Teriflunomide interactions

Teriflunomide (Aubagio), an immunosuppressant has 75 documented interactions across the FDA labels and fact sheets we index: 10 major, 50 moderate, 14 minor, and 1 where a label reports no significant interaction. Each entry below quotes the sentence behind it. This drug page is a starting point, not a verdict for your situation.

Major interactions (10)

  • AdalimumabimmunosuppressantMajor

    It is uncertain whether the occurrence of HSTCL is related to use of a TNF blocker or a TNF blocker in combination with these other immunosuppressants [see Warnings and Precautions (5.2) ] . (Adalimumab label, Boxed warning)

  • CaptoprilACE inhibitorMajor

    About 13 percent of the cases of neutropenia have ended fatally, but almost all fatalities were in patients with serious illness, having collagen vascular disease, renal failure, heart failure or immunosuppressant therapy, or a combination of these complicating factors. (Captopril label, Warnings)

  • Cholestyraminebile acid sequestrantMajor

    If drug induced liver injury is suspected, discontinue AUBAGIO and start an accelerated elimination procedure with cholestyramine or charcoal [see Warnings and Precautions (5.3) ] . (Teriflunomide label, Boxed warning)

  • CyclosporineimmunosuppressantMajor

    In kidney, liver, and heart transplant patients Neoral may be administered with other immunosuppressive agents. (Cyclosporine label, Boxed warning)

  • FingolimodimmunosuppressantMajor

    When switching from drugs with prolonged immune effects, such as natalizumab, teriflunomide or mitoxantrone, the duration and mode of action of these drugs must be considered to avoid unintended additive immunosuppressive effects when initiating GILENYA [see Warnings and Precautions (5.2)] . (Fingolimod label, Drug interactions)

  • FludrocortisonecorticosteroidMajor

    Chicken pox and measles, for example, can have a more serious or even fatal course in children on immunosuppressant corticosteroids. (Fludrocortisone label, Warnings)

  • Itraconazoleazole antifungalMajor

    Immunosuppressants Everolimus Sirolimus Temsirolimus (IV) Not recommended during and 2 weeks after TOLSURA treatment. (Itraconazole label, Drug interactions)

  • LeflunomideimmunosuppressantMajor

    Current leflunomide treatment ( 4 ) (Teriflunomide label, Contraindications)

  • Nirmatrelvir and ritonavirantiviralMajor

    …methylergonovine • HMG-CoA reductase inhibitors: lovastatin, simvastatin (these drugs can be temporarily discontinued to allow PAXLOVID use [see Table 2 , Drug Interactions (7.3) ] ) • Immunosuppressants: voclosporin • Microsomal triglyceride transfer protein inhibitor: lomitapide • Migraine medications: eletriptan, ubrogepant • Mineralocorticoid receptor antagonists:… (Nirmatrelvir and ritonavir label, Contraindications)

  • TacrolimusimmunosuppressantMajor

    …IN TRANSPLANT PATIENTS; AND INCREASED MORTALITY IN FEMALE LIVER TRANSPLANT PATIENTS • Increased risk for developing serious infections and malignancies with ASTAGRAF XL ® or other immunosuppressants that may lead to hospitalization or death. [see Warnings and Precautions ( 5.1 , 5.2 )] • Increased mortality in female liver transplant patients with ASTAGRAF XL. (Tacrolimus label, Boxed warning)

Moderate interactions (50)

  • Allopurinolxanthine oxidase inhibitorModerate

    In patients taking AUBAGIO, exposure of drugs metabolized by CYP1A2 (e.g., alosetron, duloxetine, theophylline, tizanidine) may be reduced. (Teriflunomide label, Drug interactions)

  • AlosetronModerate

    In patients taking AUBAGIO, exposure of drugs metabolized by CYP1A2 (e.g., alosetron, duloxetine, theophylline, tizanidine) may be reduced. (Teriflunomide label, Drug interactions)

  • Amlodipinedihydropyridine calcium channel blockerModerate

    Immunosuppressants Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (Amlodipine label, Drug interactions)

  • Amoxicillinpenicillin antibioticModerate

    In patients taking AUBAGIO, exposure of drugs which are OAT3 substrates (e.g., cefaclor, cimetidine, ciprofloxacin, penicillin G, ketoprofen, furosemide, methotrexate, zidovudine) may be increased. (Teriflunomide label, Drug interactions)

  • Amoxicillin and clavulanatepenicillin antibioticModerate

    In patients taking AUBAGIO, exposure of drugs which are OAT3 substrates (e.g., cefaclor, cimetidine, ciprofloxacin, penicillin G, ketoprofen, furosemide, methotrexate, zidovudine) may be increased. (Teriflunomide label, Drug interactions)

