Mavenclad vs. Aubagio

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

Because of its safety profile, use of Mavenclad is generally recommended for patients who have had an inadequate response to, or are unable to tolerate, an alternate drug indicated for the treatment of MS.

Mavenclad and Aubagio belong to different drug classes. Mavenclad is a purine antimetabolite and Aubagio is a pyrimidine synthesis inhibitor.

Side effects of Mavenclad and Aubagio that are similar include nausea.

Side effects of Mavenclad that are different from Aubagio include upper respiratory tract infection, headache, low white blood cell count (lymphopenia), back pain, joint pain, and insomnia.

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

Both Mavenclad and Aubagio may interact with hormonal contraceptives.

Mavenclad may also interact with immunosuppressive drugs, hematotoxic drugs, antiviral and antiretroviral drugs, ritonavir, eltrombopag, curcumin, cyclosporine, dilazep, nifedipine, nimodipine, cilostazol, sulindac, dipyridamole, reserpine, interferon-beta, corticosteroids, rifampicin, and St. John's wort.

Aubagio may also interact with warfarin.

Common side effects of Mavenclad include:

• upper respiratory tract infection,
• headache,
• low white blood cell count (lymphopenia),
• nausea,
• back pain,
• joint pain, and
• insomnia

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.

Mavenclad (cladribine) is a purine antimetabolite indicated for the treatment of relapsing forms of multiple sclerosis (MS), to include relapsing-remitting disease and active secondary progressive disease, in adults. Because of its safety profile, use of Mavenclad is generally recommended for patients who have had an inadequate response to, or are unable to tolerate, an alternate drug indicated for the treatment of MS.

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

Mavenclad may interact with immunosuppressive drugs, hematotoxic drugs, antiviral and antiretroviral drugs, ritonavir, eltrombopag, curcumin, cyclosporine, dilazep, nifedipine, nimodipine, cilostazol, sulindac, dipyridamole, reserpine, interferon-beta, corticosteroids, rifampicin, St. John's wort, or hormonal contraceptives. Tell your doctor all medications and supplements you use. Mavenclad is not recommended for use during pregnancy; it may harm a fetus. Pregnancy should be excluded before the initiation of each treatment course of Mavenclad. Females of reproductive potential should prevent pregnancy by use of effective contraception during Mavenclad dosing and for at least 6 months after the last dose in each treatment course. Males of reproductive potential should take precautions to prevent pregnancy of their partner during Mavenclad dosing and for at least 6 months after the last dose in each treatment course. Because of the potential for serious adverse reactions in nursing infants, Mavenclad is not recommended for use while breastfeeding.

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.

The cumulative dosage of 3.5 mg/kg Mavenclad is administered orally and divided into 2 treatment courses (1.75 mg/ kg per treatment course). Each treatment course is divided into 2 treatment cycles.

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