Mavenclad 10mg Tabs (7) Pak
WARNING: This drug may lower the ability of the bone marrow to make blood cells that the body needs. If blood cell counts get very low, this can lead to bleeding problems, infections, or anemia. If you have questions, talk with the doctor.This drug may raise the risk of cancer. Do not take this drug to treat MS if you have cancer. If you have a risk for cancer or have ever had cancer, talk with your doctor.This drug may cause harm to the unborn baby if you take it while pregnant. Do not take this drug if you are pregnant, or if you are able to get pregnant but are not using birth control.If you are able to get pregnant, a pregnancy test will be done to show that you are NOT pregnant before starting this drug. Talk with your doctor.If you or your sex partner may become pregnant, you must use birth control while taking this drug and for 6 months after the last dose. Ask your doctor how long to use birth control and what kind of birth control to use. If you or your sex partner gets pregnant while taking this drug or within 6 months after stopping it, call the doctor right away. @ COMMON USES: It is used to treat MS (multiple sclerosis).
Drug Class
Disease-modifying therapy (DMT) for Multiple Sclerosis (MS)
Pharmacologic Class
Purine nucleoside analog; Antimetabolite
Pregnancy Category
Not available
FDA Approved
Mar 2019
DEA Schedule
Not Controlled
Overview
What is this medicine?
Mavenclad is a medication used to treat a type of multiple sclerosis (MS) called relapsing-remitting MS. It works by temporarily reducing certain immune cells (lymphocytes) that are thought to cause MS, and then allowing the immune system to rebuild itself in a way that may reduce MS attacks. It's given in short courses over two years, with no treatment in between.
How to Use This Medicine
Taking Your Medication
To take this medication correctly, follow your doctor's instructions and read all the information provided. You can take it with or without food, but be sure to swallow the tablet whole with a glass of water. Do not chew the tablet.
If you take other oral medications, take them at least 3 hours before or 3 hours after this medication. If this is not possible, consult your doctor for guidance.
Handling Your Medication
When handling this medication, take special precautions. Consult your doctor or pharmacist for instructions on how to handle it safely. Only remove the medication from the blister pack when you are ready to take it, and take it immediately after opening the pack. Do not store the removed medication for future use.
Before touching the medication, make sure your hands are dry. Wash your hands after handling the medication.
Storing and Disposing of Your Medication
Store the medication in its original container at room temperature, in a dry place. Avoid storing it in a bathroom. Keep all medications in a safe location, out of the reach of children and pets.
Missing a Dose
If you miss a dose, take it as soon as you remember on the same day. If you don't remember until the next day, take the missed dose and then resume your regular schedule the following day. This may extend your treatment week by one day. Do not take two doses at the same time or take extra doses.
To take this medication correctly, follow your doctor's instructions and read all the information provided. You can take it with or without food, but be sure to swallow the tablet whole with a glass of water. Do not chew the tablet.
If you take other oral medications, take them at least 3 hours before or 3 hours after this medication. If this is not possible, consult your doctor for guidance.
Handling Your Medication
When handling this medication, take special precautions. Consult your doctor or pharmacist for instructions on how to handle it safely. Only remove the medication from the blister pack when you are ready to take it, and take it immediately after opening the pack. Do not store the removed medication for future use.
Before touching the medication, make sure your hands are dry. Wash your hands after handling the medication.
Storing and Disposing of Your Medication
Store the medication in its original container at room temperature, in a dry place. Avoid storing it in a bathroom. Keep all medications in a safe location, out of the reach of children and pets.
Missing a Dose
If you miss a dose, take it as soon as you remember on the same day. If you don't remember until the next day, take the missed dose and then resume your regular schedule the following day. This may extend your treatment week by one day. Do not take two doses at the same time or take extra doses.
Lifestyle & Tips
- Avoid live or live-attenuated vaccines during and for at least 6 months after treatment.
- Practice good hygiene (hand washing) and avoid sick individuals to reduce infection risk.
- Report any signs of infection (fever, chills, sore throat) immediately.
- Females of reproductive potential must use effective contraception during treatment and for 6 months after the last dose of each treatment year.
- Male patients must take precautions to prevent pregnancy of their partner during treatment and for 6 months after the last dose of each treatment year.
- Attend all scheduled blood tests and doctor appointments to monitor your immune cell counts and overall health.
