سعر افارا 20مجم 30 قرص 2025

Leflunomide 20 mg film-coated tablets, 30 tablets (3 strips); pyrimidine synthesis inhibitor DMARD (Sanofi).

• Treatment of adults with active rheumatoid arthritis.Population: AdultsDailyMed (U.S. National Library of Medicine)

• Most common adverse reactions: diarrhea, elevated liver enzymes (ALT and AST), alopecia and rash. Postmarketing reports include agranulocytosis, pancytopenia, hepatitis and hepatic failure, pancreatitis, interstitial lung disease, pulmonary hypertension, erythema multiforme and vasculitis.International label, same formulation · DailyMed (U.S. National Library of Medicine)

• Pregnancy.International label, same formulation · DailyMed (U.S. National Library of Medicine)
• Severe hepatic impairment.International label, same formulation · DailyMed (U.S. National Library of Medicine)
• Known hypersensitivity to leflunomide or any inactive component (reactions have included anaphylaxis).International label, same formulation · DailyMed (U.S. National Library of Medicine)

• Boxed warning - embryo-fetal toxicity: exclude pregnancy before starting, use effective contraception, and stop and perform accelerated elimination if pregnancy occurs.International label, same formulation · DailyMed (U.S. National Library of Medicine)
• Boxed warning - hepatotoxicity: severe liver injury including fatal liver failure has been reported; avoid in pre-existing liver disease or ALT >2 x ULN; use caution with other hepatotoxic drugs; interrupt treatment and start accelerated elimination if ALT rises >3 x ULN.International label, same formulation · DailyMed (U.S. National Library of Medicine)
• Immunosuppression, bone marrow suppression and serious infections (including Pneumocystis jirovecii pneumonia, tuberculosis and aspergillosis) may occur; not recommended in severe immunodeficiency, bone marrow dysplasia or severe uncontrolled infections; screen for latent tuberculosis before starting.International label, same formulation · DailyMed (U.S. National Library of Medicine)

• CYP2C8 substrates (e.g. paclitaxel, pioglitazone, repaglinide, rosiglitazone)Teriflunomide increases exposure of CYP2C8 substrates; monitor patients.DailyMed (U.S. National Library of Medicine)
• Oral contraceptives (ethinylestradiol, levonorgestrel)Teriflunomide increases ethinylestradiol and levonorgestrel exposure; consider the type and dose of contraceptive.DailyMed (U.S. National Library of Medicine)
• WarfarinCoadministration may decrease peak INR (about 25%); monitor INR closely.DailyMed (U.S. National Library of Medicine)

• Contraindicated in pregnancy: may cause fetal harm (teratogenic and embryolethal in animals at exposures below human exposure). Exclude pregnancy before starting; females of reproductive potential must use effective contraception during treatment and during the accelerated elimination procedure; if pregnancy occurs, stop treatment and perform accelerated elimination.International label, same formulation · DailyMed (U.S. National Library of Medicine)
• Advise women not to breastfeed during treatment because of the potential for serious adverse reactions in the breastfed infant.International label, same formulation · DailyMed (U.S. National Library of Medicine)

• Leflunomide: Isoxazole immunomodulatory agent that inhibits dihydroorotate dehydrogenase (an enzyme of de novo pyrimidine synthesis) and has antiproliferative activity; its activity is due mainly to the active metabolite teriflunomide.