Rheumatology · Pyrimidine synthesis inhibitor
Leflunomide
Dose
10–20 mg PO OD.
Use
Rheumatoid and psoriatic arthritis when methotrexate unsuitable.
Monitoring
BP, weight, FBC and LFT fortnightly ×6 months then 2-monthly.
Side effects
- • Diarrhoea
- • Hypertension
- • Hepatotoxicity
- • Weight loss
- • Peripheral neuropathy
Pregnancy safety
Teratogenic with a long half-life — cholestyramine washout required before conception.
Always confirm dose against your local formulary / BNF before prescribing.
