teriflunomide
Teriflunomide (Aubagio) helps treat relapsing forms of multiple sclerosis (MS) in adults. It's a type of disease-modifying therapy (DMT) that helps slow down MS and lower the number of relapses. The typical dose is 1 tablet by mouth once a day. Side effects includes headache, diarrhea, and hair loss. Teriflunomide (Aubagio) comes as a brand-name and generic medication.
What is Teriflunomide (Aubagio)?
What is Teriflunomide (Aubagio) used for?
- Relapsing forms of multiple sclerosis (MS)
How Teriflunomide (Aubagio) works
Teriflunomide (Aubagio) is a type of disease-modifying treatment (DMT). More specifically, it's a pyrimidine synthesis inhibitor.
The exact way teriflunomide (Aubagio) works to treat MS isn't clear. But researchers think that it blocks a protein in the body that helps turn on the immune system.
By blocking this protein, the medication helps calm the immune system. This might stop the immune system from attacking the nervous system in people with MS.
Drug facts
Side effects of Teriflunomide (Aubagio)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Headache (up to 18%)
- Higher liver enzyme levels (up to 15%)
- Diarrhea (up to 14%)
- Hair loss (up to 13%)
- Nausea (up to 11%)
Less Common Side Effects
- Feeling of "pins and needles" in arms or legs
- Joint pain
- High blood pressure
- Low white blood cell count
Teriflunomide (Aubagio) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Liver problems: nausea, vomiting, stomach pain, swelling of your stomach, yellow skin or whites of the eyes, clay-colored stool, confusion
- Infection: fever, chills, sweating, weakness, trouble breathing, cough, diarrhea
- Lung problems: cough, trouble breathing
- Serious allergic reaction: sore throat, fever, fatigue, rash, hives, swollen lymph nodes, swelling around the eyes, swelling of the face or lips, throat tightness, trouble breathing
- Serious skin reaction: rash, hives, sores, painful blisters, skin reddening, skin peeling, fever, sore throat, body aches
The following Teriflunomide (Aubagio) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions or angioedema—skin rash, itching or hives, swelling of the face, eyes, lips, tongue, arms, or legs, trouble swallowing or breathing
- Dry cough, shortness of breath or trouble breathing
- Increase in blood pressure
- Infection—fever, chills, cough, sore throat, wounds that don't heal, pain or trouble when passing urine, general feeling of discomfort or being unwell
- Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
- Pain, tingling, or numbness in the hands or feet
- Rash, fever, and swollen lymph nodes
- Redness, blistering, peeling, or loosening of the skin, including inside the mouth
- Unusual bruising or bleeding
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
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Pros and cons of Teriflunomide (Aubagio)
Pros
- Helps prevent MS relapse and slow MS from getting worse
- A tablet that's taken by mouth once per day
- Can take with or without food
Cons
- Higher risk of infection
- Has a risk of severe liver damage
- Might need to follow special instructions to help get rid of it from your body faster in certain situations
- Can't take during pregnancy
Pharmacist tips for Teriflunomide (Aubagio)
- Take teriflunomide (Aubagio) at the same time every day, with or without food. Taking it with food can help with side effects like nausea and stomach upset.
- Get any blood tests that your prescriber tells you to get on time. These blood tests check your liver health and blood cell count. This helps your prescriber make sure teriflunomide (Aubagio) is still safe for you to take.
- If you want or need to stop taking teriflunomide (Aubagio) for any reason, talk to your prescriber. After stopping, this medication can still stay in your body for a long time (up to 2 years). To help get rid of it faster, your prescriber will give you specific directions to do this. Follow these directions carefully.
- Teriflunomide (Aubagio) can raise your blood pressure. It's a good idea to regularly check your blood pressure at home. If it stays higher than usual, tell your care team.
- Teriflunomide (Aubagio) can cause numbness and tingling in the hands and feet. Let your care team know if this happens and it bothers you. Depending on how serious it is, your prescriber might suggest stopping the medication.
- Some people can have hair thinning or hair loss while taking teriflunomide (Aubagio). In a study, this usually started within the first 3 months and was mild. Hair often grows back on its own over time. Talk to your care team if you're worried about this side effect.
- Before getting any vaccines, tell the healthcare professional you're taking teriflunomide (Aubagio). They can check if the vaccine is safe for you. Live vaccines, like the chickenpox vaccine, aren't recommended during treatment. It's not clear how well it works and how safe they are with this medication.
