Mavenclad (cladribine)

Reviewed by: HU Medical Review Board | Last reviewed: April 2023

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

Mavenclad is a short-course treatment that requires a maximum of 10 days of oral therapy to deliver 2 years of clinical benefit to a patient. The US Food and Drug Administration (FDA) has approved Mavenclad, which has been available in 50 countries 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
  • Having lower-than-normal number of lymphocytes, a type of white blood cell, in the blood (lymphopenia)

Mavenclad has a boxed warning, the strictest warning from the FDA. It has this warning because it can increase your risk of developing cancer. It also has this warning because animal studies show that it harms unborn babies. It should not be used by anyone who is pregnant or does not plan to use effective contraception during or for 6 months after the last dose in a course of treatment.2

These are not all the possible side effects of Mavenclad. Talk to your doctor about what to expect when taking Mavenclad. You also should call your doctor if you have any changes that concern you when taking Mavenclad.

Other things to know about Mavenclad

Mavenclad is a purine antimetabolite. It contains the nucleoside metabolic inhibitor cladribine.2

Before starting Mavenclad, your doctor should assess the appropriateness of the treatment and consider any other conditions you may have. This includes presence or history of cancer, pregnancy, full blood counts, infections, or liver injury.2

Be sure to talk with your doctor if you:2

  • Have cancer
  • Are pregnant or planning to get pregnant
  • Have HIV
  • Have chronic infections such as hepatitis or TB
  • Have a history of hypersensitivity to cladribine
  • Intend to breastfeed

People 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).2

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

Talk to your doctor if you take certain antiviral or antiretroviral drugs, as they may affect the effectiveness of Mavenclad. Also tell them if you take certain immunosuppressive, myelosuppressive, or immunomodulatory drugs such as interferon beta, because use of Mavenclad at the same time can increase the risk of adverse reactions.2

Before beginning treatment for MS, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you are taking. This includes over-the-counter drugs.

For more information, read the full prescribing information of Mavenclad.

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