Available Forms & Alternatives
Dosing & Administration
Adult Dosing
Standard Dose:
The recommended cumulative dose of Mavenclad is 3.5 mg/kg body weight over 2 years, administered as 2 annual treatment courses. Each treatment course consists of 2 treatment cycles. Each treatment cycle consists of 10 mg or 20 mg (one or two 10 mg tablets) taken once daily for 4 or 5 consecutive days. The total dose for each treatment course is 1.75 mg/kg.
Condition-Specific Dosing:
Multiple Sclerosis (MS):
Cumulative dose of 3.5 mg/kg over 2 years. Year 1: 1.75 mg/kg divided into 2 treatment cycles (Cycle 1: 1.75 mg/kg over 4-5 days; Cycle 2: 1.75 mg/kg over 4-5 days, 23-27 days after Cycle 1). Year 2: 1.75 mg/kg divided into 2 treatment cycles (Cycle 3: 1.75 mg/kg over 4-5 days, 12 months after Cycle 1; Cycle 4: 1.75 mg/kg over 4-5 days, 23-27 days after Cycle 3). No further cladribine treatment is recommended after 2 courses.
Pediatric Dosing
Neonatal:
Not established
Infant:
Not established
Child:
Not established
Adolescent:
Not established
Dose Adjustments
Renal Impairment:
Mild:
No dose adjustment required (CrCl 60-89 mL/min)
Moderate:
No dose adjustment required (CrCl 30-59 mL/min)
Severe:
Contraindicated (CrCl < 30 mL/min)
Dialysis:
Contraindicated
Hepatic Impairment:
Mild:
No dose adjustment required
Moderate:
No dose adjustment required
Severe:
No dose adjustment required, but caution is advised due to limited data.
Pharmacology
Mechanism of Action
Cladribine is a purine nucleoside analog. It is a prodrug that is phosphorylated intracellularly by deoxycytidine kinase (dCK) to its active triphosphate form, 2-chlorodeoxyadenosine triphosphate (Cd-ATP). Cd-ATP interferes with DNA synthesis and repair, leading to DNA strand breaks and activation of programmed cell death (apoptosis), particularly in lymphocytes. Cladribine selectively targets lymphocytes (B and T cells) due to their relatively high dCK activity and low 5'-nucleotidase activity, which allows for the accumulation of the active triphosphate form.
Pharmacokinetics
Absorption:
Bioavailability:
Approximately 40% (oral)
Tmax:
0.5 to 1.5 hours
FoodEffect:
Food does not significantly affect bioavailability.
Distribution:
Vd:
Approximately 490-980 L (high)
ProteinBinding:
Approximately 20%
CnssPenetration:
Limited (CSF concentrations are approximately 25% of plasma concentrations)
Elimination:
HalfLife:
Approximately 24 hours (terminal plasma half-life)
Clearance:
Approximately 660-780 mL/min (renal and non-renal)
ExcretionRoute:
Renal (primarily unchanged drug and metabolites)
Unchanged:
Approximately 18% (renal excretion of unchanged drug)
Pharmacodynamics
OnsetOfAction:
Lymphocyte count reduction typically begins within days of dosing.
PeakEffect:
Maximum lymphocyte reduction typically occurs 2-3 months after each treatment course.
DurationOfAction:
Immunological effects (lymphocyte reduction) can be long-lasting, with lymphocyte counts gradually recovering over 6-9 months, but the therapeutic effect on MS disease activity extends beyond this period due to immune reconstitution.
Safety & Warnings
BLACK BOX WARNING
MALIGNANCY and TERATOGENICITY. Mavenclad is associated with an increased risk of malignancy. Do not administer Mavenclad to patients with active malignancy. Mavenclad may cause fetal harm when administered to a pregnant woman. Exclude pregnancy before initiating Mavenclad. Advise females of reproductive potential to use effective contraception during Mavenclad dosing and for 6 months after the last dose in each treatment year. Advise male patients to take precautions to prevent pregnancy of their partner during Mavenclad dosing and for 6 months after the last dose in each treatment year.
Side Effects
Urgent Side Effects: Seek Medical Help Immediately
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical attention right away:
Signs of an allergic reaction: rash, hives, itching, red, swollen, blistered, or peeling skin (with or without fever), wheezing, tightness in the chest or throat, trouble breathing, swallowing, or talking, unusual hoarseness, or swelling of the mouth, face, lips, tongue, or throat.
