Aubagio vs. Gilenya

Aubagio (teriflunomide) and Gilenya (fingolimod) are used to treat relapsing forms of multiple sclerosis (MS).

Aubagio and Gilenya belong to different drug classes. Aubagio is a pyrimidine synthesis inhibitor and Gilenya is a sphingosine 1-phosphate receptor modulator.

Side effects of Aubagio and Gilenya that are similar include liver problems, influenza, and diarrhea.

Side effects of Aubagio that are different from Gilenya include hair loss or thinning hair, nausea, burning or prickly feeling in your skin, and numbness or tingling in your hands or feet that is different from your MS symptoms.

Side effects of Gilenya that are different from Aubagio include headache, tired feeling, stuffy nose, sinus pain, back pain, and cough.

Aubagio may interact with ethinyl estradiol, levonorgestrel, and warfarin.

Gilenya may interact with beta-blockers, calcium channel blockers, citalopram, chlorpromazine, digoxin, erythromycin, haloperidol, ketoconazole, medications to control the immune system, medications for cancer, medicines to treat heart problems or high blood pressure, and methadone.

Common side effects of Aubagio include:

• liver problems,
• influenza,
• hair loss or thinning hair,
• nausea,
• diarrhea,
• burning or prickly feeling in your skin, or
• numbness or tingling in your hands or feet that is different from your MS symptoms.

Tell your doctor if you have serious side effects of Aubagio including:

• fever,
• chills,
• body aches,
• flu symptoms,
• sores in your mouth and throat,
• itching,
• tired feeling,
• loss of appetite,
• dark urine,
• clay-colored stools,
• yellowing of the skin or eyes,
• fast or racing heartbeats,
• confusion,
• little or no urinating,
• chest pain,
• dry cough,
• wheezing,
• feeling short of breath,
• skin redness or peeling,
• swelling,
• rapid weight gain, or
• severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common side effects of Gilenya include:

• headache,
• tired feeling,
• influenza,
• stuffy nose,
• sinus pain,
• diarrhea,
• back pain,
• liver transaminase elevations, and
• cough.

Gilenya can affect your immune system's ability to fight an infection while you are taking the medication and for 2 months after your last dose. Tell your doctor right away if you develop signs of an infection such as:

• persistent cough or sore throat,
• difficulty breathing,
• fever,
• chills, or
• cold/flu symptoms.

Aubagio (teriflunomide) is a pyrimidine synthesis inhibitor used to treat relapsing forms of multiple sclerosis (MS).

Gilenya (fingolimod) is a sphingosine 1-phosphate receptor modulator used to treat patients with relapsing forms of multiple sclerosis (MS) to reduce the frequency of exacerbations and to delay physical disability.

Aubagio may increase exposure of ethinyl estradiol and levonorgestrel. Patients taking Coumadin (warfarin) should be closely monitored as interactions may occur. Aubagio may cause major birth defects if used during pregnancy. Pregnancy must be excluded before starting treatment with Aubagio. Pregnancy must be avoided while taking Aubagio treat relapsing forms of multiple sclerosis (MS). If Aubagio is used during pregnancy, or if the patient becomes pregnant while taking Aubagio, the drug should be discontinued immediately and an accelerated elimination procedure should be initiated. Consult your doctor before breastfeeding.

Gilenya may interact with:

• beta-blockers,
• calcium channel blockers,
• citalopram,
• chlorpromazine,
• digoxin,
• erythromycin,
• haloperidol,
• ketoconazole,
• medications to control the immune system,
• medications for cancer, heart problems, or high blood pressure, and
• methadone

Tell your doctor all medications and supplements you use. Gilenya may cause fetal harm. It takes approximately 2 months for Gilenya to be eliminated from the body. Women should avoid pregnancy during treatment with Gilenya and for 2 months after treatment. It is not known if Gilenya passes into breast milk. Women and their doctors should decide whether to take Gilenya or breastfeed. Women should not do both.

The recommended dose for Aubagio is 7 mg or 14 mg taken orally, once daily, with or without food.

The recommended dose for Gilenya is 0.5 mg orally once daily, with or without food.