Last update June 7, 2022

Teriflunomide

Incompatible

Very unsafe. Contraindicated. Use of an alternative or cessation of breastfeeding. Read the Commentary.

It is the main active metabolite of leflunomide. It inhibits the synthesis of pyrimidine and has immunomodulatory, anti-inflammatory and immunosuppressive properties. Indicated in the treatment of multiple sclerosis. Oral administration once a day.

Since the last update we have not found published data on its excretion in breastmilk.

Its high binding to plasma proteins makes its transfer to milk in significant concentrations unlikely.

Its slow elimination (half-life of 18-19 days) and its potentially serious side effects means it is recommended that, until there is more published information about this drug in relation to breastfeeding, safer alternatives are used (Sammaritano 2020, Alroughani 2016, Almas 2016, Cree 2013), especially during the neonatal period and in case of prematurity.


See below the information of this related product:

  • Leflunomide (Very unsafe. Contraindicated. Use of an alternative or cessation of breastfeeding. Read the Commentary.)

Alternatives

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Teriflunomide in other languages or writings:

Group

Teriflunomide belongs to this group or family:

Tradenames

Main tradenames from several countries containing Teriflunomide in its composition:

Pharmacokinetics

Variable Value Unit
Molecular weight 270 daltons
Protein Binding 99 %
VD 0.16 l/Kg
Tmax 1 - 4 hours
432 - 456 hours

References

  1. Sammaritano LR, Bermas BL, Chakravarty EE, Chambers C, Clowse MEB, Lockshin MD, Marder W, Guyatt G, Branch DW, Buyon J, Christopher-Stine L, Crow-Hercher R, Cush J, Druzin M, Kavanaugh A, Laskin CA, Plante L, Salmon J, Simard J, Somers EC, Steen V, Tedeschi SK, et al. 2020 American College of Rheumatology Guideline for the Management of Reproductive Health in Rheumatic and Musculoskeletal Diseases. Arthritis Rheumatol. 2020 Apr;72(4):529-556. Abstract Full text (link to original source)
  2. Langer-Gould AM. Pregnancy and Family Planning in Multiple Sclerosis. Continuum (Minneap Minn). 2019 Jun;25(3):773-792. Abstract
  3. Alroughani R, Altintas A, Al Jumah M, Sahraian M, Alsharoqi I, AlTahan A, Daif A, Dahdaleh M, Deleu D, Fernandez O, Grigoriadis N, Inshasi J, Karabudak R, Taha K, Totolyan N, Yamout BI, Zakaria M, Bohlega S. Pregnancy and the Use of Disease-Modifying Therapies in Patients with Multiple Sclerosis: Benefits versus Risks. Mult Scler Int. 2016 Abstract Full text (link to original source) Full text (in our servers)
  4. Almas S, Vance J, Baker T, Hale T. Management of Multiple Sclerosis in the Breastfeeding Mother. Mult Scler Int. 2016;2016:6527458. Abstract Full text (link to original source) Full text (in our servers)
  5. Cree BA. Update on reproductive safety of current and emerging disease-modifying therapies for multiple sclerosis. Mult Scler. 2013 Jun;19(7):835-43. Abstract Full text (link to original source) Full text (in our servers)

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