Cladribine Treatment: Dosage, Side Effects & Benefits for MS

Summary of Key Points

Cladribine is a prescription medication used to treat certain cancers and multiple sclerosis (MS). It works by reducing the number of abnormal cells in the body. Cladribine is commonly prescribed for conditions such as hairy cell leukemia, multiple sclerosis, and other blood-related cancers. Always consult your healthcare provider before starting or adjusting your dose. You can also speak with one of our providers through telemedicine for personalized advice on Cladribine treatment.

Names of Medication

US Brand Name: Mavenclad

Generic Name: Cladribine

The generic name refers to the chemical composition of the drug, while the brand name is assigned by the manufacturer. The generic name is listed in parentheses.

Pharmacologic Category

Categories:

1. Antineoplastic Agent
2. Antimetabolite
3. Pyrimidine Analog

Cladribine Dosage

Cladribine is prescribed for various conditions, each with its own dosing schedule. It’s essential to follow your doctor’s instructions carefully and never alter your dose without consulting them first. You can also schedule a telemedicine appointment with one of our providers to discuss your Cladribine treatment plan.

Cladribine for Multiple Sclerosis (MS)

Dosage: 3.5 mg/kg over 2 years, divided into two yearly treatment courses.

Frequency: Two treatment cycles per year, each lasting 4-5 days.

Length of Treatment: 2 years.

Cladribine for Hairy Cell Leukemia

Dosage: 0.09 mg/kg/day.

Frequency: Administered daily for 7 days via continuous intravenous infusion.

Length of Treatment: 7 days.

Cladribine for Chronic Lymphocytic Leukemia (CLL)

Dosage: 0.12 mg/kg/day.

Frequency: Administered daily for 5 days via intravenous infusion.

Length of Treatment: 5 days.

Cladribine for Non-Hodgkin Lymphoma

Dosage: 0.1 mg/kg/day.

Frequency: Administered daily for 5 days via intravenous infusion.

Length of Treatment: 5 days.

Cladribine for Acute Lymphoblastic Leukemia (ALL)

Dosage: 0.1 mg/kg/day.

Frequency: Administered daily for 7 days via intravenous infusion.

Length of Treatment: 7 days.

Cladribine for Myelodysplastic Syndromes (MDS)

Dosage: 0.1 mg/kg/day.

Frequency: Administered daily for 5 days via intravenous infusion.

Length of Treatment: 5 days.

Cladribine for Acute Myeloid Leukemia (AML)

Dosage: 0.1 mg/kg/day.

Frequency: Administered daily for 7 days via intravenous infusion.

Length of Treatment: 7 days.

Cladribine for Lymphocytic Leukemia

Dosage: 0.1 mg/kg/day.

Frequency: Administered daily for 5 days via intravenous infusion.

Length of Treatment: 5 days.

Cladribine for T-cell Lymphomas

Dosage: 0.1 mg/kg/day.

Frequency: Administered daily for 5 days via intravenous infusion.

Length of Treatment: 5 days.

Cladribine for B-cell Lymphomas

Dosage: 0.1 mg/kg/day.

Frequency: Administered daily for 5 days via intravenous infusion.

Length of Treatment: 5 days.

Dosage Forms and Strengths

Available Forms:

1. Tablets: 10 mg (Cladribine tablets)
2. Injection: 1 mg/mL in 10 mL vials

Administration Instructions for Cladribine

Cladribine can be taken orally (as Cladribine tablets) or administered intravenously (as an injection). For the oral form, swallow the tablet whole with water. Do not crush, chew, or break the tablet. If receiving the intravenous form, it will be administered by a healthcare professional. Always follow your doctor’s instructions, and if you have any questions, consult one of our providers through telemedicine.

Contraindications for Cladribine

A contraindication is a condition where a medication should not be used due to potential harm. Before starting Cladribine, discuss your medical history with your healthcare provider to ensure it is safe for you.

Key Contraindications for Cladribine

Pregnancy: Cladribine can harm an unborn baby. It is contraindicated in pregnant women due to the risk of birth defects or miscarriage.

Breastfeeding: Cladribine is contraindicated during breastfeeding as it may pass into breast milk and harm the infant.

Active infections: Cladribine suppresses the immune system, making it harder to fight infections. If you have an active infection, Cladribine could worsen your condition.

HIV or other immunodeficiency conditions: Cladribine weakens the immune system, which can be dangerous for individuals with immunodeficiencies like HIV.

Severe liver or kidney disease: Cladribine is processed by the liver and kidneys. If these organs are not functioning properly, the medication may accumulate, leading to toxicity.

Drug-to-Drug Interactions

Cladribine can interact with other medications, increasing the risk of side effects or reducing treatment effectiveness. Inform your healthcare provider about all medications you are taking, including over-the-counter drugs, supplements, and herbal products.

Medications That May Interact with Cladribine

Immunosuppressants: Drugs like Cyclosporine (Neoral, Sandimmune) or Tacrolimus (Prograf) can increase the risk of infections when taken with Cladribine.

Live vaccines: Vaccines such as MMR (measles, mumps, rubella) or Varicella (chickenpox) should be avoided while taking Cladribine, as your immune system may not respond properly, potentially causing the infection the vaccine is meant to prevent.