Signs of infection: fever, chills, severe sore throat, ear or sinus pain, cough, increased or discolored sputum, painful urination, mouth sores, or a wound that won't heal.
Signs of shingles: pain, itching, or tingling, fever, muscle aches, or a rash (with or without blisters).
Signs of bleeding: vomiting or coughing up blood, coffee ground-like vomit, blood in the urine, black, red, or tarry stools, gum bleeding, abnormal vaginal bleeding, unexplained bruises or bruises that enlarge, or uncontrolled bleeding.
Signs of a severe skin reaction (Stevens-Johnson syndrome/toxic epidermal necrolysis): red, swollen, blistered, or peeling skin (with or without fever), red or irritated eyes, or sores in the mouth, throat, nose, or eyes.
Feeling extremely tired or weak.
Shortness of breath, significant weight gain, or swelling in the arms or legs.
Rapid or abnormal heartbeat.
Signs of high blood pressure: severe headache or dizziness, fainting, or changes in vision.
Depression.
A rare but serious brain condition called progressive multifocal leukoencephalopathy (PML) has been associated with this medication. If you experience symptoms like confusion, memory problems, depression, changes in behavior, uneven strength, speech or thinking difficulties, balance problems, or vision changes, contact your doctor immediately.
Liver problems have occurred with this medication, sometimes with life-threatening consequences. If you notice signs of liver problems, such as dark urine, fatigue, decreased appetite, stomach upset or pain, light-colored stools, vomiting, or yellow skin or eyes, seek medical attention right away.
Other Possible Side Effects
Like all medications, this drug can cause side effects. Many people may not experience any side effects or only minor ones. If you're concerned about any of the following side effects or if they persist, contact your doctor:
Common cold symptoms.
Upset stomach.
Headache.
Back pain.
Joint pain.
Sleep disturbances.
* Hair thinning or loss.
This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical attention right away:
Signs of an allergic reaction: rash, hives, itching, red, swollen, blistered, or peeling skin (with or without fever), wheezing, tightness in the chest or throat, trouble breathing, swallowing, or talking, unusual hoarseness, or swelling of the mouth, face, lips, tongue, or throat.
Signs of infection: fever, chills, severe sore throat, ear or sinus pain, cough, increased or discolored sputum, painful urination, mouth sores, or a wound that won't heal.
Signs of shingles: pain, itching, or tingling, fever, muscle aches, or a rash (with or without blisters).
Signs of bleeding: vomiting or coughing up blood, coffee ground-like vomit, blood in the urine, black, red, or tarry stools, gum bleeding, abnormal vaginal bleeding, unexplained bruises or bruises that enlarge, or uncontrolled bleeding.
Signs of a severe skin reaction (Stevens-Johnson syndrome/toxic epidermal necrolysis): red, swollen, blistered, or peeling skin (with or without fever), red or irritated eyes, or sores in the mouth, throat, nose, or eyes.
Feeling extremely tired or weak.
Shortness of breath, significant weight gain, or swelling in the arms or legs.
Rapid or abnormal heartbeat.
Signs of high blood pressure: severe headache or dizziness, fainting, or changes in vision.
Depression.
A rare but serious brain condition called progressive multifocal leukoencephalopathy (PML) has been associated with this medication. If you experience symptoms like confusion, memory problems, depression, changes in behavior, uneven strength, speech or thinking difficulties, balance problems, or vision changes, contact your doctor immediately.
Liver problems have occurred with this medication, sometimes with life-threatening consequences. If you notice signs of liver problems, such as dark urine, fatigue, decreased appetite, stomach upset or pain, light-colored stools, vomiting, or yellow skin or eyes, seek medical attention right away.
Other Possible Side Effects
Like all medications, this drug can cause side effects. Many people may not experience any side effects or only minor ones. If you're concerned about any of the following side effects or if they persist, contact your doctor:
Common cold symptoms.
Upset stomach.
Headache.
Back pain.
Joint pain.
Sleep disturbances.
* Hair thinning or loss.
This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Signs of infection: fever, chills, body aches, sore throat, cough, painful urination, skin rash, unusual fatigue.
- Signs of malignancy: new or growing lumps, unexplained weight loss, persistent cough, changes in moles or skin lesions.
