Mavenclad is a brand-name prescription drug that’s FDA-approved to treat certain types of multiple sclerosis (MS) in adults. MS is a condition in which your immune system (your body’s defense against infection) mistakenly attacks your brain and spinal cord. MS may cause you to have changes in your vision, numbness, tingling, or trouble walking.

Mavenclad contains the active drug ingredient cladribine. It belongs to a class of medications called antimetabolites. (A class of medications is a group of drugs that work in a similar way.) Mavenclad works by decreasing the number of immune system cells that are attacking your body and causing your MS symptoms.

Mavenclad comes as a 10-mg tablet that you swallow. You’ll typically take the drug in cycles of a few days.

What it does

Mavenclad is used for relapsing forms of MS. With these forms, you have times when you have few or no symptoms (remission), followed by flare-ups during which your symptoms get worse (relapses). Mavenclad is approved to treat:

  • Relapsing-remitting MS. With relapsing-remitting MS (RRMS), your symptoms may flare up and then go into remission.
  • Active secondary progressive MS. RRMS can become secondary progressive MS (SPMS). With SPMS, you may feel like your symptoms always remain and get worse gradually. The disease doesn’t have periods of remission. “Active” means that your symptoms flare up or an MRI scan shows that the MS is more active.

Due to the side effects that Mavenclad can cause, you should take the drug only if you’ve tried other MS treatments that didn’t work or you couldn’t tolerate. Also, you shouldn’t use Mavenclad if you have clinically isolated syndrome (CIS), which can be the development of the first symptoms or episode of MS.

Effectiveness

A clinical trial looked at people with relapsing forms of MS, which includes RRMS and SPMS. The results showed that Mavenclad was effective at decreasing the frequency of MS relapses (flare-ups).

Over 96 weeks, people took either Mavenclad or a placebo (treatment with no active drug). In the study, 81% of people who took Mavenclad didn’t have a relapse. This means that during the study, they didn’t have times in which their MS symptoms got worse. However, only 63% of people who took a placebo had the same results.

Mavenclad is available only as a brand-name medication. It’s not currently available in generic form. A generic drug is an exact copy of the active drug in a brand-name medication.

Mavenclad contains the active drug ingredient cladribine.

The Food and Drug Administration (FDA) approves prescription drugs such as Mavenclad to treat certain conditions. Mavenclad may also be used off-label for other conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

MS explained

Mavenclad is FDA-approved to treat certain types of multiple sclerosis (MS). MS is a condition in which your own immune system (your body’s defense against infection) mistakenly attacks your body. Specifically, your immune system attacks the myelin sheath. This is the covering over your nerves that helps your brain and body communicate. When the myelin sheath is under attack, your brain and body have trouble communicating with each other. This may cause symptoms such as changes in vision, numbness, tingling, or trouble walking.

Types of MS

Mavenclad is approved by the FDA to treat the following types of relapsing forms of MS:

With RRMS, you may have periods when the disease gets worse (relapses) and then times when it doesn’t worsen (remission). RRMS can become SPMS. With SPMS, you may feel like your symptoms always remain and get worse gradually. The disease doesn’t have periods of remission. “Active” means that your symptoms flare up or an MRI scan shows that the MS is more active.

Due to the side effects that Mavenclad can cause, you should take the drug only if you’ve tried other MS treatments that didn’t work or you couldn’t tolerate. (For more about Mavenclad’s side effects, see the “Mavenclad side effects” section below.)

Also, because of the drug’s possible side effects, you shouldn’t use Mavenclad if you have clinically isolated syndrome (CIS). CIS is the first occurrence of MS-like symptoms. (CIS doesn’t always turn into MS.)

Effectiveness

A clinical trial looked at people with relapsing forms of MS, which includes RRMS and SPMS. The results showed that Mavenclad was effective at decreasing the frequency of MS relapses (flare-ups).

Over 96 weeks, people took either Mavenclad or a placebo (treatment with no active drug). In the study, 81% of people who took Mavenclad didn’t have a relapse. This means that during the study, they didn’t have times in which their MS symptoms got worse. However, only 63% of people who took a placebo had the same results.

In addition to the uses listed above, you may wonder if Mavenclad is used for certain other conditions.

Mavenclad for hairy cell leukemia (not an appropriate use)

The FDA has approved Mavenclad to treat only certain types of MS. However, cladribine (the active drug in Mavenclad) is approved to treat a kind of blood cancer called hairy cell leukemia. With this cancer, your body makes too many abnormal white blood cells. At this time, Mavenclad isn’t approved to treat hairy cell leukemia.

Mavenclad comes as a tablet that you swallow. Cladribine, on the other hand, comes as an intravenous (IV) liquid solution. It’s given as injection into your vein that’s slowly dripped in over time (infusion).

If you’re interested in cladribine or other treatments for hairy cell leukemia, talk with your doctor.

Mavenclad can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Mavenclad. These lists don’t include all possible side effects.

For more information on the possible side effects of Mavenclad, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs they have approved. If you would like to report to the FDA a side effect you’ve had with Mavenclad, you can do so through MedWatch.

Mild side effects

The mild side effects of Mavenclad that are more common* can include:

The mild side effects of Mavenclad that are less common** can include:

* Occurred in more than 20% of people in clinical studies

** Occurred in less than or equal to 20% of people in clinical studies

Most of these side effects may go away within a few days or a couple of weeks. But if they become more severe or don’t go away, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Mavenclad aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

  • Decreased level of lymphocytes (a type of white blood cell) or other cells in your blood. Symptoms can include:
  • Liver injury. Symptoms can include:
    • nausea or vomiting
    • belly pain
    • yellowing of your skin or white of your eyes
    • dark urine
    • loss of appetite

Other serious side effects, explained in more detail below in “Side effect details,” include:

* Mavenclad has boxed warnings for cancer and the risk of birth defects. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For more information, see “FDA warnings” at the beginning of this article.

Side effect details

You may wonder how often certain side effects occur with this drug, or whether certain side effects pertain to it. Here’s some detail on several of the side effects this drug may or may not cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Mavenclad. Clinical trials looked at people with relapsing forms of multiple sclerosis (MS), which includes relapsing-remitting MS (RRMS) and active secondary progressive MS (SPMS). For more about these MS forms, see the “What is Mavenclad?” section above.

About 11% of people who took Mavenclad reported having an allergic reaction. However, only 0.5% of people had a serious allergic reaction. In comparison, 7% of people who took a placebo (treatment with no active drug) had an allergic reaction. And 0.1% of people who took a placebo had a serious allergic reaction.

Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (warmth and redness in your skin)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing

Call your doctor right away if you have a severe allergic reaction to Mavenclad. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Hair loss

Hair loss is a rare side effect that may occur with Mavenclad. In clinical trials of people with relapsing forms of MS, only 3% of people who took the medication developed hair loss. About 1% of people who took a placebo also had hair loss.

If you develop hair loss that is significant or bothersome to you, talk with your doctor. They may be able to recommend treatments that may help.

Fatigue

Fatigue (a lack of energy) wasn’t a side effect reported by people who took Mavenclad. However, it’s a very common symptom of multiple sclerosis (MS). This may be because it takes extra energy for your brain and body to communicate with each other.

Fatigue also may be a symptom of some serious side effects of Mavenclad. For example, liver conditions and cancer* can cause you to feel more tired and worn out than usual. So although fatigue isn’t directly a side effect of Mavenclad, it could be a sign of something else that may be serious.

If you’re taking Mavenclad and have fatigue, especially if it’s worse than usual, talk with your doctor. They may be able to recommend ways to reduce your symptoms. They may also test your blood and screen you for cancer.

* Mavenclad has a boxed warning for cancer. This is the most serious warning from the FDA. For more information, see “FDA warnings” at the beginning of this article.

Heart problems

Heart problems such as heart failure are a very rare side effect of Mavenclad. Heart failure occurs when your heart doesn’t work as well as normal to pump blood throughout your body. In clinical trials of people with relapsing forms of MS, one person who took Mavenclad had serious heart failure. It’s not known if anyone who took a placebo developed heart failure.

Symptoms of heart failure can include:

  • trouble breathing
  • irregular heartbeat (your heart feels like it’s beating fast or skipping beats)
  • swelling in your arms or legs

If you develop any of these symptoms, see your doctor right away. They’ll likely test your heart to make sure it’s working properly.

Serious infections

Mavenclad use can increase the risk of developing an infection such as a cold. The drug can weaken your immune system, which decreases your body’s ability to fight infections. In clinical trials of people with relapsing forms of MS, 49% of people who took Mavenclad developed an infection. About 44% of people who took a placebo also had an infection.

Sometimes people developed infections that were serious. These included herpes virus infections such as shingles, a lung infection called tuberculosis (TB), or hepatitis, which affects your liver. For you to develop these infections, you must have previously been exposed to the bacteria or virus that causes them.

Clinical trials also found that:

  • About 6% of people who took Mavenclad developed a herpes virus infection. Of those people, 2% had shingles. In comparison, only 2% of people who took a placebo developed a herpes virus infection, and 0.2% of the people developed shingles.
  • Three people who took cladribine (the active drug in Mavenclad) developed TB. However, these people all lived in places where TB is often found. (TB isn’t very common in the United States.) One person died from their TB infection. It’s not known if anyone who took a placebo developed TB.
  • One person died from hepatitis B infection while taking Mavenclad. It’s not known if anyone who took a placebo developed hepatitis B.

Symptoms of serious infections can include:

  • fever
  • muscle pain
  • headache
  • decreased appetite
  • skin that feels like it’s burning, numb, or itchy

If you develop any of these symptoms of infections, tell your doctor right away. And for more information on infections and Mavenclad, see the “Mavenclad precautions” section below.

Progressive multifocal leukoencephalopathy (PML)

PML is a very rare but serious brain infection that can occur with Mavenclad in people with a weakened immune system. In clinical trials of people with relapsing forms of MS, no one who took Mavenclad developed PML. However, there have been reports of people who took cladribine for cancer and developed PML.

Before you start taking Mavenclad, you’ll have an MRI scan of your brain. Your doctor will be able to compare this scan with later scans to determine if there are any changes.

Symptoms of PML can include:

  • decreased strength or balance
  • changes in vision, thoughts, or memory
  • changes in personality
  • weakness on one side of your body
  • confusion

If you develop any symptoms of PML, it’s important to tell your doctor right away. They may have you stop taking Mavenclad.

Cancer

Cancer, including ovarian, pancreatic, and melanoma skin cancer, can occur with Mavenclad.* Cancer can occur because your immune system is weakened while you’re taking the drug. Although there’s an increased risk of developing cancer while taking Mavenclad, the risk is very small.

In clinical studies of people with relapsing forms of MS, 0.27 cases of cancer occurred in 100 patient years. This means that for every 100 years that someone takes Mavenclad, 0.27 cases of cancer will occur. In people who took a placebo, there were 0.13 cases of cancer per 100 patient years. However, people who took a placebo developed different types of cancer (cervical cancer and basal cell skin cancer) than people who took Mavenclad.

After you take Mavenclad for two treatment courses, you shouldn’t take the drug for 2 years. People who took Mavenclad sooner than 2 years after completing two treatment courses had an increased risk of developing cancer. In this group, there were 0.91 cases of cancer per 100 patient years. It is not known how many people taking a placebo (a pill with no active drug in it) also developed cancer.

You should never start taking Mavenclad if you have a current cancer. This is because Mavenclad weakens your immune system and may make your cancer worse.

