Interactions between Arava and Zyrtec

The cetirizine in Zyrtec has a moderate potential interaction with Acute Alcohol Intoxication.

Alcohol should be avoided when using cetirizine, and some other antihistamines. Cetirizine may produce drowsiness that may be increase by the use of alcohol, sedatives and tranquilizers.

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.

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.

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.

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.

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.

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.

The cetirizine in Zyrtec has a moderate potential interaction with Liver Disease.

Cetirizine is eliminated primarily by the kidney but also undergoes metabolism in the liver to some extent. Patients with renal and/or liver disease may be at greater risk for adverse effects from cetirizine due to decreased drug clearance. The manufacturer recommends an initial dosage of 5 mg once daily in patients 6 years of age and older with decreased renal function (CrCl <= 30 mL/min, including those on hemodialysis) and/or impaired hepatic function. Cetirizine should preferably not be used in children less than 6 years of age with renal and/or hepatic impairment because of the difficulty in reliably administering doses smaller than 2.5 mg (1/2 teaspoonful) and a lack of pharmacokinetic and safety data in this population.

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.

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.

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.

The cetirizine in Zyrtec has a moderate potential interaction with Renal Dysfunction.

Cetirizine is eliminated primarily by the kidney but also undergoes metabolism in the liver to some extent. Patients with renal and/or liver disease may be at greater risk for adverse effects from cetirizine due to decreased drug clearance. The manufacturer recommends an initial dosage of 5 mg once daily in patients 6 years of age and older with decreased renal function (CrCl <= 30 mL/min, including those on hemodialysis) and/or impaired hepatic function. Cetirizine should preferably not be used in children less than 6 years of age with renal and/or hepatic impairment because of the difficulty in reliably administering doses smaller than 2.5 mg (1/2 teaspoonful) and a lack of pharmacokinetic and safety data in this population.

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.

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.