Mavenclad (cladribine)

Reviewed by: HU Medical Review Board | Last reviewed: February 2022. | Last updated: October 2022

Mavenclad® is an approved oral medication indicated for relapsing forms of multiple sclerosis (MS). It includes the treatment of relapsing-remitting and active secondary progressive disease in adults. It comes in tablet form and is taken by mouth.1-3 Mavenclad is generally recommended for adults who have had an inadequate response to, or cannot tolerate, alternate drugs indicated for the treatment of MS. This is because of Mavenclad’s safety profile which can reduce the body’s immune defense system and increase risk of infections and malignancies.1-3

Manufactured by EMD Serono, the biopharmaceutical business of Merck KGaA, Mavenclad is a short-course treatment that requires a maximum of 20 days of oral therapy to deliver two years of clinical benefit to a patient. The FDA has approved Mavenclad which has been available in 50 countries, including the European Union (EU) since August 2017.1,2

What are the ingredients in Mavenclad?

The active ingredient in Mavenclad is cladribine.1-3

How does Mavenclad work?

It is thought that Mavenclad works by having cytotoxic (toxic to living cells) effects on B and T lymphocytes through impairment of DNA synthesis, resulting in depletion of lymphocytes. Lymphocytes are a type of white blood cell that plays a key role in the immune system’s inflammatory response. This depletion of B and T cells helps reduce inflammation and demyelination in the CNS.2

What are the possible side effects of Mavenclad?

Many clinical trials evaluated the safety and efficacy of Mavenclad. The most common side effects experienced by those taking Mavenclad include:2

  • Upper respiratory tract infection
  • Headache
  • Lymphopenia - having lower-than-normal number of lymphocytes, a type of white blood cell, in the blood

This is not an exhaustive list of all potential side effects of Mavenclad. For more information, consult your doctor or healthcare provider. If you notice any new or worsening side effects when taking Mavenclad, contact your doctor or healthcare provider promptly.

Things to note about Mavenclad

Mavenclad is a purine antimetabolite. It contains the nucleoside metabolic inhibitor cladribine.

Before starting Mavenclad, your doctor should assess the appropriateness of the treatment and consider any other conditions you may have and medications you may take. This includes presence or history of cancer, pregnancy, full blood counts, infections, or liver injury.

Be sure to talk with your doctor if you:2

  • Have a current malignancy
  • Are pregnant or planning to get pregnant, as Mavenclad may cause fetal harm. It should not be used by men or women who do not plan to use effective contraception during or for 6 months after the last dose in a course of treatment
  • Have HIV
  • Have chronic infections such as hepatitis or TB
  • Have a history of hypersensitivity to cladribine
  • Women intending to breastfeed should delay use until 10 days after the last dose
  • Take certain medications including immunosuppressive, myelosuppressive or some immunomodulatory drugs such as interferon beta, because use of Mavenclad at the same time can increase the risk of adverse reactions

Talk to your doctor if you take certain antiviral or antiretroviral drugs as they may affect the effectiveness of Mavenclad.

Individuals with the above conditions should be monitored closely while taking Mavenclad. Because of its safety profile, Mavenclad is not recommended for use in patients with clinically isolated syndrome (CIS).

All vaccines should be up to date prior to starting Mavenclad. Before starting Mavenclad, patients should be tested for varicella zoster virus and vaccinated if they are anti-body negative. Any live-attenuated or live vaccines should be given at least 4 to 6 weeks prior to starting Mavenclad to avoid risk of vaccine-related infection.2

For additional details, read the full prescribing information of Mavenclad available here.

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