Cancer symptoms

Symptoms of cancer can include:

  • a scab or cut on your skin that doesn’t heal
  • changes in the color or border of a mole
  • decreased appetite
  • nausea
  • fatigue (lack of energy)

Tell your doctor if you develop any of these symptoms while taking Mavenclad. They’ll likely test your blood or give you other tests to check for cancer.

* Mavenclad has a boxed warning for cancer. This is the most serious warning from the FDA. For more information, see “FDA warnings” at the beginning of this article.

Birth defects

Birth defects can occur if Mavenclad is taken during pregnancy.* It’s not known how many women had children with birth defects due to taking Mavenclad. However, animal studies show that birth defects can occur when a pregnant female takes Mavenclad.

Because of this risk, it’s important that you’re not pregnant or become pregnant while you’re taking Mavenclad. Both females and males taking Mavenclad should use effective birth control while taking Mavenclad and for at least 6 months after the last dose to prevent pregnancy.

For more information on the risks of birth defects while taking Mavenclad, see the “Mavenclad and pregnancy” section below.

* Mavenclad has a boxed warning for the risk of birth defects. This is the most serious warning from the FDA. For more information, see “FDA warnings” at the beginning of this article.

The Mavenclad dosage your doctor prescribes will depend on several factors. These include:

  • your body weight (doses are determined by your weight in kilograms, such as 3.5 mg/kg)
  • other medical conditions you may have

Typically, your doctor will start you on a low dosage. Then they’ll adjust it over time to reach the amount that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug forms and strengths

Mavenclad comes as a tablet that you swallow. It’s available in one strength: 10 mg.

Dosage for MS

The dosage for multiple sclerosis (MS) is based on your body weight. The recommended dose is 3.5 mg/kg. The total dosage is then divided into two treatment courses per year. Each treatment course has two cycles. The number of days that you take Mavenclad depends on your body weight.

Your doctor will determine the best schedule for you to take Mavenclad based on your body weight. However, this medication is usually taken as one to two tablets once a day. It may be taken over the course of 4 to 5 days. You shouldn’t take more than two tablets a day.

You can begin your second cycle of Mavenclad between 23 and 27 days after your last dose of the first cycle. After you complete one course of treatment, you’ll have a break from taking the medication.

After at least 43 weeks from your last dose of the first full treatment course, you can start the second course of treatment. This second course uses the same dose as your first course of treatment. The second cycle of the second course can begin 23 to 27 days after the last dose of the first cycle.

For example, if you weigh 150 pounds (about 68 kg), you’ll take six tablets with each cycle of treatment. Your medication plan would be as follows:

  • Treatment course 1, cycle 1: You’ll take one or two tablets a day for 4 to 5 days as directed by your doctor until you’ve taken a total of six tablets.
  • Treatment course 1, cycle 2: This cycle will start 23 to 27 days after your last dose of treatment course 1, cycle 1. You’ll take one or two tablets a day for 4 to 5 days as directed by your doctor until you’ve taken a total of six tablets.
  • Treatment course 2, cycle 1: This cycle will start at least 43 weeks after your last dose of treatment course 1, cycle 2. You’ll take one or two tablets a day for 4 to 5 days as directed by your doctor until you’ve taken a total of six tablets.
  • Treatment course 2, cycle 2: This cycle will start 23 to 27 days after your last dose of treatment course 2, cycle 1. You’ll take one or two tablets a day for 4 to 5 days as directed by your doctor until you’ve taken a total of six tablets.

If you have any questions about when you’re supposed to take Mavenclad, talk with your doctor or pharmacist. They’ll be able to walk you through how many tablets you should take on each day of each treatment.

What if I miss a dose?

If you miss a dose of medication, you should take your dose the next day. However, if this happens, you’ll be taking your medication for 1 day longer in that treatment cycle. If you miss two doses in a row, you should start taking Mavenclad the next day, and your treatment cycle will be 2 days longer in that case. It’s important never to take two doses in 1 day.

It’s a good idea talk with your doctor if you miss taking a dose of Mavenclad. They can help explain when to take the rest of your doses and how your treatment schedule will need to be adjusted.

To help make sure that you don’t miss a dose, try setting a reminder on your phone. You may also find it helpful to write your treatment schedule on a calendar or use a medication timer.

Will I need to use this drug long term?

Mavenclad can work over a long period of time. In a clinical trial, the drug was effective at decreasing the number of relapses people had over the course of 96 weeks.

However, after your second course of treatment, you shouldn’t take another course of Mavenclad for at least 2 years. This is because taking more medication during the 2 years after your first two treatment courses are complete can increase your risk of developing cancer.* It’s not known if Mavenclad can be restarted safely after a 2-year break.

* Mavenclad has a boxed warning for cancer. This is the most serious warning from the FDA. For more information, see “FDA warnings” at the beginning of this article.

Other drugs are available that can treat your condition. Some may be a better fit for you than others. If you’re interested in finding an alternative to Mavenclad, talk with your doctor. They can tell you about other medications that may work well for you.

Note: Some of the drugs listed here are used off-label to treat this specific condition. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Alternatives for MS

Examples of other drugs that may be used to treat relapsing multiple sclerosis (MS) include:

  • fingolimod (Gilenya)
  • dimethyl fumarate (Tecfidera)
  • teriflunomide (Aubagio)
  • ocrelizumab (Ocrevus)
  • alemtuzumab (Lemtrada)
  • natalizumab (Tysabri)
  • interferon beta-1a (Avonex)
  • interferon beta-1b (Betaseron)
  • glatiramer acetate (Copaxone)
  • peginterferon beta-1a (Plegridy)
  • siponimod (Mayzent)

You may wonder how Mavenclad compares with other medications that are prescribed for similar uses. Here we look at how Mavenclad and Ocrevus are alike and different.

Ingredients

The active ingredient in Mavenclad is cladribine. The active ingredient in Ocrevus is ocrelizumab.

Uses

Here’s some information about the uses of Mavenclad and Ocrevus.

