Teriflunomide: Usage, Dosage, Side-effects, and Warnings

teriflunomide (aubagio)

Teriflunomide, sometimes sold under the brand name Aubagio or Denopsy, is a medication used to treat Multiple Sclerosis.

Multiple Sclerosis is a disease of the central nervous system possibly caused by a malfunction of the immune system which ends up destroying myelin.

The term Myelin refers to the fatty substance that surrounds and protects nerve fibers of the brain and the spinal cord. When it gets attacked, the nerves underneath get damaged.

Some people use Teriflunomide to prevent Multiple Sclerosis relapses from happening.

Aubagio usually comes in the form of film-coated tablets for oral administration. It contains 7 mg or 14 mg of Teriflunomide, which is a Pyrimidine Synthesis Inhibitor.

This compound inhibits the Dihydroorotate dehydrogenase (DHODH) enzyme, a mitochondrial protein involved in the production of Pyrimidine.

Pyrimidine derivatives play a significant role in boosting the immune system as well as attacking and destroying cells.

The inactive ingredients found in this medication include lactose monohydrate, corn starch, hydroxypropyl cellulose, microcrystalline cellulose, sodium starch glycolate, and magnesium stearate.


More often than not, people use Aubagio to treat relapsing forms of Multiple Sclerosis.

However, this medication is not a cure for the condition. It just decreases the activity of the immune system cells that can potentially damage the nerves in the brain and the spinal cord.

Doctors can provide with a medication guide before the patient starts taking Teriflunomide. Such instructions may vary depending on each particular case.

When the Teriflunomide treatment is over, medical experts may prescribe another medicine to remove the drug from the patient’s body.

Such a removal becomes necessary because Teriflunomide can stay in the body for as long as two years even after stopping the treatment.

Healthcare providers may do this especially if the patient is a woman of childbearing age or a man who wants to father a child.

If the patients display undesirable effects as a result of taking Teriflunomide, doctors will likely stop the treatment and prescribe Cholestyramine to help the body expel the substance.


The recommended dose will vary depending on the case. The minimum being 7mg while the maximum dosage is 14mg.

Patients must take one Teriflunomide tablet per day, and they can use the medication before or after a meal.

Medical experts will have to monitor their patients to assess their safety regularly.

That means they will likely order tests to measure transaminase and bilirubin levels six months before starting the treatment as well as a complete blood cell count (CBC).


Just like many other medicines, there is always a possibility of patients having adverse reactions to Aubagio.

It can cause a mild rash and other typical signs of allergic reactions. If the patient showcases a severe response featuring itching and swelling, the best thing to do is getting medical help as soon as possible.

Some of these side-effects include diarrhea, nausea, and in some cases, a burning tingling sensation in the skin. Other patients may even display numbness.

People had reported cases of temporary hair loss, but when the treatment ends and Teriflunomide gets removed from the body, hair growth returns to normal.

More often than not, taking medication does not result in any life-threatening side-effect.

However, in very few cases, patients may display highly severe and adverse reactions to Teriflunomide. Some of these side-effects include the following:

  • Hepatotoxicity, which refers to liver damage sometimes caused by the chemical agents in drugs or medications.
  • Potential development of Osteomyelitis, a term that describes an inflammation of the bone marrow (soft and gelatinous tissue in the center of most bones).
  • Peripheral Neuropathy, a condition that usually features weakness, numbness, and pain, often in the hands and the feet, due to damage in the nerves.

Aubagio can also raise the blood pressure and cause some respiratory issues.

Still, most of the side-effects mentioned in this article only occur in rare cases.


Patients with a pre-existing acute or chronic liver disease are at higher risk of having liver failure as a result of taking Teriflunomide. They shouldn’t get a treatment based on this medication.

If the patient is pregnant, she shouldn’t take Teriflunomide because it will likely cause fetal harm. This medication is not recommended for females of reproductive potential either.

Due to its immunosuppressive effects, no patient with active acute or chronic infections should not take Teriflunomide until they overcome such conditions.