If you have a certain kind of multiple sclerosis (MS), your doctor may recommend treatment with Mavenclad.
Mavenclad is a prescription drug used to treat relapsing types of MS in adults.
To learn more about relapsing forms of MS and how Mavenclad is used to treat them, see the “Is Mavenclad used for MS?” section just below.
Note: Mavenclad should not be prescribed to treat clinically isolated syndrome (CIS). CIS may be the first sign of MS for some people.
Mavenclad basics
Mavenclad comes as tablets that you swallow. It contains cladribine as the active drug. An active drug is the ingredient that makes a medication work.
Mavenclad isn’t available as a generic drug.
Keep reading to learn more about Mavenclad, including its uses, side effects, dosage, and more.
Mavenclad is a prescription drug used to treat relapsing types of multiple sclerosis (MS) in adults.
About MS
MS is a chronic (long-term) condition that affects the central nervous system. With MS, the immune system mistakenly attacks a protective layer, called myelin, which is wrapped around nerve fibers. This causes a range of symptoms, including:
- fatigue (low energy)
- trouble walking
- pain
- vision problems
- trouble speaking
- muscle tremors
There are different types of MS. Mavenclad is prescribed to treat relapsing forms of MS. People with these forms of MS have periods with little or no symptoms, called remission. These are followed by periods of high symptom activity, called relapse.
Relapsing forms of MS that Mavenclad is prescribed to treat include:
- Relapsing-remitting MS (RRMS). With RRMS, you alternate between periods of relapse and periods of remission.
- Active secondary progressive MS (SPMS). Active SPMS doesn’t have periods of remission. Symptoms remain present and worsen over time.
About Mavenclad for treating relapsing forms of MS
Mavenclad is usually prescribed to people with MS who’ve tried treatments that didn’t work to lessen symptoms or caused bothersome side effects.
It’s not fully understood how Mavenclad works to treat MS. It’s thought that the drug lowers the lymphocyte level in your body. Lymphocytes are a kind of white blood cell that’s part of your immune system. Lowering the level of these cells may help ease MS symptoms and decrease your risk of relapses.
For information about Mavenclad as a safe, effective treatment for relapsing forms of MS, talk with your doctor or pharmacist.
Note: Mavenclad should not be prescribed to treat clinically isolated syndrome (CIS). CIS may be the first sign of MS for some people.
Like most drugs, Mavenclad may cause mild or serious side effects. The lists below describe some of the more common side effects that Mavenclad may cause. These lists don’t include all possible side effects.
Keep in mind that side effects of a drug can depend on:
- your age
- other health conditions you have
- other medications you take
For more information about Mavenclad’s side effects than what you’ll find below, see this article. Your doctor or pharmacist can also tell you more about the potential side effects of Mavenclad. And they can suggest ways to help reduce side effects.
Mild side effects
Here’s a short list of some of the mild side effects that Mavenclad can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read Mavenclad’s prescribing information.
Mild side effects of Mavenclad that have been reported include:
- back pain
- bronchitis
- headache
- joint pain
- nausea
- sleep problems
- upper respiratory infection, such as the common cold
- hair loss*
* For more information about this side effect, see the “Side effect focus” section below.
Mild side effects of many drugs may go away within a few days to a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.
Serious side effects
Serious side effects from Mavenclad can occur, but they aren’t common. If you have serious side effects from Mavenclad, call your doctor right away. But if you think you’re having a medical emergency, immediately call 911 or your local emergency number.
Serious side effects of Mavenclad that have been reported include:
- depression
- blood disorders, including:
- low blood level of lymphocytes (a kind of white blood cell)
- low blood level of neutrophils (another kind of white blood cell)
- low blood level of platelets (a kind of blood cell that helps form clots)
- low level of hemoglobin (a protein that delivers oxygen throughout the body)
- heart failure
- liver injury
- progressive multifocal leukoencephalopathy (PML)
- seizures
- serious infection, including shingles and pyelonephritis (a sudden kidney infection)
- boxed warnings: risk of cancer* and risk of problems with fetal development (commonly known as birth defects)?
- allergic reaction*
* For more information about this side effect, see the “Side effect focus” section below.
? For more information about the risk of problems with fetal development, see the “What should be considered before taking Mavenclad?” section below.
Side effect focus
Learn more about some of the side effects Mavenclad may cause.
Boxed warnings
Mavenclad has the
Risk of cancer. Treatment with Mavenclad may raise your risk of cancer, although this risk is small. Due to this risk, doctors won’t prescribe Mavenclad for at least 2 years after you’ve completed two treatment courses with the drug. Also, as a result of this risk, your doctor likely won’t prescribe Mavenclad if you have cancer.