What Mavenclad is used for

The Food and Drug Administration (FDA) has approved Mavenclad to treat certain types of multiple sclerosis (MS) in adults. MS is a condition in which your immune system (your body’s defense against infection) mistakenly attacks your brain and spinal cord. MS may cause you to have changes in your vision, numbness, tingling, or trouble walking.

Mavenclad is used for relapsing forms of MS. With these forms, you have times when you have few or no symptoms (remission), followed by flare-ups during which your symptoms get worse (relapses). Mavenclad is approved to treat:

  • Relapsing-remitting MS. With relapsing-remitting MS (RRMS), your symptoms may flare up and then go into remission.
  • Active secondary progressive MS. RRMS can become secondary progressive MS (SPMS). With SPMS, you may feel like your symptoms always remain and get worse gradually. The disease doesn’t have periods of remission. “Active” means that your symptoms flare up or an MRI scan shows that the MS is more active.

Because of the side effects that Mavenclad can cause, you should take the drug only if you’ve tried other MS treatments that didn’t work or you couldn’t tolerate. Also, you shouldn’t use Mavenclad if you have clinically isolated syndrome (CIS), which can be the development of the first symptoms or episode of MS.

What Ocrevus is used for

Ocrevus is approved for use in adults with the following:

  • RRMS
  • active SPMS
  • CIS
  • primary progressive MS (This type of MS keeps getting worse from when you’re first diagnosed, but you may have short times when your symptoms don’t worsen.)

Drug forms and administration

Mavenclad comes as a tablet that you swallow.

Ocrevus is given by a healthcare provider as an intravenous (IV) infusion. This is an injection into your vein that’s slowly dripped in over time.

Side effects and risks

Mavenclad and Ocrevus both contain drugs to treat MS. Therefore, these medications can cause some similar side effects, but some different ones as well. Below are examples of these side effects.

Mild side effects

These lists contain examples of mild side effects that can occur with Mavenclad, with Ocrevus, or with both drugs (when taken individually).

Serious side effects

These lists contain examples of serious side effects that can occur with Mavenclad, with Ocrevus, or with both drugs (when taken individually).

* Mavenclad has boxed warnings for cancer and the risk of birth defects. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For more information, see “FDA warnings” at the beginning of this article.

Effectiveness

The only condition both Mavenclad and Ocrevus are used to treat is MS.

These drugs haven’t been directly compared in clinical studies, but studies have found both Mavenclad and Ocrevus to be effective for treating certain forms of MS.

Costs

Mavenclad and Ocrevus are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

According to estimates on WellRx.com, a year of Mavenclad tablets costs significantly more than a year of Ocrevus IV infusions. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

Like Ocrevus (above), the drug Mayzent has uses similar to those of Mavenclad. Here’s a comparison of how Mavenclad and Mayzent are alike and different.

Ingredients

The active ingredient in Mavenclad is cladribine. The active ingredient in Mayzent is siponimod.

Uses

Here’s some information about the uses of Mavenclad and Mayzent.

What Mavenclad is used for

The Food and Drug Administration (FDA) has approved Mavenclad to treat certain types of multiple sclerosis (MS) in adults. MS is a condition in which your immune system (your body’s defense against infection) mistakenly attacks your brain and spinal cord. MS may cause you to have changes in your vision, numbness, tingling, or trouble walking.

Mavenclad is used for relapsing forms of MS. With these forms, you have times when you have few or no symptoms (remission), followed by flare-ups during which your symptoms get worse (relapses). Mavenclad is approved to treat:

  • Relapsing-remitting MS. With relapsing-remitting MS (RRMS), your symptoms may flare up and then go into remission.
  • Active secondary progressive MS. RRMS can become secondary progressive MS (SPMS). With SPMS, you may feel like your symptoms always remain and get worse gradually. The disease doesn’t have periods of remission. “Active” means that your symptoms flare up or an MRI scan shows that the MS is more active.

Because of the side effects that Mavenclad can cause, you should take the drug only if you’ve tried other MS treatments that didn’t work or you couldn’t tolerate. Also, you shouldn’t use Mavenclad if you have clinically isolated syndrome (CIS), which can be the development of the first symptoms or episode of MS.

What Mayzent is used for

Mayzent is approved to treat adults with the following types of relapsing MS:

  • RRMS
  • active SPMS
  • CIS

Drug forms and administration

Both Mavenclad and Mayzent come as tablets that you swallow.

Side effects and risks

Mavenclad and Mayzent both contain drugs that treat MS. Therefore, these medications can cause some similar side effects, but some different ones as well. Below are examples of these side effects.

Mild side effects

These lists contain examples of mild side effects that can occur with Mavenclad, with Mayzent, or with both drugs (when taken individually).

Serious side effects

These lists contain examples of serious side effects that can occur with Mavenclad, with Mayzent, or with both drugs (when taken individually).

* Mavenclad has boxed warnings for cancer and the risk of birth defects. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For more information, see “FDA warnings” at the beginning of this article.

Effectiveness

The only condition both Mavenclad and Mayzent are used to treat is MS.

These drugs haven’t been directly compared in clinical studies, but studies have found both Mavenclad and Mayzent to be effective for treating certain forms of MS.

Costs

Mavenclad and Mayzent are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

According to estimates on WellRx.com, Mavenclad costs significantly more than Mayzent. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

There are no known interactions between Mavenclad and alcohol. However, Mavenclad can cause liver injury, which may be worsened by alcohol.

Talk with your doctor about what amount of alcohol is safe to drink while you’re taking Mavenclad.

Mavenclad can interact with several other medications. It’s not known to interact with supplements or foods.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase the number of side effects or make them more severe.

Mavenclad and other medications

Below is a list of medications that can interact with Mavenclad. This list doesn’t contain all drugs that may interact with Mavenclad.

