Leustatin-Cladribine

Patient Education Quick Reference Guide Diablo Valley Oncology/Hematology Medical Group Phone Number: 925-677-5041

WARNING Blood related problems: Cladribine may cause serious decreases in your red blood cell, white blood cell and platelet levels which can cause infections, anemia, bruising and bleeding (see Precautions To Be Aware Of Before Taking This Medication). Central nervous system related problems: This medication, especially when used at high doses, can cause damage to your central nervous system which can lead to muscle weakness and/or paralysis of the arms or legs. Kidney related problems: Cladribine, especially when used at high doses can cause changes in the ability of your kidneys to work normally, especially when it is given with other medications that can cause kidney damage. (see Precautions To Be Aware Of Before Taking This Medication). Uses For This Medication
  • Cladribine is used to treat adults with a certain types of leukemia (hairy cell leukemia, chronic lymphocytic leukemia).
  • Cladribine is being studied for the treatment of other blood based cancers, including non-Hodgkin’s lymphoma.
  • This medication may also be given for other conditions as determined by your doctor.
  How This Medication Works Cladribine is a chemotherapy medication that doesn’t allow cancer cells, also known as tumor cells, to divide and grow normally, which leads to tumor cell death. Benefits of This Medication In patients with hairy cell leukemia, cladribine is used to help bring on remission from the disease. Who Should Not Take This Medication You should not take this medication if you:
  • Are allergic to cladribine or any of its components
  Precautions to be Aware of Before Taking This Medication

Blood related precautions

  • This medication may temporarily reduce the number of platelets in your blood. This can increase your risk of bleeding. Contact your doctor or healthcare provider if you notice unusual bleeding or bruising, have black or tar-like stools, see blood in your urine, or develop pinpoint red spots on your skin. If your platelet levels become too low, your doctor or healthcare provider may recommend that your treatment be delayed, that you receive a platelet transfusion, and/or that you take medication to help increase the number of platelets in your blood. To lower your chance of bleeding, do not use aspirin, aspirin-containing medications, or aspirin-like medications (for example ibuprofen, naproxen). Use caution with sharp objects like razors and nail cutters, and avoid activities that can cause cuts, bumps and bruises.
  • This medication will temporarily reduce the number of germ fighting white blood cells in your blood. This can increase your risk of infection. Contact your doctor or healthcare provider promptly if you develop any signs of an infection such as fever, painful urination, chills or a sore throat that doesn’t go away. If your white blood cell levels become too low, your doctor or healthcare provider may recommend that your treatment be delayed and/or you receive medication to increase the number of white cells in your blood. To lower your risk of infection, stay away from crowds and people with colds or other illnesses, wash your hands with soap and water well and often, and brush and floss your teeth daily.
  • This medication may temporarily lower the number of red cells in your blood. This can increase your risk of anemia. If your red blood cell level becomes low, you may feel tired and weak. If your red blood cell level becomes too low, your doctor or healthcare provider may recommend that your treatment be delayed, that you receive a red blood cell transfusion, and/or you receive a medication to help increase the red cells in your blood.
  Infection related precautions Very serious bacterial, viral, and fungal infections have been reported in patients receiving cladribine. The risk of developing these infections may last for several months even after treatment is complete. Your doctor or healthcare provider will prescribe medications to help prevent certain infections. These medications will be given at the start of cladribine treatment and may be continued even after your last cladribine dose. Organ related precautions This medication can cause changes in the ability of your kidneys to work normally. In addition, this medication is cleared from the body by the kidneys. In patients with severe kidney problems, cladribine may not be cleared from the body as well. This can lead to high levels of this medication in the body and a greater chance of side effects. Your doctor or healthcare provider will check your kidneys regularly, usually through blood tests, while you are on this medication to make sure that your kidneys are working properly. If you have any kidney problems before starting this medication, make sure that you tell your doctor or healthcare provider so that he or she can watch you carefully for possible problems or side effects.