- Signs of liver problems: yellowing of skin or eyes (jaundice), dark urine, severe stomach pain, nausea, vomiting.
- Signs of Progressive Multifocal Leukoencephalopathy (PML): new or worsening weakness on one side of the body, clumsiness, vision changes, changes in thinking or memory, personality changes.
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Describe the allergic reaction you experienced, including the symptoms that occurred.
Existing health conditions, including kidney disease, liver disease, hepatitis B, hepatitis C, HIV, or other infections.
If you have been diagnosed with tuberculosis (TB).
Any medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins, as some may interact with this medication. Specifically, certain drugs used to treat hepatitis C, HIV, and infections may be contraindicated.
If you have been diagnosed with clinically isolated syndrome (CIS).
If you are breastfeeding or plan to breastfeed. Note that breastfeeding is not recommended while taking this medication, and you may need to avoid breastfeeding for a period after your last dose. Consult your doctor to determine the necessary duration.
This list is not exhaustive, and it is crucial to discuss all your medications, health conditions, and concerns with your doctor and pharmacist to ensure safe use. Do not initiate, discontinue, or modify the dosage of any medication without first consulting your doctor.
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Describe the allergic reaction you experienced, including the symptoms that occurred.
Existing health conditions, including kidney disease, liver disease, hepatitis B, hepatitis C, HIV, or other infections.
If you have been diagnosed with tuberculosis (TB).
Any medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins, as some may interact with this medication. Specifically, certain drugs used to treat hepatitis C, HIV, and infections may be contraindicated.
If you have been diagnosed with clinically isolated syndrome (CIS).
If you are breastfeeding or plan to breastfeed. Note that breastfeeding is not recommended while taking this medication, and you may need to avoid breastfeeding for a period after your last dose. Consult your doctor to determine the necessary duration.
This list is not exhaustive, and it is crucial to discuss all your medications, health conditions, and concerns with your doctor and pharmacist to ensure safe use. Do not initiate, discontinue, or modify the dosage of any medication without first consulting your doctor.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.
While taking this drug, you may be at a higher risk of developing infections, some of which can be severe or even life-threatening. To minimize this risk, practice good hygiene by washing your hands frequently and avoid close contact with individuals who have infections, colds, or flu.
Additionally, this medication may increase your tendency to bleed easily. Therefore, it is crucial to be cautious and avoid injuries. To reduce the risk of bleeding, use a soft toothbrush and an electric razor for shaving.
Regular monitoring of your blood work and other laboratory tests is necessary, as directed by your doctor. If you are not up to date with all recommended vaccinations, consult your doctor, as you may need to receive certain vaccines before starting treatment with this drug.
Before receiving any vaccinations, discuss the potential risks and benefits with your doctor, as some vaccines may not be effective or may increase the risk of infection when taken with this medication.
If you have taken this drug and are scheduled to receive a blood transfusion, inform your doctor, as they may need to order an MRI scan before initiating treatment.
There is a risk of developing herpes zoster (shingles) while taking this medication. Your doctor may recommend a vaccine against shingles before starting treatment.
Furthermore, cases of hepatitis and tuberculosis (TB) have been reported in patients taking this drug, and in some instances, these infections have been fatal. To assess your risk, you will undergo testing for hepatitis and TB before the first and second treatment courses.
While taking this drug, you may be at a higher risk of developing infections, some of which can be severe or even life-threatening. To minimize this risk, practice good hygiene by washing your hands frequently and avoid close contact with individuals who have infections, colds, or flu.
Additionally, this medication may increase your tendency to bleed easily. Therefore, it is crucial to be cautious and avoid injuries. To reduce the risk of bleeding, use a soft toothbrush and an electric razor for shaving.
Regular monitoring of your blood work and other laboratory tests is necessary, as directed by your doctor. If you are not up to date with all recommended vaccinations, consult your doctor, as you may need to receive certain vaccines before starting treatment with this drug.
Before receiving any vaccinations, discuss the potential risks and benefits with your doctor, as some vaccines may not be effective or may increase the risk of infection when taken with this medication.
If you have taken this drug and are scheduled to receive a blood transfusion, inform your doctor, as they may need to order an MRI scan before initiating treatment.
There is a risk of developing herpes zoster (shingles) while taking this medication. Your doctor may recommend a vaccine against shingles before starting treatment.
