Lefora Tablet 20mg

About Lefora Tablet 20mg

Lefora Tablet Uses

• Treats active rheumatoid arthritis in adults
• Slows joint damage and structural progression in rheumatoid arthritis
• Reduces joint pain, swelling and morning stiffness
• Used as a disease modifying antirheumatic drug when first line therapy is not tolerated or is insufficient
• Sometimes used off label for psoriatic arthritis under specialist supervision

Lefora Tablet Benefits

• Improves physical function and joint mobility over time
• Reduces reliance on long term steroid use in some patients
• Once daily dosing supports easier treatment adherence
• Can be combined with other DMARDs under close specialist monitoring
• Supports sustained disease control with regular follow up

What Experts Say

Leflunomide, the active ingredient in Lefora Tablet, works by inhibiting dihydroorotate dehydrogenase, an enzyme needed for pyrimidine synthesis in rapidly dividing cells. This action slows the proliferation of activated lymphocytes that drive the inflammatory joint damage seen in rheumatoid arthritis.

The 20mg strength is commonly used as a maintenance dose once disease activity has been assessed, following an initial loading phase in some regimens. Leflunomide is converted to its active metabolite, teriflunomide, which has a notably long half life, often exceeding two weeks, meaning steady state effects and any adverse reactions can take time to appear or resolve.

Because of this prolonged activity, clinicians monitor liver function and complete blood counts regularly throughout treatment. Leflunomide carries a pregnancy category X classification and a documented risk of hepatotoxicity, so a cholestyramine or activated charcoal washout protocol is required before pregnancy planning or in cases of serious toxicity.

Drug Class

• Disease Modifying Antirheumatic Drug (DMARD)
• Pyrimidine Synthesis Inhibitor
• Immunomodulatory Agent

Lefora Tablet 20mg formula

• Leflunomide

Available forms

• Tablet

How to use Lefora Tablet 20mg?

• Lefora Tablet 20mg should be taken once daily with or without food, at the same time each day.
• The tablet should be swallowed whole with a full glass of water.
• Crushing or chewing the tablet is not recommended unless your doctor advises otherwise.
• This medicine should be taken exactly as prescribed, without stopping suddenly.
• Scheduled liver function and blood tests should be attended throughout treatment.
• Any plan for pregnancy should be discussed with your doctor beforehand, since a washout procedure may be required.

Drug Interactions

• Methotrexate: Combined use significantly increases the risk of liver toxicity and requires close monitoring of liver enzymes.
• Live Vaccines: Live vaccines should be avoided during treatment due to immune suppression.
• Warfarin: Leflunomide may increase the anticoagulant effect of warfarin, raising bleeding risk.
• Rifampicin: Rifampicin can increase plasma levels of the active leflunomide metabolite.
• Hepatotoxic Medicines: Combining leflunomide with other liver toxic medicines, including certain NSAIDs used long term, raises the risk of liver damage.
• Cholestyramine: This drug speeds elimination of leflunomide and is used intentionally for washout, not for routine combined therapy.

Risks and warnings

• Liver Toxicity: Leflunomide can cause serious, sometimes fatal liver injury. Liver function tests are required before starting treatment and periodically during therapy.
• Pregnancy Risk: Leflunomide is classified as pregnancy category X and can cause severe fetal harm. It must not be used during pregnancy or while planning pregnancy.
• Washout Requirement: The active metabolite stays in the body for up to two years. A cholestyramine or activated charcoal washout is needed before pregnancy or if severe toxicity occurs.
• Infection Risk: This medicine suppresses immune response and can increase susceptibility to serious infections, including reactivation of tuberculosis.
• Bone Marrow Suppression: Blood counts should be monitored regularly, as leflunomide can lower white blood cells, red blood cells and platelets.
• Breastfeeding Caution: Use during breastfeeding is not recommended due to potential harm to the infant.

Lefora Tablet Side Effects

• Diarrhea and abdominal discomfort
• Nausea and mild vomiting
• Headache
• Hair thinning or hair loss
• Skin rash or itching
• Elevated liver enzymes
• High blood pressure
• Mouth ulcers
• Low blood counts in some cases
• Unexplained weight loss

Storage Conditions

• Store below 30°C in a cool, dry place
• Keep away from direct sunlight and moisture
• Keep the tablet in its original blister pack until use
• Store out of reach and sight of children
• Discard any expired or unused tablets safely