Teriflunomide is highly protein-bound, minimally metabolized, and is eliminated in the feces and urine. It is additionally subject to enterohepatic recycling, thus adding to the long half-life (10-12 days). Thus rapid excretion is problematic. As presented recently at the Americas Committee for Treatment and Research in Multiple Sclerosis (Limsakun T and Menguy-Vacheron F, San Antonio, TX, June 5, 2010), cholestyramine can successfully accelerate elimination of teriflunomide, a property that may prove useful in situations of overdose or toxicity. Cholestyramine and/or activated charcoal are not needed as "pre-treatment" as the article erroneously indicated.
Clarification regarding teriflunomide effects
9 June 2010
Teriflunomide is highly protein-bound, minimally metabolized, and is eliminated in the feces and urine. It is additionally subject to enterohepatic recycling, thus adding to the long half-life (10-12 days). Thus rapid excretion is problematic. As presented recently at the Americas Committee for Treatment and Research in Multiple Sclerosis (Limsakun T and Menguy-Vacheron F, San Antonio, TX, June 5, 2010), cholestyramine can successfully accelerate elimination of teriflunomide, a property that may prove useful in situations of overdose or toxicity. Cholestyramine and/or activated charcoal are not needed as "pre-treatment" as the article erroneously indicated.
Competing interests
none