If you have multiple sclerosis (MS), your doctor might suggest Aubagio (teriflunomide) as a treatment option for you. Along with other questions you may have about the drug, you could be wondering about its side effects.

Aubagio is a prescription medication that’s used to treat the following conditions in adults:

  • Clinically isolated syndrome (CIS). With CIS, a person has an episode of MS-like symptoms for 24 hours or more. CIS can progress to MS, but this doesn’t always happen.
  • Relapsing-remitting MS (RRMS). RRMS involves periods of relapse (when symptoms come back or worsen) and periods of remission (when symptoms lessen or go away).
  • Active secondary progressive MS (SPMS). With active SPMS, symptoms continue to worsen over time.

Aubagio helps slow the worsening of MS symptoms. It’s a tablet that you take by mouth once daily. If Aubagio works for you, your doctor will likely recommend that you take it long term.

For more information about Aubagio, including details about its uses, see this in-depth article.

Like other drugs, Aubagio can cause mild or serious side effects. Keep reading to learn more.

Some people may have mild or serious side effects during their Aubagio treatment. Examples of Aubagio’s commonly reported side effects include:

* To learn more about this side effect, see “Side effects explained” below.
† Aubagio has a boxed warning for this side effect. This is the most serious warning from the Food and Drug Administration (FDA). To learn more, see “Side effects explained” below.

Mild side effects have been reported by people taking Aubagio. Examples of these side effects include:

* To learn more about this side effect, see “Side effects explained” below.

In most cases, these side effects should be temporary. And some may be easily managed, too. But if you have any symptoms that are ongoing or that bother you, talk with your doctor or pharmacist. And don’t stop using Aubagio unless your doctor recommends it.

Aubagio may cause mild side effects other than the ones listed above. See the Aubagio medication guide for details.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Aubagio, visit MedWatch.

Although rare, serious side effects may occur from taking Aubagio. Serious side effects that have been reported with Aubagio include:

* Aubagio has a boxed warning for this side effect. This is the most serious warning from the Food and Drug Administration (FDA). To learn more, see “Side effects explained” below.
† To learn more about this side effect, see “Side effects explained” below.

If you develop serious side effects while taking Aubagio, call your doctor right away. If the side effects seem life threatening or if you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Get answers to some frequently asked questions about Aubagio’s side effects.

Will stopping Aubagio treatment cause any side effects?

It’s possible that stopping Aubagio treatment may cause side effects. If you have side effects after you stop taking Aubagio, they’ll likely be symptoms of multiple sclerosis (MS) returning.

Aubagio helps reduce symptoms of MS and slow worsening of symptoms. For this reason, stopping treatment may cause symptoms of MS to get worse.

Before you stop taking Aubagio, talk with your doctor. They can recommend the best way for you to stop taking Aubagio. They may also be able to recommend a different medication for your condition.

Does Aubagio cause PML?

No, Aubagio doesn’t cause progressive multifocal leukoencephalopathy (PML). PML is a rare but serious side effect that may occur with some MS treatments. But it isn’t known to occur with Aubagio.

PML attacks your nervous system and can cause symptoms such as changes in personality, memory problems, and weakness. Its more serious side effects include seizures and coma.

Examples of MS medications that may cause PML include Tysabri (natalizumab), Gilenya (fingolimod), and Ocrevus (ocrelizumab).

If you have questions about PML, talk with your doctor or pharmacist.

How long do Aubagio’s side effects usually last?

It depends on what side effects you’re experiencing. For example, you may have nausea or headaches when you first start taking Aubagio. But, over time, your body may adjust to the medication. As a result, you might not have headaches or nausea after that.

Other side effects may be longer term. For example, liver damage or hair loss may last longer and continue throughout treatment with Aubagio. In some cases, you may need to stop your treatment if your side effects become too severe.

Discuss the side effects you’re having with your doctor. They can work with you to find the best ways to treat your side effects while you’re taking Aubagio.

Can Aubagio cause weight loss or weight gain?

No, you shouldn’t have weight loss or weight gain from taking Aubagio. No changes in weight were reported as side effects in people taking this medication.

But it’s possible that your weight may change due to having MS. This condition may make you feel very tired or weak. As a result, you could become less active, which can lead to weight gain.

