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cladribine
Used for Leukemia, Multiple Sclerosis
Used for Leukemia, Multiple Sclerosis
Cladribine injection is a chemotherapy medication used to treat hairy cell leukemia, a rare blood cancer that causes abnormal white blood cells to build up in the body. It’s given into a vein (IV) continuously for 5 to 7 days by a healthcare professional. In some cases, it might be given as a 2-hour infusion once a day for 5 days. Most people only need one course of treatment. Common side effects include fever, tiredness, and nausea.
What is Cladribine?
What is Cladribine used for?
How Cladribine works
Cladribine is an antimetabolite chemotherapy. It works by getting inside cancer cells and interfering with how they make and repair DNA. This damages the cancer cells and causes them to die.
Drug facts
| Common Brands | Leustatin |
|---|---|
| Drug Class | Antimetabolite |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | Lower-cost generic available |
| Availability | Prescription only |
Side effects of Cladribine
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Fever (33%)
- Tiredness (31%)
- Nausea (22%)
- Rash (16%)
- Headache (14%)
- Injection site reactions (11%)
Less Common Side Effects
- Vomiting
- Reduced appetite
- Cough
- Diarrhea
- Dizziness
- Muscle pain
- Weakness
- Shortness of breath
- Stomach pain
- Constipation
- Sweating
- Trouble sleeping
- Itching
Cladribine serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Serious infections: fever, chills, body aches, tiredness, cough, shortness of breath
- Bleeding: easy bruising, nosebleeds, blood in urine, blood in stool
- Nervous system problems: muscle weakness, paralysis, numbness, tingling, trouble walking
- Kidney problems: swelling, urinating less, tiredness, nausea, confusion
When do Cladribine possible side effects begin and end?
Time passed since treatment started:
H
D
W
M
Low blood cell counts
Kidney problems
Nervous system problems
Seek immediate medical care if you experience this side effect.
The following Cladribine side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Infection—fever, chills, cough, sore throat, wounds that don't heal, pain or trouble when passing urine, general feeling of discomfort or being unwell
- Low red blood cell level—unusual weakness or fatigue, dizziness, headache, trouble breathing
- Pain, tingling, or numbness in the hands or feet, muscle weakness, change in vision, confusion or trouble speaking, loss of balance or coordination, trouble walking, seizures
- Unusual bruising or bleeding
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
Pros and cons of Cladribine
Pros
- Recommended treatment for hairy cell leukemia
- Only requires a single course of treatment
- Unlikely to interact with other medications
Cons
- Might require a continuous IV infusion for 5 to 7 days
- Can cause low blood cells and raise your risk for infection
- Can rarely cause serious nervous system or kidney problems
Pharmacist tips for Cladribine
- Cladribine injection is usually given as one continuous IV infusion over 5 to 7 days. In some cases, it might be given as a 2-hour IV infusion once a day for 5 days. Typically, you'll only need one course of treatment.
- Cladribine injection often causes low white blood cells, which can make it harder for your body to fight infections. Help prevent infections by washing your hands often, avoiding crowds, and washing raw fruits and vegetables before eating them.
- Check your temperature regularly while getting cladribine injection. Call your cancer care team right away if your temperature reaches 100.4° F or higher, since a fever might be the only sign of an infection.
- Avoid live vaccines while receiving cladribine injection because the medication weakens your immune system. Live vaccines could cause an infection if your immune system can’t fight them normally.
- Cladribine injection can rarely cause serious nerve problems, especially at doses much higher than those used for hairy cell leukemia. Tell your cancer care team right away if you develop new numbness, tingling, muscle weakness, or trouble walking.
- Cladribine injection can cause serious kidney problems, especially at high doses or when combined with other treatments that can harm your kidneys. Tell your cancer care team right away if you have symptoms such as swelling in your legs or feet, urinating less than usual, or unusual tiredness.
- It isn’t known whether cladribine injection affects your ability to have children in the future. If this is a concern, talk with your oncologist about fertility preservation.
- Pregnancy: Cladribine injection can harm an unborn baby. If you can become pregnant, use effective birth control during treatment and tell your oncologist right away if you become pregnant.
- Breastfeeding: It isn’t known whether cladribine injection passes into breast milk. Talk with your oncologist about the risks and benefits of breastfeeding during treatment so you can decide what’s best for you and your baby.
Risks and warnings for Cladribine
Cladribine can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Nervous system problems (BBW)
- Risk factors: High doses of cladribine
Cladribine can cause serious nervous system problems, including severe weakness or paralysis in your arms or legs. These side effects are most common at doses higher than those used for hairy cell leukemia, with symptoms reported about 1 to 3 months after starting high-dose treatment. But they can rarely happen at regular doses too. Contact your care team right away if you develop new weakness, numbness, tingling, or trouble walking.
Kidney problems (BBW)
- Risk factors: High doses of cladribine | Also receiving other medications that are harmful to the kidneys
Cladribine can cause serious kidney problems, especially at doses much higher than the currently approved dose. In studies of high-dose treatment, some people had trouble urinating and needed dialysis. While this is less likely with regular doses, your care team will monitor your kidney health with lab tests during treatment.
Low blood cell counts
- Risk factors: High doses of cladribine
Cladribine injection can lower your white blood cells, red blood cells, and platelets. Many people with hairy cell leukemia already have low blood cell counts, and treatment can temporarily lower them even more. Low white blood cells can raise your risk of infection, low platelets can make you bleed or bruise more easily, and low red blood cells can make you feel tired.
Blood cell counts typically drop the most during the first month after treatment, so close monitoring is especially important during the first 4 to 8 weeks. Your care team will check your blood counts regularly. Contact your oncologist if you develop fever, chills, unusual bruising or bleeding, or severe tiredness.
Serious infections
Some people taking cladribine injection have developed serious infections, including pneumonia and sepsis. Your oncologist might recommend medications, such as antibiotics or antivirals, to help prevent infections.
Watch for signs of infection, such as fever, chills, or body aches. Fever is especially important to watch for because cladribine can lower your white blood cell count, making fever the only sign of an infection. Contact your care team right away if your temperature reaches 100.4°F or higher.
Live vaccines
Don't receive live vaccines during treatment with cladribine injection. Because the medication weakens your immune system, a live vaccine could cause an infection. Check with your care team before receiving any vaccines during or after treatment.
Tumor lysis syndrome
- Risk factors: Certain blood cancers | High tumor burden
Although rare, cladribine injection can cause tumor lysis syndrome (TLS). This happens when many cancer cells die quickly and release their contents into the blood. TLS can cause serious problems, including kidney damage and changes in your electrolyte levels. Your care team might monitor you more closely if you’re at risk for this serious condition.
Harm to unborn baby
Cladribine hasn’t been studied in human pregnancy. But based on animal studies and how the medication works, it could harm an unborn baby. If you can become pregnant, use effective birth control during treatment. Tell your care team right away if you become pregnant during treatment.
Cladribine dosage
The average cost for 1 box of 10 tablets of 10mg of Cladribine is $27,371.51 with a free GoodRx coupon.
Typical dosage for Cladribine
The typical dose is 0.09 mg/kg per day, given as a continuous IV infusion for 7 days in a row. In some cases, you might receive it as a continuous infusion for 5 days or as a 2-hour IV infusion once a day for 5 days, depending on your treatment plan.
Receiving more than one treatment course isn’t recommended.
How much does Cladribine cost?
To access savings, use a GoodRx coupon and pay just a fraction of the retail price.
News about Cladribine
Cladribine images
