Leflunomide (Arava®) is a pyrimidine synthesis inhibitor used in the treatment of active rheumatoid arthritis. The drug is available in oral doses containing 10, 20, or 100 mg of active drug. Arava® is an isoxazole immunodulatory agent which inhibits dihydroorotate dehydrogenase (an enzyme involved in de novo pyrimidine synthesis) and has antiproliferative activity. Following oral administration, leflunomide is metabolized to an active metabolite, A77-1726 (teriflunomide), which is responsible for essentially all of its activity in vivo. Peak levels of this metabolite occurred 6 to 12 hours after dosing, with a long half-life (about two weeks).