In addition, some medications that are used to treat MS relapses (periods when symptoms come back or worsen) may cause weight gain. An example is prednisone.

In severe cases of MS, you may lose muscle mass if you can’t move around as much as you used to. This can lead to weight loss.

If you have weight changes while you’re receiving treatment MS, talk with your doctor. They’ll try to find out what may be causing your weight change and suggest treatments to address this.

Does Aubagio cause any eye-related side effects?

No, Aubagio shouldn’t cause you to have any eye-related side effects. This type of side effect wasn’t reported by people taking Aubagio.

But MS itself can cause vision problems. Some symptoms of MS that may affect your eyes include double vision, blurry vision, eye pain, and even blindness.

If you have any changes in your vision or eye-related side effects while taking Aubagio, tell your doctor. They can find out if your eye-related side effects are due to an MS relapse or something else.

Learn more about some of the side effects that Aubagio may cause.

Serious skin problems

In rare cases, people taking Aubagio have reported serious skin problems. Examples include Stevens-Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN). These conditions cause severe symptoms, including:

  • fever
  • blistering rash that is red or discolored
  • peeling skin

Aubagio can also cause a condition called drug reaction with eosinophilia and systemic symptoms (DRESS). This can result in a serious skin rash as well as organ problems, such as liver or kidney problems.

What might help

If you notice a rash while taking Aubagio, talk with your doctor. They’ll try to determine how serious your rash is and whether it needs treatment.

If you develop SJS, TEN, or DRESS, your doctor will have you stop taking Aubagio. They may also suggest a different medication for treating your multiple sclerosis (MS).

Liver damage

Aubagio has a boxed warning for liver damage. This is the most serious warning from the Food and Drug Administration (FDA).*

Aubagio may cause increased blood levels of liver enzymes. This was a commonly reported side effect in people taking Aubagio.

Increased liver enzyme levels may indicate liver damage, including liver failure. This rare side effect of taking Aubagio can be life threatening.

You should know the possible symptoms of liver damage so that you can report them to your doctor right away if they occur. Symptoms to watch for include:

* Aubagio also has a boxed warning for risk of fetal harm. For details, see “Pregnancy and breastfeeding while using Aubagio” under “Warnings for Aubagio” below.

What might help

Your doctor will check your liver enzyme levels before you start taking Aubagio. Then they’ll do this each month for the first 6 months after you start taking Aubagio. This monitors for any liver damage that may be occurring.

If you notice any symptoms of liver damage, tell your doctor right away. They’ll likely order a blood test to check your liver function.

If you do develop liver problems from Aubagio treatment, your doctor will have you stop taking the medication. Also, they’ll likely give you another medication to get the Aubagio out of your body more quickly. Examples include cholestyramine (Prevalite) and charcoal.

If you have any liver conditions, be sure to tell your doctor about them before you start taking Aubagio. In this case, they may recommend a different medication to treat your MS.

High blood pressure

It’s possible to develop high blood pressure from taking Aubagio, as this drug can increase blood pressure. If you already have high blood pressure, taking Aubagio may increase your blood pressure even more.

High blood pressure wasn’t a commonly reported side effect of Aubagio. But you should still be aware of its symptoms in case you experience them. These include:

What might help

Your doctor will check your blood pressure before you start taking Aubagio. Then they’ll monitor your blood pressure throughout your treatment. This is to make sure that your blood pressure isn’t increasing to an unsafe level.

If you notice symptoms of high blood pressure, tell your doctor. They can check your blood pressure to be sure that it isn’t too high. If you do develop high blood pressure, your doctor may recommend a blood pressure medication to help treat it.

Headache

You may have headaches while taking Aubagio. Headache was the most common side effect that people taking Aubagio reported.

What might help

If you have headaches from taking Aubagio, especially ones that are severe or bothersome to you, tell your doctor. They may be able to recommend over-the-counter medications to treat this side effect. Examples include Tylenol (acetaminophen) and Advil (ibuprofen).

Hair loss

You may experience hair loss or thinning from taking Aubagio. This is a common side effect reported by people taking Aubagio.

In most cases, hair loss began around 3 months after starting Aubagio treatment and was temporary.

