Mavenclad (cladribine) is a disease-modifying treatment for relapsing forms of multiple sclerosis (MS), including relapsing-remitting MS (RRMS) and active secondary progressive MS. It is a short-course oral treatment taken in two yearly courses, after which no further treatment is usually required for years.

Cladribine is a purine analogue that selectively depletes T-lymphocytes and B-lymphocytes (types of immune cells), reducing the immune activity that drives MS inflammation. Because these cells gradually recover, the treatment effect persists long after the tablets are stopped.

Mavenclad is taken as short courses of tablets, not as a daily ongoing medicine. The total treatment is given over two years:

• Year 1: two short treatment weeks (each week consists of 4 to 5 tablets taken over consecutive days), separated by approximately four weeks
• Year 2: the same two short treatment weeks are repeated

After completing both years, no further Mavenclad is given. The immune system gradually rebuilds, and the treatment effect typically lasts several more years.

Each daily tablet should be taken at least 3 hours before or after other oral medicines. Hands should be washed after handling tablets.

Do not take Mavenclad if you are pregnant or planning to become pregnant. Effective contraception is required during treatment and for 6 months after the last dose in each year.

If you miss a dose on a treatment day, take it on the next day and add a day to your treatment week. Do not take two tablets on the same day.

Contact your neurologist or a poison control centre immediately.

How Should You Store Mavenclad

• Store below 25°C
• Keep in the original blister pack to protect from moisture
• Keep out of reach of children
• Wash hands after handling tablets (avoid contact with skin and eyes)

Side effects occur mainly around the time of treatment.

Very common side effects:

• Low lymphocyte counts (lymphopenia): the intended immunological effect. Your blood count is monitored before, during, and after treatment
• Headache
  
  

Common side effects:

• Herpes virus reactivation (oral or genital herpes, or shingles): antiviral medicines may be prescribed if your lymphocytes fall very low
• Nausea

Serious side effects:

• Serious infections: very low lymphocyte counts increase infection risk. Report fever, cough, or unusual symptoms promptly
• Cancer risk: a slightly increased risk of malignancy has been observed in some studies. Your doctor will discuss this with you
• PML (progressive multifocal leukoencephalopathy): a rare but serious brain infection. Report any new neurological symptoms immediately

Blood tests are mandatory before each treatment year and at regular intervals during the monitoring period.

• Other immunosuppressants: increased risk of serious immune suppression
• Live vaccines: not permitted during or shortly after treatment
• Medicines that affect lymphocyte counts: discuss all medicines with your neurologist before starting

Your neurologist will review all your medicines before prescribing Mavenclad.

Do I really only need treatment for two years?

Yes, for most people. Mavenclad works by resetting parts of the immune system. After two short annual courses, the treatment is complete. The depleted immune cells gradually recover over the following months, but the benefit to MS disease activity typically lasts several more years without ongoing medicine. This is a significant practical advantage for some patients who prefer not to take daily or regular injections indefinitely.

Can I have children after Mavenclad?

You must avoid pregnancy during treatment and for 6 months after the last dose in each treatment year. After this period, pregnancy is not specifically contraindicated, but you should discuss your plans with your neurologist. Cladribine can stay in the body and harm a developing baby during treatment. Breastfeeding must also be avoided during treatment.

Ace provides accurate and independent information medically reviewed on prescription medications. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment.