teriflunomide at a glance
Medicine class
Immunomodulator and dihydroorotate dehydrogenase inhibitor
Licensed role
Disease-modifying treatment for relapsing-remitting multiple sclerosis
Administration
Swallow the film-coated tablet whole with water
Food
May be taken with or without food
Routine checks
Blood pressure, liver function and blood counts require assessment
Slow elimination
Teriflunomide can remain in the body long after treatment stops
What is teriflunomide used for?
The selected UK product is licensed for:
Relapsing-remitting multiple sclerosis in adults.
Relapsing-remitting multiple sclerosis in children and adolescents aged 10 years and over.
How does teriflunomide work?
Teriflunomide reversibly blocks dihydroorotate dehydrogenase, an enzyme needed to make pyrimidines. This limits the expansion of rapidly dividing activated lymphocytes and reduces immune-driven inflammation. Its full therapeutic mechanism is not completely understood.
teriflunomide preparations and strengths
Tablet
Route: Oral
Strengths: 7 mg, 14 mg
How to take teriflunomide
Follow the instructions from the specialist managing the multiple sclerosis.
Swallow the tablet whole with water.
It may be taken with or without food.
teriflunomide side effects
Common or expected effects
- Headache
- Diarrhoea or nausea
- Hair thinning or hair loss
- Raised liver enzymes
- Upper respiratory or urinary infection
- Pins and needles
- Raised blood pressure
- Rash
- Muscle or joint pain
- Reduced white blood cell count
Get urgent medical advice
- Serious allergic reaction
- Severe skin reaction, including blistering or peeling
- Drug-induced liver injury or acute hepatitis
- Serious infection or sepsis
- Interstitial lung disease or pulmonary hypertension
- Peripheral neuropathy
- Pancreatitis
- Severe blood-cell disorders
teriflunomide in pregnancy
Teriflunomide is contraindicated during pregnancy because it may cause serious birth defects. Pregnancy must be excluded before treatment, and effective contraception is required while teriflunomide remains in the blood. Anyone planning or suspecting pregnancy should contact the specialist immediately because treatment cessation, accelerated elimination and blood-level testing may be required.
teriflunomide while breastfeeding
Teriflunomide is contraindicated during breastfeeding. Discuss alternative feeding or multiple-sclerosis treatment options with the specialist team before birth or restarting treatment.
teriflunomide interactions
Tell the prescriber and pharmacist about all medicines, supplements and herbal products. Important examples include:
Rifampicin, carbamazepine, phenytoin, phenobarbital and St John’s wort
Potent enzyme and transporter induction can lower teriflunomide exposure and may reduce its effect.
Warfarin
Teriflunomide can reduce the peak INR response, so closer INR monitoring is needed.
Repaglinide, pioglitazone and other CYP2C8 substrates
Exposure may increase, raising the risk of adverse effects.
Common questions about teriflunomide
Answers are fully visible for fast scanning and source review.
Does teriflunomide cure multiple sclerosis?
No. It is intended to reduce inflammatory disease activity; it does not cure MS or reverse existing nerve damage.
How long does teriflunomide stay in the body?
It is removed slowly. Without accelerated elimination, reaching a low blood concentration takes about eight months on average and can take up to two years in some people.
Why are blood tests needed?
They help identify liver injury and changes in blood-cell counts, which may occur without obvious early symptoms.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.