Pyrimidine synthesis inhibitor
Teriflunomide
Brand names: Aubagio
Adult dose
Dose: 14mg PO OD
Route: PO
Frequency: OD
Clinical pearls
- Relapsing MS
- Pregnancy: cholestyramine accelerated elimination; reliable contraception
Contraindications
- Severe hepatic impairment
- Pregnancy (highly teratogenic — accelerated elimination required)
- Severe immunodeficiency
- Severe active infection
Side effects
- Hepatotoxicity
- Hypertension
- Diarrhoea
- Alopecia
- Cytopenias
- Peripheral neuropathy
- Severe skin reactions
Interactions
- Strong CYP1A2 substrates
- Warfarin
- Hormonal contraceptives (additional method)
Monitoring
- LFTs (monthly x6)
- BP
- FBC
Reference: BNF; NICE TA303; SmPC; https://bnf.nice.org.uk/drugs/teriflunomide/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- SMART Risk Score for Recurrent CVD · Cardiovascular Risk
- PCSK9 Inhibitor Eligibility Assessment · Lipid Management
- Immune-Related Adverse Events (irAE) -- GI Toxicity Colitis Grading · Oncology-Related GI
- irAE Hepatitis Grading (CTCAE) · Immunotherapy
- DIPSS — Dynamic International Prognostic Scoring System for Myelofibrosis · Cancer Prognosis
- BALL Score for Relapsed/Refractory CLL · Leukaemia
Pathways
- Acute Stroke / TIA Assessment · NICE NG128; RCP Stroke Guidelines 2023
- Status Epilepticus (Adults) · NICE CG137; ESEM guidelines; RCP Neurology Guidelines
- Suspected Subarachnoid Haemorrhage · NICE NG228; RCEM 2023; AHA/ASA 2023
- Adult Head Injury · NICE NG232 (2023)
- Bell's Palsy / Facial Nerve Palsy · ENT UK 2017; AAN
- Vertigo Workup · ENT UK; NICE CKS