  • Ampicillinpenicillin antibioticModerate

    In patients taking AUBAGIO, exposure of drugs which are OAT3 substrates (e.g., cefaclor, cimetidine, ciprofloxacin, penicillin G, ketoprofen, furosemide, methotrexate, zidovudine) may be increased. (Teriflunomide label, Drug interactions)

  • AtorvastatinstatinModerate

    For other substrates of BCRP (e.g., mitoxantrone) and drugs in the OATP family (e.g., methotrexate, rifampin), especially HMG-Co reductase inhibitors (e.g., atorvastatin, nateglinide, pravastatin, repaglinide, and simvastatin), consider reducing the dose of these drugs and monitor patients closely for signs and symptoms of increased exposures to the drugs while… (Teriflunomide label, Drug interactions)

  • Butalbital, acetaminophen, and caffeinebarbiturateModerate

    In patients taking AUBAGIO, exposure of drugs metabolized by CYP1A2 (e.g., alosetron, duloxetine, theophylline, tizanidine) may be reduced. (Teriflunomide label, Drug interactions)

  • CimetidineH2 blockerModerate

    In patients taking AUBAGIO, exposure of drugs which are OAT3 substrates (e.g., cefaclor, cimetidine, ciprofloxacin, penicillin G, ketoprofen, furosemide, methotrexate, zidovudine) may be increased. (Teriflunomide label, Drug interactions)

  • CiprofloxacinfluoroquinoloneModerate

    In patients taking AUBAGIO, exposure of drugs which are OAT3 substrates (e.g., cefaclor, cimetidine, ciprofloxacin, penicillin G, ketoprofen, furosemide, methotrexate, zidovudine) may be increased. (Teriflunomide label, Drug interactions)

  • Conjugated estrogensestrogenModerate

    Effect of AUBAGIO on Oral Contraceptives AUBAGIO may increase the systemic exposures of ethinylestradiol and levonorgestrel. (Teriflunomide label, Drug interactions)

  • DenosumabModerate

    Other risk factors for the development of ONJ include immunosuppressive therapy, treatment with angiogenesis inhibitors, systemic corticosteroids, diabetes, and gingival infections. (Denosumab label, Warnings and precautions)

  • Dicloxacillinpenicillin antibioticModerate

    In patients taking AUBAGIO, exposure of drugs which are OAT3 substrates (e.g., cefaclor, cimetidine, ciprofloxacin, penicillin G, ketoprofen, furosemide, methotrexate, zidovudine) may be increased. (Teriflunomide label, Drug interactions)

  • Drospirenone and ethinyl estradioloral contraceptiveModerate

    Effect of AUBAGIO on Oral Contraceptives AUBAGIO may increase the systemic exposures of ethinylestradiol and levonorgestrel. (Teriflunomide label, Drug interactions)

  • DuloxetineSNRIModerate

    In patients taking AUBAGIO, exposure of drugs metabolized by CYP1A2 (e.g., alosetron, duloxetine, theophylline, tizanidine) may be reduced. (Teriflunomide label, Drug interactions)

  • EstradiolestrogenModerate

    Effect of AUBAGIO on Oral Contraceptives AUBAGIO may increase the systemic exposures of ethinylestradiol and levonorgestrel. (Teriflunomide label, Drug interactions)

  • EverolimusimmunosuppressantModerate

    Lymphomas and Other Malignancies Patients receiving immunosuppressants, including Zortress, are at increased risk of developing lymphomas and other malignancies, particularly of the skin. (Everolimus label, Warnings and precautions)

  • Ezetimibe and simvastatinstatinModerate

    …(e.g., mitoxantrone) and drugs in the OATP family (e.g., methotrexate, rifampin), especially HMG-Co reductase inhibitors (e.g., atorvastatin, nateglinide, pravastatin, repaglinide, and simvastatin), consider reducing the dose of these drugs and monitor patients closely for signs and symptoms of increased exposures to the drugs while patients are taking AUBAGIO [see… (Teriflunomide label, Drug interactions)

  • Febuxostatxanthine oxidase inhibitorModerate

    In patients taking AUBAGIO, exposure of drugs metabolized by CYP1A2 (e.g., alosetron, duloxetine, theophylline, tizanidine) may be reduced. (Teriflunomide label, Drug interactions)

