Aubagio
teriflunomide
Keep this leaflet. You may need to read it again.
If you have any further questions, ask your doctor or pharmacist.
This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects
not listed in this leaflet. See section 4.
What AUBAGIO is and what it is used for
What you need to know before you take AUBAGIO
How to take AUBAGIO
Possible side effects
How to store AUBAGIO
Contents of the pack and other information
AUBAGIO contains the active substance teriflunomide which is an immunomodulatory agent and adjusts the immune system to limit its attack on the nervous system.
AUBAGIO is used in adults and in children and adolescents (10 years of age and older) to treat relapsing remitting multiple sclerosis (MS).
MS is a long-term illness that affects the central nervous system (CNS). The CNS is made up of the brain and spinal cord. In multiple sclerosis, inflammation destroys the protective sheath (called myelin) around the nerves in the CNS. This loss of myelin is called demyelination. This stops nerves from working properly.
People with relapsing form of multiple sclerosis will have repeated attacks (relapses) of physical symptoms caused by their nerves not working properly. These symptoms vary from patient to patient but usually involve:
difficulty walking
vision problems
balance problems.
Symptoms may disappear completely after the relapse is over, but over time, some problems may remain between relapses. This can cause physical disabilities that may interfere with your daily activities.
AUBAGIO helps to protect against attacks on the central nervous system by the immune system by limiting the increase of some white blood cells (lymphocytes). This limits the inflammation that leads to nerve damage in MS.
if you are allergic to teriflunomide or any of the other ingredients of this medicine (listed in section 6),
if you have ever developed a severe skin rash or skin peeling, blistering and/or mouth sores after taking teriflunomide or leflunomide,
if you have severe liver problems,
if you are pregnant, think you may be pregnant, or are breast-feeding,
if you suffer from a serious problem which affects your immune system e.g. acquired immunodeficiency syndrome (AIDS),
if you have a serious problem with your bone marrow, or if you have low numbers of red or white cells in your blood or a reduced number of blood platelets,
if you are suffering from a serious infection,
if you have severe kidney problems which require dialysis,
if you have very low levels of proteins in your blood (hypoproteinaemia), If you are not sure, talk to your doctor or pharmacist before taking this medicine.
Talk to your doctor or pharmacist before taking AUBAGIO if:
you have liver problems and/or if you drink large amounts of alcohol. Your doctor will carry out blood tests before and during treatment to check how well your liver is working. If your test results show a
problem with your liver, your doctor may stop your treatment with AUBAGIO. Please read section 4.
you have high blood pressure (hypertension) whether it is controlled with medicines or not.
AUBAGIO can cause an increase in blood pressure. Your doctor will check your blood pressure before the start of treatment and regularly thereafter. Please read section 4.
you have an infection. Before you take AUBAGIO, your doctor will make sure you have enough white blood cells and platelets in your blood. As AUBAGIO decreases the number of white cells in the
blood this may affect your ability to fight the infection. Your doctor may do blood tests to check your white blood cells if you think you have an infection. Please read section 4.
you have severe skin reactions.
you have respiratory symptoms.
you have weakness, numbness and pain in the hands and feet.
you are going to have a vaccination.
you take leflunomide with AUBAGIO.
you are switching to or from AUBAGIO.
you are due to have a specific blood test (calcium level). Falsely low levels of calcium can be detected.
Tell your doctor if you have unexplained cough and dyspnoea (shortness of breath). Your doctor may perform additional tests
AUBAGIO is not intended for use in children under 10 years of age, as it has not been studied in MS patients in this age group.
The warnings and precautions listed above also apply to children. The following information is important for
children and their caregivers:
Tell your your doctor or pharmacist if you are taking, have recently taken or might take any other medicines. This includes medicines obtained without a prescription.
In particular, tell your doctor or pharmacist if you are taking any of the following:
leflunomide, methotrexate and other medicines that affect the immune system (often called immunosuppressants or immunomodulators)
rifampicin (a medicine used to treat tuberculosis and other infections)
carbamazepine, phenobarbital, phenytoin for epilepsy
St John’s wort (a herbal medicine for depression)
repaglinide, pioglitazone, nateglinide, or rosiglitazone for diabetes
daunorubicin, doxorubicin, paclitaxel, or topotecan for cancer
duloxetine for depression, urinary incontinenece or in kidney disease in diabetics
alosetron for the management of severe diarrhoea
theophylline for asthma
tizanidine, a muscle relaxant
warfarin, an anticoagulant used to make the blood thinner (i.e. more fluid) in order to avoid blood clots
oral contraceptives (containing ethinylestradiol and levonorgestrel)
cefaclor, benzylpenicillin (penicillin G), ciprofloxacin for infections
indometacin, ketoprofen for pain or inflammation
furosemide for heart disease
cimetidine for reducing gastric acid
zidovudine for HIV infection
rosuvastatin, simvastatin, atorvastatin, pravastatin for hypercholesterolemia (high cholesterol)
sulfasalazine for inflammatory bowel disease or rheumatoid arthritis
cholestyramine for high cholesterol or relief from itching in liver disease
activated charcoal to reduce absorption of medicines or other substances
If your daughter reaches menses while taking AUBAGIO, you should inform the doctor, who will provide specialist counselling regarding contraception and the potential risks in case of pregnancy.
