For patients

Leflunomide

Arava, teriflunomide (active metabolite)

Are you a clinician? See the clinical version of this page.

The short versionLeflunomide is stopped before pregnancy. Because it stays in the body a long time, your team uses a washout medicine (cholestyramine) to clear it faster and then checks blood levels. Reassuringly, where washout has been done, outcomes have generally been good.

The washout medicine and a blood test are how your team makes sure the drug is cleared before pregnancy.

Through your pregnancy journey

Stop pre-conception

Before pregnancy

Stopped before conception. Because it clears slowly, your team either waits about 3.5 months or uses a washout medicine (cholestyramine) and confirms it with a blood test.

Avoid

First trimester

Not used in pregnancy.

Avoid

Second & third trimester

Not used in pregnancy.

Avoid

Breastfeeding

Usually avoided while breastfeeding.

Continue

For fathers-to-be

Considered compatible for fathers-to-be on current evidence.

iThis page helps you prepare a conversation with your care team. It does not replace individual medical advice. Always confirm your own plan with your rheumatology and pregnancy team.

When to call your team

Use reliable contraception while taking leflunomide.
If you might be pregnant or plan to conceive, contact your team so washout can be arranged.