What the F*ck is Aubagio?
Aubagio Details: Effects, Application for MS, Expense, and Further Insights
Aubagio, a prescription medication approved by the FDA, is a brand-name treatment for specific conditions in adults - relapsing-remitting MS, active secondary progressive MS, and clinically isolated syndrome. Aubagio contains the active drug teriflunomide, which is a type of pyrimidine synthesis inhibitor.
It comes as a tablet taken once per day, available in strengths of 7 milligrams (mg) and 14 mg. The effectiveness of Aubagio is discussed in its "uses" section below[1].
Side Effects
Aubagio can bring on mild or serious side effects. The following is a list of some common and severe side effects that may occur while taking Aubagio. This list isn't exhaustive, and you should consult your doctor or pharmacist for more information or if any bothersome symptoms arise[2].
More Common Side Effects
- Headache
- Hair loss (alopecia)
- Decreased phosphate level
- Decreased white blood cell count (specifically neutrophils)
- Nausea
- Diarrhea
- Increased liver enzyme levels, which may signal liver damage
- High blood pressure
- Numbness or tingling in hands and feet
- Joint pain
Most of these side effects will subside within a few days or a couple of weeks. Speak to your doctor or pharmacist if they are more severe or do not improve.
Serious Side Effects
Serious side effects and their symptoms include:
- Low white blood cell count, with symptoms like fever, fatigue, body aches, chills, and nausea.
- High blood pressure, manifesting as headache, fatigue or confusion, vision changes, or irregular heartbeat.
- Respiratory problems, including interstitial lung disease, presenting with shortness of breath or coughing (with or without fever).
- Liver damage, including liver failure.
- Severe skin reactions, such as Stevens-Johnson syndrome, drug reaction with eosinophilia and systemic symptoms (DRESS), and toxic epidermal necrolysis (TEN).
- Allergic reaction.
Contact your doctor immediately if you experience any of these symptoms, and call 911 if symptoms feel life-threatening or if you think you're having a medical emergency.
Side Effect Details
You may wonder how often certain side effects occur with this medication, or whether specific side effects are related to it. Here is some detail on some side effects that Aubagio may or may not cause:
Allergic Reaction
Like most medications, some individuals may have an allergic reaction after taking Aubagio. Symptoms of a mild allergic reaction can include:
- Skin rash
- Itchiness
A more severe allergic reaction is rare but possible. Symptoms of a serious allergic reaction can include:
- Angioedema (swelling under the skin, typically in eyelids, lips, hands, or feet)
- Swelling of the tongue, mouth, or throat
- Trouble breathing
- Discolored skin
- Peeling skin
Contact your doctor immediately if you have a severe allergic reaction to Aubagio[2].
Skin Problems or Rash
Aubagio can cause serious skin reactions, including Stevens-Johnson syndrome, DRESS, and TEN, which are medical emergencies. These may result in painful sores on the mouth, throat, eyes, or genitals, as well as a serious skin rash and problems with organs[2].
Liver Damage
Aubagio has a boxed warning from the FDA for severe liver damage. Before beginning Aubagio treatment, your doctor will give you a blood test to check your liver function. As you take Aubagio, you'll receive monthly tests to monitor your liver[2].
Symptoms of liver damage include:
- Nausea
- Vomiting
- Pain in the abdomen
- Appetite loss
- Tiredness
- Dark urine
- Yellowing of the skin or eyes
Hair Loss
One of the most common side effects of Aubagio is alopecia (hair thinning or loss). Symptoms usually appear within 3 months of taking the drug. Most cases of alopecia last less than 6 months and ease as treatment continues[2].
If you're concerned about hair loss while taking Aubagio, consult your doctor.
Diarrhea
Diarrhea is a common side effect of Aubagio. In clinical trials, about 14% of those taking Aubagio experienced diarrhea, compared to 8% of those receiving a placebo (no treatment)[1]. Most cases of diarrhea are mild to moderate and resolve on their own.
To treat mild diarrhea, drink plenty of water or electrolyte solutions to help replace lost fluids. If your diarrhea persists for several days, contact your doctor[2].
PML (Not a Side Effect)
Progressive Multifocal Leukoencephalopathy (PML) isn't a side effect of Aubagio. PML is a disease that attacks the central nervous system. One case was reported where a person developed PML after switching from natalizumab (Tysabri) to Aubagio. However, it's likely that the natalizumab caused the PML, not Aubagio[1].
If you switch to Aubagio after taking natalizumab, your doctor will screen you for PML[1].
Fatigue (Not a Side Effect)
Fatigue isn't a common side effect of Aubagio. However, fatigue is a common symptom of MS. Fatigue may also be a sign of liver damage. If you're concerned about fatigue while taking Aubagio, discuss it with your doctor[1].
Weight Loss or Weight Gain (Not a Side Effect)
Weight loss and weight gain weren't side effects of Aubagio in clinical trials. You're unlikely to experience weight changes while taking Aubagio[1].
However, one of the most common symptoms of MS is fatigue. If your energy level is low, you may not be as active, leading to potential weight gain. If you're concerned about changes in your weight, speak with your doctor[1].
Cancer (Not a Side Effect)
Taking medication that affects your immune system, like Aubagio, may increase your risk for cancer. However, clinical trials for Aubagio didn't report an increase in the number of individuals who developed cancer[1].
