Consumer medicine information

Teriflagio

Teriflunomide

BRAND INFORMATION

Brand name

Teriflagio

Active ingredient

Teriflunomide

Schedule

S4

 

Consumer medicine information (CMI) leaflet

Please read this leaflet carefully before you start using Teriflagio.

Teriflagio

Teriflagio


 Consumer Medicine Information (CMI) summary

The full CMI on the next page has more details. If you are worried about using this medicine, speak to your doctor or pharmacist.


 1. Why am I using Teriflagio?

Teriflagio contains the active ingredient teriflunomide. Teriflagio is used to treat relapsing forms of multiple sclerosis (MS). For more information, see Section 1. Why am I using Teriflagio? in the full CMI.

 2. What should I know before I use Teriflagio?

Do not use if you have ever had an allergic reaction to teriflunomide, leflunomide or any of the ingredients listed at the end of the CMI.

Talk to your doctor if you have any other medical conditions, take any other medicines, or are pregnant or plan to become pregnant or are breastfeeding.

For more information, see Section 2. What should I know before I use Teriflagio? in the full CMI.

 3. What if I am taking other medicines?

Some medicines may interfere with Teriflagio and affect how it works.

A list of these medicines is in Section 3. What if I am taking other medicines? in the full CMI.

 4. How do I use Teriflagio?
  • Follow all directions given to you by your doctor and pharmacist carefully. The usual dose for this medicine is one 14 mg tablet per day. Swallow the tablet whole with a glass of water.

More instructions can be found in Section 4. How do I use Teriflagio? in the full CMI.

 5. What should I know while using Teriflagio?

Things you should do
  • Remind any doctor, dentist or pharmacist you visit that you are using Teriflagio.
  • If you become pregnant while you are taking this medicine, stop taking it and tell your doctor or pharmacist immediately.
Things you should not do
  • Do not stop taking Teriflagio, or lower the dose, without checking with your doctor.
Driving or using machines
  • Be careful before you drive or use any machines or tools until you know how Teriflagio affects you.
Drinking alcohol
  • Tell your doctor if you drink alcohol. The effects of alcohol could be made worse while taking Teriflagio.
    It is recommended that you minimise your alcohol intake while taking Teriflagio.
Looking after your medicine
  • Keep the medicine in a cool dry place where the temperature stays below 25°C.
  • Keep your tablets in the container until it is time to take them.

For more information, see Section 5. What should I know while using Teriflagio? in the full CMI.

 6. Are there any side effects?

Less serious side effects include diarrhoea; rashes, itchy skin; hair loss; weight loss; unusual tiredness or weakness; numbness or tingling of hands or feet; thickened, inflamed, red patches on the skin, which may be accompanied with whitish scaly skin, or accompanied by white pus-filled bumps. More serious side effects include signs and symptoms of severe infection e.g fever; severe upper stomach pain, often with nausea and vomiting; severe skin rash or sores in your mouth; skin becoming pale, you start to feel tired, you become prone to infections or bruising; new or worsening symptoms such as cough or trouble breathing, with or without a fever; allergic reaction such as swelling of the face, lips, mouth or throat, which may cause difficulty in swallowing or breathing, hives, fainting, yellowing of the skin and eyes (jaundice), thickened patches of red skin.

For more information, including what to do if you have any side effects, see Section 6. Are there any side effects? in the full CMI.


Teriflagio

Active ingredient(s): Teriflunomide


 Consumer Medicine Information (CMI)

This leaflet provides important information about using Teriflagio. You should also speak to your doctor or pharmacist if you would like further information or if you have any concerns or questions about using Teriflagio.

Where to find information in this leaflet:

1. Why am I using Teriflagio?
2. What should I know before I use Teriflagio?
3. What if I am taking other medicines?
4. How do I use Teriflagio?
5. What should I know while using Teriflagio?
6. Are there any side effects?
7. Product details

1. Why am I using Teriflagio?

Teriflagio contains the active ingredient teriflunomide.

Teriflagio is used to treat relapsing forms of multiple sclerosis (MS).

The cause of MS is not yet known. MS affects the central nervous system (CNS) - the brain and spinal cord.

