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leflunomide Side Effects

Also known as: Arava

Analysis of 102,095 adverse event reports submitted to the FDA from 2004 to 2025.

Total Reports

102,095

Death-Related

8,456

8.3% of reports

Hospitalizations

27,652

27.1% of reports

Top Indication

Rheumatoid Arthritis

Most Reported Adverse Reactions

DRUG INEFFECTIVE
36,983
RHEUMATOID ARTHRITIS
24,923
PAIN
20,055
ARTHRALGIA
16,941
DRUG INTOLERANCE
15,586
JOINT SWELLING
15,567
FATIGUE
15,384
RASH
13,321
OFF LABEL USE
11,798
ABDOMINAL DISCOMFORT
11,731
ALOPECIA
11,692
CONTRAINDICATED PRODUCT ADMINISTERED
11,637
ARTHROPATHY
10,791
CONDITION AGGRAVATED
10,367
SWELLING
10,250
NAUSEA
10,126
SYNOVITIS
10,026
SYSTEMIC LUPUS ERYTHEMATOSUS
9,625
TREATMENT FAILURE
9,615
DRUG HYPERSENSITIVITY
9,588

Who Reports Side Effects

Gender Distribution

Female 74,653 (82%)
Male 16,529 (18%)
Unknown 141

Age Distribution

0-17 912 (1%)
18-44 14,295 (23%)
45-64 29,335 (48%)
65-74 11,490 (19%)
75+ 5,158 (8%)

Reporting Trend by Year

2004 2025

Reactions in Death Reports

Top reactions reported in 8,456 reports where death was an outcome. These are voluntarily reported and do not establish causation.

Reaction Reports
OFF LABEL USE 2,411
RHEUMATOID ARTHRITIS 2,231
SYSTEMIC LUPUS ERYTHEMATOSUS 2,196
GENERAL PHYSICAL HEALTH DETERIORATION 2,146
GLOSSODYNIA 2,120
TYPE 2 DIABETES MELLITUS 2,093
RASH 2,072
JOINT SWELLING 2,064
HAND DEFORMITY 2,063
FATIGUE 2,058
PSORIATIC ARTHROPATHY 2,051
SYNOVITIS 2,040
DUODENAL ULCER PERFORATION 2,017
HYPOAESTHESIA 2,017
FIBROMYALGIA 2,013
INFUSION RELATED REACTION 1,993
HEPATIC ENZYME INCREASED 1,990
HYPERTENSION 1,985
SWELLING 1,983
HELICOBACTER INFECTION 1,976

Reactions in Hospitalization Reports

Top reactions in 27,652 reports where hospitalization was an outcome.

Reaction Reports
DRUG INEFFECTIVE 6,726
RHEUMATOID ARTHRITIS 6,005
PAIN 5,662
ARTHRALGIA 5,457
FATIGUE 4,987
OFF LABEL USE 4,890
RASH 4,745
JOINT SWELLING 4,576
ARTHROPATHY 4,339
DRUG HYPERSENSITIVITY 4,027
SYNOVITIS 3,959
CONDITION AGGRAVATED 3,941
DRUG INTOLERANCE 3,900
NAUSEA 3,826
ABDOMINAL DISCOMFORT 3,823
DIARRHOEA 3,729
HEADACHE 3,715
HYPERSENSITIVITY 3,657
INFUSION RELATED REACTION 3,604
VOMITING 3,534

Nearby — Related Medications

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What the FAERS Data Reveals About leflunomide Side Effects

The FDA Adverse Event Reporting System (FAERS) contains 102,095 voluntary reports linked to leflunomide and its brand equivalents (Arava), spanning 2004 through 2025. Of those, 8,456 (8.3%) listed death as an outcome and 27,652 (27.1%) involved hospitalization. The most common indication reported alongside adverse events was Rheumatoid Arthritis.

Demographic breakdowns help contextualize who is being exposed to the drug. Of reports with known sex, 82% were female and 18% male; age distribution skews toward 45-64, with 29,335 reports in that bracket. The single most reported reaction is drug ineffective with 36,983 submissions, followed by rheumatoid arthritis and pain.

FAERS is a signal-detection tool, not a scorecard. Reports are voluntary, and a single case may list multiple suspect drugs, so numbers above should not be read as incidence rates or per-patient risk. Widely prescribed drugs naturally accumulate more reports than niche therapies even when individual risk is low. These aggregates are useful for spotting patterns that merit further pharmacovigilance, not for choosing between medications. This page is for educational reference only and is not medical advice — speak with a licensed clinician about any side-effect concerns.