MS- Teriflunomide DI

Question 1

Teriflunomide brand name

Answer 1

Aubagio

Question 2

Teriflunomide indications

Answer 2

CIS, active SPMS, RRMS

Question 3

Teriflunomide MoA

Answer 3

Blocks pyrimidine synthesis in rapidly dividing cells, inhibits protein tyrosine-kinase and COX2 activity, and decreases ability of APCs to activate T-cells and reduce B-lymphocyte proliferation

Question 4

Teriflunomide dosing

Answer 4

7-14mg PO

Question 5

Teriflunomide ADEs

Answer 5

HA, nasopharyngitis, URTI, alopecia, sensory disturbances, nausea, paresthesias, insomnia, fatigue, UTI, increases in LFTs, back pain, limb pain, diarrhea, arthralgia, neuropathy, kidney problems, hyperkalemia, serious skin problems, breathing problems, interstitial lung disease, HTN

Question 6

Teriflunomide DDIs

Answer 6

May increase exposure to drugs metabolized by CYP2C8, OAT3, BCRP, and OAT1B1/B3 and to ethinylestradiol and levonorgestrel

Question 7

What dose of rosuvastatin should patients taking teriflunomide not exceed?

Answer 7

10mg

Question 8

Teriflunomide and INR

Answer 8

INR may decrease

Question 9

Teriflunomide BBWs

Answer 9

Hepatotoxicity and teratogenicity

Question 10

How to quickly get rid of teriflunomide

Answer 10

Cholestyramine 5-8g q8h x11 days
Activated charcoal q12h x11 days

Question 11

Teriflunomide monitoring

Answer 11

CBC within 6 months before starting
LFTs and bilirubin within 6 months
Latent TB infections

Question 12

Teriflunomide bioavailability

Answer 12

100% in FASTED patients, peaks in 1-2 hours. Food delays the absorption by 6 hours

Question 13

Teriflunomide half-life

Answer 13

10-12 days

Question 14

Teriflunomide plasma clearance

Answer 14

0.5 L/hr