  • FenofibratefibrateModerate

    Immunosuppressants Clinical Impact: Immunosuppressants such as cyclosporine and tacrolimus can produce nephrotoxicity with decreases in creatinine clearance and rises in serum creatinine, and because renal excretion is the primary elimination route of fibrate drugs including fenofibrate, there is a risk that an interaction will lead to deterioration of renal… (Fenofibrate label, Drug interactions)

  • Furosemideloop diureticModerate

    In patients taking AUBAGIO, exposure of drugs which are OAT3 substrates (e.g., cefaclor, cimetidine, ciprofloxacin, penicillin G, ketoprofen, furosemide, methotrexate, zidovudine) may be increased. (Teriflunomide label, Drug interactions)

  • InfliximabimmunosuppressantModerate

    When treating patients, consideration of whether to use RENFLEXIS alone or in combination with other immunosuppressants such as azathioprine or 6-mercaptopurine should take into account a possibility that there is a higher risk of HSTCL with combination therapy versus an observed increased risk of immunogenicity and hypersensitivity reactions with infliximab… (Infliximab label, Warnings and precautions)

  • Ketoconazoleazole antifungalModerate

    Immunosuppressants everolimus, rapamycin (also known as sirolimus), temsirolimus budesonide, ciclesonide, cyclosporine, dexamethasone, fluticasone, methylprednisolone, tacrolimus Rapamycin (sirolimus): Ketoconazole tablets 200 mg daily for 10 days increased the C max and AUC of a single 5 mg dose of sirolimus by 4.3 fold and 10.9 fold, respectively in 23 healthy… (Ketoconazole label, Drug interactions)

  • LevonorgestrelprogestinModerate

    Teriflunomide may increase exposure of ethinylestradiol and levonorgestrel. (Teriflunomide label, Drug interactions)

  • Levonorgestrel and ethinyl estradioloral contraceptiveModerate

    Teriflunomide may increase exposure of ethinylestradiol and levonorgestrel. (Teriflunomide label, Drug interactions)

  • MedroxyprogesteroneprogestinModerate

    Effect of AUBAGIO on Oral Contraceptives AUBAGIO may increase the systemic exposures of ethinylestradiol and levonorgestrel. (Teriflunomide label, Drug interactions)

  • MegestrolprogestinModerate

    Effect of AUBAGIO on Oral Contraceptives AUBAGIO may increase the systemic exposures of ethinylestradiol and levonorgestrel. (Teriflunomide label, Drug interactions)

  • MethotrexateimmunosuppressantModerate

    In patients taking AUBAGIO, exposure of drugs which are OAT3 substrates (e.g., cefaclor, cimetidine, ciprofloxacin, penicillin G, ketoprofen, furosemide, methotrexate, zidovudine) may be increased. (Teriflunomide label, Drug interactions)

  • MycophenolateimmunosuppressantModerate

    Lymphoma and Other Malignancies Patients receiving immunosuppressants, including MYHIBBIN, are at increased risk of developing lymphomas and other malignancies, particularly of the skin [see Adverse Reactions ( 6.1 )]. (Mycophenolate label, Warnings and precautions)

  • NorethindroneprogestinModerate

    Effect of AUBAGIO on Oral Contraceptives AUBAGIO may increase the systemic exposures of ethinylestradiol and levonorgestrel. (Teriflunomide label, Drug interactions)

  • Norethindrone and ethinyl estradioloral contraceptiveModerate

    Effect of AUBAGIO on Oral Contraceptives AUBAGIO may increase the systemic exposures of ethinylestradiol and levonorgestrel. (Teriflunomide label, Drug interactions)

  • Norgestimate and ethinyl estradioloral contraceptiveModerate

    Effect of AUBAGIO on Oral Contraceptives AUBAGIO may increase the systemic exposures of ethinylestradiol and levonorgestrel. (Teriflunomide label, Drug interactions)

  • OcrelizumabimmunosuppressantModerate

    When switching from drugs with prolonged immune effects, such as daclizumab, fingolimod, natalizumab, teriflunomide, or mitoxantrone, consider the duration and mode of action of these drugs because of additive immunosuppressive effects when initiating OCREVUS [see Warnings and Precautions (5.2) ]. (Ocrelizumab label, Drug interactions)

  • Penicillin Gpenicillin antibioticModerate

    In patients taking AUBAGIO, exposure of drugs which are OAT3 substrates (e.g., cefaclor, cimetidine, ciprofloxacin, penicillin G, ketoprofen, furosemide, methotrexate, zidovudine) may be increased. (Teriflunomide label, Drug interactions)

