Aubagio interactions: Alcohol, medications, and other factors

Aubagio interactions with other medications  

Before you start treatment with Aubagio, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether Aubagio interacts with supplements, herbs, or vitamins, see the “Aubagio and other interactions” section below.)

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a table of drugs that can interact with Aubagio. Keep in mind that this table doesn’t include all drugs that may interact with Aubagio. Some of these interactions are described in detail just below in “Drug interactions in depth.”

When to avoid Aubagio

In some cases, factors or conditions could prevent your doctor from prescribing Aubagio due to the risk of harm. These are known as contraindications. The contraindications of Aubagio include:

Having severe liver problems

Doctors typically won’t prescribe Aubagio for people with severe liver problems, including liver failure. This is because Aubagio may cause liver damage, which can worsen existing liver problems.

In fact, Aubagio has a boxed warning about the risk of liver damage. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For details, see “Boxed warnings” at the beginning of this article.

If you have severe liver problems, talk with your doctor before taking Aubagio. They’ll likely prescribe a treatment other than Aubagio for your condition.

Taking leflunomide (Arava)

Doctors typically will not prescribe Aubagio in combination with leflunomide (Arava), which is used to treat rheumatoid arthritis.

This is because leflunomide is broken down into teriflunomide in your body. Aubagio contains the active drug teriflunomide. So taking leflunomide with Aubagio can increase the amount of teriflunomide in your body. This can raise your risk of serious side effects from teriflunomide.

Before you start treatment with Aubagio, it’s important to tell your doctor if you take leflunomide. They’ll likely have you stop taking leflunomide before you start taking Aubagio.

Are pregnant or may become pregnant

Doctors typically won’t prescribe Aubagio during pregnancy. They’re also unlikely to prescribe the drug for this use if you’re able to become pregnant and are not using effective birth control.

This is because Aubagio may not be safe to take during pregnancy. In fact, the drug has a boxed warning about the risk of fetal harm. A boxed warning is the most serious warning from the FDA. For details, see “Boxed warnings” at the beginning of this article.

For the treatment of multiple sclerosis during pregnancy, your doctor can recommend a different treatment that’s safe for use in pregnancy. If you’re able to become pregnant, your doctor can advise you on birth control options to use while taking Aubagio for multiple sclerosis.

Having had an allergic reaction to Aubagio or any of its ingredients

If you have had an allergic reaction to Aubagio, any of its ingredients, or a similar drug called leflunomide (Arava), your doctor will likely not prescribe Aubagio. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

Note:Before you start treatment with Aubagio, it’s important to tell your doctor if these contraindications apply to you. They can determine whether to prescribe Aubagio.

Can I drink alcohol while taking Aubagio?

There aren’t any known interactions between Aubagio and alcohol. However, your doctor may advise you to avoid or limit alcohol consumption during Aubagio treatment.

This is because drinking alcohol while taking the drug may worsen some of Aubagio’s side effects. For example, you may experience:

• nausea
• headache
• diarrhea

In addition, consuming large amounts of alcohol can cause liver damage. Aubagio may also cause liver damage* as a side effect. This means that drinking alcohol during Aubagio treatment may increase the risk of liver problems.

If you consume alcohol during Aubagio treatment, these side effects may be more likely to occur. If you have questions about drinking alcohol while taking Aubagio, talk with your doctor.

*Aubagio has a boxed warning about the risk of liver damage. For more information, see the “Boxed warnings” at the start of this article.

Drug interactions in depth

Here’s a closer look at certain drug interactions of Aubagio.

Statins

Statins are used to help lower high cholesterol levels. Doctors commonly prescribe these drugs. However, they can interact with Aubagio.

Interaction result:Taking Aubagio with a statin can raise your risk of side effects from the statin. If you already have side effects, it could make them worse. Taking Aubagio with a statin can also raise your risk of liver damage. (Aubagio has a boxed warning about the risk of liver damage. For more information, see the “Boxed warnings” at the start of this article.)

Interaction explained:Aubagio reduces the activity of certain transport proteins in your body. Transport proteins help move certain drugs, including statins, around your body. For example, some of these proteins help move statins into cells in your liver that break down these drugs.

By reducing the activity of transport proteins, Aubagio can make statins build up in your blood. This can raise your risk of side effects from the statin. Examples of statin side effects include headache, rash, and muscle problems.

As well, both Aubagio and statins can cause liver damage. So taking these drugs together can raise your risk of this side effect.

