teriflunomide (Flucyamide, Aubagio, A77 1726)
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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
Adverse effects
- same side effects as leflunomide
- nausea, diarrhea,
- alopecia
- hepatotoxicity
- increased risk of respiratory tract infection
- 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)
More general terms
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
- ↑ 4.0 4.1 Medical Knowledge Self Assessment Program (MKSAP) 17, American College of Physicians, Philadelphia 2015
- ↑ 5.0 5.1 Therapeutics Letter #108. Therapeutics Initiative Drugs to Avoid. http://www.ti.ubc.ca/2018/01/04/108-drugs-avoid/