  • Penicillin Vpenicillin antibioticModerate

    In patients taking AUBAGIO, exposure of drugs which are OAT3 substrates (e.g., cefaclor, cimetidine, ciprofloxacin, penicillin G, ketoprofen, furosemide, methotrexate, zidovudine) may be increased. (Teriflunomide label, Drug interactions)

  • PentoxifyllinemethylxanthineModerate

    In patients taking AUBAGIO, exposure of drugs metabolized by CYP1A2 (e.g., alosetron, duloxetine, theophylline, tizanidine) may be reduced. (Teriflunomide label, Drug interactions)

  • PioglitazonethiazolidinedioneModerate

    In patients taking AUBAGIO, exposure of drugs metabolized by CYP2C8 (e.g., paclitaxel, pioglitazone, repaglinide, rosiglitazone) may be increased. (Teriflunomide label, Drug interactions)

  • Pioglitazone and metforminthiazolidinedioneModerate

    In patients taking AUBAGIO, exposure of drugs metabolized by CYP2C8 (e.g., paclitaxel, pioglitazone, repaglinide, rosiglitazone) may be increased. (Teriflunomide label, Drug interactions)

  • PravastatinstatinModerate

    …other substrates of BCRP (e.g., mitoxantrone) and drugs in the OATP family (e.g., methotrexate, rifampin), especially HMG-Co reductase inhibitors (e.g., atorvastatin, nateglinide, pravastatin, repaglinide, and simvastatin), consider reducing the dose of these drugs and monitor patients closely for signs and symptoms of increased exposures to the drugs while patients… (Teriflunomide label, Drug interactions)

  • ProgesteroneprogestinModerate

    Effect of AUBAGIO on Oral Contraceptives AUBAGIO may increase the systemic exposures of ethinylestradiol and levonorgestrel. (Teriflunomide label, Drug interactions)

  • RepaglinidemeglitinideModerate

    In patients taking AUBAGIO, exposure of drugs metabolized by CYP2C8 (e.g., paclitaxel, pioglitazone, repaglinide, rosiglitazone) may be increased. (Teriflunomide label, Drug interactions)

  • RifampinantibioticModerate

    For other substrates of BCRP (e.g., mitoxantrone) and drugs in the OATP family (e.g., methotrexate, rifampin), especially HMG-Co reductase inhibitors (e.g., atorvastatin, nateglinide, pravastatin, repaglinide, and simvastatin), consider reducing the dose of these drugs and monitor patients closely for signs and symptoms of increased exposures to the drugs while… (Teriflunomide label, Drug interactions)

  • RitonavirantiretroviralModerate

    Immunosuppressants: cyclosporine, tacrolimus, sirolimus (rapamycin) ↑ immunosuppressants Therapeutic concentration monitoring is recommended for immunosuppressant agents when co-administered with ritonavir. (Ritonavir label, Drug interactions)

  • RosuvastatinstatinModerate

    Rosuvastatin: The dose of rosuvastatin should not exceed 10 mg once daily in patients taking AUBAGIO. (Teriflunomide label, Drug interactions)

  • SimvastatinstatinModerate

    …(e.g., mitoxantrone) and drugs in the OATP family (e.g., methotrexate, rifampin), especially HMG-Co reductase inhibitors (e.g., atorvastatin, nateglinide, pravastatin, repaglinide, and simvastatin), consider reducing the dose of these drugs and monitor patients closely for signs and symptoms of increased exposures to the drugs while patients are taking AUBAGIO [see… (Teriflunomide label, Drug interactions)

  • Sofosbuvir and velpatasvirantiviralModerate

    HBV reactivation has also been reported in patients receiving certain immunosuppressant or chemotherapeutic agents; the risk of HBV reactivation associated with treatment with HCV direct-acting antivirals may be increased in these patients. (Sofosbuvir and velpatasvir label, Warnings and precautions)

  • TheophyllinemethylxanthineModerate

    In patients taking AUBAGIO, exposure of drugs metabolized by CYP1A2 (e.g., alosetron, duloxetine, theophylline, tizanidine) may be reduced. (Teriflunomide label, Drug interactions)

  • TinidazoleantibioticModerate

    Cyclosporine, tacrolimus: Monitor for toxicities of these immunosuppressive drugs ( 7.1 ) (Tinidazole label, Drug interactions)

  • Tizanidinemuscle relaxantModerate

    In patients taking AUBAGIO, exposure of drugs metabolized by CYP1A2 (e.g., alosetron, duloxetine, theophylline, tizanidine) may be reduced. (Teriflunomide label, Drug interactions)