Before taking Mavenclad, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Mavenclad and other drugs that weaken your immune system

Mavenclad works to treat your multiple sclerosis (MS) by weakening your immune system. However, taking Mavenclad along with other medications that may weaken your immune system can make your body unable to fight infections. This can lead to serious side effects, such as developing an infection (such as shingles) that your body can’t fight. (For more about the side effects of Mavenclad, see the “Mavenclad side effects” section above.)

Examples of medications that can weaken your immune system include:

  • corticosteroids (used long term), such as:
    • prednisone (Rayos)
    • methylprednisolone (Medrol, Solu-Medrol)
  • other drugs, such as:
    • tacrolimus (Prograf)
    • sirolimus (Rapamune)

It’s not recommended that you take any other drugs that can weaken your immune system while using Mavenclad. However, if you need a steroid, such as prednisone, for short-term use, it’s fine to take it while you’re using Mavenclad.

Before you start taking Mavenclad, talk with your doctor about any other medications you take. Be sure to tell them about drugs you use to treat your MS, even ones that you’ve stopped taking. Sometimes these medications can stay in your body for weeks even after you’ve stopped using them, and they can be affected by Mavenclad.

Mavenclad and interferon-beta

It’s not recommended that you take Mavenclad with interferon-beta medications. Taking them together can increase your risk of side effects. (For more about the side effects of Mavenclad, see the “Mavenclad side effects” section above.) Both Mavenclad and interferon-beta drugs can lower your level of lymphocytes (a type of white blood cell). Having a low white blood cell count can increase your risk for infections, so you may get sick more easily than usual.

Examples of interferon-beta medications include:

  • peginterferon beta-1a (Plegridy)
  • interferon beta-1a (Avonex)
  • interferon beta-1b (Betaseron)

Before starting Mavenclad treatment, talk with your doctor about any other medications that you take. And be sure to tell them about any drugs that you recently stopped taking. These medications can stay in your body for weeks and may still be having an effect after your last dose.

Mavenclad and drugs that affect your blood cells

If you’re taking any medications that can affect your blood cells while you’re taking Mavenclad, talk with your doctor. Mavenclad can affect a specific type of white blood cell called a lymphocyte. However, Mavenclad can also affect other blood cells, such as platelets, which help your blood clot if you’re bleeding.

So if you’re taking Mavenclad along with another medication that can also affect your blood cells, you’re at an even higher risk for side effects. (For more about the side effects of Mavenclad, see the “Mavenclad side effects” section above.) It’ll be easier for your body to be affected by the medications, and your blood cell levels may decrease.

Examples of drugs that affect your blood cells can include:

Before you start taking Mavenclad, be sure to tell your doctor what other medications you’re taking. If you need to take other drugs that affect your blood during your Mavenclad treatment, your doctor may monitor your blood levels to make sure that they aren’t decreasing too much.

Mavenclad and certain HIV drugs

You shouldn’t take certain HIV medications while you’re using Mavenclad. Some HIV drugs need to be activated by a specific enzyme before they can work. (An enzyme is a protein that aids chemical changes in your body.) Mavenclad also needs to be activated by the same enzyme. So if you take both Mavenclad and the HIV drug, they’ll compete against each other to become activated by the enzyme. If this occurs, you may not get enough of either medication in your body. This means that neither Mavenclad nor the HIV drug may work as well as it should.

Examples of HIV medications that you should avoid while you’re taking Mavenclad include:

  • lamivudine (Epivir)
  • ribavirin (Ribasphere)
  • stavudine (Zerit)
  • zidovudine (Retrovir)

If you need to take an HIV drug while taking Mavenclad, your doctor may recommend a medication that doesn’t interact with Mavenclad.

Mavenclad and rifampin

If you’re taking rifampin (Rimactane), talk with your doctor before starting Mavenclad treatment. Rifampin may decrease the level of Mavenclad in your body. This means that Mavenclad may not work as well to treat your MS. Your doctor may have you take a medication other than rifampin that doesn’t interact with Mavenclad.

Before using Mavenclad, be sure to talk with your doctor about any medications that you’re taking.

Mavenclad and drugs that can increase the effects of Mavenclad

Taking Mavenclad with certain medications may raise Mavenclad to a dangerous level in your body. This can increase the number of side effects or make them more severe. (For more about the side effects of Mavenclad, see the “Mavenclad side effects” section above.)

Examples of drugs that can increase the effects of Mavenclad include:

Before you start using Mavenclad, tell your doctor if you’re taking any of these medications. They can adjust your treatment as needed or switch you to different medications.

Mavenclad and birth control

Mavenclad may affect how well your birth control works, meaning that it may not prevent pregnancy. This includes birth control in pill, patch, or injectable form.

Examples of birth control that can interact with Mavenclad include:

  • medroxyprogesterone acetate (Depo-Provera)
  • ethinyl estradiol/norethindrone (Junel)
  • estradiol patch (Vivelle-Dot)
  • drospirenone/ethinyl estradiol (Yaz)

For more information on using birth control while taking Mavenclad, see the “Mavenclad and birth control” section below.

Mavenclad and herbs and supplements

Mavenclad can interact with certain herbs and supplements.

Curcumin

You shouldn’t take a curcumin supplement while you’re using Mavenclad. (Curcumin is the active ingredient in a spice called turmeric.) Curcumin may increase the level of Mavenclad in your body. This can cause an increased risk of side effects. (For more about the side effects of Mavenclad, see the “Mavenclad side effects” section above.)

If you’re taking Mavenclad, talk with your doctor before taking any supplements with curcumin in them. Your doctor may recommend a different supplement or medication for you to take instead of curcumin. But if you’re taking curcumin, they may monitor you more often for side effects or have you space out the dosing of curcumin and Mavenclad.

St. John’s wort

Before you start your Mavenclad treatment, be sure to tell your doctor if you’re taking St. John’s wort. This herb can decrease the level of Mavenclad in your body, so Mavenclad may not work as well to treat your MS.

