Teriflunomide and Xatmep

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Talk to your doctor before using methotrexate together with teriflunomide. Combining these medications may increase the risk of serious side effects such as nerve damage, liver injury, and impaired bone marrow function resulting in low numbers of different types of blood cells. You may be more likely to develop anemia, bleeding problems, or infections due to low blood cell counts. You should avoid or limit the use of alcohol while being treated with these medications. Call your doctor immediately if you have fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark colored urine, light colored stools, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

GENERALLY AVOID: Coadministration of methotrexate and leflunomide has been associated with an increased risk for hepatotoxicity. The risk probably extends to teriflunomide, its principal active metabolite, because recommended dosages of both result in a similar range of plasma concentrations of teriflunomide. One small study reported a 2- to 3-fold elevation in liver enzymes in 16% of patients receiving this combination. Serious hepatic reactions have also been reported in patients being concurrently treated with other hepatotoxic agents, including methotrexate. The risk of additive hematologic toxicity may also be increased.

MANAGEMENT: The use of leflunomide or teriflunomide in combination with methotrexate is not recommended. Since the active metabolite of leflunomide may remain in the body for up to 2 years, the cholestyramine washout procedure is recommended when changing from leflunomide to methotrexate. Liver enzyme levels should be obtained before beginning leflunomide/teriflunomide and monthly during therapy. If ALT increases to 2 to 3 times normal, the dose should be reduced and liver enzymes monitored weekly. If ALT increases to more than 3 times normal, therapy should be discontinued and the washout procedure should be instituted.

Teriflunomide

Generic Name: teriflunomide

Brand name: Aubagio

Synonyms: n.a.

What is Teriflunomide?

Xatmep

Generic Name: methotrexate

Brand name: Rheumatrex Dose Pack, Trexall, Xatmep, Otrexup, Rasuvo, Methotrexate Sodium, Preservative Free

Synonyms: n.a.

What is Xatmep?