Cladribine is used to treat relapsing forms of multiple sclerosis (a certain type of disease affecting the brain and/or spinal cord), including relapsing-remitting disease and active secondary progressive disease.
Take Cladribine exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.
You may take this medicine with or without food. Try to take it at the same time each day.
Swallow the tablet whole with a glass of water. Do not chew, divide, or crush the tablet.
Once you remove the tablet from the blister pack, swallow it immediately. Tablets must not be handled longer than required or left exposed on surfaces. Avoid touching your nose, eyes, or other areas of your body. Wash your hands and any surface that came in contact with the tablet thoroughly.
Ensure that your hands are dry when handling the tablet and wash thoroughly afterwards.
Take the missed dose as soon as you remember on the same day you were supposed to take it.
If you miss a dose and do not remember it until the following day, do not take the missed dose together with the next scheduled dose. Take the missed dose on the next day and extend the number of days in that treatment week.
DO NOT double a dose under any circumstances.
If you often forget to take your medicine, let your doctor and pharmacist know.
Alert your doctor if you have the following conditions:
- HIV infection
- active tuberculosis
- active inflammation of the liver known as hepatitis
- active cancer
- weakened immune system
- moderate to severe kidney disease
as Cladribine may not be suitable for you.
Do not take this medicine if you are pregnant or planning to have a baby soon. If you become pregnant while on Cladribine therapy, alert your doctor immediately. This medicine may cause harm to your unborn child.
Men should not father a child while being treated with Cladribine. Both men and women must use proven birth control methods during Cladribine therapy and for at least 6 months after stopping the treatment. Birth control medicines containing hormones may not be effective. You may wish to discuss other reliable methods of birth control with your doctor.
Do not breastfeed while you are being treated with this medicine and for at least 10 days after your last dose.
Alert your doctor if you have been recently vaccinated. You must avoid any vaccinations without consulting with your doctor.
Do not take Cladribine with medicines that may weaken the immune system or affect the production of blood cells in the bone marrow. Please see the section “Can I take this with other medicines?” below for more information.
Inform your doctor if you have the following conditions:
- previously had a cancer
- active infection or with signs and symptoms of infection
- moderate to severe liver disease
- no previous exposure to shingles or chickenpox
If you are undergoing a blood transfusion, inform your doctor that you are taking Cladribine.
Why is it important to keep my appointments with the doctor?
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Pregnancy test must be done before each treatment course to know if this medicine is suited for you to take.
- Screening for the presence of cancer, HIV infection, tuberculosis or hepatitis may be done prior to initiating each treatment course.
- Your doctor may need to perform a head MRI (magnetic resonance imaging) before you start your treatment with this medicine.
- Routine tests (e.g. complete blood count, liver function) may be done before and during your treatment with Cladribine. Your doctor will advise you about how often you need to have these tests.
- Regular monitoring for signs of infection may also be needed.
Cladribine may cause any of the following side effects: headache, cold sores, nausea, back or joint pain, rashes, hair loss, and difficulty sleeping.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- signs of shingles e.g. fever, severe pain and blistering rash usually on one side of the upper body or the face; burning, tingling, numbness, or itching of the skin at the affected area
- shortness of breath, chest pain, fast or irregular heartbeat
- yellowing of the skin or eyes, dark coloured urine, tiredness, swelling in the legs and ankles
- blurred or double vision, confusion, memory loss, problems with balance, trouble speaking or thinking, persistent numbness, weakness in arms or legs, loss of sensation
This medicine will cause the level of your white blood cells to drop.
White blood cells help your body to fight infections. A fall in the level of your white blood cells may put you at higher risk for infections, such as coughs, colds and flu, which may lead to more serious infections. Avoid crowded places and people who are sick. Alert your doctor if you have a fever, or a cough or flu that does not go away.
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Avoid vaccinations during treatment with Cladribine. Alert your doctor if you have been recently vaccinated or if you are planning to get vaccinated.
Do not take Cladribine with the following medicines:
- medicines used in organ transplant or certain immune disorders e.g. azathioprine, ciclosporin
- medicines for cancer e.g. cyclophosphamide, methotrexate
- anti-inflammatory medicines (long-term use) e.g. prednisone
Inform your doctor and pharmacist if you are taking any of these medicines:
- medicines for high blood pressure e.g. nifedipine, nimodipine, reserpine
- carbamazepine (medicine for fits or seizures)
- rifampicin (medicine to treat TB, an infection known as tuberculosis)
- St. John’s wort (herbal medicine)
This list does not include all medicines that may interact with Cladribine.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements and medicines that you buy without a prescription.
Store in a cool, dry place away from the reach of children.
Medicines must not be used past the expiry date.
Keep tablets in their original package to protect from moisture.
Always return any unused or expired tablets to the clinic, hospital, or pharmacy for disposal. Do not throw it away in the household waste.