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Teriflunomide – Accelerated Elimination for Pregnancy — SCE Neurology MCQ

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HardMultiple Sclerosis & CNS InflammationTeriflunomide – Accelerated Elimination for PregnancySCE Neurology

A woman taking teriflunomide for multiple sclerosis plans conception. After stopping treatment she completes cholestyramine 8 g three times daily for 11 days. Which laboratory endpoint confirms that accelerated elimination has been adequate?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Plasma teriflunomide below 0.02 mg/L twice, separated by 14 days

Explanation lettering: D = shown as B · B = shown as C · C = shown as D

A uses the wrong matrix and an unvalidated endpoint. B monitors hepatic safety, not elimination. C uses a tenfold-too-high threshold and only one sample. D omits the required pharmacokinetic confirmation. E is correct: the target is below 0.02 mg/L on two measurements separated by at least 14 days after the 11-day cholestyramine or activated-charcoal procedure.

Reference: Teriflunomide 14 mg tablets: SmPC: https://www.medicines.org.uk/emc/product/100504/smpc