Enbrel (Etanercept Prefilled Syringes) and Leflunomide

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Using leflunomide together with etanercept can increase the risk of side effects that affect your bone marrow function, resulting in low numbers of different types of blood cells. This can make you more likely to develop anemia, bleeding problems, or infections. Because leflunomide can stay in your blood for a prolonged period after the last dose, interactions with other drugs may occur for some time even after you have stopped taking it. Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. Contact your doctor immediately if you develop paleness, fatigue, dizziness, lightheadedness, unusual bleeding or bruising, fever, chills, diarrhea, sore throat, muscle aches, shortness of breath, blood in phlegm, weight loss, red or inflamed skin, body sores, and pain or burning during urination. 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.

GENERALLY AVOID: Coadministration of leflunomide with other immuno- or myelosuppressive antirheumatic agents may potentiate the risk of infections. Serious infections including sepsis, as well as opportunistic infections like Pneumocystis jiroveci pneumonia, pulmonary and extrapulmonary tuberculosis, and aspergillosis have been reported with the use of leflunomide, particularly in patients on concomitant hematotoxic therapy. There have also been rare reports of pancytopenia, agranulocytosis, and thrombocytopenia in patients receiving leflunomide alone. However, these events occurred more frequently in patients who received concomitant treatment with methotrexate or other hematotoxic agents, or who had recently discontinued these agents.

MANAGEMENT: Concomitant use of leflunomide with other immuno- or myelosuppressive antirheumatic agents should generally be avoided. When switching from leflunomide to one of these agents, consideration should be given to administering a washout procedure with cholestyramine or activated charcoal to accelerate elimination of leflunomide's active metabolite from plasma, which otherwise may take up to two years. This will decrease the overlap of systemic exposure to both compounds and reduce the likelihood of additive hematologic toxicities. However, the washout procedure may also induce disease worsening if the patient had been responding to leflunomide treatment. Patients who do not receive the washout procedure prior to switching should be monitored closely for hematologic toxicity. All patients treated with leflunomide should be advised to contact their physician if they develop signs and symptoms of infection such as fever, chills, diarrhea, sore throat, muscle aches, shortness of breath, blood in phlegm, weight loss, red or inflamed skin, body sores, and pain or burning during urination. If evidence of serious infection or bone marrow suppression occurs, treatment with leflunomide should be stopped and washout procedure administered.

Enbrel (Etanercept Prefilled Syringes)

Generic Name: etanercept

Brand name: Enbrel, Enbrel Prefilled Syringe, Enbrel SureClick, Erelzi Prefilled Syringe, Erelzi Sensoready Pen, Enbrel Mini Prefilled Cartridge

Synonyms: Enbrel

What is Enbrel (Etanercept Prefilled Syringes)?

Leflunomide

Generic Name: leflunomide

Brand name: Arava

Synonyms: n.a.

What is Leflunomide?