Search
teriflunomide (Flucyamide, Aubagio, A77 1726)
Indications:
- relapsing forms of multiple sclerosis*
* not for rapidly evolving severe relapsing disease [NGC (NICE)]
* on list of drugs to avoid for treatment of multiple sclerosis [5]
- disproportionate adverse effects cited
Contraindications:
- pregnancy: X (teratrogenic)
Dosage:
- oral dosing
Pharmacokinetics:
- major metabolite of leflunomide
Monitor:
- negative TB testing before starting Aubagio
- monthly for 1st 6 months then every 6 months
- liver function tests
- complete blood count (CBC)
- serum amylase, serum lipase
- blood pressure [4]
Adverse effects:
- same side effects as leflunomide
- nausea, diarrhea,
- alopecia
- hepatotoxicity
- increased risk of respiratory tract infection
- tuberculosis
- pancreatitis
- elevated serum transaminases
- lymphopenia
- hypertension
- peripheral neuropathy
Notes:
- costs about $3400/month in 2012
- compared to $4400 for Gilenya, $4000 for Copaxone (glatiramer), or $3745 for Avonex (beta-interferon)
General
amide
pharmacologic metabolite
Database Correlations
PUBCHEM cid=5353833
References
- PubChem: 5353833
- Wikipedia: Teriflunomide
http://en.wikipedia.org/wiki/Teriflunomide
- Prescriber's Letter 19(11): 2012
No Detail-Document
(subscription needed) http://www.prescribersletter.com
- Medical Knowledge Self Assessment Program (MKSAP) 17,
American College of Physicians, Philadelphia 2015
- Therapeutics Letter #108. Therapeutics Initiative
Drugs to Avoid.
http://www.ti.ubc.ca/2018/01/04/108-drugs-avoid/