  • WarfarinanticoagulantModerate

    Warfarin: Monitor INR as teriflunomide may decrease INR. (Teriflunomide label, Drug interactions)

Minor mentions (14)

  • Cannabidiol (prescription)anticonvulsantMinor

    Effect of AUBAGIO on CYP2C8 Substrates Teriflunomide is an inhibitor of CYP2C8 in vivo . (Teriflunomide label, Drug interactions)

  • CarbamazepineanticonvulsantMinor

    Effect of AUBAGIO on CYP1A2 Substrates Teriflunomide may be a weak inducer of CYP1A2 in vivo . (Teriflunomide label, Drug interactions)

  • Deferasiroxiron supplementMinor

    Effect of AUBAGIO on CYP2C8 Substrates Teriflunomide is an inhibitor of CYP2C8 in vivo . (Teriflunomide label, Drug interactions)

  • FluvastatinstatinMinor

    IMNM is characterized by proximal muscle weakness and elevated serum CK, which persist despite discontinuation of statin treatment; positive anti-HMG CoA reductase antibody, muscle biopsy showing necrotizing myopathy, and improvement with immunosuppressive agents. (Fluvastatin label, Warnings and precautions)

  • GemfibrozilfibrateMinor

    Effect of AUBAGIO on CYP2C8 Substrates Teriflunomide is an inhibitor of CYP2C8 in vivo . (Teriflunomide label, Drug interactions)

  • GlatiramerMinor

    Safety studies in which AUBAGIO was concomitantly administered with other immune modulating therapies for up to one year (interferon beta, glatiramer acetate) did not reveal any specific safety concerns. (Teriflunomide label, Warnings and precautions)

  • LovastatinstatinMinor

    IMNM is characterized by: proximal muscle weakness and elevated serum creatine kinase, which persist despite discontinuation of statin treatment; positive anti-HMG CoA reductase antibody; muscle biopsy showing necrotizing myopathy; and improvement with immunosuppressive agents. (Lovastatin label, Warnings)

  • Methimazoleantithyroid drugMinor

    In some cases, vasculitis resolved/improved with drug discontinuation; however, more severe cases required treatment with additional measures including corticosteroids, immunosuppressant therapy, and plasmapheresis. (Methimazole label, Warnings)

  • PerampanelanticonvulsantMinor

    Effect of AUBAGIO on CYP2C8 Substrates Teriflunomide is an inhibitor of CYP2C8 in vivo . (Teriflunomide label, Drug interactions)

  • PitavastatinstatinMinor

    IMNM is characterized by proximal muscle weakness and elevated serum creatine kinase that persist despite discontinuation of statin treatment; positive anti-HMG CoA reductase antibody; muscle biopsy showing necrotizing myopathy; and improvement with immunosuppressive agents. (Pitavastatin label, Warnings and precautions)

  • Posaconazoleazole antifungalMinor

    CYP3A Substrates Immunosuppressants that are CYP3A4 Substrates Mechanism and Clinical Effect(s) Posaconazole is a strong CYP3A4 inhibitor. (Posaconazole label, Drug interactions)

  • Propylthiouracilantithyroid drugMinor

    In some cases, vasculitis resolved/improved with drug discontinuation; however, more severe cases required treatment with additional measures including corticosteroids, immunosuppressant therapy, and plasmapheresis. (Propylthiouracil label, Warnings)

  • Sulfamethoxazole and trimethoprimsulfonamideMinor

    Effect of AUBAGIO on CYP2C8 Substrates Teriflunomide is an inhibitor of CYP2C8 in vivo . (Teriflunomide label, Drug interactions)

  • TrimethoprimantibioticMinor

    Effect of AUBAGIO on CYP2C8 Substrates Teriflunomide is an inhibitor of CYP2C8 in vivo . (Teriflunomide label, Drug interactions)

No significant interaction reported (1)

  • Clarithromycinmacrolide antibioticNo interaction

    …Repaglinide, Rosiglitazone: [See Warnings and Precautions ( 5.4 ) and Adverse Reactions ( 6.2 )] Insulin Insulin: [See Warnings and Precautions ( 5.4 ) and Adverse Reactions ( 6.2 )] Immunosuppressants: Cyclosporine Use With Caution Cyclosporine: There have been spontaneous or published reports of CYP3A based interactions of clarithromycin with cyclosporine. (Clarithromycin label, Drug interactions)

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Not medical advice. Severity reflects the label's wording, not your circumstances. A "major" flag can be routine under supervision and a "minor" one can matter at high doses. Ask a pharmacist.