Drug General Information (ID: DDI69PJYTA)
Drug Name			Teriflunomide		Drug Info		Entrectinib		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Selective Immunosuppressants				Multikinase Inhibitors
Structure

Mechanism of Teriflunomide-Entrectinib Interaction (Severity Level: Major)
Additive myelosuppressive effects Click to Show/Hide Mechanism Graph
Drug Name		Teriflunomide				Entrectinib
Mechanism 1		Myelosuppressive effects				Myelosuppressive effects
Key Mechanism Factor 1
		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 Entrectinib
Increased risk of hepatotoxicity Click to Show/Hide Mechanism Graph
Drug Name		Teriflunomide				Entrectinib
Mechanism 2		Hepatotoxicity				Hepatotoxicity
Key Mechanism Factor 2
		Factor Name		Hepatotoxicity
		Factor Description		Combination of drugs that can induce hepatotoxicity may increase the risk of liver injury. Symptoms vary depending on the level of exposure and the total extent of liver damage, and may cause few symptoms if the damage is mild, and eventually lead to liver failure in patients with severe damage.
Mechanism Description		Increased risk of hepatotoxicity by the combination of Teriflunomide and Entrectinib

Recommended Action
Management		Close monitoring is recommended if leflunomide or teriflunomide is used in patients who are currently receiving or have recently received other immunosuppressive and hepatotoxic agents, and vice versa. Due to the prolonged elimination half-life of leflunomide's active metabolite, an interaction may occur even when these agents are initiated after the discontinuation of treatment with leflunomide or teriflunomide. Liver enzymes, bilirubin, platelet, white blood cell count, and hemoglobin or hematocrit should be evaluated at baseline and regularly during therapy.

References
1	Product Information. Arava (leflunomide). Hoechst Marion-Roussel Inc, Kansas City, MO.