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Drug Formulary
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cladribine

( CLA-dri-been )
Other Name(s): Leustatin® (generic brand available)
Appearance: clear solution mixed into larger bags of fluids
pdf download cladribine patient.pdf
pdf download cladribine pour le patient.pdf

Medication Information Sheet
cladribine (CLA-dri-been)
This document provides general information about your medication. It does not replace the advice of your health care professional. Always discuss your therapy with your health care professional and refer to the package insert for more details.

Other Name: Generic brand(s) available, Leustatin®

Appearance:
clear solution mixed into larger bags of fluids

What is this medication for?
  • For treating certain cancers of the blood, such as hairy cell leukemia.
What should I do before I have this medication?
  • Tell your doctor if you have/had significant medical condition(s), especially if you have / had kidney disease, or if you have any allergies.
  • Cladribine may harm the unborn baby.
  • Let your doctor know if you are breastfeeding, pregnant or plan to become pregnant
  • People who have cancer or leukemia are at a higher risk of developing other cancers/leukemias or blood clots. Also, some cancer medications may increase these risks. You should discuss these with your doctor.
How will this medication affect sex, pregnancy and breastfeeding?
  • Do not use cladribine if you are pregnant. If there is ANY chance that you or your partner may become pregnant, you and your partner together must:► Use 2 effective forms of birth control at the same time while taking this drug: Keep using birth control until 6 months after the last dose (general recommendation). Discuss with your healthcare team.
  • Tell your doctor right away if you or your partner becomes pregnant.
  • Do not breastfeed while on cladribine treatment.
  • Effects on Fertility: Probable
  • Effects on Fertility: Probable
How is this medication given?

  • This drug is given by injection into a vein.

 

 

 

What else do I need to know while on this medication?

  • This medication can interact with other medications and can result in the treatment not working as well or cause severe side effects.

  • Make sure your health care team knows about all your medications (prescription, over-the-counter, herbals and supplements). Check with your health care team before starting or stopping any of them.

  • For mild aches and pain:

    • You may take acetaminophen (Tylenol®) tablets. Ask your health care team about the right dose for you. 
    • Ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or aspirin (acetylsalicylic acid, ASA), including low dose aspirin for heart conditions, may increase your chance of bleeding.
    • Talk to your health care team before you start or stop these medications.
    • If you feel unwell, take your temperature before taking any of these medications. They may hide a fever. 
    • Talk to your health care team or go to the closest emergency room right away if you have a fever.  See the Fever pamphlet for more information.
What are the side effects of this medication?

The following side effects are common or severe. You may not have all of the side effects. Other side effects may occur. If you have any unusual or bothersome symptoms, discuss with your doctor.
 

Side effects and what to do When to contact doctor?
More Common Side Effects

Unusual bleeding or bruising

You may have black stools, cough up blood, blood in your urine, purple or red dots on your skin or bleeding that will not stop. 

Fever, chills, infection

You have a fever if your temperature taken in your mouth (oral temperature) is:

  • 38.3°C (100.9°F) or higher at any time OR
  • 38.0°C (100.4°F) or higher for at least one hour.

 

While you are getting chemotherapy treatments:

  • Keep a digital thermometer at home and take your temperature if you feel hot or unwell (for example, chills).
  • Avoid taking medications that treat a fever before you take your temperature (for example, Tylenol®, acetaminophen, Advil® or ibuprofen) as they may hide a fever.
  • Do not eat or drink anything hot or cold right before taking your temperature.
  • Wash your hands often.
  • Check with your doctor before getting any vaccines, surgeries or visiting your dentist.

If you have a fever, talk to your health care team or go to the closest emergency room. 
See our Neutropenia (Low white blood cell count) pamphlet for more information.