Miscellaneous precautions

  • Many patients will have a fever after receiving cladribine, especially in the first month of treatment.
  • This medication can cause tumor lysis syndrome (TLS). This occurs when chemotherapy medications rapidly kill large numbers of cancer cells and cause abnormal changes in your blood. Your doctor or healthcare provider will check your blood regularly through blood tests. In addition, if you experience symptoms such as muscle weakness, tingling on the lips, arms or legs, anxiety, cough, wheezing, rapid and irregular heart beats, dizziness, chest tightness (shortness of breath), fatigue, increased nausea and/or vomiting, joint-pain, or a feeling of general discomfort, you should contact your doctor or healthcare provider.
  • Do not receive any immunizations (vaccinations) while on this medication without your doctor or healthcare provider’s approval. This medication can increase your risk of infection. For certain immunizations, you may develop the infection that the immunization is intended to prevent.
 

Patient specific precautions

  • It is not known if this medication is safe and effective in children.
  Pregnancy and Breastfeeding Precautions
  • This medication may cause fetal harm. When taking this medication, you should use effective birth control to prevent pregnancy. Tell your doctor or healthcare provider right away if you or your spouse/partner becomes pregnant.
  • It is not known whether this medication is found or excreted in breast milk. Since many medications are excreted in breast milk and because this medication can cause serious harmful reactions in infants, breastfeeding should be avoided.
  • Many anti-cancer therapies can cause sterility. Notify your doctor or healthcare provider if you want to have children in the future.
 

Medication and Food Interactions

Before using this medication, tell your doctor or healthcare provider of all prescription or over-the- counter products you are taking, including dietary supplements or vitamins, herbal medicines and homeopathic remedies. Do not start or stop any medication without your doctor or healthcare provider’s approval.
  • There are no known interactions with this medication.
  Side Effects
  • All medications can cause side effects. However, not all patients will experience these side effects. In addition, other side effects not listed can also occur in some patients. You should call your doctor or healthcare provider if you have any questions or concerns while you are on this medication.
  • You should contact your doctor or healthcare provider if you experience any side effect(s) which don’t go away, worsen, are serious in nature, or are worrisome to you.
  • Side effects can occur when cladribine is given alone or together with other chemotherapy medications. The side effects listed below are those reported in patients who were treated with cladribine alone.
 

More common side effects

  • Decreased platelet, red blood cell, and/or white blood cell levels (see Precautions To Be Aware Of Before Taking This Medication)
  • Headache
  • Nausea
  • Tiredness (fatigue)
  • Rash
  • Fever
  • Reactivation of herpes virus infection (which is usually prevented by taking medications) (see Precautions To Be Aware Of Before Taking This Medication)
 

Less common side effects

  • Loss of appetite
  • Vomiting, diarrhea
  • Headache
  • Pain and/or redness at injection site
 

Rare side effects

This is not a complete list of the rare side effects reported with cladribine. For a complete list, please talk with your doctor or healthcare provider about reviewing a copy of the package insert.
  • Trouble sleeping, dizziness
  • Coughing, shortness of breath
  • Muscle pain, bone pain
  • Redness of skin, itching, sweating
  • Diarrhea, constipation, stomach pain
  • Swelling of ankles
  • Increased heart rate (heart beat)
  • Aplastic anemia and hemolytic anemia
  How To Take This Medication
  • This medication is given by injection into a vein (IV) by a healthcare professional. This medication can be given in different doses depending on your weight, your type of condition and whether cladribine is being given with other chemotherapy medications.
  • Antiviral medications and antibiotics may be prescribed for you while you on receiving cladribine to prevent the reactivation of a herpes virus infection and to prevent the development of a lung infection called pneumocystis carinii pneumonia (PCP).
  • In the unlikely event of an overdose of this medication contact your doctor, your local poison control center at 1-800-222-1222, or emergency services immediately.
  Proper Storage
  • It is unlikely that you will need to store this medication. However, in the event that you do, the unopened containers should be stored in the refrigerator. Keep in original package to protect from light.
  • Keep this medication out of the reach of children or pets.
  • Ask your doctor or healthcare provider how to dispose of any medication that you no longer use.