Furthermore, cases of hepatitis and tuberculosis (TB) have been reported in patients taking this drug, and in some instances, these infections have been fatal. To assess your risk, you will undergo testing for hepatitis and TB before the first and second treatment courses.
Overdose Information
Overdose Symptoms:
- Severe myelosuppression (e.g., severe lymphopenia, neutropenia, anemia, thrombocytopenia)
- Neurological toxicity (e.g., ataxia, weakness)
What to Do:
There is no specific antidote for cladribine overdose. Management should consist of supportive care and careful monitoring of hematologic parameters. Consider blood transfusions or growth factors as needed. Call 1-800-222-1222 (Poison Control Center) for further guidance.
Drug Interactions
Contraindicated Interactions
- Immunosuppressants (e.g., methotrexate, cyclosporine, azathioprine, natalizumab, fingolimod, ocrelizumab, alemtuzumab) - due to additive immunosuppression and risk of severe myelosuppression.
- Live or live-attenuated vaccines - due to risk of vaccine-induced infection.
Major Interactions
- Other myelosuppressive agents (e.g., carbamazepine, chloramphenicol, colchicine, flucytosine, ganciclovir, interferon alfa, zidovudine) - increased risk of hematologic toxicity.
- Nephrotoxic agents (e.g., aminoglycosides, NSAIDs, cisplatin) - potential for increased renal toxicity, though cladribine is not primarily nephrotoxic.
- BCRP (Breast Cancer Resistance Protein) inhibitors (e.g., eltrombopag, cyclosporine, gefitinib, lapatinib, ritonavir) - may increase cladribine exposure.
- BCRP inducers (e.g., rifampin, St. John's Wort) - may decrease cladribine exposure.
Moderate Interactions
- P-glycoprotein (P-gp) inhibitors (e.g., amiodarone, carvedilol, clarithromycin, cyclosporine, diltiazem, dronedarone, erythromycin, itraconazole, ketoconazole, quinidine, ranolazine, verapamil) - may increase cladribine exposure.
- P-glycoprotein (P-gp) inducers (e.g., carbamazepine, phenobarbital, phenytoin, rifampin, St. John's Wort) - may decrease cladribine exposure.
Minor Interactions
- Not specifically identified for minor interactions with significant clinical impact.
Monitoring
Baseline Monitoring
Complete Blood Count (CBC) with differential
Rationale: To ensure baseline lymphocyte count is within normal limits (≥ 800 cells/mm³) and to assess for other cytopenias before initiating treatment.
Timing: Within 10 days prior to the first dose of each treatment course (Year 1 and Year 2).
Varicella Zoster Virus (VZV) serology
Rationale: To determine immune status to VZV. Patients seronegative for VZV should be vaccinated prior to treatment.
Timing: Prior to initiation of Mavenclad.
Tuberculosis (TB) screening
Rationale: To screen for active or latent TB infection. Treatment should be deferred until TB infection is adequately treated.
Timing: Prior to initiation of Mavenclad.
Malignancy screening
Rationale: To screen for active malignancy. Mavenclad is contraindicated in patients with active malignancy.
Timing: Prior to initiation of Mavenclad.
Liver function tests (LFTs)
Rationale: To assess baseline hepatic function.
Timing: Prior to initiation of Mavenclad.
Routine Monitoring
Complete Blood Count (CBC) with differential (especially lymphocyte count)
Frequency: Before each treatment course (Year 1 and Year 2), and at months 2 and 6 of Year 1 and Year 2.
Target: Lymphocyte count ≥ 800 cells/mm³ before starting each treatment course. If < 800 cells/mm³, defer treatment.
Action Threshold: If lymphocyte count is < 500 cells/mm³ at month 2 or 6, monitor closely until recovery. If severe lymphopenia (Grade 4, < 200 cells/mm³) occurs, consider antiviral prophylaxis.
Signs and symptoms of infection
Frequency: Regularly throughout treatment and for at least 6 months after the last dose.
Target: N/A
Action Threshold: Promptly investigate and treat any signs of infection. Consider delaying or discontinuing treatment if severe infection occurs.
Signs and symptoms of malignancy
Frequency: Regularly throughout treatment and follow-up.
Target: N/A
Action Threshold: Promptly investigate any suspicious findings. Discontinue treatment if malignancy is diagnosed.
