored carefully during leflunomide treatment for possible reactivation of the infection.
More resources
Arava
A total of 721 drugs are known to interact with Arava.
- Arava is in the following drug classes: antirheumatics, selective immunosuppressants.
- Arava is used to treat Rheumatoid Arthritis.
hepatitis b adult vaccine
A total of 340 drugs are known to interact with hepatitis b adult vaccine.
- Hepatitis b adult vaccine is in the drug class viral vaccines.
- Hepatitis b adult vaccine is used to treat Hepatitis B Prevention.
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| 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. | |
| No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.