- Tell your prescriber and pharmacist about all the medications you take or plan to take. Teriflunomide (Aubagio) can interact with other medications. For example, teriflunomide (Aubagio) can make the blood thinner warfarin (Coumadin) work less well. This can raise your risk of blood clots. Also, medications that affect your immune system can put you at even higher risk of serious infections.
- If you or your partner can get pregnant and you're having sex, you must use reliable birth control while taking teriflunomide (Aubagio). This medication can seriously harm an unborn baby. Tell your care team right away if you or your partner becomes pregnant or plans to have a baby. They'll help make a plan so you can stop the medication quickly.
- Talk to your prescriber if you plan to breastfeed. It's not recommended to breastfeed while taking teriflunomide (Aubagio). This is because the medication might cause severe side effects in your baby.
Common questions about Teriflunomide (Aubagio)
Studies show that teriflunomide (Aubagio) starts to work within about 3 months to help slow down MS. But it can take several months to see the full benefits, like having fewer MS relapses. Keep in mind that everyone reacts to medication differently. So it's important to check in with your care team so they can track how you're doing with treatment. Ask your prescriber if you have questions about how long it's taking teriflunomide (Aubagio) to work for you.
You can think of teriflunomide (Aubagio) as an immunosuppressant, or a medication that weakens your immune system. It blocks a certain protein to make your immune system less active. This might help stop the immune system from attacking your nerves and causing inflammation and MS symptoms. But having a weaker immune system also means that you might have a higher risk of infection.
No, teriflunomide (Aubagio) isn't a biologic. Biologics are medications that are made from living sources, like cells. Instead, teriflunomide (Aubagio) is a small-molecule drug. It's made in the lab from chemicals.
No, teriflunomide (Aubagio) doesn't cause weight gain. In studies, people taking the medication didn't report gaining weight. If you notice any weight changes that worry you, let your primary care provider know. They can help you figure out what might be causing it and what to do to manage your weight.
Ask your prescriber if you need to do a washout after stopping teriflunomide (Aubagio). If you need to get rid of it from your body quickly, you'll need to follow some specific instructions. This involves taking cholestyramine or activated charcoal for about 11 days. It's usually done if you have serious side effects, become pregnant, or plan to have a baby while taking this medication. Without the washout, teriflunomide (Aubagio) can stay in the body for a long time. It can take an average of 8 months to 2 years for the body to fully get rid of it on its own. Talk to your prescriber if you're worried about how long teriflunomide (Aubagio) stays in your system.
No, teriflunomide (Aubagio) doesn't raise the risk for PML, a serious brain infection. But this medication can weaken your immune system, which might make it easier to get sick from other infections. Some of these can be serious. Talk to your care team if you have a fever, cough, weakness, night sweats, or chills. These could be signs of an infection that needs medical care.
Yes, there are generic versions of Aubagio available. The generic is called teriflunomide. Talk to your prescriber or pharmacist if you're looking for the generic.
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Risks and warnings for Teriflunomide (Aubagio)
Teriflunomide (Aubagio) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Liver problems
- Risk factors: History of liver problems | Taking medications that harm the liver
Some people taking teriflunomide (Aubagio) have had liver damage. This can be serious or even life-threatening. Higher liver enzyme levels on blood tests can be a sign of liver damage.
Tell your prescriber if you have liver problems because your risk is higher. If you have serious liver problems, you can't take teriflunomide (Aubagio). The risk of liver problems is also higher if you take other medications that harm the liver.
Your prescriber will check your liver with blood tests while you're taking teriflunomide (Aubagio). Call your care team if you have symptoms of liver damage. This can be having nausea you can't explain, stomach pain, little to no appetite, or yellow skin or eyes. If your lab tests show signs of serious liver damage or if you have symptoms, you might need to stop the medication. Follow your prescriber's instructions to do this, if needed.
Harm to an unborn baby
Teriflunomide (Aubagio) can cause serious harm to an unborn baby if taken during pregnancy. People who are pregnant or can become pregnant but aren't using reliable birth control can't take this medication.
If you can become pregnant, you'll need to take a pregnancy test before starting teriflunomide (Aubagio). This makes sure you're not pregnant when you start treatment.
While taking this medication, use effective birth control if you're having sex. This is important whether you or your partner can become pregnant.
