Leflunomide - Necessary Laboratory Examinations

Necessary Laboratory Examinations

• Hematologic Monitoring

Patients taking Arava should have platelet count, white blood cell count, and hemoglobin or hematocrit monitored before initiation of treatment (baseline values), monthly for six months following initiation of therapy, and every 6 to 8 weeks thereafter.

• Bone Marrow Suppression Monitoring for Combination Therapy with Immunosuppressants

If used concomitantly with immunosuppressants such as methotrexate, chronic monitoring should be monthly.

• Liver Enzyme Monitoring

ALT (SGPT) values must be obtained at baseline and monitored at monthly intervals during the first six months then, if stable, every 6 to 8 weeks thereafter. In addition, if leflunomide and methotrexate are given concomitantly, ACR guidelines for monitoring methotrexate liver toxicity must be followed with ALT, AST, and serum albumin testing every month.