Cancers reported in people who took Mavenclad in studies include:
Symptoms of cancer vary depending on the kind, but can include:
- nausea
- fatigue (low energy)
- decreased appetite
- skin moles with changes in color or borders
- skin cuts or scabs that won’t heal
Risk of problems with fetal development. Treatment with Mavenclad during pregnancy can cause problems with fetal development (commonly known as birth defects). See the “What should be considered before taking Mavenclad?” section below for more information.
What might help
Your doctor will tell you more about how they’ll screen you for cancer before Mavenclad treatment. They’ll also monitor you for cancer while you’re taking the drug. If you develop symptoms of cancer such as those listed above, contact your doctor right away.
Hair loss
Hair loss is a possible side effect that Mavenclad can cause. But this was rarely reported in studies of the drug.
What might help
Talk with your doctor if you have hair loss that bothers you while taking Mavenclad. They may recommend a treatment for this side effect. But they may also recommend stopping Mavenclad treatment and trying a different medication for your MS.
Liver injury
It’s possible to have liver injury as a side effect from treatment with Mavenclad. But this side effect was rare in Mavenclad’s studies.
Symptoms of liver injury can include:
- fatigue
- belly pain
- dark urine
- decreased appetite
- nausea or vomiting
- yellowing of the skin or white of the eyes
What might help
Your doctor will check your liver function during treatment with Mavenclad. They can tell you more about these tests, including how often you should have them.
Call your doctor if you notice symptoms of liver injury while you’re taking Mavenclad. They’ll likely pause your treatment to investigate your symptoms further. If your doctor suspects or confirms you’ve had liver injury, they’ll have you permanently stop Mavenclad treatment.
Allergic reactionSome people may have an allergic reaction to Mavenclad. These reactions were reported in studies of the drug.
Symptoms of a mild allergic reaction can include:
A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, usually in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.
Call your doctor right away if you have an allergic reaction to Mavenclad. But if you think you’re having a medical emergency, call 911 or your local emergency number.
Your doctor will recommend the dosage of Mavenclad that’s right for you. Below are commonly prescribed dosages, but always follow the dosing schedule your doctor gives you.
For more information about Mavenclad’s dosage, see this article.
Form and strength
Mavenclad comes as tablets that you swallow. They’re available in one strength: 10 milligrams (mg).
Recommended dosages
You’ll take Mavenclad over two treatment courses. Each course is divided into two cycles:
- During the first cycle, you’ll take your prescribed dose once each day for 4 or 5 days.
- You’ll start the second cycle of a course 23 to 27 days after you finish the first cycle. Again, you’ll take your prescribed dose once each day for 4 or 5 days.
After completing the first treatment course, you’ll wait at least 43 weeks before beginning the second treatment course.
Your doctor will calculate your Mavenclad dose based on your body weight in kilograms (kg).* The dosing chart below shows example dosages for a few weight ranges. The maximum dosage is two tablets per day.
Weight range | Mavenclad dose per cycle | How often to take |
40 kg to less than 50 kg | 40 mg (four tablets) | one tablet each day for 4 days |
70 kg to less than 80 kg | 70 mg (seven tablets) | two tablets once each day for 4 days, then one tablet on the 5th day |
110 kg and above | 100 mg (10 tablets) | two tablets once each day for 5 days |
* 1 kg is about 2.2 pounds (lbs.). As an example, a person weighing 80 kg is about 176 lbs.
For more information about what dose you’ll be prescribed and other dosage details, talk with your doctor or pharmacist.
Questions about Mavenclad’s dosage
Below are some common answers to questions about Mavenclad’s dosage.
- What if I miss a dose of Mavenclad? If you miss a dose of Mavenclad, take it the next day. Then extend the number of days in your treatment cycle so that you take the total number of doses your doctor prescribed. Call your doctor or pharmacist if you need help adjusting your Mavenclad dosing schedule.
- Will I need to take Mavenclad long term? Mavenclad works over a long period of time, but you won’t take the drug long term. After your second course of treatment, you shouldn’t take Mavenclad again for at least 2 years.
- How long does Mavenclad take to work? Mavenclad begins working as soon as you take a dose. But it may take a few days or weeks before you begin noticing your MS symptoms decreasing.
Mavenclad and Ocrevus are drugs prescribed to adults with multiple sclerosis (MS). Both may be used to treat relapsing forms of MS.
