> Thank you Ellie and everyone else. My concern is the long time that
> leflunomide/Arava stays in your system. I read somewhere that it is months
> or even years after you stop taking it. That doesn't give much flexibility
> if you get an infection. I guess I am just gun shy after my recent bout
> with cellulitis. It was pretty hard on my system.
I've ben on Arava in the past. The advice about resistance to infection
being lowered is applicable to ALL the DMARDs for arthritis. The reality is
that DMARDs work by interfering with the action of the immune system and that
also lowers its ability to fight off other stuff. But........ enbrel and
arava work by different mechanisms, affecting different parts of the immune
system's response. So it is quite possible that individuals who are
particularly susceptible to infection with one of these DMARDs will not be as
suceptible under a different one.
It's a bit scary, true, but it is the reality. Also, I don't think arava
leaves one any more susceptible to infection than mtx does - and if you are
on arava, you most likely will not be on mtx as well - very few of us have
taken that combo as it's really rough on the liver. So, you would be on only
one DMARD rather than the 2 you have been on so there will be only one med
interferring with your response to infection. (I hope I'm making sense! My
coffee has entirely kicked in yet.)
Meanwhile, the fact that they now know to avoid amoxicillin with you should
make any future battles with infection less torturous! And should you get
really ill, there is a medication they can give you to clear the arava from
your system. But when I stopped it for brief periods for viruses, I
definitely noticed that the bulk of its effect faded quickly so it doesn't
seem to stay at full force in your body for all that long. Still, it will be
important to pay attention to any signs of infection of stop it when
something hits and get in to a doctor quickly should you think you need
antibiotics. 'Tis a pain, indeed.

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Bob - 19 May 2006 11:33 GMT
>> Thank you Ellie and everyone else. My concern is the long time that
>> leflunomide/Arava stays in your system. I read somewhere that it is
[quoted text clipped - 14 lines]
>
> It's a bit scary, true, but it is the reality. ............But when I
stopped it for brief
> periods for viruses, I definitely noticed that the bulk of its effect
> faded quickly so it doesn't seem to stay at full force in your body
> for all that long. Still, it will be important to pay attention to
> any signs of infection of stop it when something hits and get in to a
> doctor quickly should you think you need antibiotics. 'Tis a pain,
> indeed.
Thanks Nann for your really thoughtful and logical response. Thanks to you
too Becky for sharing your experience and for your support. Yeah, it is
the proverbial, "between a rock and a hard place." The longer I wait
before starting the new therapy the more RA reminds me that I must do
something. As my GP said yesterday when I discussed it with him, he just
happened to call me on another item, it is a quality of life issue. What
are you willing to live with.
Sounds like the Arava leaves your system fairly rapidly after cessation up
to a point but then the residuals are there for quite a while. I guess
that is my biggest fear having just been through an infection. Again,
thanks to all for you responses. The more I know the better off I am in
coping.