DMARDs (disease modifying antirheumatic drugs) for rheumatological and GI problems.
Name
METHOTREXATE SULPHASALAZINE LEFHINAMIDE (Leflunomide) |
Effect
Anti-metabolite drug that blocks metabolism of cells (esp. folic acid) therefore useful in treating disease with abnormally rapid cell growth Broken down in to 5-ASA, which inhibits the enzymes that produce prostaglandins thus reducing their production. It is a pro-drug so not active in its ingested form, only once it has been broken down in the colon Inhibits activity of immune cells that are responsible for inflammation (pyrimidine synthesis inhibitor). |
Uses
Used for treatment of cancer (breast), psoriasis and rheumatoid arthritis (mechanism unknown for this). UC and Crohn’s but can also be used for RA Used for treating RA |
Dose
Weekly injection or oral suspension, 7.5mg/week. 1000-4000mg per day 2-4 times per day with food. 100mg/day for first 3 days then 10-20mg/day tablets. |
Side effect
Mouth sores, stomach upset, and low white blood counts therefore increased susceptibility to infection. SHOULD NOT BE TAKEN IN CONJUNCTION WITH NSAIDs. Nausea, vomiting, gastric distress, and anorexia (loss of appetite) commonly occur, skin or urine colour change, headache, allergic reactions, and photosensitivity (development of a rash when exposed to sunlight) Diarrhea, nausea, headache, rash, itching, loss or thinning of hair, and weight loss. May also cause high blood pressure, chest pain and abnormal heartbeats. May also increase risk of infections as it suppresses the immune system. |