Can Teriflunomide (leflunomide derivative) cause anemia?

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Last updated: April 17, 2025View editorial policy

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From the Guidelines

Teriflunomide can cause anemia as a side effect, although the provided evidence does not directly support this claim, and the information is based on the related medication leflunomide, which has a similar mechanism of action. The medication leflunomide, which is related to teriflunomide, has been associated with hematologic effects, including rare reports of pancytopenia, agranulocytosis, and thrombocytopenia in patients treated with or who had recently discontinued methotrexate or other immunosuppressive agents 1. While the exact risk of anemia with teriflunomide is not specified in the provided evidence, it is essential to monitor patients taking this medication for any changes in blood cell counts, as recommended for leflunomide, with monthly CBC with differential and LFTs for the first 6 months and every 6-8 weeks thereafter 1. Symptoms of anemia, such as fatigue, weakness, pale skin, shortness of breath, or dizziness, should be promptly evaluated, and treatment adjusted accordingly. Given the potential for hematologic effects, it is crucial to prioritize regular blood monitoring and promptly address any signs of anemia in patients taking teriflunomide. Key considerations for managing anemia in patients taking teriflunomide include:

  • Regular blood monitoring
  • Prompt evaluation of symptoms
  • Potential adjustment of medication dosage or temporary discontinuation
  • Treatment of anemia itself, if necessary.

From the Research

Teriflunomide and Anemia

  • Teriflunomide is a drug used to treat multiple sclerosis and rheumatoid arthritis, and its potential to cause anemia is not directly addressed in the provided studies 2, 3, 4, 5, 6.
  • However, one study mentions that teriflunomide can cause decreases in lymphocyte counts, which may be related to its immunosuppressive effects 3.
  • Another study discusses the importance of iron deficiency and anemia diagnosis, but does not mention teriflunomide as a potential cause of anemia 4.
  • Studies on iron supplementation and erythropoiesis-stimulating agents provide information on anemia treatment, but do not address teriflunomide's potential role in causing anemia 5, 6.
  • Overall, there is no direct evidence in the provided studies to suggest that teriflunomide can cause anemia, but its immunosuppressive effects may be related to changes in blood cell counts 3.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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