Ocrevus may also be used to treat other types of MS, such as primary progressive MS. And it can be prescribed to treat clinically isolated syndrome (CIS). CIS may be the first sign of MS for some people.
Mavenclad comes as tablets that you swallow. Ocrevus is given as an intravenous (IV) infusion (an injection into your vein given over time) by a healthcare professional.
To find out more about these two medications, see this detailed comparison. You can also talk with your doctor about which drug is right for your condition.
Find answers to some commonly asked questions about Mavenclad.
How does Mavenclad work?
How a drug works is known as its mechanism of action.
Mavenclad’s mechanism of action for treating certain kinds of multiple sclerosis (MS) isn’t fully understood. It’s thought that the drug lowers the lymphocyte level in your body. Lymphocytes are a kind of white blood cell that’s part of your immune system. Lowering the level of these cells may help ease MS symptoms and decrease your risk of relapses.
If you’d like to learn more about Mavenclad’s mechanism of action, talk with your doctor or pharmacist.
How does Mavenclad compare with Mayzent, Tecfidera, Tysabri, and Lemtrada?
Like Mavenclad, Mayzent, Tecfidera, Tysabri, and Lemtrada are all prescription drugs used to treat certain forms of MS in adults. The chart below lists a few basics about these drugs.
Drug name | Active ingredient | What it treats | Form it comes in |
Mavenclad | cladribine | relapsing forms of MS | tablet |
Mayzent | siponimod | relapsing forms of MS | tablet |
Tecfidera | dimethyl fumarate | relapsing forms of MS, clinically isolated syndrome (CIS) | delayed-release* capsule |
Tysabri | natalizumab | relapsing forms of MS, CIS | intravenous (IV) infusion? |
Lemtrada | alemtuzumab | relapsing forms of MS | IV infusion |
* Delayed-release capsules are designed to release a drug slowly. This helps prevent the drug from being released all at once in your stomach, which can help reduce side effects.
? An IV infusion is an injection into your vein given over time.
If you’re interested in learning more about how these drugs compare, talk with your pharmacist or doctor.
Will I have fatigue from taking Mavenclad?
It’s not likely. Fatigue (low energy) wasn’t a side effect reported by people who took Mavenclad in a study.
But fatigue can be a symptom of other side effects Mavenclad can cause, including depression and liver injury.
Fatigue is also one of the most common symptoms of MS, which Mavenclad is used to treat. Treatment with Mavenclad can help reduce symptoms of MS, including fatigue.
If you’re experiencing fatigue, talk with your doctor. They can help identify possible causes of this symptom and recommend ways to treat it.
Can Mavenclad cause long-term side effects?
Yes, Mavenclad can cause long-term side effects.
Long-term side effects can refer to:
- side effects that start while you’re taking a drug and continue for a long time even after you stop taking the drug
- side effects that start after you’ve taken a medication for a long time or even after ending treatment
Long-term side effects reported in studies of Mavenclad include:
- risk of cancer*
- infections that persist for a long time
- liver injury
- heart failure
* Mavenclad has a
Liver injury usually occurs within a few weeks or months after first starting Mavenclad treatment. But this side effect may not go away, even after stopping Mavenclad treatment. The other side effects listed may occur at any time while taking Mavenclad, even after taking the drug for a long time.
If you have questions about Mavenclad’s long-term side effects, talk with your doctor or pharmacist.
Important things to discuss with your doctor when considering treatment with Mavenclad include your overall health and any medical conditions you may have. You should also discuss any medications you take.
Interactions
Taking a medication with certain vaccines, foods, and other things can affect how the medication works. These effects are called interactions.
Before taking Mavenclad, be sure to tell your doctor about all medications you take, including prescription and over-the-counter kinds. Also, describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions these items may cause with Mavenclad.
Interactions with drugs or supplements
Mavenclad may interact with several kinds of drugs. These drugs include:
- corticosteroids, such as prednisone (Rayos)
- the organ transplant drugs cyclosporine (Gengraf, Neoral, Sandimmune) and tacrolimus (Prograf)
- interferon beta medications, such as peginterferon beta-1a (Pegasys)
- the antipsychotic medication clozapine (Clozaril)
- the antiepileptic drug carbamazepine (Carbatrol, Tegretol)
- certain HIV medications, such as zidovudine (Retrovir)
- the antibiotic rifampin (Rifadin)
- hormonal birth control, such as:
- the estradiol patch (Vivelle-Dot)
- drospirenone and ethinyl estradiol (Yaz)
- medroxyprogesterone acetate (Depo-Provera)
This list does not contain all kinds of drugs that may interact with Mavenclad. Your doctor or pharmacist can tell you more about these interactions and any others that may occur with Mavenclad.
