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Teriflunomide (Aubagio)

Teriflunomide is a disease modifying therapy (DMT) for relapsing MS. Its brand name is Aubagio and you take it as a tablet.

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Who can take teriflunomide (Aubagio)?

In ScotlandWales and Northern Ireland you can take teriflunomide (its brand name is Aubagio) if:

  • you have relapsing MS and you’ve had a recent relapse and/or if MRI scans show new signs that their MS is active (you have new lesions)

In England you can have this drug if:

  • you’ve had two relapses in the last two years

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How does teriflunomide (Aubagio) work?

We don't know exactly how teriflunomide (Aubagio) works, but it dampens down inflammation. Your immune system makes cells, called T-cells, that kill viruses and bacteria. But in MS these cells are believed to attack the coating (called myelin) around nerves in your brain and spinal cord. This drug stops T-cells getting into your brain and spinal cord, and causing damage to the nerves there.

Teriflunomide is a tablet you take once a day.

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How effective is teriflunomide (Aubagio)?

MS drugs can be put into three groups based on how well they control it. The effectiveness of teriflunomide (Aubagio) is classed as 'moderate', the least effective of the three groups. This is based on how much it reduces relapses and slows down how fast people's disability gets worse.

Relapses dropped by: 31%

This means that in a trial, on average, people saw a 31% drop in the numbers of relapses they had. This was compared to people who took a placebo, a dummy treatment with no drug in it.

Disability getting worse was slowed by: 30%

This means that in a trial, on average, people saw a 30% drop in the risk of their disability getting worse. This was compared to people who took a placebo.

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What are the side effects of teriflunomide (Aubagio)?

Compared to other DMTs the risk of side effects, especially serious ones, is among the lowest.

More than one in 10 people get headaches, diarrhoea or feel sick. Your hair might get thinner but it grows back after six months. You might be more likely to get common infections like colds, 'cold sores', urinary tract or chest



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Teriflunomide (Aubagio) and pregnancy, breastfeeding and contraception

Pregnancy

Teriflunomide (Aubagio) might harm unborn babies. So, if you can get pregnant, you’ll need reliable contraception (such as condoms, the ‘pill’, an implant or IUD) while taking this drug to avoid a pregnancy.

This drug stays in the body far longer than other DMTs. Before you can get pregnant, you’ll need to wait until the amount of the drug in your body drops to a safe level. The time this takes is called the ‘washout period’. For teriflunomide this can be up to two years. You can take medication that speeds this up to under two months.

If you want to keep taking a DMT through your pregnancy, talk to your neurologist about switching to a different DMT. Or you and your doctor might decide that you’ll stop taking your DMT during your pregnancy, then restart it soon after the baby’s born.

If you’ve just had a baby, you’re more likely to have a relapse. So if you stop teriflunomide, it’s recommended you restart it soon after giving birth.

If you and your partner want to have a child, discuss this with your neurologist. If you think you’ve become pregnant, let your medical team know at once. Never stop your DMT without first getting their advice.

Breastfeeding

Teriflunomide (Aubagio) might pass into breast milk. So, if you want to breastfeed, you shouldn’t feed your baby this way while taking this drug (and for however long your neurologist recommends after you stop taking it).

Contraception

If you can get pregnant, you must avoid this if you’re taking teriflunomide (Aubagio). You need to use reliable contraception (condoms, the ‘pill’, an implant or IUD) while on this drug. A woman who decides to stop taking it, for example to get pregnant, still needs contraception possibly for up to two years after her last dose. You can take a drug to speed this up, bringing the time needed down to under two months.

If you’re a man taking teriflunomide, the drug can affect your sperm and, if you make a woman pregnant, this can affect the unborn baby. You should use condoms while you're on this drug, but also during the washout period if you stop taking it. 

Teriflunomide can also lower sperm counts. Your neurologist can give you more advice about contraception and fertility.

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