Combination of Arava and Methotrexate safe?


My wife is in India and currently under the treatment of a rhematologist there. she is taking 7.5 mg of methotrexate every week. She is due for a follow up visit and the doctor had suggested that he may add Arava to Methotrexate. I have read articles to the effect that these two medicines don’t go well together. Grateful for your advice.


Certainly there can be additive toxicities of many medications.  In the case of methotrexate and Arava (leflunomide) these can be effects on the liver and on blood counts.  However, there are also well documented reports of the efficacy of this combination.  In general, when used in combination the blood is monitored very carefully and the doses of the agents are sometimes decreased to allow the combination to be given.

Clifton Bingham, III, MD

About Clifton Bingham, III, MD

Associate Professor of Medicine
Director - Johns Hopkins Arthritis Center