سعر مافينكلاد 10مجم 1 قرص 2024

Cladribine 10 mg tablet (pack of 1) - Mavenclad by Merck, manufactured by Nerpharma and listed in Egypt for relapsing multiple sclerosis; a cytotoxic oral disease-modifying therapy.

• Adult patients with highly active relapsing multiple sclerosis as defined by clinical or imaging features.Population: AdultsEuropean Medicines Agency (EMA)
• Relapsing forms of multiple sclerosis (relapsing-remitting and active secondary progressive disease) in adults, generally for patients with inadequate response to or intolerance of another MS drug; not recommended for clinically isolated syndrome.Population: AdultsDailyMed (U.S. National Library of Medicine)

• Most common (at least 20%): upper respiratory tract infection (38% vs 32% placebo), headache (25% vs 19%) and lymphopenia (24% vs 2%); also nausea, back pain, arthralgia, insomnia, bronchitis, hypertension, fever, depression and alopecia.International label, same product · DailyMed (U.S. National Library of Medicine)
• Most clinically relevant adverse reactions: lymphopenia (25.6%) and herpes zoster (3.0%).International label, same product · European Medicines Agency (EMA)

• Current malignancy; HIV infection; active chronic infections (e.g. hepatitis, tuberculosis); history of hypersensitivity to cladribine.International label, same product · DailyMed (U.S. National Library of Medicine)
• Pregnancy, and females and males of reproductive potential not using effective contraception during dosing and for 6 months (females) or 14 weeks (males) after the last dose of each course; breastfeeding on treatment days and for 10 days after the last dose.International label, same product · DailyMed (U.S. National Library of Medicine)
• Hypersensitivity; HIV infection; active chronic infection (tuberculosis or hepatitis); initiation in immunocompromised patients including those on immunosuppressive or myelosuppressive therapy; active malignancy; moderate or severe renal impairment; pregnancy and breast-feeding.International label, same product · European Medicines Agency (EMA)

• Boxed warning: may increase the risk of malignancy (contraindicated in current malignancy; follow cancer screening guidelines) and risk of teratogenicity (exclude pregnancy; effective contraception required).International label, same product · DailyMed (U.S. National Library of Medicine)
• Dose-dependent lymphopenia occurred in 87% of patients, with nadir about 2-3 months after each course; additive haematological toxicity with other myelosuppressive drugs; other blood cell decreases also reported.International label, same product · DailyMed (U.S. National Library of Medicine)
• Serious, including fatal, bacterial, viral, parasitic and fungal infections, including herpes zoster and progressive multifocal leukoencephalopathy risk; delay treatment in acute infection.International label, same product · DailyMed (U.S. National Library of Medicine)

• Immunomodulatory, immunosuppressive or myelosuppressive drugsAdditive immune effects; concomitant use not recommended (acute short-term corticosteroids allowed).DailyMed (U.S. National Library of Medicine)
• Interferon-betaLymphopenia risk may be increased; concomitant use not recommended.DailyMed (U.S. National Library of Medicine)
• Hematotoxic drugsAdditive haematological effects; monitor haematological parameters.DailyMed (U.S. National Library of Medicine)

• Contraindicated in pregnancy; cladribine was embryolethal and teratogenic in animals; exclude pregnancy before each course, use effective contraception during dosing and for at least 6 months after the last dose of each course (women) and 14 weeks (men); stop if pregnancy occurs.International label, same product · DailyMed (U.S. National Library of Medicine)
• Could cause congenital malformations; women must use effective contraception during treatment and for at least 6 months after the last dose, and male patients must prevent pregnancy of their partner for at least 3 months after the last dose.International label, same product · European Medicines Agency (EMA)
• Contraindicated in breastfeeding; cladribine is present in human milk; do not breastfeed during dosing and for 10 days after the last dose.International label, same product · DailyMed (U.S. National Library of Medicine)

• Cladribine: Prodrug phosphorylated in lymphocytes to the active triphosphate; thought to act in MS through cytotoxic effects on B and T lymphocytes by impairing DNA synthesis, depleting lymphocytes.