Arava Warnings and Precautions

Specific Precautions and Warnings With Arava

Some warnings and precautions to be aware of prior to taking this drug include the following:
  • Arava can cause severe liver damage. People with liver disease, or those with elevated liver enzymes, are at an increased risk for this side effect and, therefore, should not take Arava. Let your healthcare provider know if you experience any signs of liver problems, including:
    • Unusual tiredness
    • Abdominal (stomach) pain
    • Yellowing of the whites of the eyes or skin (jaundice).
  • Arava suppresses the immune system, which may increase your risk for developing an infection, including potentially serious infections. Contact your healthcare provider immediately if you notice any signs of an infection while taking this medication.
  • There have been reports of low blood cell counts, such as low platelets and low white blood cells, in people taking Arava. Depending on the type of blood cell affected, this could increase your risk for developing an infection or experiencing a dangerous bleeding problem.
  • People taking Arava will need regular monitoring because of the potential for serious Arava side effects. Your healthcare provider will monitor your liver enzymes and blood cell counts at least monthly for the first six months of treatment, and then every six to eight weeks. You will also need to have your blood pressure checked periodically. To use Arava safely, it is important to keep all your healthcare appointments.
  • There have been rare reports of skin reactions with Arava use, including potentially life-threatening skin rashes known as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). Contact your healthcare provider immediately if you notice an unexplained skin rash while taking this medication.
  • This drug may increase the risk for developing cancer, especially cancer of the lymphocytes (a type of white blood cell), such as lymphoma and leukemia.
  • Arava can cause serious and potentially life-threatening lung problems. Let your healthcare provider know if you develop any breathing problems, including shortness of breath or coughing, while you are taking this medication.
  • This medicine may not be safe for use in people with tuberculosis. Therefore, your healthcare provider will test you for tuberculosis with a skin test before you begin treatment.
  • Arava is a pregnancy Category X medication, which means it can harm a developing fetus. Women of childbearing age should be tested for pregnancy before starting the medication, and should use reliable birth control while taking it. If you believe you may be pregnant and are taking Arava, contact your healthcare provider right away (see Arava and Pregnancy).
  • It is unknown if Arava passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Arava and Breastfeeding).
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