What might help

If you notice hair loss or thinning while taking Aubagio, talk with your doctor. They may be able to recommend ways to decrease this side effect, such as using hair-thickening shampoo.

If this side effect is very bothersome to you, your doctor may recommend that you take a different medication.

Allergic reaction

Like most drugs, Aubagio can cause an allergic reaction in some people.

Symptoms can be mild or serious and can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. To manage these symptoms, they may suggest an over-the-counter antihistamine that you take by mouth, such as Benadryl (diphenhydramine). Or they may recommend a product that you apply to your skin, such as hydrocortisone cream.

If your doctor confirms that you had a mild allergic reaction to Aubagio, they’ll decide if you should continue using it.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms that you had a serious allergic reaction to Aubagio, they may have you switch to a different treatment.

Keeping track of side effects

During your Aubagio treatment, consider keeping notes on any side effects you’re having. Then, you can share this information with your doctor. This is especially helpful to do when you first start taking new drugs or using a combination of treatments.

Your side effect notes can include things such as:

  • what dose of the drug you were taking when you had the side effect
  • how soon after starting that dose you had the side effect
  • what your symptoms were from the side effect
  • how it affected your daily activities
  • what other medications you were also taking
  • any other information you feel is important

Keeping notes and sharing them with your doctor will help your doctor learn more about how Aubagio affects you. And your doctor can use this information to adjust your treatment plan if needed.

Aubagio has several warnings that may affect whether you can safely use this drug to treat multiple sclerosis (MS).

Boxed warnings: Liver damage and risk of fetal harm

Aubagio has boxed warnings for liver damage and risk of fetal harm. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

It’s possible that Aubagio may cause an increase in liver enzyme levels, which may indicate liver damage. In some cases, this can be very serious or even life threatening.

Aubagio can also cause harm to a fetus if taken during pregnancy. If you or your partner can become pregnant, your doctor will likely recommend that you use birth control while taking Aubagio.

To learn more about liver damage from Aubagio, see “Side effects explained” above. For details about risk of fetal harm with this drug, see “Pregnancy and breastfeeding while using Aubagio” below.

Other warnings

Aubagio may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you take Aubagio. The list below includes factors to consider.

Kidney problems. Although rare, Aubagio can cause kidney problems to occur. If you already have kidney problems, Aubagio may make your kidney problems worse. Tell your doctor if you have any kidney problems. They may monitor you more often for kidney problems or recommend a different medication to treat your MS.

Allergic reaction. If you’ve had an allergic reaction to Aubagio or any of its ingredients, you shouldn’t take Aubagio. You also shouldn’t take Aubagio if you’ve had an allergic reaction to leflunomide (Arava). Ask your doctor what other medications are better options for you.

A weakened immune system, a fever, or an infection. Aubagio may cause a decrease in white blood cells. White blood cells help the body fight infections. If you already have a weakened immune system, or if you have a fever or an infection, Aubagio may further weaken your immune system. This may make your body less able to fight an infection.

Before taking Aubagio, tell your doctor about any immune system problems, active infections, or fevers that you have. They may recommend treating your infection first, or they may suggest that you take a different medication for your MS.

Peripheral neuropathy. If you have peripheral neuropathy (a nerve disorder that causes numbness or tingling in your hands or feet), tell your doctor before you start Aubagio. This medication may cause peripheral neuropathy to occur. If you already have this condition, taking Aubagio can make numbness or tingling in your hands or feet worse. Your doctor may monitor your symptoms more often, or they may recommend a different medication for you.

Diabetes. If you have diabetes, tell your doctor before you start taking Aubagio. Diabetes may cause numbness or tingling in your arms or feet. Aubagio may also cause this, so taking this medication could increase your risk of developing numbness or tingling. If you have diabetes, your doctor may monitor you more often for these side effects.

Skin problems or rash from taking other medications. Although rare, Aubagio can cause a rash that can be severe or even life threatening. (For more information, see “Side effects explained” above.)

If you’ve ever had a skin problem or rash from another medication, tell your doctor before you start taking Aubagio. You may have an increased risk of developing a serious rash from Aubagio. Your doctor may monitor you more often or recommend a different medication for you.

