Do you or someone in your family have Multiple Sclerosis (MS)? If so, your doctor may have advised you to start taking a pill called Cladribine. When you hear this name, you may have a lot of questions. "What kind of medicine is this?", "What will happen to it?", "Are there any side effects?" You may be wondering. Don't be afraid of it at all. In this article today, we will talk about these Cladribine pills in a very simple and clear way, like a friend to you.
Simply put, what is Cladribine?
Cladribine is a pill used to treat a condition called multiple sclerosis (MS) . However, it is not usually prescribed for everyone with MS. Doctors often prescribe this medication when other treatments have not worked or when they are too difficult to tolerate.
So how does this medicine work? Think about it, our body has a defense system, we call it the immune system . Its job is to fight off foreign germs and protect us from disease. But in diseases like MS, this immune system becomes a little too active (overactive) and starts attacking the body's own good cells. What Cladribine pills do is slow down the overactive immune system a little and calm it down.
What are the benefits of this?
- Stops or delays the worsening of symptoms.
- Reduces the number of flare-ups.
This medicine is most commonly seen in Sri Lanka and around the world under the brand name MAVENCLAD .
Things you need to tell your doctor before starting this medication:
This is a very important part. Cladribine is a very powerful drug. Therefore, it is important that your doctor is aware of any other health problems you may have. See the table below. If you have any of these conditions, be sure to tell your doctor before starting the medication.
| Your health condition | Why should you tell the doctor? (Simply) |
|---|---|
| If you have had or currently have cancer | Because this drug affects the immune system, special care should be taken regarding the risk of cancer. |
| Heart failure or other heart defects | For some people, this medicine may affect heart function. |
| HIV or AIDS conditions | Cladribine is not suitable for use in patients who have already weakened their immune system due to these diseases. |
| Existing infections (e.g. tuberculosis (TB), fungal, bacterial or viral infections) | Because Cladribine suppresses the immune system, an infection that is already present in the body can become very severe. |
| Kidney or liver disease | Because these organs are involved in the process of removing drugs from the body, their disease conditions can alter the effectiveness of the drug. |
| If you have recently received a vaccine or are scheduled to receive one in the future | It is especially dangerous to take live virus vaccines with this medicine. |
| Allergies to Cladribine or other medicines, foods, or dyes | This is important to know in advance if you may have allergies. |
| If you or your partner are trying to get pregnant or are already pregnant | This medicine can cause serious harm to the baby in the womb. This is extremely important. |
| If you are breastfeeding your baby (Breastfeeding) | The medicine can pass through breast milk and harm the baby. |
How exactly do you use these pills?
The most important thing is to follow the doctor's instructions. But let's be aware of how to use this medicine in general.
- This pill should be taken by mouth with a glass of water.
- Try to take it at the same time every day.
- Most importantly: Do not break, crush, or chew the tablet. Swallow the entire tablet at once.
- You can take it before or after meals, but if you experience stomach upset, it's best to take it with food.
- Take the medicine as prescribed until the doctor tells you to stop.
The 'Cycle' of taking medicine
This medication is not something you take all the time. It is taken in 'cycles'. Simply put, there are certain days when you take the medication and certain days when you don't. It is very important to follow this schedule exactly. Follow your doctor's instructions exactly. If you don't understand something, ask your doctor for clarification. Taking more than the prescribed amount can cause serious side effects.
Important: If you are taking other medications, do not take them at the same time as Cladribine. Ask your doctor how many hours after taking Cladribine you should take other medications.
Be careful when handling the medicine.
Handling this medicine should also be done with caution. Wash your hands thoroughly with soap and water before and after handling the pill. Your doctor will give you specific instructions on this.
Overdosage
If you suddenly think you have taken too much of this medicine, do not delay. Immediately call the National Poisons Information Centre at the Colombo National Hospital , or go to the Emergency Treatment Unit (ETU) of the nearest hospital.
What to do if you miss a dose of medication?
If you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take your next dose at the scheduled time. Never take a double dose to make up for a missed dose.
What other medications may interact with Cladribine?