If you're concerned about developing cancer, consult your doctor.
Depression (Not a Side Effect)
Depression isn't a side effect of Aubagio, but it's a common symptom of MS. If you have symptoms of depression, inform your doctor. Several antidepressant drugs are available to help ease your symptoms[1].
Dosage
The Aubagio dosage your doctor prescribes will depend on factors like the type and severity of your condition, your age, the form of Aubagio you take, and other medical conditions you may have.
For more information on Aubagio dosage, see here.
Aubagio and Alcohol
There's no known interaction between Aubagio and alcohol. However, alcohol may increase your risk for certain side effects, such as nausea, diarrhea, and headache, and may also increase your risk for liver damage. Be mindful of your alcohol consumption when taking Aubagio[2].
Aubagio Interactions
Aubagio can interact with several other medications and supplements. If you take Aubagio, inform your doctor and pharmacist about all prescription, over-the-counter, and other drugs along with any vitamins, herbs, and supplements you use. This helps you avoid potential interactions[2].
Alternatives to Aubagio
Other drugs can treat relapsing-remitting MS, active secondary progressive MS, or clinically isolated syndrome. To find an alternative, consult your doctor to determine what medication may work best for you[2].
Examples of other drugs used for these conditions include beta interferons, ocrelizumab, dimethyl fumarate, glatiramer acetate, fingolimod, and natalizumab[2].
Aubagio vs. Tecfidera
Aubagio and Tecfidera are both used to treat the same conditions. Both drugs work differently but share some common and serious side effects. Speak to your doctor to determine which medication is best for you[2].
Aubagio vs. Gilenya
Aubagio and Gilenya can be used interchangeably for some conditions. However, Aubagio contains teriflunomide, and Gilenya contains fingolimod. These drugs have different side effects, and it's essential to discuss the potential risks and benefits with your doctor to determine the best medication for you[2].
How to Take Aubagio
Take Aubagio as prescribed, once per day, ideally at the same time each day. You can take it with or without food[2].
Aubagio and Pregnancy, Breastfeeding, and Birth Control
If you can get pregnant, are breastfeeding, or are using birth control, discuss these matters with your doctor before starting Aubagio treatment[2].
Clinical Trials
In clinical trials, Aubagio was found to be safe and effective for the treatment of relapsing-remitting MS, active secondary progressive MS, and clinically isolated syndrome[1].
FDA Warnings
Aubagio carries a boxed warning from the FDA related to severe liver damage. Ensure your doctor performs blood tests to check liver function before and during treatment. If you have liver disease, discuss the potential risks and benefits of Aubagio with your doctor[2].
If you have severe hepatic impairment or are pregnant, do not take Aubagio. Speak with your doctor if you have a history of hypersensitivity to teriflunomide, leflunomide, or any inactive ingredients in Aubagio[3].
Insurance Coverage and Costs
Your insurance coverage and costs will vary based on your specific plan, location, and pharmacy you use. Talk to your doctor or pharmacist for information on financial assistance programs and generic alternatives to help lower the cost of Aubagio[1].
References
[1] Multiple Sclerosis Information (MS)
[2] Mayo Clinic: Aubagio (Teriflunomide) for Multiple Sclerosis
[3] Drugs.com: Aubagio Prescribing Information
[4] MedLinePlus: Aubagio (Teriflunomide) Oral
[5] U.S. Food and Drug Administration: AUBAGIO (teriflunomide) Tablets C-IV
[6] Neurology Advisor: Aubagio: Toxic Epidermal Necrolysis
[7] National Institutes of Health: Aubagio (Teriflunomide) Oral Tablets, Cut Score: 0.4786
- Aubagio, a drug used for specific neurological disorders like relapsing-remitting MS, active secondary progressive MS, and clinically isolated syndrome, may lead to common side effects such as headache, hair loss (alopecia), decreased phosphate level, decreased white blood cell count (neutrophils), nausea, diarrhea, high blood pressure, numbness or tingling in hands and feet, joint pain, and increased liver enzyme levels.
- More severe side effects that may occur while taking Aubagio include low white blood cell count, high blood pressure, respiratory problems, liver damage, severe skin reactions, allergic reactions, and PML (Progressive Multifocal Leukoencephalopathy) in rare cases.
- Skin problems or rash, allergic reactions, liver damage, and hair loss are some examples of side effects that Aubagio may or may not cause, and their occurrence can vary among individuals.
- Consult your doctor or pharmacist if you experience any bothersome symptoms while taking Aubagio, and be aware that most side effects will subside within a few days or a couple of weeks.
- In addition to managing multiple sclerosis, taking care of your health and wellness involves maintaining a healthy lifestyle, including fitness and exercise, mental health, skin care, nutrition, and weight management.
- The prescription medication Aubagio interacts with several other medications and supplements, so inform your doctor and pharmacist about all drugs, vitamins, herbs, and supplements you use to avoid potential interactions.
- Consult your doctor to explore alternative treatments for multiple sclerosis or discuss other available drugs that could address your specific condition, as there are other medications like beta interferons, ocrelizumab, dimethyl fumarate, glatiramer acetate, fingolimod, and natalizumab.
