Drug General Information (ID: DDI5GCYOX3)
Drug Name			Teriflunomide		Drug Info		Olaparib		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Selective Immunosuppressants				Poly (Adp-Ribose) Polymerase Inhibitors
Structure

Mechanism of Teriflunomide-Olaparib Interaction (Severity Level: Major)
Additive immunosuppressive effects Click to Show/Hide Mechanism Graph
Drug Name		Teriflunomide				Olaparib
Mechanism 1		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 Teriflunomide and Olaparib
Additive myelosuppressive effects Click to Show/Hide Mechanism Graph
Drug Name		Teriflunomide				Olaparib
Mechanism 2		Myelosuppressive effects				Myelosuppressive effects
Key Mechanism Factor 2
		Factor Name		Myelosuppressive effects
		Factor Description		Myelosuppression, also known as bone marrow suppression, is a decrease in bone marrow activity that leads to a decrease in the production of blood cells. Some blood cell disorders include: erythrocytopenia (anemia), leukopenia (neutropenia), and thrombocytopenia (thrombocytopenia).
Mechanism Description		Additive myelosuppressive effects by the combination of Teriflunomide and Olaparib

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.