Is teriflunomide safe to take with Augmentin (amoxicillin/clavulanate) and fluticasone nasal spray?

Safety of Teriflunomide with Augmentin and Fluticasone Nasal Spray

Teriflunomide can be safely taken with Augmentin (amoxicillin/clavulanate) and fluticasone nasal spray as there are no significant drug interactions between these medications.

Teriflunomide Safety Profile

Teriflunomide is an oral disease-modifying drug used for relapsing multiple sclerosis that works by inhibiting de novo pyrimidine synthesis, which reduces lymphocyte proliferation 1. Key safety considerations include:

• Teriflunomide is considered cytostatic but not cytotoxic, affecting rapidly dividing lymphocytes while sparing resting or slowly dividing ones 1
• It has a manageable safety profile with over 6800 patient-years of exposure in clinical development programs 2
• As the main active metabolite of leflunomide, its long-term safety profile can be extrapolated from leflunomide's extensive post-approval data 1, 3

Compatibility with Augmentin

Augmentin (amoxicillin/clavulanate) is a first-line antibiotic for acute bacterial rhinosinusitis 4:

• No documented interactions between teriflunomide and amoxicillin/clavulanate exist in the available evidence
• Augmentin is typically prescribed for short-term use (5-7 days in adults) 4, minimizing potential interaction concerns
• The mechanism of action of Augmentin (bacterial cell wall inhibition) does not interfere with teriflunomide's immunomodulatory effects

Compatibility with Fluticasone Nasal Spray

Fluticasone nasal spray is a common intranasal corticosteroid used for allergic rhinitis and as an adjunctive therapy for rhinosinusitis 5:

• No documented interactions between teriflunomide and fluticasone nasal spray exist in the available evidence
• Intranasal corticosteroids like fluticasone have minimal systemic absorption when used as directed 5
• Fluticasone nasal spray can be safely used with antibiotics like Augmentin for rhinosinusitis management 5

Important Considerations

Monitoring for Side Effects

While these medications can be used together, be aware of potential side effects of each:

• Teriflunomide: Monitor for increased liver enzyme levels, as it can affect hepatic function 1, 2
• Fluticasone: Common side effects include epistaxis (nosebleeds), which can be minimized with proper administration technique 5
• Augmentin: Watch for gastrointestinal side effects and potential allergic reactions 4

Special Precautions

1. Pregnancy concerns: Teriflunomide is contraindicated in pregnancy due to potential teratogenicity 1, 2

2. Skin reactions: Rare but serious skin reactions have been reported with teriflunomide, including bullous pemphigoid 6

3. Proper nasal spray technique: Administer fluticasone away from the nasal septum to minimize epistaxis risk 5

Conclusion

The combination of teriflunomide with Augmentin and fluticasone nasal spray appears to be safe based on available evidence. There are no documented significant pharmacological interactions between these medications that would preclude their concurrent use. However, patients should be monitored for the individual side effects of each medication.