In MS, the body's immune system reacts against its own myelin (the 'insulation' or the protective sheath surrounding nerve fibres). With relapsing forms of MS, people can have repeated attacks or relapses of inflammation of the CNS from time to time.

Symptoms vary from patient to patient and may include blurred vision, weakness in the legs or arms, or loss of control of bowel or bladder function. These are followed by periods of recovery.

Teriflagio works by selectively interfering with the ability of white blood cells (lymphocytes) to produce the disease response and nerve damage that ultimately leads to relapses.

Teriflagio has been shown to reduce or decrease the number of relapses and slow down the progression of physical disability in patients with relapsing forms of MS. Although it is not a cure, patients treated with Teriflagio generally find they will have fewer relapses.

Your doctor, however, may have prescribed Teriflagio for another purpose.

Ask your doctor if you have any questions about why it has been prescribed for you.

2. What should I know before I use

Warnings

Do not use Teriflagio if:

  • you are allergic to teriflunomide, leflunomide or any of the ingredients listed at the end of this leaflet.
    Always check the ingredients to make sure you can use this medicine.
  • have any diseases which reduce your body's natural defenses.
  • have any diseases of the blood.
  • have, or have had any serious skin disorders such as rash with blisters and peeling of the skin or extended rashes with the liver, blood and other body organs involvement.
  • have severe liver disease.
  • have a condition called hypoproteinaemia (when you do not have enough protein in your blood).
  • are pregnant or plan to become pregnant.
  • are not using reliable birth control.
  • are breastfeeding.

Check with your doctor if you:

  • intend to become pregnant or father a child.
  • have any other medical conditions especially the following: Liver problems, high blood pressure, chronic or serious infection, a decrease in the number of white blood cells or an illness which lowered your body's resistance to disease, tuberculosis, lung problems, such as interstitial lung disease (an inflammation of lung tissue) which is a serious and potentially fatal disease, or kidney disease.

Before you start Teriflagio, your doctor will need to take blood samples to check the health of your liver and blood cells. This must be done in the last 6 months before starting this medicine.

Tell your doctor if you plan to have surgery.

During treatment, you may be at risk of developing certain side effects. It is important you understand these risks and how to monitor for them. See additional information under Section 6. Are there any side effects?

Pregnancy and breastfeeding

You must not become pregnant while taking Teriflagio and for a certain period of time after stopping Teriflagio.

Teriflagio may increase the risk of birth defects. To reduce any risk to the developing baby, you will need to stop taking Teriflagio and may need to undergo a wash-out procedure. Your doctor will discuss the wash-out procedure with you.

Women of childbearing potential must use reliable contraception while taking Teriflagio.

Tell your doctor immediately if you think you could be pregnant while taking Teriflagio.

Tell your doctor if you intend to become pregnant or father a child.

Do not take it if you are breastfeeding or planning to breastfeed

Teriflagio passes into breast milk and there is a serious risk to the baby. You and your doctor will decide what is best for you and your baby.

Children and adolescents

Do not give Teriflagio to a child or adolescent

Teriflagio is not approved for use in children or adolescents under 18 years old.

3. What if I am taking other medicines?

Tell your doctor or pharmacist if you are taking any other medicines, including any medicines, vitamins or supplements that you buy without a prescription from your pharmacy, supermarket or health food shop.

Some medicines may interfere with Teriflagio and affect how it works or be affected by Teriflagio.

Interactions between Teriflagio and other medications include:

  • Some antibiotics such as rifampicin, cefaclor, penicillin G and ciprofloxacin
  • Some medicines used to treat epilepsy such as carbamazepine and phenytoin
  • Some medicines used for diabetes such as repaglinide or pioglitazone
  • Some medicines to treat cancer such as paclitaxel, doxorubicin, methotrexate
  • Some medicines used to treat depression such as duloxetine
  • Ondansetron, a medicine used to prevent and treat nausea
  • Theophylline, a medicine used to prevent asthma
  • Warfarin, a medicine used to prevent blood clots
  • Some medicines used to lower cholesterol such as “statins” - rosuvastatin
  • St John's Wort

You may need to use different amounts of your medicine, or take different medicines. Your doctor or pharmacist will advise you.

