Arava Hair Loss | Arthritis Information

I added 10 mg of Arava along with Orencia about 3-1/2 weeks ago. The last month my RA has been great....but as many of you know, there's usually a down side. The last three weeks my hair has been thinning out like crazy. Today, it came out the most ever. I just don't know how I can continue this medicine, with such a side effect.

Does anyone know if the hair loss lets up after a while, or does it continue to thin as long as you take the drug? Also, how long does it take for the hair loss to stop if you discontinue it? I know Arava is a medicine that stays in your system for over a year unless you do the detox program. Any info would be greatly appreciated!!

(Calling my doctor is almost impossible -- almost as impossible as geting an appointment these days.)

I discontinued Arava for this reason. Even after I stopped taking it, however, I continued to have hair loss/thinning. So I insisted that I do the washout (even though my RD didn't think it necessary). After the washout, it took almost nine months for my hair to get back to semi-normal. It's still thinner than it was originally was (or perhaps "more fine" is a better way to put it), but I'll take that over baldness. HTH. Kim,

Do you remember what dosage you were on? I was hoping that taking the 10 mg versus 20 mg would lessen this side-effect. Was the wash-out as bad as I imagine? Thank you for taking the time to respond.

Sharon

I am on 20 mg and don't think I'm having that problem. It is hard to tell because my hair is really, really thick and med length. I haven't noticed a lot on my brush or anything. Good luck, I hope it works out for you.

Phats

Thank you, Phats. Everyone usually tells me my hair is thick too, but I know the change is going to be obvious if this keeps up. I just read you have to go through the wash-out if you want to switch to another DMARD. Sometimes, it's really hard to make a decision. I tried to stay away from Arava, but Methotrexate just didn't agree with me. Glad you're not having a problem.....everyone sure responds differently.Sorry, Sharon, but I was on 10 mg. It seemed like once it starts with the Arava, it didn't stop. While it's possible that your experience may be different, it could take a very long time to find out (since the half-life of the drug is so long).

The wash-out sucked. I actually didn't finish it (which may be why it took so long for my hair to get back to near-normal). I'd read that approximately 80% of the drug would be removed within 6 days via cholestyramine, so I only did 6 days. Maybe it would have been better if I had finished the whole regimen. But it was very difficult due to the timing restrictions. (I don't know about you, but I'm on a lot of other meds, and when cholestyramine tends to remove ALL drugs from your system... and you don't want that to happen... then you have to be careful of the timing on when you take the cholestyramine.)

What is this about a wash out? I only knew of a wash out when/if you become pregnant and need to get it out of your system pronto!

We were going to switch my DMARDS at the last visit and he didn't say anything about a washout for me. Hmmmmm, weird. Maybe it is the difference in RD's?

Phats

Phats,

I was never told about a washout either -- only what I've read on-line. The whole thing is upsetting! But when I think about stopping the Arava, that is almost more upsetting, as it has helped me so much. We are getting ready to leave for Arizona for two months and the last thing I want is to start up the RA again. I have a hair appointment next week....I'll get his opinion on what's happening to my hair. Last month, he said he couldn't see a real difference. Sometimes I hesitate to write anything on the message boards because I don't want to upset anyone else by giving any mis-information. WE ALL RESPOND DIFFERENTLY. But, it does help to vent to other people who are going through the same problems!

What on earth is a washout? I've had arthritis for years and never heard of this term. [QUOTE=Green~Tara]What on earth is a washout? I've had arthritis for years and never heard of this term. [/QUOTE]
The washout under discussion is specific to Arava when a pregnancy is desired or with elevated liver enzymes:
http://www.rxlist.com/arava-drug.htm
"PREGNANCY MUST BE AVOIDED DURING ARAVA TREATMENT OR PRIOR TO THE COMPLETION OF THE DRUG ELIMINATION PROCEDURE AFTER ARAVA TREATMENT. "

"Adverse reactions associated with the use of leflunomide in RA include diarrhea, elevated liver enzymes (ALT and AST), alopecia and rash."

A couple of weeks ago, there was some conversation about thinning hair. It may be worthwhile revisiting that discussion: http://arthritisinsight.com/forum/forum_posts.asp?TID=23811&KW=

Just wanted to mention that I discontinued Arava for different reasons (heavy menstruation and nightmares) and did not have to do the washout before moving on to Imuran.

Sharon, I wish you the best with your hair and I hope it bounces back quickly. Although I haven't dealt with major hair loss, I've dealt with minor hair loss and damage from the biologicals, and I know how upsetting it can be, especially on top of what we're already dealing with. Hugs!

Thanks, Spelunker. I guess the washout isn't considered for hair loss. I think I'll hang in there for a while and hope that the thinning levels out. Right now, we're waiting for my husband to either pass a kidney stone or have lipotripsey procedure to remove it. Suppose to leave for Arizona next Sunday.Thank you for the information, Spelunker.

Sharo - I wish you the very best. That we have to deal with hair loss among other side effects on top of everything else we're going through - is like salt in the wounds.

Thanks, everyone....you are a great support group! -- Sharon