Arava
Arava
Arava (Leflunomide)Medicinal forms
Tablets covered with a cover 10mg, tablets covered with a cover 20mg
International name the Leflunomide
Structure
Active substance - Leflunomide.
Pharmacological action
Antirheumatic agent. Arava belongs to a class of basic antirheumatic preparations and possesses antiproliferative, immunomodulirujushchimi and antiinflammatory properties. Arava quickly turns to the active metabolite. At intake it is absorbed from 82 to 95 % of a preparation. The maximum plasma concentration are defined from 1 till 24 o'clock after unitary accepted dose. Arava can be accepted together with nutrition. Arava Deducing from an organism slow also is characterised by a clearance of 31 ml/hour. The semideducing period makes about 2 weeks. At the patients who are on a hemodialysis, deducing of a preparation faster and the period of semideducing is shorter.
Indications to application
For treatment of adult patients with the active form of a pseudorheumatism for the purpose of reduction of symptoms of disease and an arrest of development of structural damages of joints.
Contraindications
Hypersensitivity, disturbances of functions of a liver, a serious immunodeficiency, appreciable disturbances of a medullar hemopoiesis or an anaemia, a leukopenia or a thrombocytopenia, serious uncontrollable infections, renal insufficiency, a hypoproteinemia, pregnancy, feeding by a breast, age is more younger 18 years.
Side effect
Cardiovascular system: rising of arterial pressure. Gastroenteric system, a liver: diarrhoeia, a nausea, vomiting, an anorexia, diseases of a mucous mouth, a pain in an abdominal cavity, ascending of parametres of a liver, a hepatitis, a jaundice/holestaz, hepatic insufficiency, an acute necrosis of a liver. Metabolism and food disturbances: loss of mass of a body, a hypopotassemia. Nervous system: a headache, giddiness, an asthenia, a parasthesia, taste disturbance, anxiety. The Locomotorium: rupture of ligaments. A skin and derivatives: the strengthened abaissement of hair, an eczema, a dry skin, Stevens-Johnson's syndrome, a Lyell's disease, an erythema. An allergy: allergic reactions, an eruption, an itch, an urticaria, anafilakticheskie/anafilaktoidnye reactions. System of a hemopoiesis and lymphatic system: a leukopenia, an anaemia, a small thrombocytopenia, an eosinophilia, a leukopenia, a pancytopenia, an agranulocytosis.
Interaction
There are no data concerning joint Arava application with the antimalarial preparations used in rheumatology, entered intramusculary or perorally gold preparations, D-penitsillaminom, Azathioprinum and other immunodepressive agents (except for Methotrexatum). The risk bound to appointment of complex therapy is not known, especially at long treatment.
Overdosage
In a case the overdosage or toxicity is recommended to accept the activated coal.
Special indicatings
The preparation can be prescribed to patients only after careful medical examination. It is recommended to refrain from alcohol reception. The full clinical analysis of blood is necessary for spending prior to the beginning of treatment, and also each 2 weeks within first 6 months of treatment and each 8 weeks after treatment end. In case of development of hematological reactions, including a pancytopenia, it is necessary to stop reception of a preparation and any other accompanying preparation suppressing a medullar hemopoiesis, and to begin "washing up" procedure. Transition to reception of other basic preparation without "washing up" procedure can enlarge possibility of occurrence of additional risk even after long time after transition. In case of stomacace development it is necessary to stop Arava reception. In case of occurrence of dermal and-or mucous reactions, it is necessary to stop treatment by a preparation and to begin "washing up" procedure. Before the Arava treatment beginning and periodically after its beginning it is necessary to supervise level of arterial pressure. Irrespective of the chosen procedure of a lavage it is necessary to inspect two separate tests with an interval, at least, in 14 days and to wait 1,5 months since that moment when concentration of a preparation in plasma will be fixed for the first time below 0,02 mg/l, till the moment of a fertilization of the Woman of genital age should remember, that there should pass 2 years after the Arava treatment termination before they can become pregnant. It is recommended to use alternative methods of contraception.
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