Your doctor and pharmacist have more information on medicines to be careful with or avoid while taking Teriflagio.

In certain situations, for example, if you experience a serious side effect, you change your medication or you want to fall pregnant, your doctor will ask you to take medication that will help your body get rid of Teriflagio faster.

Check with your doctor or pharmacist if you are not sure about what medicines, vitamins or supplements you are taking and if these affect Teriflagio.

4. How do I use Teriflagio?

How much to take

  • The usual dose for this medicine is one 14 mg tablet per day.
  • Your doctor may have prescribed a different dose.
  • Ask your doctor or pharmacist if you are unsure of the correct dose for you. They will tell you exactly how much to take.
  • Follow the instructions they give you. These directions may differ from the information contained in this leaflet. If you take the wrong dose, Teriflagio may not work as well.
  • Continue taking your medicine for as long as your doctor or pharmacist tells you.
    The medicine helps control your condition, but it does not cure it. Therefore, you must take it every day.

When to take Teriflagio

  • Teriflagio should be taken at about the same time every day. Taking your tablets at the same time each day will have the best effect. It will also help you to remember when to take the tablets.
  • It does not matter if you take Teriflagio before or after food

How to take Teriflagio

  • Swallow the tablet whole with a full glass of water.

If you forget to use Teriflagio

Teriflagio should be used regularly at the same time each day.

If it is almost time for your next dose, skip the dose you missed and take your next dose when you are meant to.

Do not take a double dose to make up for the dose you missed.

This may increase the chance of you getting an unwanted side effect.

If there is still a long time to go before your next dose, take it as soon as you remember, and then go back to taking it as you would normally.

If you are not sure what to do, ask your doctor or pharmacist.

If you use too much Teriflagio

If you think that you or anyone else may have used too much Teriflagio, you may need urgent medical attention.

You should immediately:

  • phone the Poisons Information Centre
  • (by calling 13 11 26 in Australia), or
  • contact your doctor, or
  • go to the Emergency Department at your nearest hospital.

You should do this even if there are no signs of discomfort or poisoning.

5. What should I know while using Teriflagio?

Things you should do

If you become pregnant while you are taking this medicine, stop taking it and tell your doctor or pharmacist immediately.

If you need to stop treatment, the levels of Teriflagio in your blood can be lowered rapidly using a special wash-out procedure.

If you are female talk to your doctor about birth control that you must use during treatment. You must use reliable methods of birth control while taking Teriflagio.

Talk to your doctor if you plan to become pregnant or before you stop taking this medicine.

Tell your doctor if you need to have a vaccination during treatment with this medicine or for 6 months after stopping treatment.

Call your doctor straight away if you:

  • have an infection or notice chills or a fever or signs of an infection while taking this medicine.
  • your skin becomes itchy or yellow, the whites of your eyes become yellow, you start to bleed or bruise easily, or your urine becomes very dark or you have stomach pain, nausea or vomiting, stop taking it immediately. You may be developing a liver problem.
  • experience numbness or tingling in the hands or feet or numbness or weakness of the arms and legs.

Remind any doctor, dentist or pharmacist you visit that you are using Teriflagio.

If you are about to be started on any new medicine, tell your doctor and pharmacist that you are taking Teriflagio.

Things you should not do

  • Do not take more than the recommended dose unless your doctor tells you to.
  • Do not give this medicine to anyone else, even if they have the same condition as you.
  • Do not use this medicine to treat any other complaints unless your doctor tells you to.
  • Do not stop taking Teriflagio, or lower the dose, without checking with your doctor.

Driving or using machines

Be careful before you drive or use any machines or tools until you know how Teriflagio affects you.

Drinking alcohol

Tell your doctor if you drink alcohol.

The effects of alcohol could be made worse while taking Teriflagio. It is recommended that you minimise your alcohol intake while taking Teriflagio.

Looking after your medicine

  • Keep the medicine in a cool dry place where the temperature stays below 25°C.
  • Keep your tablets in the container until it is time to take them.

Follow the instructions on the carton on how to take care of your medicine properly.

Store it in a cool dry place away from moisture, heat or sunlight; for example, do not store it:

  • in the bathroom or near a sink, or
  • in the car or on window sills.

