Teriflunomide

Generic name: Teriflunomide

Drug class: Immunomodulatory agents

Dosage form: Oral tablets (7 mg and 14 mg)

Route of administration: Oral

Dose: 7 mg or 14 mg once daily

Mechanism of action: Teriflunomide inhibits the enzyme dihydroorotate dehydrogenase, leading to a decrease in pyrimidine synthesis. This reduction impairs the proliferation of activated T and B lymphocytes, which are implicated in the pathogenesis of multiple sclerosis, thereby modulating the immune response and reducing inflammation.

Drug usage cases:

• Treatment of relapsing forms of multiple sclerosis, including clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease in adults.

Drug contraindications:

• Severe hepatic impairment
• Hypersensitivity to teriflunomide or any of its components
• Pregnancy and women planning to become pregnant
• Breastfeeding

Side effects:

• Headache
• Diarrhea
• Nausea
• Hair thinning or loss (alopecia)
• Elevated liver enzymes (transaminases)
• Hypertension
• Peripheral neuropathy
• Increased risk of infections due to lymphopenia
• Elevated blood pressure
• Rash
• Fatigue
• Elevated liver enzymes

Warnings:

• Hepatotoxicity: Monitor liver function tests before starting therapy and periodically thereafter. Discontinue if significant liver injury occurs.
• Teratogenicity: Contraindicated during pregnancy and in women planning to become pregnant. Effective contraception is required during treatment and for a period after discontinuation.
• Infections: Increased risk due to immunosuppressive effects. Screen for latent tuberculosis before initiating therapy.
• Hypertension: Monitor blood pressure regularly; manage as needed.
• Peripheral Neuropathy: Discontinue if symptoms develop.
• Drug Interactions: May interact with other immunosuppressive agents and certain vaccines. Consult healthcare provider before starting new medications or vaccines.

Use during pregnancy or breastfeeding:

Teriflunomide is contraindicated during pregnancy due to potential teratogenic effects. Women of childbearing potential should use effective contraception during treatment and for at least two years after discontinuation, or until the drug is eliminated from the body. Teriflunomide is also contraindicated during breastfeeding. If pregnancy occurs during treatment, teriflunomide should be discontinued, and the drug elimination procedure should be initiated to reduce fetal risk.