Examples of statin drugs: Here are some statins that may interact with Aubagio:

• atorvastatin (Lipitor)
• lovastatin (Altoprev)
• rosuvastatin (Crestor)
• simvastatin (Zocor, Flolipid)

Steps you or your doctor may take:If your doctor prescribes Aubagio with a statin, they may prescribe a dosage of the statin that’s lower than usual. They may also monitor you more closely for statin side effects, such as muscle and liver problems.

If you take Aubagio with a statin, tell your doctor if you have bothersome side effects. In particular, tell your doctor right away if you have any unexpected muscle pain, tenderness, or weakness, especially if you also have a fever or feel unwell. Also tell your doctor if you have symptoms of liver problems. These can include nausea, abdominal pain, dark, urine, and jaundice.

If you have questions about taking Aubagio with a statin, talk with your doctor or pharmacist.

Oral contraceptives

Aubagio can interact with oral contraceptives (birth control pills).

Interaction result: Taking Aubagio with an oral contraceptive can raise your risk of side effects from the contraceptive.

Interaction explained: Aubagio can increase the levels of hormones from oral contraceptives in your body. This can raise your risk of side effects from these hormones. If you already have side effects, it could make them worse.

Examples of oral contraceptives: Here are some oral contraceptives that may interact with Aubagio:

• ethinyl estradiol/drospirenone (Yaz, others)
• ethinyl estradiol/levonorgestrel (Altavera, others)
• ethinyl estradiol/norethindrone (Junel, others)

Steps you or your doctor may take: Your doctor may recommend using a form of birth control other than an oral contraceptive while you are taking Aubagio.

Keep in mind that Aubagio can cause fetal harm if taken during pregnancy. (Aubagio has a boxed warning about the risk of fetal harm if used during pregnancy. For more information, see the “Boxed warnings” at the start of this article.)

If you’re able to become pregnant, your doctor will likely not prescribe Aubagio unless you are using an effective form of birth control. Talk with your doctor about forms of birth control that may be good a option for you.

If you take Aubagio with an oral contraceptive, tell your doctor if you have bothersome side effects from the contraceptive.

If you have questions about taking Aubagio with an oral contraceptive, talk with your doctor or pharmacist.

Warfarin

Warfarin (Jantoven) is an anticoagulant that doctors prescribe to treat and help prevent dangerous blood clots.

Interaction result: Taking Aubagio with warfarin can make warfarin less effective at treating and preventing blood clots.

Interaction explained: Aubagio can speed up the action of an enzyme in your body that helps break down warfarin. This can lower the amount of warfarin in your body, which can make it less effective.

Steps you or your doctor may take: If you take Aubagio with warfarin, your doctor will likely monitor your International Normalized Ratio (INR) more frequently. INR is a blood test that measures the length of time it takes your blood to clot. Doctors use it to monitor the effect of warfarin on your body.

If needed, your doctor may increase your warfarin dosage based on your INR.

If you have questions about taking Aubagio with warfarin, talk with your doctor or pharmacist.

Aubagio and other interactions

Aubagio may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Aubagio.

Aubagio interactions with supplements

Aubagio can interact with activated charcoal supplements, which are taken for various reasons. These include lowering cholesterol and treating diarrhea or gas. Doctors also use activated charcoal to treat poisoning or overdose with certain drugs. They may also prescribe it to help clear Aubagio from your system. (Aubagio can stay in your system for up to 2 years after stopping treatment unless your doctor prescribes activated charcoal or another medication to help remove it.)

You shouldn’t take activated charcoal supplements with Aubagio. These supplements can lower the amount of Aubagio in your body and make it less effective at treating multiple sclerosis.

Before you start treatment with Aubagio, tell your doctor and pharmacist which supplements, herbs, and vitamins you take. By sharing this information with them, you may help prevent possible interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Aubagio and herbs

There are no specific reports of herbs interacting with Aubagio. However, that doesn’t mean herbal interactions won’t occur or be recognized in the future. Because of this, it’s important to check with your doctor or pharmacist before taking any of these products during Aubagio treatment.

Aubagio and vitamins

There are no specific reports of vitamins interacting with Aubagio. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with Aubagio.

Aubagio interactions with food

There were no reports of food interactions with Aubagio. If you’d like to learn more about eating certain foods during treatment with Aubagio, talk with your doctor.

Aubagio interactions with vaccines

Aubagio is known to interact with live vaccines. A live vaccine contains live but weakened pieces of the virus or bacterium it’s meant to defend against. When your immune system is healthy, live vaccines usually won’t cause infection.