Keep it where young children cannot reach it.

Getting rid of any unwanted medicine

If you no longer need to use this medicine or it is out of date, take it to any pharmacy for safe disposal.

Do not use this medicine after the expiry date.

6. Are there any side effects?

All medicines can have side effects. If you do experience any side effects, most of them are minor and temporary. However, some side effects may need medical attention.

See the information below and, if you need to, ask your doctor or pharmacist if you have any further questions about side effects.

Less serious side effects

Less serious side effectsWhat to do
  • Diarrhoea
  • Rashes, itchy skin
  • Hair loss
  • Weight loss
  • Unusual tiredness or weakness
  • Numbness or tingling of hands or feet
  • Thickened, inflamed, red patches on the skin, which may be accompanied with whitish scaly skin, or accompanied by white pus-filled bumps
  • Nail disorders
Speak to your doctor if you have any of these less serious side effects and they worry you.

Serious side effects

Serious side effectsWhat to do
  • Signs and symptoms of severe infection e.g fever
  • Severe upper stomach pain, often with nausea and vomiting
  • Severe skin rash or sores in your mouth
  • Your skin becomes pale, you start to feel tired, you become prone to infections or bruising
  • If you develop new or worsening symptoms such as cough or trouble breathing, with or without a fever
  • Feeling short of breath, tired, experiencing dizziness or fainting, have a blue tinge to your lips or skin, feeling pressure in your chest, have swelling around your ankles and legs, weight gain over a short period of time or abdominal bloating
  • Inflammation of the colon, symptoms include diarrhoea usually with blood and mucus
Allergic reaction:
  • Swelling of the face, lips, mouth or throat, which may cause difficulty in swallowing or breathing
  • Hives
  • Fainting
  • Yellowing of the skin and eyes (jaundice)
  • Thickened patches of red skin
Call your doctor straight away, or go straight to the Emergency Department at your nearest hospital if you notice any of these serious side effects.

Tell your doctor or pharmacist if you notice anything else that may be making you feel unwell.

Other side effects not listed here may occur in some people.

Reporting side effects

After you have received medical advice for any side effects you experience, you can report side effects to the Therapeutic Goods Administration online at www.tga.gov.au/reporting-problems (Australia).

By reporting side effects, you can help provide more information on the safety of this medicine.

Always make sure you speak to your doctor or pharmacist before you decide to stop taking any of your medicines.

7. Product details

This medicine is only available with a doctor's prescription.

What Teriflagio contains

Active ingredient
(main ingredient)
Teriflunomide 14 mg
Other ingredients
(inactive ingredients)
Lactose monohydrate
Maize starch
Hyprolose
Microcrystalline cellulose
Sodium starch glycollate type A
Colloidal anhydrous silica
Magnesium stearate
Hypromellose
Titanium dioxide
Purified talc
Macrogol 6000
Indigo carmine aluminium lake
Excipient with known effectLactose monohydrate

Do not take this medicine if you are allergic to any of these ingredients.

What Teriflagio looks like

Teriflagio 14 mg tablets are blue pentagonal film coated tablets with "T2" debossed on one side and plain on the other. Teriflagio 14 mg tablets are supplied in blister packs of 10, 14, 28 and 84 tablets.

(AUST R 303521)

Who distributes Teriflagio

Teriflagio is supplied in Australia by:

Arrotex Pharmaceuticals
Cremorne VIC 3121

Freecall No: 1800 195 055

This leaflet was prepared in May 2022

Published by MIMS June 2022

BRAND INFORMATION

Brand name

Teriflagio

Active ingredient

Teriflunomide

Schedule

S4

 

1 Name of Medicine

Teriflunomide.

2 Qualitative and Quantitative Composition

Teriflunomide 14 mg per tablet.
Excipient with known effect. Lactose monohydrate.
For the full list of excipients, see Section 6.1 List of Excipients.

3 Pharmaceutical Form

Teriflagio 14 mg film-coated tablets. Blue coloured, pentagonal shaped, film coated tablet, debossed with "T2" on one side and plain on other side.

