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Multiple Sclerosis (relapsing)
- Typically in combination with other MS agents (e.g. Interferon Beta, glatiramir)
- Immunomodulatory agent that inhibits Pyrimidine synthesis
- Teriflunomide is an active metabolite of Leflunomide
- Teriflunomide (Aubagio) tablets: 7 mg, 14 mg
- Adults: 7 to 14 mg orally once daily
- Hepatotoxicity (black-box warning)
- May be severe or fatal, similar to Leflunomide toxicity (uncommon)
- Stop Teriflunomide at the first sign of liver toxicity
- Gastrointestinal
- Diarrhea
- Nausea
- Neurologic
- Paresthesias
- Dermatologic
- Alopecia
- Unknown safety in Lactation
- Contraindicated in Pregnancy
- Pregnancy Category X in all trimesters
- Use effective Contraception
- Men and women should not try to conceive until Teriflunomide serum levels are <0.02 mcg/ml
- Monitoring
- Liver Function Tests (at baseline and then every 6 months)
- Complete Blood Count (at baseline and periodically, including with signs infection)
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