 
 Get emergency medical help right away

Nausea and vomiting

  • Drink clear fluids and avoid large meals. Get fresh air and rest.
  • Limit spicy, fried foods or foods with a strong smell.
  • Take anti-nausea drug(s) exactly as directed by your doctor. It is easier to prevent nausea than to treat it.
  • Contact your doctor if nausea lasts more than 48 hours or vomiting for more than 24 hours.
  • Also see Nausea & Vomiting pamphlet.*
 Contact your health care team if no improvement or if severe

Rash (may be severe with blisters and skin peeling)

  • Stay out of the sun; wear sunblock, a hat and cover exposed skin.
  • Use daily moisturizer.
  • If severe, get emergency medical help right away.
 Contact your health care team if no improvement or if severe

Headache

  • Take painkiller(s) as directed, if given to you by your doctor.
  • Otherwise, take acetaminophen (Tylenol®) tablets as needed for mild aches and pains. Ask your doctor or pharmacist about the right dose for you.
  • Rest often, but may try light exercise.

 

 Contact your health care team if no improvement or if severe
Reactions at the injection site (redness, itchiness, bruising, mild rash or swelling) Contact your health care team if no improvement or if severe

Poor Appetite; don't feel like eating; weight loss

  • Eat foods that you like and try to eat regular small meals.
  • Use meal supplements if possible.  See a dietitian.

 

 Contact your health care team if no improvement or if severe

Tiredness

  • Rest often; take naps if needed. Move slowly when getting up.
  • Eat well-balanced meals and drink plenty of fluids. Light exercise may help.
  • Do not drive a motor vehicle or operate machinery when feeling tired.
 Contact your health care team if no improvement or if severe

Side effects and what to do When to contact doctor?
Less Common Side Effects, but may be Severe
Blood clot (limb pain or swelling, hardened vein in limb), may occur in lungs (sudden start of coughing, breathing problems, chest pain, coughing blood) Get emergency medical help right away

Allergic reaction (fever, severe rash, itchiness, swollen face, lip or tongue, chest or throat tightness)

  • May occur during or shortly after the drug is given.
 Get emergency medical help right away

Kidney problems
(lower back pain, body swelling)

  • Also look for passing little or no urine, darkening or blood in urine, or recent unusual weight gain 
 Get emergency medical help right away
Tingling, numb toes or fingers, difficulty with movements
  • May slowly return to normal after treatment ends.
  • Contact your doctor or nurse if you have trouble doing up buttons, writing, picking up small objects, pain, or trouble with movement.
  • Rarely, may be severe, including paralysis. If severe, get emergency medical help right away.
 Contact your health care team if no improvement or if severe

Lung problems
(increased cough, breathing problems, chest pain, coughing blood)

 Get emergency medical help right away

Heart problems
(irregular heartbeat, chest pain, fainting, swelling, shortness of breath)

 Get emergency medical help right away

Rapid killing of cancer cells when you start treatment may lead to build up of cell waste products

  • If mild, this may cause gout, with joint pains, but if severe, may cause fevers, kidney failure, confusion and be life-threatening.
  • You MUST take the preventive medicines given by your doctor AND
  • Drink plenty of fluids (6-8 glasses per day) and void (urinate) frequently.
 Get emergency medical help right away

For more links on how to manage your symptoms go to https://www.cancercareontario.ca/en/symptom-management.

The information set out in the medication information sheets, regimen information sheets, and symptom management information (for patients) contained in the Drug Formulary (the "Formulary") is intended to be used by health professionals and patients for informational purposes only. The information is not intended to cover all possible uses, directions, precautions, drug interactions or side effects of a certain drug, nor should it be used to indicate that use of a particular drug is safe, appropriate or effective for a given condition.

A patient should always consult a healthcare provider if he/she has any questions regarding the information set out in the Formulary. The information in the Formulary is not intended to act as or replace medical advice and should not be relied upon in any such regard. All uses of the Formulary are subject to clinical judgment and actual prescribing patterns may not follow the information provided in the Formulary.

Funding & Reimbursement

Several payment sources exist for cancer drugs in Ontario, depending on the drug, disease indication, and how and where it is delivered.

View Funding & Reimbursement

Symptom Management

Many people living with cancer experience nausea, diarrhea and other symptoms from their treatment or disease.

View Symptom Management

Drug Safety and Administration

Find documents on drug safety and administration for healthcare providers, including calculations and recommendations.

View Drug Safety and Administration