Teriflunomide is an immunomodulatory agent with anti-inflammatory properties. Teriflunomide, previously known to the Australian community as Aubagio® is now a generic medication and is produced by several manufacturers. A generic medication contains the same active ingredient as the original medication.
In MS, certain types of white blood cells (called lymphocytes) play a role in destroying myelin, the protective sheath that surrounds nerve fibres and helps with the efficient flow of nerve signals or messages to and from the brain and various parts of the body. Teriflunomide blocks the action of specific enzymes in the body so that these lymphocytes are stopped from dividing. This is thought to reduce the number of lymphocytes and interfere with their ability to produce the disease response and nerve damage that ultimately leads to relapses.
In clinical trials teriflunomide has been shown to reduce the frequency of relapses and delay progression of physical disability.
Teriflunomide is an oral tablet. The usual dose for this medicine is one 14 mg tablet per day. You receive a month’s supply, which consists of 28 tablets. It can be taken either with or without food.
Teriflunomide helps most people with MS, but may have side effects in some people. All medications have side effects. It is important to notify your health professional if you experience any side effects or are feeling unwell.
The most frequent side effects of teriflunomide include nausea, elevated liver enzymes, diarrhoea and hair thinning. Less frequent effects include increased blood pressure and skin disorders. On rare occasions some people may develop liver or blood problems, gastrointestinal disorders, severe skin reactions and hypersensitivity reactions.
Your doctor or pharmacist can provide comprehensive information on the use of teriflunomide including precautions and side effects.
Teriflunomide has a high risk of causing permanent damage to a fetus and is not safe for pregnancy. Women of child-bearing potential are also advised to use reliable and effective contraception while taking teriflunomide.
If you are currently pregnant or trying to become pregnant, please discuss your individual circumstances and treatment options with your neurologist or healthcare team.
Teriflunomide should be avoided during breastfeeding, especially when nursing a newborn or preterm infant.
If you are currently breastfeeding, please discuss your individual circumstances and treatment options with your neurologist or healthcare team.
Teriflunomide has been approved by the Therapeutic Goods Administration (TGA) and is available through the Pharmaceutical Benefits Scheme (PBS). Please discuss with your neurologist whether teriflunomide is the right treatment for you. Your neurologist will need to obtain an authority to prescribe the medication for you.
If you are eligible for medications through the PBS, you will need to pay a contribution fee each time your prescription is dispensed. The Federal Government pays for the remaining cost. The amount of the contribution fee depends upon whether or not you have a pension or concession card. The amount of this fee is set each year by the Federal Government.
Further information about the PBS, your entitlements and details regarding the PBS safety net (which protects patients and their families requiring a large number of PBS items) is available through the Medicare Australia website at: www.medicare.gov.au
If you are not eligible for teriflunomide through the PBS, for example if you are a visitor from overseas, your neurologist may write a private prescription. In this instance you will have to pay the full cost to the pharmacy that dispenses your medication. You will need to request a quote from your pharmacist for the price of any medication which is not subsidised by the PBS.
Not all pharmacies keep teriflunomide in stock. It is therefore important to let your pharmacist know a few days before you need the medication so that they can order it in for you.
Speak to your neurologist about what treatment best suits your individual circumstances.
MS Nurses can also provide information, training and ongoing support in managing your immunotherapy.
MS Australia does not recommend any specific disease-modifying treatment for people living with MS. Decisions about any treatments, taking into consideration the potential benefits and side effects for each individual’s circumstances, should be made in careful consultation with the person’s neurologist.