Tell your doctor about any supplements that you’re taking before starting to use Mavenclad. They’ll be able to tell you if they interact with Mavenclad and if they’re safe to take together.

Mavenclad and foods

While taking Mavenclad, avoid consuming foods that contain the spice turmeric. This often includes curries.

Curcumin, the active ingredient in turmeric, can increase the level of Mavenclad in your body. This can put you at a higher risk for side effects from Mavenclad. (For more about the side effects of Mavenclad, see the “Mavenclad side effects” section above.)

If you have questions about what you should or shouldn’t eat during your Mavenclad treatment, talk with your doctor or pharmacist.

Mavenclad may cause the level of your lymphocytes (a type of white blood cell) to decrease. This means you may get infections more easily than usual. If your lymphocyte level falls below 200 cells/mL, your doctor may recommend an anti-herpes medication such as valacyclovir (Valtrex). This type of drug may help prevent you from developing an infection from the herpes virus if you’ve had it before or are newly exposed to it.

If you’ve been exposed to the herpes virus in the past, the virus can reactivate (become active again) in your body and cause an infection. You can also become infected if you’re newly exposed to the virus. Taking anti-herpes medication may help prevent you from having a herpes outbreak, which can include having cold sores or a potentially serious infection called shingles.

If you have questions about preventing herpes virus infections while taking Mavenclad, talk with your doctor.

As with all medications, the cost of Mavenclad can vary. To find current prices for Mavenclad in your area, check out WellRx.com. The cost you find on WellRx.com is what you may pay without insurance. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

It’s important to note that you’ll have to get Mavenclad at a specialty pharmacy. This type of pharmacy is authorized to carry specialty medications. These are drugs that may be expensive or may require help from healthcare professionals to be used safely and effectively.

Your insurance plan may require you to get prior authorization before approving coverage for Mavenclad. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the request and let you and your doctor know if your plan will cover Mavenclad.

If you’re not sure if you’ll need to get prior authorization for Mavenclad, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Mavenclad, or if you need help understanding your insurance coverage, help is available.

EMD Serono, Inc., the manufacturer of Mavenclad, has MS LifeLines Financial Support Specialists you can talk with and a number of financial assistance programs. For more information and to find out if you’re eligible for support, call 877-447-3243 or visit the program website.

You should take Mavenclad according to your doctor’s or healthcare provider’s instructions.

Mavenclad comes as a tablet that you swallow.

When to take

During your treatment, you’ll take Mavenclad once a day, at about the same time each day. You should separate your Mavenclad doses by at least 3 hours from any other medication doses you take.

Usually, each treatment course of Mavenclad is about 4 to 5 days. There are two treatment courses in each cycle, and you’ll typically take two cycles of the drug. This adds up to a total of four treatment courses.

The usual schedule for taking Mavenclad is as follows:

  • Treatment course 1, cycle 1: You’ll take one or two tablets a day for 4 to 5 days as directed by your doctor.
  • Treatment course 1, cycle 2: This cycle will start 23 to 27 days after your last dose in treatment course 1, cycle 1. You’ll take one or two tablets a day for 4 to 5 days as directed by your doctor.
  • Treatment course 2, cycle 1: This cycle will start at least 43 weeks after your last dose in treatment course 1, cycle 2. You’ll take one or two tablets a day for 4 to 5 days as directed by your doctor.
  • Treatment course 2, cycle 2: This cycle will start 23 to 27 days after your last dose in treatment course 2, cycle 1. You’ll take one or two tablets a day for 4 to 5 days as directed by your doctor.

If you have any questions on when to take Mavenclad, talk with your doctor or pharmacist.

To help make sure that you don’t miss a dose, try setting a reminder on your phone. You may also find it helpful to write your treatment schedule on a calendar or use a medication timer.

Taking Mavenclad with food

You can take Mavenclad with or without food.

Can Mavenclad be crushed, split, or chewed?

No. You should swallow Mavenclad whole, without breaking or chewing the tablet.

Multiple sclerosis (MS) is known as an autoimmune disease because your immune system mistakenly attacks your body. (Your immune system is your body’s defense against infection.)

In the case of MS, your immune system targets the myelin sheath in your brain and spinal cord. This is the covering over your nerves that helps your brain and body communicate. When the myelin sheath is under attack, your brain and body have trouble communicating with each other. This may cause symptoms such as changes in vision, numbness, tingling, or trouble walking.

MS has several forms, but Mavenclad is used for relapsing forms of MS. With these forms, you have times when you have few or no symptoms (remission), followed by flare-ups during which your symptoms get worse (relapses). Mavenclad is approved to treat:

  • Relapsing-remitting MS. With relapsing-remitting MS (RRMS), your symptoms may flare up and then go into remission.
  • Active secondary progressive MS. RRMS can become secondary progressive MS (SPMS). With SPMS, you may feel like your symptoms always remain and get worse gradually. The disease doesn’t have periods of remission. “Active” means that your symptoms flare up or an MRI scan shows that the MS is more active.

Mavenclad works by decreasing the number of immune system cells in your body. By doing this, the drug eases your symptoms of MS and helps decrease the number of relapses you have.

How long does it take to work?

Mavenclad will start working in your body as soon as you take your first dose. However, it may take a few doses before you notice a decrease in the severity of your symptoms.

You shouldn’t take Mavenclad if you’re pregnant or are planning to become pregnant. You also shouldn’t take this medication if you’re not using birth control and are a man who can father a child or are a woman who can become pregnant.

There are no studies in pregnant women who took Mavenclad or data on the risk to a developing baby. However, animal studies have looked at cladribine (the active drug in Mavenclad) in pregnant animals. Researchers found that the drug can cause birth defects,* growth problems, or miscarriage.

