Clinical decision-support only. For use by licensed dental professionals. Not a substitute for professional judgment or a complete drug reference. Always verify with primary sources.
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Medication

Leflunomide

DMARD (pyrimidine synthesis inhibitor)

Brand names: Arava

Oral health effects

  • Oral ulceration

    Mouth ulcers are a recognized side effect.

    Clinical management: Symptomatic care; report persistent ulceration to the physician.

  • Infection and bleeding risk (immunosuppression, cytopenias)

    The label warns of immunosuppression with risk of serious infections (including opportunistic infections) and of pancytopenia, agranulocytosis and thrombocytopenia.

    Clinical management: Watch for oral infections (candidiasis, herpetic lesions) and unexplained gingival bleeding or ulceration; for invasive procedures, ask about recent blood counts and refer signs of infection promptly.

Sources

  1. A review and guide to drug-associated oral adverse effects-Oral mucosal and lichenoid reactions. Part 2. Teoh L, Moses G, McCullough MJ. Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology, 2019.
  2. Leflunomide prescribing information (FDA label) Lupin Pharmaceuticals, Inc. / DailyMed, 2025.