Drugs used in Immune Disease - Leflunomide

Question 1

What is the Loading dose for Leflunomide?

Answer 1

Oral 100mg for 3 days
This LD can increase risk of Adverse effects can be omitted

Question 2

What is the maintenance dose for Leflunomide?

Answer 2

10-20mg OD

Question 3

How long does leflunomide take to start to work?

Answer 3

Effects start 4-6 weeks and may further imporve up to 4-6 months

Question 4

What is the monitoring of leflunomide?

Answer 4

LFTs, FBCs, BP
Prior to initiation
Every 2 weeks for the first 6 months
Then every 8 weeks.

Question 5

What are the S/E of leflunomide?

Answer 5

Hepatic impairement
Bone marrow suppression
Increased BP
GI irritation
Alopecia
Skin reactions
Dizziness

Question 6

What are the contra-indications of leflunomide?

Answer 6

Hepatic impairement
Severe immunodeficiency
Severe infection
Severe hypoproteinaemia
Pregnancy / Breastfeeding

Question 7

What is the t1/2 of leflunomide?

Answer 7

1-4 weeks

Question 8

What is the wash out procedure of leflunomide?

Answer 8

Stop treatment
Give colestyramine 8g TDS or activated charcole 50g QDS
Treat for 11 days