- What is teriflunomide, and how does it work (mechanism of action)?
- What brand names are available for teriflunomide?
- Is teriflunomide available as a generic drug?
- Do I need a prescription for teriflunomide?
- What are the side effects of teriflunomide?
- What is the dosage for teriflunomide?
- Which drugs or supplements interact with teriflunomide?
- Is teriflunomide safe to take if I'm pregnant or breastfeeding?
- What else should I know about teriflunomide?
What is teriflunomide, and how does it work (mechanism of action)?
Teriflunomide is an oral immunomodulatory agent used for the treatment of patients with relapsing forms of multiple sclerosis (MS). It inhibits dihydroorotate dehydrogenase, an enzyme used to make pyrimidine which is used to build DNA. The exact mechanism of action of teriflunomide in the treatment of MS is unknown. However, it is thought to reduce the over activation of the immune system by decreasing the number of white blood cells (T and B lymphocytes) in the central nervous system. Teriflunomide decreases the number of MS relapses. The FDA approved teriflunomide in September 2013.
What are the side effects of teriflunomide?
The most common side effects associated with teriflunomide treatment are
- alopecia (hair thinning or loss),
- diarrhea,
- influenza,
- paresthesia (tingling, burning, prickling or pricking sensations of the skin),
- and increase in liver enzymes.
Serious liver injury, kidney problems, decrease in white blood cell counts, risk for serious infections such as
- tuberculosis, increase in blood potassium levels (hyperkalemia),
- increase in blood pressure, breathing problems,
- and serious skin problems were also reported in clinical studies.
What is the dosage for teriflunomide?
The recommended dose is one 7 mg or 14 mg tablet once daily with or without food. Note that a monthly blood test for liver enzyme measurements for 6 months is recommended to detect potential liver problems (see side effects section).
Which drugs or supplements interact with teriflunomide?
Teriflunomide may increase blood levels of
- repaglinide (Prandin),
- paclitaxel, pioglitazone (Actos),
- or rosiglitazone (Avandia).
Teriflunomide may also decrease the effectiveness of warfarin (Coumadin) and increases the risk for blood clots.
Teriflunomide may increase the effects of oral contraceptives (birth control pills) containing ethinylestradiol or levonorgestrel.
Teriflunomide may decrease the blood levels of drugs such as
- duloxetine (Cymbalta),
- alosetron (Lotronex),
- theophylline (Respbid, Slo-Bid, Theo-24, Theolair),
- and tizanidine that are metabolized by the CYP1A2 liver enzymes.
Blood levels of teriflunomide may be increased by
- cyclosporine,
- eltrombopag,
- and gefitinib (Iressa).

QUESTION
What kind of disease is multiple sclerosis? See AnswerIs teriflunomide safe to take if I'm pregnant or breastfeeding?
It is not known whether teriflunomide is secreted into breast milk.
What else should I know about teriflunomide?
What preparations of teriflunomide are available?
Film-coated tablets: 7 mg and 14 mg
How should I keep teriflunomide stored?
STORAGE: Tablets should to be stored at 20 C to 25 C (68 F to 77 F), but also may be stored at 15 C to 30 C (59 F to 86 F)
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Summary
teriflunomide (Aubagio) is a prescription drug prescribed to treat relapsing forms of multiple sclerosis (MS) in individuals with MS. Side effects, drug interactions, dosage, storage, and pregnancy safety information should be reviewed prior to taking this medication.
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Treatment & Diagnosis
Medications & Supplements
- Antidepressants (Depression Medications)
- prednisone (Prednisone Intensol, Rayos) Corticosteroid
- aspirin (acetylsalicylic acid, Bayer, Ecotrin, and others)
- clonazepam (Klonopin)
- acetaminophen (Tylenol, Tylenol Arthritis Pain, Tylenol Ext, Little Fevers Children's Fever/Pain)
- Interferon: Potential COVID-19 Treatment
- diazepam (Valium, Diastat, Acudial, Diastat Pediatric, Diazepam Intensol)
- methylprednisolone (Medrol)
- tizanidine (Zanaflex)
- baclofen (Gablofen, Lioresal)
- amantadine (Symmetrel - Discontinued)
- natalizumab - injection, Tysabri
- fingolimod (Gilenya)
- dimethyl fumarate (Tecfidera)
- dalfampridine, Ampyra
- mitoxantrone (Novantrone)
- Aubagio (teriflunomide)

SLIDESHOW
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Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
REFERENCE: FDA Prescribing Information.