Lefno Dosage/Direction for Use

The treatment should be initiated and supervised by specialists experienced in the treatment of rheumatoid arthritis and psoriatic arthritis.
Alanine aminotransferase (ALT) or serum glutamopyruvate transferase (SGPT) and a complete blood cell count, including a differential white blood cell count and a platelet count, must be checked simultaneously and with the same frequency: before initiation of leflunomide; every two weeks during the first six months of treatment, and; every 8 weeks thereafter (see Precautions).
Dosage: In rheumatoid arthritis: Leflunomide therapy is usually started with a loading dose of 100 mg once daily for 3 days. Omission of the loading dose may decrease the risk of adverse events. The recommended maintenance dose is leflunomide 10 mg to 20 mg once daily depending on the severity (activity) of the disease.
In psoriatic arthritis: Leflunomide therapy is started with a loading dose of 100 mg once daily for 3 days.
The recommended maintenance dose is leflunomide 20 mg once daily (see Pharmacology: Pharmacodynamics under Actions).
The therapeutic effect usually starts after 4 to 6 weeks and may further improve up to 4 to 6 months. There is no dose adjustment recommended in patients with mild renal insufficiency. No dose adjustment is required in patients above 65 years of age.
Paediatric population: Lefno is not recommended for use in patients below 18 years since efficacy and safety in juvenile rheumatoid arthritis (JRA) have not been established (see Pharmacology: Pharmacodynamics and Pharmacokinetics under Actions).
Method of administration: Lefno tablets should be swallowed whole with sufficient amounts of liquid. The extent of leflunomide absorption is not affected if it is taken with food.