But Aubagio works by weakening your immune system. So if you get a live vaccine, your immune system may not be able to fight the virus or bacterium. This may cause you to become sick or develop symptoms of the illness the vaccine is meant to prevent.

Examples of live vaccines to avoid during Aubagio treatment and for at least 6 months after stopping Aubagio include:

• measles, mumps, rubella (MMR)
• chickenpox
• flu vaccine (nasal spray form)

Before starting Aubagio, talk with your doctor or pharmacist about any vaccines you may need.

Aubagio and lab tests

Aubagio isn’t known to interact with any lab tests. If you have concerns about this medication interacting with lab tests, talk to your doctor.

AUBAGIO INTERACTION WITH CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with Aubagio. However, as with any drug or supplement, talk with your doctor before using cannabis in combination with Aubagio. The effect of cannabis may affect how well you stick to your Aubagio treatment plan.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Aubagio and health-related interactions

Certain medical conditions and other factors may increase the risk of interactions with Aubagio. Before you take this drug, be sure to talk with your doctor about your health history. Aubagio may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Aubagio include:

• Infections: Aubagio can make it harder for your body to fight infections. If you have an infection, be sure to tell your doctor before starting Aubagio. Your doctor may prescribe medication to treat the infection before you start taking Aubagio.
• Tuberculosis: Your doctor may test you for tuberculosis (TB) before prescribing Aubagio. If you test positive, your doctor may prescribe medication to treat TB before you start taking Aubagio.
• High blood pressure: Aubagio can increase your blood pressure. If you already have high blood pressure, talk with your doctor about whether Aubagio is right for you.
• Diabetes: Aubagio may rarely cause peripheral neuropathy (nerve damage). If you have diabetes, you may have a higher risk of this side effect. Talk with your doctor about whether Aubagio is right for you.
• Liver problems: Aubagio has a boxed warning for the risk of liver damage. For more information, see the “Boxed warnings” at the start of this article. If you have a liver problem, such as liver disease or raised liver enzymes, you may have a higher risk of liver damage with Aubagio. If you have a severe liver problem, your doctor will likely not prescribe Aubagio. You can ask them about other treatments that may be better choices for you.
• Allergic reaction: If you’ve had an allergic reaction to Aubagio, any of its ingredients, or a similar drug called leflunomide (Arava), your doctor will likely not prescribe Aubagio. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.
• Breastfeeding: It’s not known whether it’s safe to use Aubagio while breastfeeding. There isn’t enough information to determine whether the drug passes into breast milk or what effects Aubagio may have on a child who is breastfed. If you’re breastfeeding or planning to, talk with your doctor before using Aubagio. They can talk with you about treatment options and ways to feed your child.
• Pregnancy: Aubagio is not safe to use while pregnant. In fact, the drug has a boxed warning for the risk of fetal harm if used during pregnancy. For more information, see the “Boxed warnings” at the start of this article. If you’re pregnant or planning to become pregnant, tell your doctor before starting Aubagio. They can advise you on the right treatment plan for you.

FAQs about Aubagio and interactions

Here are some frequently asked questions about Aubagio and possible interactions.

Can you take Tylenol with Aubagio?

Most people can take acetaminophen (Tylenol) with Aubagio. These drugs have not been reported to interact.

However, if you have a liver problem, you should talk with your doctor before taking Tylenol with Aubagio. This is because both these drugs can cause liver damage. In fact, Aubagio has a boxed warning about the risk of liver damage. For more information, see the “Boxed warnings” at the start of this article. If you have a liver problem, you may have a higher risk of liver damage if you take Tylenol with Aubagio.

If you have other questions about taking Tylenol with Aubagio, talk with your doctor or pharmacist.

Can you take ibuprofen with Aubagio?

Yes, you can typically take ibuprofen (Advil, Motrin) with Aubagio. These drugs have not been reported to interact.

However, if you have a liver problem, you should talk with your doctor before taking ibuprofen with Aubagio. This is because both these drugs can cause liver damage. In fact, Aubagio has a boxed warning about the risk of liver damage. For more information, see the “Boxed warnings” at the start of this article. If you have a liver problem, you may have a higher risk of liver damage if you take ibuprofen with Aubagio.

If you have other questions about taking ibuprofen with Aubagio, talk with your doctor or pharmacist.

Preventing interactions

You can take certain steps to help prevent interactions with Aubagio. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

• Let them know if you drink alcohol or use cannabis.
• Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the Aubagio label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.

If Aubagio doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with Aubagio by taking it exactly as your doctor prescribes.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.