Taking Aubagio? These Drug Interactions Could Affect Your MS Treatment

If you are taking Aubagio (teriflunomide) to manage your relapsing multiple sclerosis, you probably know it is a once-daily oral medication that helps reduce MS flare-ups. What you might not realize is that Aubagio has over 760 documented drug interactions—making it one of the MS medications that requires the most careful coordination with your other prescriptions.

This guide breaks down the most important Aubagio drug interactions you need to know—organized by medication type—so you can advocate for yourself at your next appointment.

How Aubagio Causes Drug Interactions

Before diving into specific interactions, it helps to understand WHY Aubagio causes so many of them. Teriflunomide affects several important pathways:

CYP2C8 Inhibitor

CYP2C8 is a liver enzyme that breaks down many medications. When Aubagio inhibits this enzyme, drugs processed by CYP2C8 (like certain diabetes medications) can build up to higher-than-expected levels.

Weak CYP1A2 Inducer

Aubagio can speed up the breakdown of some medications, making them LESS effective. Affected drugs include duloxetine, theophylline, and tizanidine.

Drug Transporter Effects (BCRP, OATP1B1/B3, OAT3)

Aubagio blocks several drug transporters, which can significantly increase blood levels of statins and certain antibiotics.

Aubagio + Cholesterol Medications (Statins)

Primary concern: INCREASED STATIN LEVELS → RISK OF MUSCLE DAMAGE

Aubagio + Blood Thinners (Warfarin)

Primary concern: DECREASED WARFARIN EFFECTIVENESS → BLOOD CLOT RISK

Aubagio can decrease your peak INR by approximately 25%—meaning your blood may not be as “thin” as your doctor intended.

Aubagio + Diabetes Medications

Primary concern: INCREASED DRUG LEVELS → HYPOGLYCEMIA RISK

Aubagio + Leflunomide (Arava): NEVER COMBINE

Aubagio + Vaccines

Primary concern: LIVE VACCINES NOT RECOMMENDED

Important: Wait at least 6 months after stopping Aubagio before receiving any live vaccine.

Aubagio + CYP1A2-Metabolized Medications

Primary concern: DECREASED DRUG EFFECTIVENESS

Aubagio can reduce blood levels of these medications:

• Duloxetine (Cymbalta) – May need higher dose for effectiveness
• Theophylline – Monitor levels for asthma/COPD control
• Tizanidine (Zanaflex) – May be less effective for muscle spasticity
• Alosetron (Lotronex) – Monitor IBS symptoms

Aubagio + Hepatotoxic (Liver-Affecting) Medications

Primary concern: INCREASED LIVER DAMAGE RISK

Aubagio has a boxed warning about liver damage. Use caution with:

• Acetaminophen (Tylenol) in high doses
• NSAIDs (ibuprofen, naproxen) – particularly with existing liver issues
• Statins
• Certain antibiotics (isoniazid, rifampin)
• Alcohol

Red Flags: When to Call Your Doctor Immediately

5 Questions to Ask Your Healthcare Team

1. “Have you checked all my medications for interactions with Aubagio?”
2. “Do any of my current medications need dose adjustments?”
3. “What monitoring do I need?” – Ask about liver tests, INR checks, blood counts.
4. “Are my vaccines up to date?” – Live vaccines should be given BEFORE starting Aubagio.
5. “What symptoms should I watch for?”

The Cost Factor: Affording Your Aubagio Treatment

Managing MS with Aubagio often means juggling multiple medications—and multiple costs. That is where MS medication copay assistance comes in.

At QuickRx Specialty Pharmacy, we specialize in helping MS patients access copay cards, patient assistance programs, and manufacturer savings to reduce out-of-pocket costs—often to $0.

Our MS Copay Assistance Services Include:

• Aubagio (teriflunomide) copay assistance
• Ampyra (dalfampridine) copay card
• Copaxone (glatiramer acetate) copay card
• Gilenya (fingolimod) copay assistance
• Mavenclad (cladribine) patient assistance
• Tecfidera (dimethyl fumarate) copay card
• Vumerity (diroximel fumarate) copay assistance

Visit our Multiple Sclerosis Copay Assistance page to learn more.

Ready to explore your copay assistance options?

Call: (917) 830-2525 | Toll-Free: (800) 496-6111

Frequently Asked Questions

Can I take over-the-counter pain relievers with Aubagio?

Generally, occasional use of acetaminophen or ibuprofen is acceptable. However, because Aubagio can affect the liver, avoid high doses and check with your pharmacist first.

I am on Aubagio and my doctor wants to prescribe a statin. Is that safe?

Statins can be used with Aubagio, but with important limitations. Rosuvastatin must be capped at 10mg daily. Other statins may need dose reductions.

How long do I need to wait after stopping Aubagio before getting a live vaccine?

At least 6 months. Aubagio has a very long half-life (18-19 days) and stays in your system for months. Your doctor can perform an “accelerated elimination procedure” if needed sooner.

Can I drink alcohol while taking Aubagio?

While there is no direct interaction, both can stress your liver. It is best to limit alcohol consumption while on Aubagio.

How does QuickRx help with Aubagio costs?

QuickRx provides free copay assistance services for MS patients. We help you enroll in manufacturer copay cards, patient assistance programs, and foundation grants. Many patients reduce their costs to $0. Call (917) 830-2525 to learn more.

Medical References

1. Aubagio (teriflunomide) Prescribing Information. Sanofi Genzyme. 2024.
2. Drugs.com. Aubagio Drug Interactions. Accessed December 2025.
3. Medscape. Teriflunomide Drug Interactions. Accessed December 2025.
4. Oh J, O Connor PW. Teriflunomide. The Formulary. 2013.
5. National Multiple Sclerosis Society. Disease-Modifying Therapies. Accessed December 2025.