Treatment for Still’s Disease
What is Arava?
Arava is a type of medication called a “disease-modifying antirheumatic drug or DMARD.”
How does Arava work?
Arava works to modify the disease. Arava cannot cure RA, but it can help control the symptoms and progression of the disease.
How is Arava different from other RA medications?
Arava works differently than other available medications by affecting a unique stage in the disease process.
How do I know if Arava is working?
You may begin to experience an improvement in joint swelling and tenderness after about 4 weeks.
How often do I need to take Arava?
You’ll only need to take Arava once a day. It works best if you take it at the same time every day.
Should I take Arava with food?
Arava can be taken with or without food.
How long will I need to take Arava?
Remember, there is no cure for RA, but Arava can help improve the signs and symptoms and slow down joint damage. You must follow your doctor’s instructions for taking Arava. Most people have to take RA medications for the rest of their lives. If you do not follow the treatment program, Arava will not be able to work properly, which may lead to worsening symptoms. IMPORTANT SAFETY INFORMATION
Can I take Arava if I am pregnant or wish to become pregnant?
No. Your doctor will verify that you are not pregnant before starting Arava, and will counsel you on the risk of birth defects if you become pregnant while taking Arava. IMPORTANT INFORMATION AND WARNING: Arava must not be used in pregnant women or women who can become pregnant who are not using reliable birth control because Arava may increase the risk of birth defects. You may be at increased risk of death of your unborn child or of having a baby with a birth defect if:
- You are pregnant when you start taking Arava
- You become pregnant while you are taking Arava, or
- You do not wait to become pregnant until you have stopped taking Arava and followed the drug elimination procedure described below.
If you are currently taking Arava or have discontinued Arava and are going through the required drug elimination procedure, you and your partner should take every precaution to avoid becoming pregnant, such as both partners using reliable birth control as recommended by your doctor. It is VERY IMPORTANT that you contact your doctor IMMEDIATELY if your menstrual period is at all late or if for any other reason you believe you may be pregnant. If you discontinue Arava treatment for any reason, you should undergo the drug elimination procedure described below.
Drug Elimination Procedure
After discontinuing Arava, your doctor will prescribe a drug elimination procedure consisting of a full 11-day course of drug elimination medication followed by 2 separate laboratory blood tests at least 14 days apart to assure a very low drug level in your body. If your drug levels are too high, your doctor may recommend additional drug elimination medication. After the drug elimination procedure, your risk of having a baby with a birth defect is very low and should be no higher than the risk in the general population. If you do not follow the drug elimination procedure, it could take up to 2 years to reach this very low drug level in your blood.
Can I take Arava if I wish to father a child?
Available information does not suggest that Arava taken by the father would be associated with an increased risk to the unborn child. To minimize any possible risk, men wishing to father a child should consider discontinuing use of Arava and taking cholestyramine 8 grams 3 times daily for 11 days.
Who else should not take Arava?
People who are hypersensitive to any of the ingredients of the product must not take Arava.
- Arava should not be used by nursing mothers.
- Arava is not recommended for patients with serious immune deficiencies or severe uncontrolled infections.
- If you have other diseases such as kidney problems, tell your doctor.
How might Arava affect my liver?
Arava can cause an increase in liver enzymes. Therefore, your doctor will monitor your liver enzyme blood test to check for problems and adjust or discontinue your dose if necessary. Arava is not recommended in patients with significant liver disease or hepatitis B or C.
Does Arava cause any side effects?
In clinical trials the most common side effects were: diarrhea, high liver enzymes, loss or thinning of hair, or rash. Your doctor may recommend medication if you develop gastrointestinal (stomach/digestive) problems. However, you may experience other less frequent side effects not listed here. If you notice any of the listed side effects or any other problems, talk with your doctor. Arava is not recommended in patients with significant liver disease or hepatitis B or C.
What if I am taking other medications?
Let your doctor know about all of the medications you are taking. Most medications can be given with Arava. Be sure to tell your doctor if you are taking cholestyramine, methotrexate, or rifampin. If you have additional questions about Arava, please talk with your doctor.