The main uses include:

• Rheumatoid arthritis (its primary approved use)
• Sometimes Psoriatic arthritis, although this may depend on local treatment guidelines and physician judgment.

How it works

Leflunomide blocks an enzyme that immune cells need to multiply. This reduces the overactive immune response that causes joint inflammation and damage.

How it’s taken

• Usually as a tablet once daily.
• Some treatment plans begin with a higher “loading dose,” but many clinicians skip this to reduce side effects.

Important considerations with leflunomide

Leflunomide can affect the liver and blood counts, so people taking it typically need regular blood tests. It’s also important to discuss other medicines, supplements, and significant dietary changes with the prescribing clinician.

If you’re looking specifically for foods that support liver health and nutrition while taking leflunomide, I can give you a practical list of foods to eat more often and foods to limit.

Leflunomide and beets

If you’re taking leflunomide for rheumatoid arthritis, beets can generally be included as part of a balanced diet. There is no well-established food interaction between beets and leflunomide.

Beets as nutrition

Beets provide:

• Folate (vitamin B9) — important for normal cell production.

• Potassium — supports normal nerve and muscle function.

• Dietary fiber — supports digestive health.

• Nitrates — can contribute to nitric-oxide production and healthy blood-vessel function.

• Betalains and other antioxidants — plant compounds with antioxidant and potentially anti-inflammatory properties.

The FDA prescribing information describes cholestyramine 8 g three times daily for 11 days as an accelerated elimination regimen; activated charcoal is another option. This should be done under medical supervision rather than attempted independently.

If you’re considering stopping because of side effects

Contact your rheumatology team rather than simply discontinuing the medication. Particularly important symptoms include yellowing of the skin/eyes, severe rash, unusual bruising or bleeding, fever or significant infection, new/worsening shortness of breath, or unexplained severe weakness

One important feature of leflunomide is that its active metabolite, teriflunomide, can remain in the body for a long time after the last tablet. Therefore, simply stopping the tablets does not immediately remove the medicine from your system.

When a washout may be needed

An accelerated elimination (“washout”) procedure may be recommended in situations such as:

• Significant liver toxicity

• Serious infection or certain serious blood-count abnormalities

• Serious skin reactions

• Some serious lung reactions

• Switching to another medication where prolonged leflunomide exposure is a concern

• Pregnancy or plans for pregnancy, because leflunomide can harm a developing fetus