Drug General Information (ID: DDI4Q5JB60)
Drug Name			Leflunomide		Drug Info		Belatacept		Drug Info
Drug Type		Small molecule				Protein/peptide
Therapeutic Class		Antiinflammatory Agents				Selective Immunosuppressants

Mechanism of Leflunomide-Belatacept Interaction (Severity Level: Major)
Additive immunosuppressive effects Click to Show/Hide Mechanism Graph
Drug Name		Leflunomide				Belatacept
Mechanism		Immunosuppressive effects				Immunosuppressive effects
Key Mechanism Factor 1
		Factor Name		Immunosuppressive effects
		Factor Description		Immunosuppression is when your immune system is not functioning as it should. The immune system is made up of cells, tissues and organs that help the body fight off infections. If the immune system is suppressed, an infection that your body was able to control may become serious or even fatal.
Mechanism Description		Additive immunosuppressive effects by the combination of Leflunomide and Belatacept

Recommended Action
Management		Close monitoring for the development of infection is recommended if leflunomide or teriflunomide is used in patients who are currently receiving or have recently received other immuno- or myelosuppressive agents, and vice versa. Platelet, white blood cell count, and hemoglobin or hematocrit should be evaluated at baseline and regularly during therapy. Patients should be advised to contact their physician if they develop signs and symptoms of infection such as fever, chills, diarrhea, sore throat, muscle aches, shortness of breath, blood in phlegm, weight loss, red or inflamed skin, body sores, and pain or burning during urination. If evidence of serious infection or bone marrow suppression occurs, treatment should be stopped, and cholestyramine or charcoal administered to accelerate elimination of leflunomide's active metabolite from plasma, which otherwise may take up to two years.

References
1	Product Information. Arava (leflunomide). Hoechst Marion-Roussel Inc, Kansas City, MO.
2	Product Information. Aubagio (teriflunomide). Genzyme Corporation, Cambridge, MA.