Iguratimod
Indications
Iguratimod is used for:
Caution should be exercised when Iguratimod is taken alongside other medications. Patients who are already receiving other disease-modifying anti-rheumatic drugs (DMARDs) such as Methotrexate, non-steroidal anti-inflammatory drugs (NSAIDs) like Ibuprofen or Diclofenac, or steroids and other immunosuppressive agents, should only use Iguratimod under strict medical supervision.
Adult Dose
Adult Dose Dose Adjustment Details 1 tablet (25 mg) once daily after breakfast for more than 4 weeks
Child Dose
Instruction General Adult Dose Dose Adjustment Details 1 tablet (25 mg) once daily after breakfast for more than 4 weeks. If instructed by your doctor, 1 tablet twice daily (after breakfast and supper); maximum 2 tablets (50 mg) daily.
Renal Dose
Instruction General Adult Dose Dose Adjustment Details 1 tablet (25 mg) once daily after breakfast for more than 4 weeks. If instructed by your doctor, 1 tablet twice daily (after breakfast and supper); maximum 2 tablets (50 mg) daily.
Administration
If you miss a dose, simply skip it and take the next scheduled dose as usual. Do not take two doses at once to make up for a missed dose. If you accidentally take more than your prescribed dose, consult your doctor or pharmacist immediately. This medicine typically begins to show its effect within 16 weeks of starting treatment. Do not stop taking this medicine unless your doctor specifically instructs you to do so.
Contra Indications
Iguratimod should not be used in patients who are pregnant or breastfeeding, those who have a known allergy to Iguratimod, and individuals with active gastrointestinal ulcers, severe hepatic or renal dysfunction, or blood disorders such as low white blood cell count, low platelets, or anemia. It is also contraindicated in patients who are currently using other DMARDs or immunosuppressants without proper medical supervision.
Precautions
Before and during treatment with Iguratimod, regular monitoring of liver function tests, blood counts, and renal function is essential. The drug should be used cautiously in patients with a history of heavy alcohol use, gastrointestinal conditions, or other chronic illnesses. Women of childbearing potential must have a negative pregnancy test before starting therapy and must use effective contraception throughout the treatment period and for at least one month after stopping the medication. Avoid alcohol and vaccinations during treatment unless advised by a healthcare provider.
Pregnancy-Lactation
Iguratimod is not recommended during pregnancy as it may harm the developing fetus. Breastfeeding is also not advised during treatment with Iguratimod, as it is not known whether the drug is excreted in breast milk.
Interactions
Caution should be exercised when Iguratimod is taken alongside other medications. Patients who are already receiving other disease-modifying anti-rheumatic drugs (DMARDs) such as Methotrexate, non-steroidal anti-inflammatory drugs (NSAIDs) like Ibuprofen or Diclofenac, or steroids and other immunosuppressive agents, should only use Iguratimod under strict medical supervision.
Adverse Effects
Side effects of Iguratimod :
Very common side effects (more than 1 in 10 patients) include elevated liver enzymes. Common side effects (more than 1 in 100 but less than 1 in 10) include nausea, anorexia, upper abdominal discomfort, rashes, headache, dizziness, fatigue, reduced white blood cell or platelet counts, insomnia, and abnormal ECG. Rare side effects (less than 1 in 1000) may include vomiting, gastric or duodenal ulcers, reflux esophagitis, oral ulcers, facial swelling, fever, and flu-like symptoms. Most side effects resolve upon dose reduction or drug discontinuation.
Mechanism of Action
Iguratimod suppresses the production of several key cytokines involved in the progression of rheumatoid arthritis (RA):
Interleukins: It inhibits the production of IL-1, IL-6, and IL-8.
TNF-α: It reduces the levels of Tumor Necrosis Factor-alpha, which is a primary driver of joint inflammation and destruction.