Consumer medicine information

Teriflunomide Dr.Reddy's

Teriflunomide

BRAND INFORMATION

Brand name

Teriflunomide Dr Reddy's

Active ingredient

Teriflunomide

Schedule

S4

 

Consumer medicine information (CMI) leaflet

Please read this leaflet carefully before you start using Teriflunomide Dr.Reddy's.

What is in this leaflet

This leaflet answers some common questions about Teriflunomide Dr.Reddy’s.

It does not contain all the available information. It does not take the place of talking to your doctor or pharmacist.

All medicines have risks and benefits. Your doctor has weighed the risks of you taking Teriflunomide Dr.Reddy’s against the benefits they expect it will have for you.

If you have any concerns about taking this medicine, ask your doctor or pharmacist.

Keep this leaflet with the medicine. You may need to read it again.

What Teriflunomide Dr.Reddy’s is used for

Teriflunomide Dr.Reddy’s 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.

Teriflunomide Dr.Reddy’s 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.

Teriflunomide Dr.Reddy’s 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 Teriflunomide Dr.Reddy’s generally find they will have fewer relapses.

Your doctor, however, may have prescribed Teriflunomide Dr.Reddy’s for another purpose.

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

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

Before you take it

When you must not take it

Do not take Teriflunomide Dr.Reddy’s if you:

  • have any diseases which reduce your body's natural defences
  • have any diseases of the blood
  • have any serious skin disorders
  • 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

You must not become pregnant while taking Teriflunomide Dr.Reddy’s and for a certain period of time after stopping Teriflunomide Dr.Reddy’s. Teriflunomide Dr.Reddy’s may increase the risk of birth defects.

Women of childbearing potential must use reliable contraception while taking Teriflunomide Dr.Reddy’s.

Do not take it if you are breastfeeding or planning to breastfeed Teriflunomide Dr.Reddy’s passes into the breast milk and therefore there is a possibility that the breastfed baby may be affected

Do not take Teriflunomide Dr.Reddy’s if you are allergic to teriflunomide, leflunomide or any of the ingredients listed at the end of this leaflet

Some symptoms of an allergic reaction include skin rash, itching, shortness of breath or swelling of the face, lips or tongue, which may cause difficulty in swallowing or breathing.

Do not give Teriflunomide Dr.Reddy’s to a child or adolescent Teriflunomide Dr.Reddy’s is not approved for use in children or adolescents under 18 years old.

Do not take it after the expiry date (exp) printed on the pack.

Do not take it if the packaging is torn or shows signs of tampering. If it has expired or is damaged return it to your pharmacist for disposal.

Before you start to take it

Tell your doctor or pharmacist if you have allergies to:

  • leflunomide or any of the ingredients listed at the end of this leaflet
  • Any other substances, such as foods, preservatives or dyes.

Tell your doctor immediately if you think you could be pregnant while taking Teriflunomide Dr.Reddy’s.

Tell your doctor if you intend to become pregnant or father a child. Teriflunomide Dr.Reddy’s may increase the risk of birth defects. To reduce any risk to the developing baby, you will need to stop taking Teriflunomide Dr.Reddy’s and may need to undergo a wash-out procedure. Your doctor will discuss the wash-out procedure with you.

You should not breastfeed while you are taking Teriflunomide Dr.Reddy’s. Teriflunomide Dr.Reddy’s can pass 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.

Tell your doctor if you have or have had any 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
  • Kidney disease

Before you start Teriflunomide Dr.Reddy’s, 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.

If you have not told your doctor about any of the above, tell them before you take Teriflunomide Dr.Reddy’s.

Taking other medicines

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

Interactions between Teriflunomide Dr.Reddy’s 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

These medicines may be affected by Teriflunomide Dr.Reddy’s, or may affect how Teriflunomide Dr.Reddy’s works. You may need to use different amounts of your medicine, or take different medicines. Your doctor or pharmacist will advise you.

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 Teriflunomide Dr.Reddy’s faster.

Your doctor and pharmacist have more information on medicines to be careful with or avoid while taking Teriflunomide Dr.Reddy’s.

How to take it

Follow all directions given to you by your doctor and pharmacist carefully. They may differ from the information contained in this leaflet.

If you do not understand the instructions on the label, ask your doctor or pharmacist for help.

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, Teriflunomide Dr.Reddy’s may not work as well.

How to take it

Swallow the tablet whole with a full glass of water.

When to take it

It does not matter if you take Teriflunomide Dr.Reddy’s before or after food.

Take Teriflunomide Dr.Reddy’s at about the same time each 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.

If you are not sure when to take it, ask your doctor or pharmacist.

How long to take it

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.

Ask your doctor or pharmacist if you are not sure how long to take the medicine for.

If you forget to take it

Do not take a double dose to make up for the dose that you missed. This may increase the chance of you getting an unwanted side effect.

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

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 take too much (overdose)

Immediately telephone your doctor or the poisons information centre (Australia 13 11 26 or New Zealand 0800 poison or 0800 764766), or go to accident and emergency at your nearest hospital, if you think you or anyone else may have taken too much Teriflunomide Dr.Reddy’s.

Do this even if there are no signs of discomfort or poisoning. You may need urgent medical attention.

While you are taking it

Things you must do

Tell all the doctors, dentists and pharmacists or other healthcare providers who are treating you that you are taking Teriflunomide Dr.Reddy’s.

If you are about to be started on any new medicine, tell your doctor and pharmacist that you are taking Teriflunomide Dr.Reddy’s.