Before starting Mavenclad treatment, your doctor will have you take a pregnancy test to make sure you’re aren’t pregnant. Both men and women should use birth control while taking Mavenclad and afterward. For details, see the “Mavenclad and birth control” section below.

Talk with your doctor before starting Mavenclad if you’re pregnant or planning to become pregnant. They may be able to recommend a different medication to treat your MS.

* Mavenclad has a boxed warning for the risk of birth defects. This is the most serious warning from the FDA. For more information, see “FDA warnings” at the beginning of this article.

Mavenclad shouldn’t be taken during pregnancy. Animal studies have shown that this medication can be very harmful to a developing baby.*

Women should use birth control while taking Mavenclad and for at least 6 months after the last dose of each course of treatment. It’s possible that Mavenclad may interact with birth control medications such as pills, patches, or injections. Because of this, it’s recommended that women use a barrier contraceptive (such as a condom) while taking Mavenclad and for at least 4 weeks after the last dose of each treatment course.

Men who are taking Mavenclad also need to take steps to prevent their partners from becoming pregnant. These men should use a barrier contraceptive or make sure that their partner is using effective birth control. Men should use contraception while taking Mavenclad and for at least 6 months after the last dose of medication in each course of treatment.

If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re using Mavenclad.

* Mavenclad has a boxed warning for the risk of birth defects. This is the most serious warning from the FDA. For more information, see “FDA warnings” at the beginning of this article.

You shouldn’t take Mavenclad while breastfeeding. It’s not known if Mavenclad passes into human breast milk or what effects the drug will have on a breastfed infant. However, it’s believed that serious side effects may occur in children if they’re exposed to Mavenclad. Women shouldn’t breastfeed while taking Mavenclad or for at least 10 days after the last dose of medication.

If you’re breastfeeding or plan to breastfeed, talk with your doctor before taking Mavenclad. They can recommend the best way for you to feed child or suggest a different medication.

Here are answers to some frequently asked questions about Mavenclad.

Is Mavenclad safe for older adults?

It’s not known for sure if Mavenclad is safe for older adults. This is because not enough adults ages 65 years and older were included in clinical trials. However, reports show that older adults didn’t respond differently to the medication than younger adults.

If you’re an older adult taking Mavenclad, your doctor may give you additional blood tests. Older adults may be at an increased risk of side effects due to other drugs they’re taking or other medical conditions they have. So your doctor will monitor you for any side effects. (For more about the side effects of Mavenclad, see the “Mavenclad side effects” section above.)

If you’re interested in taking Mavenclad and are an older adult, talk with your doctor. They can help you decide on the right treatment for you.

Why do I or my caregiver need to be cautious when handling Mavenclad?

Mavenclad is a cytotoxic drug, which means that it works by killing cells in your body. By handling the drug incorrectly, you or your caregiver may be at risk for serious side effects from the medication. (For more about the side effects of Mavenclad, see the “Mavenclad side effects” section above.)

You should handle the tablets for as short a time as possible. Be sure to thoroughly wash any areas of your skin that touch Mavenclad. You should also keep the tablets in their original carton until you’re supposed to take your dose. This helps limit exposure to the medication.

Will I need any tests before I start taking Mavenclad?

Yes, your doctor will likely have you take some tests before you start your Mavenclad treatment. These can include:

  • Routine blood tests. These tests will help your doctor see if there are any changes, especially in your white blood cells or liver function, while you’re taking Mavenclad. They may also have you go for blood work while you’re taking the medication and after you complete treatment.
  • Tests for infections. Your doctor may test you for infections such as HIV, hepatitis, and tuberculosis (TB). Mavenclad can weaken your immune system and may cause these infections to become much worse. If you currently have symptoms of an infection such as hepatitis or TB, your doctor will treat you for the infection before you start taking Mavenclad. And if you have HIV, they’ll recommend a different treatment for your MS.
  • MRI scan. Your doctor will also have you go for an MRI scan of your brain. The scan will help determine if there are any changes to your brain during your treatment. This is important due to the risk of a rare but very serious brain infection called progressive multifocal leukoencephalopathy (PML). (For more about PML, see the “Mavenclad side effects” section above.)
  • Pregnancy test. If you’re female, your doctor will have you take a pregnancy test because you shouldn’t take Mavenclad while you’re pregnant. The drug can cause serious birth defects* and may even result in miscarriage. Your doctor will be sure that you aren’t pregnant before you start taking Mavenclad.

If you have questions about any tests that you’ll need before you start Mavenclad treatment, talk with your doctor.

* Mavenclad has a boxed warning for the risk of birth defects. This is the most serious warning from the FDA. For more information, see “FDA warnings” at the beginning of this article.

Should I avoid getting certain vaccines during my Mavenclad treatment?

Yes, you should avoid getting any live vaccines while taking Mavenclad and for at least 4 to 6 weeks before you start taking the medication.

You may also need to avoid any live vaccines if your levels of white blood cells get too low from taking Mavenclad, even after you’re done with your treatment. This change in your white blood cell count is a side effect that may occur and last after you’ve stopped taking Mavenclad. You may have to wait until your levels return to normal before getting vaccinated. (For more about the side effects of Mavenclad, see the “Mavenclad side effects” section above.)

Live vaccines have a weakened form of bacteria or a virus in them. They don’t cause infections in people who have a healthy immune system. But because Mavenclad may weaken your immune system, your body may not be able to fight the bacteria or virus from the vaccine as well as usual. This could lead to an infection.

According to the Centers for Disease Control and Prevention (CDC), examples of live vaccines include:

Before you start taking Mavenclad, ask your doctor if you need to get any vaccines.

This drug comes with several precautions.

FDA warnings

This drug has boxed warnings. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous.