4 Clinical Particulars

4.9 Overdose

There is no experience regarding teriflunomide overdose or intoxication in humans. Teriflunomide 70 mg daily up to 14 days was well tolerated by healthy subjects.
In the event of relevant overdose or toxicity, cholestyramine or activated charcoal is recommended to accelerate elimination (see Section 4.4 Special Warnings and Precautions for Use).
Accelerated elimination procedure: cholestyramine and activated charcoal. The elimination of teriflunomide from the circulation can be accelerated by administration of cholestyramine or activated charcoal, presumably by interrupting the reabsorption processes at the intestinal level. Teriflunomide concentrations measured during an 11-day procedure to accelerate teriflunomide elimination with either 4 g cholestyramine t.i.d, 8 g cholestyramine t.i.d or 50 g activated charcoal b.i.d following cessation of teriflunomide treatment have shown that these regimens were effective in accelerating teriflunomide elimination, leading to more than 98% decrease in teriflunomide plasma concentrations, with cholestyramine being faster than charcoal. In association with this procedure a higher incidence among patients taking teriflunomide 14 mg was seen of the AEs nausea (3.3 vs 1.5% placebo), vomiting (2.4% vs 0% placebo), increased ALT (1.6% vs. 0 placebo). The choice between the 3 elimination procedures should depend on the patient's tolerability. If cholestyramine 8 g three times a day is not well tolerated, cholestyramine 4 g three times a day can be used. Alternatively, activated charcoal may also be used (the 11 days do not need to be consecutive unless there is a need to lower teriflunomide plasma concentration rapidly).
Use of the accelerated elimination procedure may potentially result in return of disease activity if the patient had been responding to teriflunomide treatment.
For information on the management of overdose, contact the Poisons Information Centre on 131126 (Australia).

5 Pharmacological Properties

5.3 Preclinical Safety Data

Genotoxicity. Teriflunomide was not mutagenic in bacteria (Salmonella typhimurium and Escherichia coli) or in Chinese hamster lung cells in vitro and did not cause chromosomal damage in vivo (mouse, rat and Chinese hamster bone marrow cells). A positive effect was found in a chromosomal damage in vitro assay in human lymphocytes, but the significance of this is unclear. 4-Trifluoromethylaniline (4-TFMA), a minor metabolite of teriflunomide, was positive in assays for gene mutation (bacteria and Chinese hamster cells) and for chromosome aberration at high in vitro concentrations (Chinese hamster cells), but negative in the unscheduled DNA synthesis test and it was not clastogenic in vivo in mice (micronucleus test) and Chinese hamsters (chromosome aberration test).
Carcinogenicity. No evidence of carcinogenicity was observed in a 2 year bioassay in rats at oral doses of teriflunomide up to the maximally tolerated dose of 4 and 12 mg/kg/day, respectively. Respective systemic exposures in these studies were about 30% and 3-fold the maximum human teriflunomide exposure based on plasma AUC0-24. The risk of malignancy, particularly lymphoproliferative disorders, is increased with the use of some immunosuppressant medications. There is a potential for immunosuppression with teriflunomide. Large, long-term studies would be needed to determine whether there is an increased risk of malignancy or lymphoproliferative disorders with teriflunomide.

6 Pharmaceutical Particulars

6.7 Physicochemical Properties

Chemical structure. Teriflunomide is a white to almost white powder that is sparingly soluble in acetone, slightly soluble in polyethylene glycol and ethanol, very slightly soluble in isopropanol and practically insoluble in water. Teriflunomide has a pKa of 3.1 at room temperature and its aqueous solubility is pH dependent and decreases with lowering pH. Teriflunomide is Class 2 in the Biopharmaceutics Classification System.
The chemical structure of teriflunomide is:
https://stagingapi.mims.com/au/public/v2/images/fullchemgif/CSTERIFL.gif Molecular formula: C12H9F3N2O2.
Molecular weight: 270.21.
Chemical name: (Z)-2-Cyano-3-hydroxy-but-2-enoic acid-(4-trifluoromethylphenyl)-amide.
CAS number. 163451-81-8.

7 Medicine Schedule (Poisons Standard)

S4 (Prescription Only Medicine).

Summary Table of Changes

https://stagingapi.mims.com/au/public/v2/images/fulltablegif/TERIFLST.gif