Antiviral medications: Drugs like Acyclovir (Zovirax) or Valacyclovir (Valtrex) may interact with Cladribine, increasing the risk of side effects such as bone marrow suppression.

Other chemotherapy drugs: Medications like Methotrexate (Trexall) or Cyclophosphamide (Cytoxan) may increase the risk of severe bone marrow suppression when used with Cladribine.

Cladribine in Pregnancy

Is Cladribine Safe During Pregnancy?

No, Cladribine is not considered safe during pregnancy. Research indicates that Cladribine can harm a developing fetus, potentially leading to birth defects or miscarriage. Women of childbearing age should use reliable contraception while undergoing Cladribine treatment and for at least six months after the final dose. If you are pregnant or planning to become pregnant, it is essential to consult your healthcare provider to discuss alternative treatment options.

Cladribine While Breastfeeding

Can You Take Cladribine While Breastfeeding?

No, Cladribine is not recommended while breastfeeding. The medication may pass into breast milk and could pose a risk to a nursing infant. Women should avoid breastfeeding during Cladribine treatment and for at least one week after the last dose. If you are currently breastfeeding, speak with your healthcare provider to explore safer alternatives.

Estimated Cost of Cladribine Medication

The cost of a 30-day supply of Cladribine tablets without insurance can vary significantly. With a GoodRx coupon, the estimated price ranges from $10,000 to $15,000 for a 30-day supply. Prices may differ depending on the pharmacy and location. It is advisable to check with your local pharmacy for the most accurate pricing information.

Possible Alternatives to Cladribine

If Cladribine is not suitable for you, there are alternative treatments available for the conditions it addresses. Always consult your healthcare provider before making any changes to your treatment plan. You may also consider scheduling a telemedicine appointment to discuss your options in more detail.

Multiple Sclerosis (MS)

Alternative medications: Interferon beta (Avonex, Rebif), Glatiramer acetate (Copaxone), Fingolimod (Gilenya)

Lifestyle changes: Incorporating regular exercise, maintaining a balanced diet, and managing stress can help alleviate symptoms of multiple sclerosis.

Hairy Cell Leukemia

Alternative treatments: Pentostatin (Nipent), Rituximab (Rituxan)

Lifestyle changes: Following a nutritious diet and practicing good hygiene to prevent infections can support your overall health during treatment.

Chronic Lymphocytic Leukemia (CLL)

Alternative treatments: Ibrutinib (Imbruvica), Venetoclax (Venclexta)

Lifestyle changes: Engaging in regular physical activity and eating a healthy diet can enhance your quality of life during CLL treatment.

Non-Hodgkin Lymphoma

Alternative treatments: Rituximab (Rituxan), Bendamustine (Treanda)

Lifestyle changes: Managing stress and staying physically active can improve your overall well-being during non-Hodgkin lymphoma treatment.

Acute Lymphoblastic Leukemia (ALL)

Alternative treatments: Blinatumomab (Blincyto), Inotuzumab ozogamicin (Besponsa)

Lifestyle changes: Maintaining a healthy diet and engaging in regular exercise may help support your body during ALL treatment.

Myelodysplastic Syndromes

Alternative treatments: Azacitidine (Vidaza), Lenalidomide (Revlimid)

Lifestyle changes: Avoiding infections and following a balanced diet can help manage symptoms of myelodysplastic syndromes.

Acute Myeloid Leukemia (AML)

Alternative treatments: Cytarabine (Cytosar-U), Daunorubicin (Cerubidine)

Lifestyle changes: Maintaining a healthy weight and avoiding tobacco use can improve treatment outcomes for AML.

Lymphocytic Leukemia

Alternative treatments: Fludarabine (Fludara), Alemtuzumab (Campath)

Lifestyle changes: Staying active and following a nutritious diet can support your overall health during lymphocytic leukemia treatment.

T-cell Lymphomas

Alternative treatments: Pralatrexate (Folotyn), Romidepsin (Istodax)

Lifestyle changes: Regular physical activity and a healthy diet can enhance your quality of life during T-cell lymphoma treatment.

B-cell Lymphomas

Alternative treatments: Rituximab (Rituxan), Ibrutinib (Imbruvica)

Lifestyle changes: Managing stress and maintaining a healthy lifestyle can complement your B-cell lymphoma treatment plan.

Recent Updates on Cladribine Research

Recent studies have focused on the long-term safety and effectiveness of Cladribine, particularly in treating multiple sclerosis (MS). Research shows that Cladribine can significantly reduce the frequency of relapses and slow the progression of disability in patients with relapsing MS. Ongoing studies are also investigating Cladribine’s potential in treating other autoimmune conditions.

For patients with hairy cell leukemia, recent research continues to affirm that Cladribine remains one of the most effective treatments, with high rates of complete remission. However, researchers are exploring ways to minimize long-term side effects, such as secondary cancers and infections.

Staying informed about the latest research is essential. Be sure to discuss any new treatment options with your healthcare provider. If you have questions or concerns about your current treatment plan, consider scheduling a telemedicine appointment with one of our providers today.

James Kingsley

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