Tell your care team right away if you or your partner becomes pregnant. Also let them know if you have plans to have a baby. You'll need to follow special directions to help remove teriflunomide (Aubagio) from your body quickly.
Special instructions to remove teriflunomide (Aubagio) from the body quickly
Your body gets rid of teriflunomide (Aubagio) very slowly. After stopping the medication, it takes an average of about 8 months for most of it to leave your body. And for some people, it can take up to 2 years.
If you have serious side effects or become pregnant while taking teriflunomide (Aubagio), your prescriber will tell you to stop taking it. They'll give you specific instructions to remove the medication from your body faster. This usually means using cholestyramine (Prevalite) or activated charcoal for 11 days to speed it up. Follow their instructions carefully.
Risk of serious infections
- Risk factors: Active, chronic (long-term), or recurrent infection | Other conditions that raise your risk of infection | Taking medications that weaken your immune system
Teriflunomide (Aubagio) can make it harder for your body to fight infections. This raises your risk of serious bacterial, viral, or fungal infections. It could also cause certain infections, like tuberculosis (TB), to come back.
Before starting teriflunomide (Aubagio), your care team can check to make sure it's safe for you. Tell your prescriber about any health problems you have. Some can raise your risk of getting sick. If you already have an infection, you'll need to wait until it goes away before you can start this medication. Your care team will also test you for TB and might give your treatment if needed.
Also tell your care team about all the medications you take. Some medications can weaken the immune system. Like teriflunomide (Aubagio), they can make it easier to get sick.
Call your care team if you feel sick while taking teriflunomide (Aubagio). Watch for signs like fever, chills, weakness, coughing, or trouble breathing. If the infection is serious, you might need to stop taking teriflunomide (Aubagio). This might help your body fully fight off the infection. Follow your care team's instructions on how to stop the medication and get rid of it from the body quickly, if needed.
Serious skin reactions
Severe and sometimes fatal skin reactions can happen with teriflunomide (Aubagio). Some include Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN).
These reactions can look like a red rash, sores, fluid-filled blisters, or peeling skin that's painful. You might also have a fever, sore throat, or body aches. Get medical help as soon as possible if this happens.
Severe allergic reactions
Severe allergic reactions to teriflunomide (Aubagio) can happen. They can be life-threatening and include swelling of the face and anaphylaxis. Some people might also have a rare reaction called drug reaction with eosinophilia and systemic symptoms (DRESS). This reaction can cause fever, rash, and swollen lymph nodes.
Get medical help right away if you have an allergic reaction. Watch for signs like a rash; fever; swollen lymph nodes; or swelling of your face, lips, or tongue. Also get help if your throat feels tight or you have trouble breathing.
Nerve problems
- Risk factors: Older than 60 years of age | Diabetes | Taking other medications that can cause nerve damage
Some people who take teriflunomide (Aubagio) can have nerve problems. This might include peripheral neuropathy (numbness or tingling). Some people might also have carpal tunnel syndrome. In studies, these problems sometimes didn't go away after stopping the medication.
If you feel numbness, tingling, or weakness in your hands or feet, tell your care team. They might ask you to stop taking teriflunomide (Aubagio). There are special instructions to remove the medication from your body quickly.
Lung problems
Although it's rare, some people who took teriflunomide (Aubagio) have had interstitial lung disease (ILD). This lung problem can happen at any time during treatment. It can sometimes be life-threatening.
Call your prescriber right away if you have a new or worse cough or trouble breathing. These could be signs of ILD. You might need to stop taking teriflunomide (Aubagio) for your care team checks this out. If so, follow the directions they give you to help get rid of the medication from your body quickly.
Teriflunomide (Aubagio) dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 7mg of | 30 tablets | $24.98 | $0.83 |
| 14mg of | 30 tablets | $30.49 | $1.02 |
Typical dosage for Teriflunomide (Aubagio)
The typical dose is 1 tablet (7 mg or 14 mg) by mouth once a day.
More on Teriflunomide (Aubagio) dosage
How much does Teriflunomide (Aubagio) cost?
$24.98
Teriflunomide (Aubagio) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Teriflunomide (Aubagio) will not be safe for you to take.
- Severe liver problems
- Currently pregnant
- Not using reliable birth control (for people who are able to become pregnant)
- Taking leflunomide (Arava) with teriflunomide (Aubagio)
- Allergy to leflunomide (Arava) or teriflunomide (Aubagio)
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