On this episode, I discuss leflunomide pharmacology. It is classified as a DMARD and is primarily used in rheumatoid arthritis.



Leflunomide carries a boxed warning for hepatoxicity. LFTs must be monitored with its use.



Leflunomide can inhibit CYP2C8 which plays an important role in pioglitazone metabolism. Concentrations of pioglitazone can go up on account of this interaction.



TB screening should be done prior to beginning the immunosuppressant leflunomide.