Other interactions
You should avoid taking supplements that contain curcumin or St. John’s wort during your Mavenclad treatment cycles. For information about the drug’s cycles, see the “What is Mavenclad’s dosage?” section above.
Boxed warnings
Mavenclad has
Mavenclad’s boxed warnings include:
- Risk of cancer. Treatment with Mavenclad may raise your risk of cancer, although this risk is small. For more information, see the “What are Mavenclad’s side effects?” section above.
- Risk of problems with fetal development. Treatment with Mavenclad during pregnancy can cause problems with fetal development (commonly known as birth defects). For more information, see the “Pregnancy and breastfeeding” section below.
Other warnings
Mavenclad may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you take Mavenclad. Factors to consider include those in the list below.
- HIV. Treatment with Mavenclad weakens the immune system, which makes it harder for the body to fight HIV. As a result, doctors usually won’t prescribe Mavenclad to people with HIV. If you have HIV, let your doctor know. They can suggest other treatments for MS.
- Current or past infections, especially hepatitis B (HBV), hepatitis C (HCV), and tuberculosis (TB). Be sure to tell your doctor if you have a chronic (long-term) infection, such as HBV, HCV, or TB. This includes if you’ve had these infections in the past. Taking Mavenclad could cause these infections to become active, possibly resulting in symptoms. Your doctor can determine whether treatment with Mavenclad is safe for you.
- Recent vaccination with a live vaccine. It’s important to wait at least 4 to 6 weeks after receiving a live vaccine* before taking Mavenclad. Mavenclad weakens your immune system, so it could cause you to get sick after getting a live vaccine. Non-live (inactive) vaccines may be safe to take right before or during treatment. If you have questions about vaccines and Mavenclad, ask your doctor or pharmacist.
- Liver problems. In rare cases, Mavenclad can cause liver injury. Before you start taking Mavenclad, tell your doctor if you have liver problems. If they prescribe Mavenclad to you, they may monitor you closely during treatment. Or they may recommend another MS treatment for you to take.
- Kidney problems. If you have certain kidney problems, such as moderate or severe chronic kidney disease (CKD), Mavenclad may not be safe to take. Having kidney problems can make it harder for your body to get rid of Mavenclad after you take a dose. This can raise your risk of side effects from taking the drug. Before starting Mavenclad treatment, tell your doctor if you have CKD or other kidney problems. This will help them determine whether Mavenclad is safe for you to take.
- Allergic reaction. If you’ve had an allergic reaction to Mavenclad or any of its ingredients, your doctor will likely not prescribe Mavenclad. Ask them what other medications are better options for you.
* Live vaccines contain a weakened version of the infection they protect against. Examples of live vaccines include the measles, mumps, rubella (MMR), chickenpox, and rotavirus vaccines.
Mavenclad and alcohol
There’s no known interaction between alcohol and Mavenclad.
But drinking alcohol could increase your risk of liver injury, as can taking Mavenclad. So drinking alcohol during Mavenclad treatment may further increase your risk of this side effect.
Your doctor can advise you on how much alcohol may be safe for you to consume while you’re taking Mavenclad.
Pregnancy and breastfeeding
Mavenclad isn’t safe to take during pregnancy or while breastfeeding.
Pregnancy
Mavenclad has a
Due to this risk, you should not take Mavenclad if you’re planning to become pregnant. If you can become pregnant, your doctor will order a pregnancy test for you before prescribing Mavenclad. They’ll want to check that it’s negative before you begin treatment.
If you can become pregnant or have a sexual partner who can become pregnant, you should use effective birth control while taking Mavenclad. And you should continue using it for at least 6 months after your last dose.
Because Mavenclad may interact with hormonal birth control, it’s recommended that females* taking this kind of birth control also use a barrier method, such as condoms. They should use the barrier method of birth control during Mavenclad treatment and for 4 weeks after their last dose.
To learn about effective birth control options for you, talk with your doctor.
Stop taking Mavenclad and immediately contact your doctor if you become pregnant during treatment.
* In this article, we use the term “female” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.
Breastfeeding
It is not known whether Mavenclad passes into breast milk. But if it does, it could cause serious side effects in a child who is breastfed. Because of this risk, you should avoid breastfeeding while taking Mavenclad and for at least 10 days after your last dose.
Talk with your doctor about safe ways to feed your child during Mavenclad treatment.
