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Leflunomide monitoring — GPhC CRA MCQ

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HardMusculoskeletal TherapeuticsLeflunomide monitoringGPhC CRA

A 60-year-old woman taking leflunomide for rheumatoid arthritis reports new breathlessness and dry cough over three weeks. Her recent bloods show ALT 92IU/L and the repeat prescription is due today. What monitoring is required?

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Correct answer: E — Urgent prescriber review with liver tests and assessment for lung toxicity

Leflunomide requires monitoring for hepatic toxicity and other serious adverse effects. New respiratory symptoms raise concern for rare interstitial lung disease, while raised ALT requires prompt review. The pharmacist should not treat the repeat as routine. Ongoing DMARD monitoring is central to safe supply.

Reference: BNF; NICE CKS DMARDs