Breathing problems. If you have breathing problems, tell your doctor before you start Aubagio treatment. This medication may cause breathing problems or lung problems. If you already have such problems, taking Aubagio may make your condition worse. Your doctor may monitor you more often, or they may recommend a different medication to treat your MS.

High blood pressure. Aubagio can cause high blood pressure. If you already have high blood pressure, taking Aubagio can cause your blood pressure to become even higher. Your doctor may recommend monitoring your blood pressure to be sure that it doesn’t get too high. They may also prescribe medications to decrease your blood pressure.

Alcohol use and Aubagio

Aubagio isn’t known to interact with alcohol. But this medication may increase your risk of side effects if you drink alcohol during your treatment. For example, Aubagio can cause nausea or headache. Alcohol may also cause these side effects. So, drinking alcohol while taking Aubagio may increase your risk of these side effects.

In addition, both Aubagio and alcohol can cause liver damage. Drinking alcohol during Aubagio treatment can further increase your risk of liver problems.

If you drink alcohol, talk with your doctor about how much alcohol is safe for you to have while taking Aubagio.

Pregnancy and breastfeeding while taking Aubagio

You shouldn’t take Aubagio if you’re pregnant or planning to become pregnant. The same goes if you’re breastfeeding or planning to breastfeed.

Aubagio may cause harm to a fetus if taken during pregnancy. Because of this risk, the drug has a boxed warning for risk of fetal harm. For more information, see “Risk of fetal harm” below.

It isn’t known if Aubagio passes into breast milk or what effects it may have on a breastfed child. But it’s possible that serious side effects may occur in a child who’s breastfed by someone taking the drug. For this reason, you shouldn’t breastfeed while taking Aubagio.

If you have any questions about pregnancy or breastfeeding while taking Aubagio, talk with your doctor.

Risk of fetal harm

Aubagio has a boxed warning for risk of fetal harm. This is the most serious warning from the FDA.

Aubagio may cause harm to a fetus if taken during pregnancy. Because of this, females* who are pregnant or planning to become pregnant shouldn’t use this drug.

* In this article, we use the terms “female” and “male” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.

For females

If you can become pregnant, your doctor will likely give you a pregnancy test. This is to make sure that you’re not pregnant before starting Aubagio treatment. They’ll also recommend that you use birth control to prevent pregnancy while taking Aubagio.

If you wish to stop taking Aubagio, your doctor may recommend that you take a medication to rid your body of the drug. This helps decrease the risk of the drug affecting your developing fetus if you become pregnant.

If you become pregnant while taking Aubagio, contact your doctor. They’ll likely have you stop Aubagio treatment. They’ll also have you take a medication that rids your body of Aubagio to decrease risk of harm to the fetus.

In addition, your doctor may suggest that you sign up for a pregnancy registry. This registry is a collection of data from females who became pregnant while taking Aubagio. The data can be used to determine the possible risks of taking Aubagio during pregnancy. You can sign up for the pregnancy registry by calling 800-745-4447.

For males

If you’re a male who’s planning a pregnancy, you should talk with your doctor. They may recommend that you stop taking Aubagio and prescribe a medication to rid your body of the drug. They may also suggest blood tests to monitor how much medication is left in your body. They’ll let you know when it’s safe to conceive.

Side effects that people have while taking Aubagio tend to be mild. But some people can develop more serious side effects. You may want to ask your doctor certain questions about what side effects you’re likely to have. Here are some examples to get you started:

  • Can my risk of side effects increase with the Aubagio 14-milligram (mg) tablets compared with the 7-mg tablets?
  • What should I do if I become pregnant while I’m taking Aubagio?
  • How should I treat side effects that I have from taking Aubagio?
  • Do my other medical conditions increase my risk of certain side effects?

For multiple sclerosis (MS) treatment updates and tips for self-care, sign up for Healthline’s MS newsletter.

Q:

Can Aubagio weaken my immune system or increase my risk of infection?

Anonymous patient

A:

Aubagio can cause decreased blood levels of white blood cells. This can lead to an increased risk of infection.

Before you start taking Aubagio, your doctor will check your white blood cell counts. This involves taking a blood sample.

If you have any symptoms of an infection while taking Aubagio, talk with your doctor right away. Symptoms may include fever, tiredness, chills, and body aches.

Neal Patel, PharmDAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.