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Can Arava taken for inflammatory arthritis cause headaches?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

I have low-grade inflammatory arthritis. I have awful joint pain, but minimal swelling and occasional slight inflammation in blood tests. The RA test is negative. Systemic steroid injection gives a massive improvement. My consultant started me on Arava recently. At the same time, I have been weaning myself off Tramadol after being put on this irresponsibly by a pain consultant. Within a couple of days of starting Arava, a background headache began, and a few days ago, this reached an agonizing peak. The only thing that helped was Aspirin. My BP was raised, and my Lisinopril has now been doubled. I stopped the Arava. My current medications are Lisinopril, Simvastatin, Omeprazole, and Duloxetine. The headache is better but still in the background. So, I have the double issue of this and stopping Tramadol. My question is - Is the headache caused mostly by the Arava? And how long should I wait before seeing the GP again? My BP is much better. I stress I am prone to migraines in any case.

Hello,

Welcome to icliniq.com.

The headache is likely to have been caused by a combination of the Arava (Leflunomide) and your raised blood pressure and inflammation in the blood. Although we cannot know how much each of these contributed? Anyway, if your blood pressure rose a lot on Arava, it is probably best not to have this again. Perhaps Methotrexate would be better for you.

Has this drug been mentioned to you? Alternatives would be Hydroxychloroquine or Sulphasalazine. I suggest trying to see your consultant or specialist nurses again to discuss these drugs. It might be possible to reduce your Lisinopril back to a normal dose soon; your GP can help with this, perhaps in a month.

I hope this helps.

Thank you.

Medically reviewed byiCliniq medical review team

Published At December 24, 2019
Reviewed AtDecember 19, 2025

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