Taking certain other medications with Cladribine can be dangerous.
Do not take these with Cladribine:
- Live virus vaccines: Vaccines like measles, mumps, rubella (MMR), and oral polio fall into this category. Because the immune system is weakened when you receive these vaccines, you can still get the disease if you get one.
Cladribine may also interact with these medications:
- Some antiviral drugs given for HIV or Hepatitis.
- Other medications that suppress the immune system (e.g., anticancer drugs, drugs that prevent rejection of transplanted organs).
The most important thing is to give your doctor a complete list of all the medications you take (including vitamins, Ayurvedic or herbal remedies, and painkillers). Then he or she can develop the safest treatment plan for you.
Things to be especially careful about when taking medication
You need to pay a little more attention to your body while taking this medicine.
- Regular medical checkups: Your doctor will need to see you regularly. Also, you will need to have regular blood tests to check your blood cell counts (especially lymphocytes) while taking this medicine.
- Risk of infection: As we discussed earlier, when you take this medicine, your body's ability to fight disease (immunity) decreases slightly. Therefore, you can easily get infections. If you experience symptoms such as fever, chills, sore throat, cough, or a cold, do not self-medicate and call your doctor immediately. It is also wise to stay away from places where sick people hang out as much as possible.
- Cancer risk: Studies have shown that taking this medication may slightly increase the risk of developing some types of cancer. Don't be alarmed by this, but be open about this risk with your doctor.
- Pregnancy and breastfeeding (very important):
- For women: Do not take this medicine if you are planning to become pregnant, are pregnant, or are breastfeeding. You should take a pregnancy test before starting this medicine to make sure you are not pregnant. You must use a highly effective form of birth control while taking the medicine and for 6 months after taking the last pill .
- For men: If your partner is able to get pregnant, you must use a condom during sex while you are taking this medicine and for 6 months after your last dose. This will prevent the medicine from passing to your partner through semen and harming the unborn baby.
- Breastfeeding: Do not breastfeed your baby while taking this medicine and for 10 days after the last dose .
What are the possible side effects?
Like all medicines, Cladribine can cause side effects, although not everybody gets them. Below is a list of possible side effects.
| Serious side effects that should be reported to the doctor immediately | |
|---|---|
| Allergic reactions | Skin rash, itching, swelling of the face, lips, tongue or throat, difficulty breathing. |
| Heart failure | Difficulty breathing, swelling of the ankles, feet or hands, sudden weight gain, extreme fatigue. |
| Infection | Fever, chills, cough, sore throat, non-healing wounds, pain when urinating, and body discomfort. |
| Symptoms of liver injury | Pain in the upper right side of the stomach, loss of appetite, nausea, light-colored stools, dark yellow or brown urine, and yellowing of the skin or eyes. |
| Characteristics related to the nervous system | Dizziness, loss of balance, confusion, difficulty speaking. |
| Side effects that are usually not serious, but should be reported to the doctor if they persist | |
| Headache | Back pain |
| Nausea | Sore throat |
| Runny or stuffy nose | |
This list does not include all possible side effects. If you experience any other unusual symptoms, talk to your doctor about them as well.
How do you protect and store your medicine?
- Keep out of reach of children and pets .
- Store at room temperature (between 20 and 25 degrees Celsius).
- Keep the medicine in the original bottle or packet it was received in.
- Protect from moisture. Keep the bottle cap tightly closed.
- Do not use expired medications. Ask your doctor how to safely dispose of expired or no longer needed medications.
Take-Home Message
- Cladribine is a powerful drug used to treat multiple sclerosis (MS). Always use this only under medical advice.
- Follow the 'cycle' schedule given by your doctor exactly. Never take more than the prescribed amount.
- Tell your doctor about any other medical conditions you have and all other medications you are taking.
- While taking the medicine, be very careful about signs of infection such as fever and cough. If you develop any such symptoms, tell your doctor immediately.
- Be sure to follow the advice on preventing pregnancy (for women and men). This is extremely important.
- This medicine is for you only. Never share this medicine with anyone else.
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