Common Registration Assessment, Part 1

Leflunomide loading dose and 10mg 20mg maintenance tablets for the GPhC assessment

Three original practice questions, with the working shown. Read the stated prescription or plan before calculating.

Published 8 November 2026. Independent revision material, not GPhC questions, not for patient care.

Close-up of a hand and wrist exercise session with a green therapy ball
Photo from Pexels, used under the Pexels licence. It is a stock image and does not show the exercise.

The manufacturer's UK product information for leflunomide tablets states that in rheumatoid arthritis, therapy is usually started with a loading dose of 100 mg once daily for 3 days, and that the recommended maintenance dose is 10 mg to 20 mg once daily depending on the severity of the disease.

The same information states that in psoriatic arthritis, therapy is started with the same loading dose of 100 mg once daily for 3 days, followed by a recommended maintenance dose of 20 mg once daily, and that the therapeutic effect usually starts after 4 to 6 weeks and may further improve up to 4 to 6 months.

It also states that ALT and a complete blood cell count must be checked before initiation, every two weeks during the first six months of treatment, and every 8 weeks thereafter.

Each question fixes the values needed for its arithmetic. Write the unit beside every step and distinguish a single dose from a daily total or a supply period. All prescriptions and patients here are fictional; these are revision materials, not for patient care.

The method

  1. Identify whether the stated plan is the loading phase or the maintenance phase.
  2. Divide the stated daily mg by the tablet strength for the daily tablet count.
  3. Multiply the daily tablet count by the stated days for a supply quantity.
  4. Keep loading doses, maintenance doses and days separate; convert only when the question asks.

Three practice questions

Work each one on paper first, then open the answer. All patients and prescriptions are fictional.

Question 1

A fictional adult starts leflunomide with the label loading dose of 100 mg once daily for 3 days, using 20 mg tablets. How many tablets are taken each day, and how many over the whole loading phase?

Show the answer

Answer: 5 tablets daily; 15 tablets

Working: Per day: 100 mg / 20 mg = 5 tablets. Loading phase: 5 tablets x 3 days = 15 tablets.

Question 2

A fictional adult with rheumatoid arthritis takes the maintenance dose of leflunomide 10 mg once daily, using 10 mg tablets. How many tablets are needed for 28 days?

Show the answer

Answer: 28 tablets

Working: One 10 mg tablet each day x 28 days = 28 tablets.

Question 3

A fictional patient starts leflunomide and asks when the therapeutic effect usually starts, according to the label. What is the answer?

Show the answer

Answer: After 4 to 6 weeks

Working: The label states the therapeutic effect usually starts after 4 to 6 weeks and may further improve up to 4 to 6 months.

eMC SmPC: Leflunomide Tillomed 10 mg Tablets

https://www.medicines.org.uk/emc/product/11362/smpc

Where marks are lost

  • Using the 20 mg tablet strength for a 10 mg maintenance supply.
  • Counting only one loading day when the label loading is 100 mg once daily for 3 days.
  • Treating the 10 mg to 20 mg maintenance range as one fixed maintenance dose.

Frequently asked questions

Are these official assessment questions?

No. They are original revision exercises, not official GPhC questions and not for patient care.

Does this calculation decide a real leflunomide course?

No. Follow the stated plan in the exercise. Real dosing depends on the indication and disease severity, with blood tests before and during treatment.

How should I check the answer?

Check whether the question covers the loading or maintenance phase, then divide the stated daily mg by the tablet strength.

Sources

The questions above are original and use fictional patients and prescriptions. PreRegExamPrep is not affiliated with or endorsed by the General Pharmaceutical Council.

Practise until the method is automatic

Try 15 free questions with worked answers. No sign-up required.

More calculation topics

See also the formula sheet, the eight sample questions and the approved calculator page.