Arava (leflunomide) is a brand-name prescription medication. The Food and Drug Administration (FDA) has approved it for use in adults who have active rheumatoid arthritis.
Arava comes as an oral tablet. It belongs to a class of drugs known as disease-modifying antirheumatic drugs. And it’s available in a generic form called leflunomide.
The following chart summarizes Arava’s dosages. (For more details, see the “Arava dosage” section below.) Your doctor will determine the dosage that’s best for you.
|Arava loading (starting) dosage*||Arava maintenance (long-term) dosage||Arava maximum daily dosage|
|100 milligrams (mg) once daily for 3 days||20 mg once daily†||20 mg once daily|
* A loading dose is prescribed to people who have a low risk for liver problems or other side effects. Note: Arava has a
† If you’re prescribed this dose and are unable to tolerate it, your doctor may decrease your dosage. For details, see “Dosage adjustments” in the “Factors that can affect your dosage” section below.
For information about the dosage of Arava, including its strengths and how to take the drug, keep reading. For a comprehensive look at Arava, see this article.
Below is information about the approved dosages of Arava. Be sure to always take the Arava dosage that your doctor recommends.
Arava comes as an oral tablet.
Arava comes in three strengths:
- 10 milligrams (mg)
- 20 mg
- 100 mg
The following information describes dosages that are commonly taken or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.
The typical Arava dosage for rheumatoid arthritis is 20 mg once daily. This will likely be your maintenance (long-term) dosage. This is also the maximum dose of Arava.
Note: If you have a low risk of certain side effects* with Arava treatment, your doctor may prescribe a loading (starting) dosage. The loading dosage is 100 mg once daily for 3 days. Then, your doctor will prescribe 20 mg once daily as your maintenance dosage.
* For more information about side effects that can affect your Arava dosage, see the “Factors that can affect your dosage” section below. To learn more about side effects of Arava treatment, see this article.
Arava is meant to be a long-term treatment. If you and your doctor determine that Arava is safe and effective for you, you’ll likely take it long term.
If you miss a dose of Arava, take it as soon as you remember. If it’s almost time for the next dose, skip the missed dose and take the next scheduled dose. Do not double up on doses to make up for a missed dose.
To help make sure you don’t miss a dose, try using a medication reminder. This can include setting an alarm or using a timer. You could also download a reminder app on your phone.
The Arava dosage your doctor prescribes will depend on several factors. These include:
- your risk of liver problems
- your risk of bone marrow suppression (your bone marrow not making enough blood cells)
- if you take certain other medications with Arava, including:
- drugs that can harm the liver, such as acetaminophen or methotrexate
- immunosuppressants (drugs that block your immune system)
- if you have certain side effects* with Arava treatment
- other medical conditions you may have
* For more information about side effects of Arava treatment, see this article.
Arava has a boxed warning about the risk of severe liver damage. This is a serious warning from the Food and Drug Administration (FDA). A
Your doctor will check your liver function with blood tests before starting Arava treatment. If you have a high risk of liver problems with Arava treatment, your doctor may not prescribe a loading (starting) dosage. Instead, they may start your treatment by prescribing 20 mg of Arava once daily. This may also apply if you have bone marrow suppression or take certain medications with Arava. (For details, see “Factors affecting dosage” just above.)
Your doctor will also check your liver function once per month for the first six months during Arava treatment. If blood tests show an increase in liver enzyme levels, your doctor may decrease your Arava dosage to 10 mg once daily.
Your doctor may also prescribe medications that’ll help your body process Arava faster than usual. This may help lower your risk of serious liver damage. If you develop serious liver damage with Arava, your doctor will likely recommend you stop taking the drug.
If you have questions about liver problems or dosage adjustments, talk with your doctor. You should not change your Arava dosage or stop taking the drug without first talking with your doctor.
Arava also has a boxed warning for risk of fetal harm. See “Boxed warnings” at the top of this article for details.
You’ll take Arava by mouth once daily with or without food.
Make sure to swallow the tablet whole. It’s important not to crush, split, or chew the tablet.
If you have trouble swallowing tablets, see this article for tips on how to take this form of medication. You can also talk with your doctor or pharmacist.
Accessible drug labels and containers
If you’re having trouble reading your prescription label, talk with your doctor or pharmacist. Some pharmacies offer labels with large print, braille, or a code you scan with a smartphone to convert text to speech. If your local pharmacy doesn’t have these options, your doctor or pharmacist might be able to recommend a pharmacy that does.
If you’re having trouble opening medication bottles, ask your pharmacist about putting Arava in an easy-open container. They may also recommend tools that can make it easier to open bottles.
If you take more Arava than your doctor prescribes, you may develop serious side effects. It’s important that you do not take more Arava than your doctor advises.
Symptoms of an overdose
Overdose symptoms of Arava can include diarrhea and abdominal pain.
Other signs of overdose, which a doctor may detect with blood tests, include:
- decreased white blood cell counts
- decreased red blood cell or hemoglobin counts
- increased liver enzyme levels
If you take more than the recommended amount of Arava
Call your doctor right away if you believe you’ve taken too much Arava. Another option is to call the American Association of Poison Control Centers at 800-222-1222 or use its online tool. If you have severe symptoms, immediately call 911 or your local emergency number, or go to the nearest emergency room.
The dosages in this article are typical dosages provided by the drug’s manufacturer. If your doctor recommends Arava for you, they will prescribe the dosage that’s right for you. Always follow the dosage that your doctor prescribes for you.
As with any drug, never change your dosage of Arava without your doctor’s recommendation. If you have questions about the dosage of Arava that’s right for you, talk with your doctor.
Besides learning about dosage, you may want other information about Arava. These additional articles might be helpful:
- More about Arava. For information about other aspects of Arava, refer to this article.
- Side effects. To learn about side effects of Arava, see this article. You can also look at the Arava prescribing information.
- Drug comparison. To find out how Arava compares with methotrexate, see this article.
- Details about rheumatoid arthritis (RA). See our RA hub and this list of rheumatology articles for more information about RA.
Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.