Which statement correctly describes the elimination method for Leflunomide?

• A. Activated charcoal wash to promote rapid elimination.
• B. Hemodialysis to promote rapid elimination.
• C. No special elimination method required.
• D. Cholestyramine wash to promote rapid elimination.

Answer: (D)

Leflunomide’s elimination relies on interrupting enterohepatic recirculation. Cholestyramine binds bile acids in the gut and also binds leflunomide, blocking its reabsorption and increasing fecal excretion, which rapidly lowers systemic levels. This makes cholestyramine the best option for rapid elimination. Hemodialysis is ineffective because leflunomide is highly protein-bound and largely distributed outside the plasma. No special elimination method would achieve rapid clearance as effectively; activated charcoal can be used as an alternative, but cholestyramine is the preferred approach.