Can Leflunomide Be Taken Instead Of Xeljanz While On Methotrexate And Forteo?

Posted on Fri, 20 Jan 2017

Question: i currently take xeljantz and have been for about a year. My insurance Medicare and united health are recommending that i switch to leslunomide. I also take methotrexate in conjunction with the zeljantz. I am also a invasive melonoma survivor and take a daily injection of forteo. Please explain the difference between the switch of meds. Thanks

Answered by Dr. Prof. Kunal Saha (3 hours later)

Brief Answer:
Adverse effect profile matters.

Detailed Answer:
Thanks for asking on HealthcareMagic.

Xeljanz (tofacitinib) works by blocking certain enzymes in the body that affect immune system function and is used to treat moderate to severe rheumatoid arthritis in adults who have tried methotrexate without successful treatment of symptoms. However, there are concerns over efficacy and safety. Tofacitinib is required by US FDA to have a boxed warning on its label about possible injury and death due to problems such as infections, Lymphoma and other malignancies which can arise from use of this drug. Probably that is the reason for your insurance Medicare and United Health's asking you to change over to Leflunomide. Leflunomide works by blocking certain other enzymes in the body that affect immune system function. Although serious liver problems have also been reported with leflunomide, the liver conditions can be monitored and the drug can be stopped if necessary. So, I guess it is to be considered better of the two and that is possibly the reason for seeking the switch.

Let me know in case of further queries.

Regards

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar