Leflunomide dose question

I'm on 20mg injected MTX and 10mg leflunomide - been on this 18 months. I had cimzia added in August but the injections were stopped a few weeks ago due to side effects. The plan is to try another anti TNF but I finish my degree at the end of May and I don't want to go on another anti TNF before then in case it makes me poorly again.

I was wondering if my leflunomide dose could be increased but not sure of the doses for RA? I want to be armed with a plan when I see rheum on 26th March. I know MTX can be increased but lef gives no side effects compared to a few side effects from MTX.


5 Replies


This can be difficult your GP or Specialist, RA Nurse can tell you that, the doses of the medications you take make a strong soup. Personally I know what I would do considering you have exams soon ??, of course you will need to discuss what is best for you and your Specialists will have to take all on board. Not qualified to make those decisions,

Thinking I would not want to take the risk at this time, you have a lot to lose.

All the best with your decisions



Thank you, Bob. The plan was to come off leflunomide, reduce dose of MTX and stay on cimzia as it was working so well but unfortunately, it was not to be.


Hi fruitycake

You need to have the discussion with your RA team....and ask them what the options are regarding increasing the DMARDS. What I would say to you is, you do not say how long you were on Cimzia or how effective it was. Not all biologics have the same side effects and all of us react differently, and it may be worth considering your quality of life if the the biologic works. For me, my response to biologics was almost immediate and if you had a similar reaction to a new biologic you would be in a better place for your upcoming exams especially as your stress levels will increase. It is a hard decision to make and I think you need to discuss all your fears with the consultant in a few weeks time. I would write everything down so you do not forget to ask and then you have a fully informed decision to be made with them

Good luck with the exams



Thank you for the replies.

I was on cimzia for 6 months. It was hugely effective and very quickly! Lef and MTX kept me stable for a short period but cimzia was my miracle drug, putting me in remission for the first time in 4.5 years. I'm gutted that I cannot tolerate the drug.

It has made me vomit and given me terrible stomach pains with no response to prescribed anti-sickness tablets. I had an endoscopy to rule out a blockage too because my symptoms were so severe.


Hello there. At the moment i'm on 20mg daily of Leflunomide. But you would need to discuss with your R.A team what dosage will be best for you. I have been on 20mg for the past 2 years. Good luck with your exams.xx


You may also like...