Your doctor will explain how you should take Mavenclad. They’ll also explain how much to take and how often. Be sure to follow your doctor’s instructions.
Taking Mavenclad
Mavenclad comes as tablets that you swallow with water.
Be sure that your hands are dry when handling Mavenclad tablets. And you should wash your hands with soap and hot water afterward.
Do not let the tablets sit on a kitchen or bathroom counter or other surface. If the tablets come in contact with any surface, you should clean that surface with water.
Accessible medication containers and labels
If it’s hard for you to read the label on your prescription, tell your doctor or pharmacist. Certain pharmacies may provide medication labels that:
- have large print
- use braille
- contain a code you can scan with a smartphone to change the text into audio
Your doctor or pharmacist may be able to recommend a pharmacy that offers these options if your current pharmacy doesn’t.
Taking Mavenclad with other drugs
You should take Mavenclad at least 3 hours before or after any other medications you take by mouth. These include other tablets, capsules, or liquids.
Your doctor may prescribe certain medications for you to take during Mavenclad treatment. These medications are meant to help prevent certain infections. Whether your doctor prescribes such medications depends on the results of certain lab tests they’ll order for you.
Questions about taking Mavenclad
Below are some common questions about taking Mavenclad.
- Can Mavenclad be chewed, crushed, or split? No, you should not chew, crush, or split Mavenclad tablets. You must swallow the tablets whole immediately after you take them out of their blister package. If you have trouble swallowing pills, consider trying the tips in this article. Your doctor or pharmacist can also suggest ways to make taking Mavenclad easier.
- Should I take Mavenclad with food? You may take Mavenclad with or without food.
Questions for your doctorYou may have questions about Mavenclad and your treatment plan. It’s important to discuss all your concerns with your doctor.
Here are a few tips that might help guide your discussion:
- Before your appointment, write down questions such as:
- How will Mavenclad affect my body, mood, or lifestyle?
- Bring someone with you to your appointment if doing so will help you feel more comfortable.
- If you don’t understand something related to your condition or treatment, ask your doctor to explain it to you.
Remember, your doctor and other healthcare professionals are available to help you. And they want you to get the best care possible. So don’t be afraid to ask questions or offer feedback on your treatment.
Costs of prescription drugs can vary depending on many factors. These factors include what your insurance plan covers and which pharmacy you use.
If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. You can also visit the Mavenclad manufacturer’s website to see if it has support options.
To learn more about saving money on prescriptions, check out this article.
Do not take more Mavenclad than your doctor prescribes. Taking more than this can lead to serious side effects.
What to do in case you take too much Mavenclad
Call your doctor if you think you’ve taken too much Mavenclad. You can also call 800-222-1222 to reach the American Association of Poison Control Centers, or use its online resource. But if you have severe symptoms, immediately call 911 or your local emergency number. Or go to the nearest emergency room.
If you’re considering treatment with Mavenclad for multiple sclerosis (MS), talk with your doctor or pharmacist. Ask questions that help you feel comfortable about the risks and benefits of taking the medication.
Here are a few examples to help you get started:
- What should I know about treatments for MS other than Mavenclad?
- Does my medical history place me at higher risk of side effects if I take Mavenclad?
- Will I take other medications for MS in between treatment cycles with Mavenclad?
To learn more about treatments for MS, see these articles:
If you’re interested in joining a supportive community of people who share your condition, check out Bezzy MS. And for updates about MS treatments, self-care tips, and more, consider signing up for Healthline’s MS newsletter.
Q:
Will I need to have lab tests while taking Mavenclad?
AnonymousA:
Yes, you’ll need to have certain lab tests while you’re taking Mavenclad.
Your doctor will order a test called a complete blood count (CBC) with differential. This test checks your blood cell levels. In addition to having this test while taking Mavenclad, you’ll also have it before and after treatment with this drug. Depending on your test results, your doctor may order this test monthly during treatment to keep watch on your blood counts.
Doctors order a CBC during Mavenclad treatment because the drug is known to cause blood disorders as a side effect. These disorders can include:
- low blood level of lymphocytes (a kind of white blood cell)
- low blood level of neutrophils (another kind of white blood cell)
- low blood level of platelets (a kind of blood cell that helps form clots)
- low level of hemoglobin (a protein that delivers oxygen throughout the body)
Depending on other factors, such as any health conditions you may have, you may also need other lab tests. Ask your doctor what other lab tests you may need during Mavenclad treatment.
The Healthline Pharmacist TeamAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.Disclaimer: Healthline 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 another 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.