Symptom Monitoring
- Signs of infection (fever, chills, sore throat, unusual fatigue, skin lesions, urinary symptoms)
- Signs of malignancy (new or worsening lumps, unexplained weight loss, persistent cough, changes in moles)
- Signs of liver injury (unexplained nausea, vomiting, abdominal pain, dark urine, jaundice)
- Progressive Multifocal Leukoencephalopathy (PML) symptoms (new or worsening neurological symptoms like cognitive changes, motor weakness, visual disturbances, speech difficulties)
Special Patient Groups
Pregnancy
Contraindicated. Mavenclad may cause fetal harm. Pregnancy must be excluded before initiation. Females of reproductive potential must use effective contraception during treatment and for 6 months after the last dose of each treatment year. Male patients must take precautions to prevent pregnancy of their partner during treatment and for 6 months after the last dose of each treatment year.
Trimester-Specific Risks:
First Trimester:
High risk of teratogenicity due to antimetabolite action.
Second Trimester:
High risk of teratogenicity due to antimetabolite action.
Third Trimester:
High risk of teratogenicity due to antimetabolite action.
Lactation
Contraindicated. It is unknown if cladribine is excreted in human milk. Due to the potential for serious adverse reactions in the breastfed infant, breastfeeding is contraindicated during treatment and for 10 days after the last dose of each treatment course.
Infant Risk:
High risk of serious adverse effects (e.g., immunosuppression, myelosuppression) in the infant.
Pediatric Use
Safety and effectiveness in pediatric patients have not been established. Not recommended for use in patients under 18 years of age.
Geriatric Use
Clinical studies did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Use with caution in elderly patients, considering the greater frequency of decreased hepatic, renal, or cardiac function, and concomitant disease or other drug therapy.
Clinical Information
Clinical Pearls
- Mavenclad is a unique oral DMT for MS, administered in short courses over two years, providing long-lasting efficacy without continuous dosing.
- Strict adherence to baseline and routine lymphocyte monitoring is crucial due to the risk of severe lymphopenia and associated infections.
- Patients must be screened for active infections (especially VZV and TB) and malignancy before initiation, as these are contraindications.
- The boxed warnings for malignancy and teratogenicity are critical; thorough patient counseling on these risks and contraception is essential.
- Avoid concomitant use of other immunosuppressants or live vaccines due to increased risks.
- Patients should carry an alert card indicating they are on Mavenclad and the potential for prolonged lymphopenia.
Alternative Therapies
- Interferon beta (e.g., Avonex, Betaseron, Rebif, Plegridy)
- Glatiramer acetate (e.g., Copaxone, Glatopa)
- Fingolimod (Gilenya)
- Natalizumab (Tysabri)
- Ocrelizumab (Ocrevus)
- Dimethyl fumarate (Tecfidera)
- Teriflunomide (Aubagio)
- Alemtuzumab (Lemtrada)
- Siponimod (Mayzent)
- Ozanimod (Zeposia)
- Ponesimod (Ponvory)
Cost & Coverage
Average Cost:
Highly variable, typically >$100,000 per treatment course per 10mg tablet (multiple tablets per course)
Insurance Coverage:
Specialty Tier (requires prior authorization, often subject to step therapy and quantity limits)
General Drug Facts
If your symptoms or health issues persist or worsen, it is essential to contact your doctor for further evaluation and guidance. To ensure safe and effective treatment, never share your medication with others or take someone else's medication.
This medication is accompanied by a Medication Guide, which is a valuable resource that provides important information about its use. It is crucial to read this guide carefully and review it again whenever your prescription is refilled. If you have any questions or concerns about this medication, do not hesitate to consult with your doctor, pharmacist, or other healthcare provider.
In the event of a suspected overdose, immediate action is necessary. Call your local poison control center or seek emergency medical attention right away. When reporting the incident, be prepared to provide detailed information, including the name of the medication taken, the amount consumed, and the time it occurred.
This medication is accompanied by a Medication Guide, which is a valuable resource that provides important information about its use. It is crucial to read this guide carefully and review it again whenever your prescription is refilled. If you have any questions or concerns about this medication, do not hesitate to consult with your doctor, pharmacist, or other healthcare provider.
In the event of a suspected overdose, immediate action is necessary. Call your local poison control center or seek emergency medical attention right away. When reporting the incident, be prepared to provide detailed information, including the name of the medication taken, the amount consumed, and the time it occurred.