If you become pregnant while you Do not use this medicine to treat any other complaints unless your are taking this medicine, stop taking it and tell your doctor or pharmacist immediately.

If you need to stop treatment, the levels of Teriflunomide Dr.Reddy’s 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 Teriflunomide Dr.Reddy’s.

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

Tell your doctor immediately

  • If you have an infection or notice chills or a fever or signs of an infection while taking this medicine
  • If 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.
  • If you experience numbness or tingling in the hands or feet or numbness or weakness of the arms and legs

Your doctor may need to take blood samples to monitor the health of your liver and blood cells while you are taking Teriflunomide Dr.Reddy’s.

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

Things you must not do

Do not take more than the recommended dose unless your doctor tells you to.doctor tells you to.

Do not stop taking Teriflunomide Dr.Reddy’s, or lower the dose, without checking with your doctor.

Do not give this medicine to anyone else, even if they have the same condition as you.

Things to be careful of

The effects of alcohol could be made worse while taking Teriflunomide Dr.Reddy’s. It is recommended that you minimise your alcohol intake while taking Teriflunomide Dr.Reddy’s.

Side effects

All medicines have some unwanted side effects. Sometimes they are serious, but most of the time they are not. Your doctor or pharmacist has weighed the risks of using this medicine against the benefits they expect it will have for you.

Do not be alarmed by this list of possible side effects. You may not experience any of them.

Tell your doctor or pharmacist as soon as possible if you do not feel well while you are taking Teriflunomide Dr.Reddy’s.

Teriflunomide Dr.Reddy’s helps most people with relapsing forms of MS, but it may have unwanted side effects although not everybody gets them.

Tell your doctor or pharmacist if you notice any of the following and they worry you:

  • 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.

If any of the following happen, tell your doctor immediately, or go to accident and emergency at your nearest hospital if you notice any of the following:

  • 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

These may be serious side effects of Teriflunomide Dr.Reddy’s and you may need urgent medical attention. Serious side effects are uncommon.

If any of the following happen, stop taking this medicine and tell your doctor immediately, or go to accident and emergency at your nearest hospital:

  • 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

These are very serious side effects. If you have them, you may have had a serious allergic reaction to Teriflunomide Dr.Reddy’s. You may need urgent medical attention or hospitalisation.

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

Some people may have other side effects not yet known or mentioned in this leaflet.

Ask your doctor or pharmacist to answer any questions you may have.

After taking it

Storage

Keep your tablets in the container until it is time to take them. If you take the tablets out of the box or the blister pack they may not keep well.

Keep the medicine in a cool dry place where the temperature stays below 25°C.

Do not store it or any other medicine in the bathroom or near a sink.

Do not leave it in the car on hot days or on window sills. Heat and dampness can destroy some medicines.

Keep it where children cannot reach it.

Disposal

If your doctor or pharmacist tells you to stop taking Teriflunomide Dr.Reddy’s or the medicine has passed its expiry date, ask your pharmacist what to do with any that are left over.

Return any unused medicine to your pharmacist.

Product description

What it looks like

Teriflunomide Dr.Reddy’s 14 mg tablets are pale blue to pastel blue pentagonal film coated tablets with "14" debossed on one side and ”T” on the other. Teriflunomide Dr.Reddy’s 14 mg tablets are supplied in blister packs of 5, 10, 14, 28 and 84 tablets. Not all pack sizes are marketed.

Ingredients

Active ingredient:

Each tablet contains 14 mg of the active ingredient, teriflunomide.

Inactive ingredients:

Lactose monohydrate

Maize starch

Hyprolose

Silicon dioxide

Sodium starch glycollate

Magnesium stearate

Hypromellose

Macrogol 6000

Iron oxide yellow

Titanium dioxide

Indigo carmine aluminium lake

Manufacturer/sponsor

Teriflunomide Dr.Reddy's is supplied in Australia by:

Dr Reddy's Laboratories (Australia) Pty Ltd
MELBOURNE VIC 3004
Phone 1800 733 397

and in New Zealand by:

Dr. Reddy's New Zealand Ltd
82 Totara Crescent Lower Hutt 5011
WELLINGTON
Tel: 0800 362 733

Australian registration number(s):

Teriflunomide Dr.Reddy's 14 mg
AUST R 304233

This leaflet was prepared in May 2020.

Published by MIMS July 2020

BRAND INFORMATION

Brand name

Teriflunomide Dr Reddy's

Active ingredient

Teriflunomide

Schedule

S4

 

1 Name of Medicine

Teriflunomide.

2 Qualitative and Quantitative Composition

Teriflunomide, is an oral de novo pyrimidine synthesis inhibitor of the dihydroorotate dehydrogenase (DHO-DH) enzyme.
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.
Teriflunomide is formulated as film-coated tablets for oral administration. Each tablet contains 14 mg of teriflunomide.
Excipients with known effect: Each tablet contains 83.4 mg of lactose monohydrate. For the full list of excipients, see Section 6.1 List of Excipients.

3 Pharmaceutical Form

Teriflunomide Dr. Reddy's is available as a blue coloured, pentagonal shaped, biconvex film-coated tablet with "14" debossed on one side and "T" on the other.

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 Australian Poison Information Centre on 13 11 26, or the New Zealand National Poisons Information Centre (telephone 0800 POISON or 0800 764 766).

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 damagein 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. 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.

Summary Table of Changes

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