Tell your doctor if you plan to become pregnant after stopping treatment with AUBAGIO, as you need to ensure that most of this medicine has left your body before trying to become pregnant. The elimination of the active substance may take up to 2 years to occur naturally. The time can be reduced to a few weeks by taking certain medicines which speed up removal of AUBAGIO from your body.
In either case it should be confirmed by a blood test that the active substance has been sufficiently removed from your body and you need confirmation from your treating physician that the blood level of AUBAGIO is low enough to allow you to become pregnant.
For further information on the laboratory testing please contact your doctor.
If you suspect that you are pregnant while taking AUBAGIO or in the two years after you have stopped treatment, you must discontinue AUBAGIO and contact your doctor immediately for a pregnancy test. If the test confirms that you are pregnant, your doctor may suggest treatment with certain medicines to remove AUBAGIO rapidly and sufficiently from your body, as this may decrease the risk to your baby.
Contraception
You must use an effective method of contraception during and after treatment with AUBAGIO. Teriflunomide remains in your blood for a long time after you stop taking it. Continue to use effective
contraception after you stop treatment.
Do this until the levels of AUBAGIO in your blood are low enough - your doctor will check this.
Talk with your doctor about the best method of contraception for you and any potential need for contraception change.
Do not take AUBAGIO when you are breast-feeding, as teriflunomide passes into the breast milk.
AUBAGIO might make you feel dizzy which may impair your ability to concentrate and react. If you are affected, do not drive or use machines.
AUBAGIO contains lactose (a type of sugar). If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicine.
This medicine contains less than 1 mmol sodium (23 mg) per tablet, that is to say essentially ‘sodium-free’.
Treatment with AUBAGIO will be overseen by a doctor who is experienced in the treatment of multiple sclerosis.
Always take this medicine exactly as your doctor has told you. Check with your doctor if you are not sure.
The recommended dose is one 14 mg tablet daily.
The dose depends on body weight:
Children with body weight greater than 40 kg: one 14 mg tablet daily.
Children with body weight less than or equal to 40 kg: one 7 mg tablet daily.
Children and adolescents who reach a stable body weight above 40 kg will be instructed by their doctor to switch to one 14 mg tablet daily.
Route/method of administration
AUBAGIO is for oral use. AUBAGIO is taken every day as a single dose at any time of the day. You should swallow the tablet whole with some water.
AUBAGIO may be taken with or without food.
If you have taken too much AUBAGIO, call your doctor straight away. You may experience side effects similar to those described in section 4 below.
Do not take a double dose to make up for a forgotten tablet. Take your next dose at the scheduled time.
Do not stop taking AUBAGIO or change your dose without talking to your doctor first.
If you have any further questions on the use of this medicine, ask your doctor or pharmacist.
Like all medicines, this medicine can cause side effects, although not everybody gets them. The following side effects may happen with this medicine.
Some side effects could be or could become serious, if you experience any of these, tell your doctor immediately.
inflammation of the pancreas which might include symptoms of pain in the abdominal area, nausea, or vomiting (the frequency is common in paediatric patients and uncommon in adult patients).
allergic reactions which might include symptoms of rash, hives, swelling of lips, tongue or face or sudden difficulty breathing.
severe skin reactions which might include symptoms of skin rash, blistering, fever, or ulcers in your
mouth
severe infections or sepsis (a potentially life-threatening type of infection) which might include symptoms of high fever, shaking, chills, reduced urine flow, or confusion
inflammation of the lungs which might include symptoms of shortness of breath or persistent cough
serious liver disease which might include symptoms of yellowing of your skin or the whites of your eyes, darker urine than normal, unexplained nausea and vomiting, or abdominal pain
Headache
Diarrhoea, feeling sick
Increase in ALT (increase in blood levels of certain hepatic enzymes) shown in tests
Hair thinning
Influenza, upper respiratory tract infection, urinary tract infection, bronchitis, sinusitis, sore throat and discomfort when swallowing, cystitis, gastroenteritis viral, oral herpes, tooth infection, laryngitis,
fungal infection of the foot
Laboratory values: a decrease in the number of red blood cells (anaemia), changes in liver and white blood cell test results (see section 2), as well as elevations in a muscle enzyme (creatine phosphokinase) have been observed.
Mild allergic reactions
Feeling anxious
Pins and needles, feeling weak, numb, tingling or pain in the lower back or leg (sciatica); feeling numb, burning, tingling or pain in the hands and fingers (carpal tunnel syndrome)
Feeling your heartbeat
Increase in blood pressure
Being sick (vomiting), toothache, upper abdominal pain
Rash, acne
Pain of the tendons, joints, bones, muscle pain (musculoskeletal pain),
Needing to urinate more often than usual
Heavy periods
Pain
Lack of energy or feeling weak (asthenia)
Weight loss
Decrease in the number of blood platelets (mild thrombocytopenia)
Increased feeling or sensitivity, especially in the skin; stabbing or throbbing pain along one or more nerves, problems in the nerves of the arms or legs (peripheral neuropathy)
Nail disorders, severe skin reactions
Post-traumatic pain
Psoriasis
Inflammation of mouth/lips
Abnormal levels of fats (lipids) in the blood
Inflammation of the colon (colitis)
Inflammation or injury of the liver
Respiratory hypertension
The side effects listed above also apply to children and adolescents. The following additional information is important for children, adolescents, and their caregivers:
Inflammation of the pancreas
If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the national reporting system listed in Appendix
V. By reporting side effects you can help provide more information on the safety of this medicine.
Keep this medicine out of the sight and reach of children.