  • Cancer. Taking Mavenclad may increase your risk of developing cancer, such as ovarian cancer, pancreatic cancer, or melanoma skin cancer. If you currently have cancer, you shouldn’t use the drug. And if you have a history of cancer or are at high risk of developing cancer, your doctor can help you decide if Mavenclad is right for you.
  • Risk of birth defects. Taking Mavenclad while you’re pregnant may increase the risk of birth defects, so you shouldn’t use the drug if you’re pregnant. You also shouldn’t use Mavenclad if you’re not using birth control and are a man who can father a child or are a woman who can become pregnant.

Other precautions

Before taking Mavenclad, talk with your doctor about your health history. Mavenclad may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Infections. Your doctor will test you for certain infections before you start taking Mavenclad. If you have an infection such as tuberculosis (TB) or hepatitis, your doctor will treat you for the infection before you start using Mavenclad. This is because the drug can weaken your immune system, and you may not be able to fight the infection as well.
  • Risk of graft-versus-host-disease after blood transfusion. There is a risk of graft-versus-host-disease (GVHD) if you receive a blood transfusion while you’re taking Mavenclad. GVHD is a disease in which lymphocytes (a type of white blood cell) from donor blood attacks your organs or blood. If you need a blood transfusion, be sure to tell your doctor that you’re taking Mavenclad. They may put the blood through a machine to decrease your risk for developing GVHD.
  • Liver injury. If you have liver injury such as a history of hepatitis, you may need to be monitored more often while taking Mavenclad. This is because the drug can also cause liver injury, which may damage your liver further. Depending on the condition of your liver, your doctor may monitor you more often while you’re taking Mavenclad or recommend a different medication to treat your MS.
  • HIV. You shouldn’t take Mavenclad if you have HIV. This is because Mavenclad can weaken your immune system and decrease your body’s ability to fight HIV. Talk with your doctor about other options to treat your MS if you have HIV.
  • History of allergy to Mavenclad. You shouldn’t take Mavenclad if you’ve had an allergic reaction from the medication or any of its ingredients in the past. Talk with your doctor about other treatment options for your MS.
  • Recent vaccinations. You should wait at least 4 to 6 weeks after receiving a live vaccine before you start taking Mavenclad. For more information, see the “Common questions about Mavenclad” section above.
  • Pregnancy and breastfeeding. You shouldn’t take Mavenclad during pregnancy or while breastfeeding. For more information, please see the “Mavenclad and pregnancy” and “Mavenclad and breastfeeding” sections above.

Note: For more information about the potential negative effects of Mavenclad, see the “Mavenclad side effects” section above.

Using more than the recommended dosage of Mavenclad can lead to serious side effects.

Don’t use more Mavenclad than your doctor recommends.

No one who took Mavenclad in clinical trials had an overdose, so it’s not known exactly what side effects you may have from taking too much Mavenclad. However, your level of lymphocytes (a type of white blood cell) is more likely to decrease if you take a higher dose of Mavenclad. So your doctor will monitor your blood to make sure that your level doesn’t get too low.

What to do in case of overdose

If you think you’ve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or visit the website. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

When you get Mavenclad from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee that the medication is effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk with your pharmacist about whether you might still be able to use it.

Storage

How long a medication remains good can depend on many factors, including how and where you store the medication.

You should store Mavenclad tablets at room temperature between 68°F to 77°F (20°C to 25°C). If necessary, you can store medication between 59°F and 86°F (15°C and 30°C) for a short time.

Keep Mavenclad in its original package until you’re ready to take your dose. This protects the medication from moisture. Avoid storing this medication in areas where it could get damp or wet, such as in bathrooms.

This medication is cytotoxic, which means that it works by killing cells in your body. So you need to handle it correctly to avoid serious side effects. You shouldn’t touch the tablets for longer than necessary. And be sure to thoroughly wash your hands or any area that the tablets came into contact with after taking your dose.

Disposal

If you no longer need to take Mavenclad and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

This article provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication.

The following information is provided for clinicians and other healthcare professionals.

Indications

Mavenclad is indicated for use in adults with the following types of multiple sclerosis (MS):

It should not be used in patients with clinically isolated syndrome due to the side effect profile. It should usually only be used in patients who have failed or are unable to take other medications for MS.

Mechanism of action

It’s not known exactly how Mavenclad works to treat MS. However, it’s believed to block DNA synthesis, which therefore kills B and T lymphocytes. This decreases the number of lymphocytes available, which may relieve MS symptoms and relapses.

Pharmacokinetics and metabolism

Mavenclad has a bioavailability of 40%. On average, it took about 30 minutes for Mavenclad to reach its maximum concentration.

Mavenclad does get through the blood-brain barrier. It’s 20% plasma protein bound.

The terminal half-life of Mavenclad is about 1 day. Mavenclad is phosphorylated and then phosphorylated again to create the active form, cladribine triphosphate (Cd-ATP). It’s not known exactly how Mavenclad is metabolized in the body. However, it’s not believed to be metabolized by hepatic enzymes. About 28.5% of the drug is excreted renally.

Contraindications

Mavenclad is contraindicated in the following:

  • patients with current cancer
  • pregnant women, and women or men of reproductive age who aren’t using contraception while taking Mavenclad and for 6 months after the last dose
  • patients with HIV
  • patients with infections, such as hepatitis or tuberculosis (TB)
  • history of allergic reaction to Mavenclad or any of the ingredients in Mavenclad
  • breastfeeding women

Storage

Mavenclad tablets should be stored at room temperature, between 68°F to 77°F (20°C to 25°C). If necessary, the medication can be stored between 59°F to 86°F (15°C to 30°C) for brief periods of time.

Mavenclad should be kept in the original package until the patient is ready to take it. This protects the medication from moisture. Avoid storing this drug in areas where it could get damp or wet, such as in bathrooms.

This medication is cytotoxic, which means it needs to be handled correctly to avoid serious side effects. The tablets should not be touched for longer than necessary. Patients or caregivers should be advised to thoroughly wash their hands or any areas that the tablets came into contact with after taking the medication.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.