Do not use this medicine after the expiry date which is stated on the carton and wallet after “EXP”. The expiry date refers to the last day of that month.
This medicine does not require any special storage conditions.
Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.
The active substance is teriflunomide.
AUBAGIO 7 mg film-coated tablets
Each tablet contains 7 mg of teriflunomide.
The other ingredients are lactose monohydrate, maize starch, microcrystalline cellulose, sodium starch glycolate (Type A), hydroxypropylcellulose, magnesium stearate, hypromellose, titanium dioxide (E171), talc, macrogol 8000, indigo carmine aluminum lake (E132), and iron oxide yellow (E172) (see section 2 “Aubagio contains lactose”).
AUBAGIO 14 mg film-coated tablets
Each tablet contains 14 mg of teriflunomide.
The other ingredients are lactose monohydrate, maize starch, microcrystalline cellulose, sodium starch glycolate (Type A), hydroxypropylcellulose, magnesium stearate, hypromellose, titanium dioxide (E171), talc, macrogol 8000, indigo carmine aluminum lake (E132) (see section 2 “Aubagio contains lactose”).
AUBAGIO 7 mg film-coated tablet (tablets)
The film-coated tablets are very light greenish-bluish grey to pale greenish-blue, hexagonal film-coated tablet with imprint on one side (‘7’) and engraved with the corporate logo on other side.
AUBAGIO 7 mg film-coated tablets are available in cardboard cartons containing 28 tablets in a wallet packs with the integrated blisters.
AUBAGIO 14 mg film-coated tablet (tablets)
The film-coated tablets are pale blue to pastel blue, pentagonal film-coated tablet with imprint on one side (‘14’) and engraved with a corporate logo on the other side.
AUBAGIO 14 mg film-coated tablets are available in cardboard cartons containing:
14, 28, 84 and 98 tablets in wallet packs with integrated blisters;
10x1 tablet in perforated unit-dose blisters.
Not all pack sizes may be marketed.
sanofi-aventis groupe 54, rue La Boétie
F-75008 Paris France
Opella Healthcare International SAS 56, Route de Choisy
60200
Compiègne France
Sanofi Winthrop Industrie 30-36, avenue Gustave Eiffel 37100 Tours
France
For any information about this medicine, please contact the local representative of the Marketing Authorisation Holder:
Sanofi Belgium
Tel/Tél/Tel: +32 (0)2 710 54 00
Swixx Biopharma UAB Tel: +370 5 236 91 40
Swixx Biopharma EOOD Тел.: +359 (0)2 4942 480
Sanofi Belgium
Tél/Tel: +32 (0)2 710 54 00 (Belgique/Belgien)
Sanofi A/S
Tlf: +45 45 16 70 00
Sanofi S.r.l.
Tel: +39 02 39394275
Sanofi-Aventis Deutschland GmbH Tel.: 0800 04 36 996
Tel. aus dem Ausland: +49 69 305 70 13
Genzyme Europe B.V. Tel: +31 20 245 4000
Swixx Biopharma OÜ Tel: +372 640 10 30
sanofi-aventis Norge AS Tlf: +47 67 10 71 00
sanofi-aventis AEBE Τηλ: +30 210 900 16 00
sanofi-aventis GmbH Tel: +43 1 80 185 – 0
sanofi-aventis S.A. Tel: +34 93 485 94 00
sanofi-aventis Sp. z o.o. Tel: +48 22 280 00 00
sanofi-aventis France Tél: 0 800 222 555
Appel depuis l’étranger: +33 1 57 63 23 23
Sanofi - Produtos Farmacêuticos, Lda
Tel: +351 21 35 89 400
Swixx Biopharma d.o.o. Tel: +385 1 2078 500
Sanofi Romania SRL Tel: +40 (0) 21 317 31 36
sanofi-aventis Ireland Ltd. T/A SANOFI Tel: +353 (0) 1 403 56 00
Swixx Biopharma d.o.o. Tel: +386 1 235 51 00
Vistor hf.
Sími: +354 535 7000
Sanofi S.r.l. Tel: 800536389
Sanofi Oy
Puh/Tel: +358 (0) 201 200 300
C.A. Papaellinas Ltd. Τηλ: +357 22 741741
Sanofi AB
Tel: +46 (0) 8 634 5000
Swixx Biopharma SIA Tel: +371 6 616 47 50
You can also find a copy of the package leaflet and a patient card with safety information at the QR code mentioned below.
QR Code to be included + www.qr-aubagio-sanofi.eu