Cladribine

What is cladribine?

Cladribine is used to kill cancer cells. It stops cancer cells from dividing and making new cells.

You may hear cladribine called CDA or 2-CDA or by its brand name, Leustatin. Cladribine comes in an injection form.

Before giving cladribine to your child

Tell your doctor if your child has ever reacted badly to cladribine or any other medication.

Talk with your doctor or pharmacist if your child has any of the following conditions. Precautions may need to be taken with this medicine if your child has:

• infection or recent exposure to infection, such as chickenpox
• low blood counts
• history of liver or kidney problems

How will your child get cladribine?

Cladribine is a clear liquid given by the nurse as a needle into your child's vein (intravenously). Your child will get cladribine in the hospital clinic or on the nursing unit. It is usually given slowly over a period of several days.

What are the possible side effects of cladribine?

Your child may have some of these side effects while they take cladribine. Check with your child's doctor if your child continues to have any of these side effects and they do not go away, or they bother your child:

• headache
• mild nausea (upset stomach)
• loss of appetite
• vomiting (throwing up)
• feeling tired
• diarrhea (watery bowel movements)
• constipation

Call your child's doctor during office hours if your child has any of these side effects:

• unusual tiredness or weakness
• swelling of feet or lower legs
• numbness or tingling in feet or hands
• mild skin rash or itching
• fast heartbeat

Most of the following side effects are not common, but they may be a sign of a serious problem. Call your child's doctor right away or take your child to Emergency if your child has any of these side effects:

• fever or chills
• cough or sore throat
• lower back or side pain
• pain or difficulty with urination (peeing)
• redness, pain, or swelling of the skin
• unusual bruising or bleeding
• blood in the urine (pee) or stools (poo)
• black, tarry stools
• difficulty moving any part of the body
• shortness of breath or difficulty breathing

What safety measures should you take when your child is using cladribine?

Keep all appointments at the clinic or doctor's office so that the doctor can check your child's response to cladribine.

Cladribine does not usually cause nausea or vomiting. If you child has an upset stomach, let the doctor or nurse know.

Hair loss does not usually occur with cladribine.

Cladribine can lower the number of white blood cells in the blood temporarily, which increases your child's chances of getting an infection. Your child can take the following precautions to prevent infections, especially when the blood count is low:

• Avoid people with infections, such as a cold or the flu.
• Avoid places that are very crowded with large groups of people.
• Be careful when brushing or flossing your child's teeth. Your doctor, nurse, or dentist may suggest different ways to clean your child's mouth and teeth.
• You or your child should not touch your child's eyes or inside their nose without washing your hands first.
• Your child's nurse will review with you what to do in case of fever.

Cladribine can lower the number of platelets in the blood, which increases your child's risk of bleeding. You can take the following precautions:

• Be careful not to cut your child when using a razor, fingernail scissors, or toenail clippers.
• Be careful when shaving or waxing.
• Your child should avoid contact sports where bruising or injury could occur.
• Your child should not receive a permanent tattoo or any kind of body piercing.
• Before your child has surgery, including dental surgery, inform the doctor or dentist that your child is taking cladribine.

Your child should not receive any immunizations (vaccines) without your child's doctor's approval. Your child or anyone else in your household should not get oral polio vaccine while your child is being treated for cancer. Tell your child's doctor if anyone in your household has recently received oral polio vaccine. Your child should avoid contact with anyone who has recently received this vaccine. Other live vaccines that your child should not get include measles, mumps, and rubella (MMR) and chickenpox vaccine.

There is a chance that cladribine may cause birth defects if it is taken at the time of conception or if it is taken during pregnancy. If your child is sexually active, it is best that they use some kind of birth control while receiving cladribine. Tell the doctor right away if your child may be pregnant.

Check with your child's doctor or pharmacist before giving your child any other medicines (prescription, non-prescription, herbal, or natural products).

Tell your doctor or dentist that your child is receiving cladribine before your child has any operation, even on teeth, or an emergency treatment.

What other important information should you know about cladribine?

• Keep a list of all medications your child is on and show the list to the doctor or pharmacist.
• Do not share your child's medicine with others and do not give anyone else's medicine to your child.
• Do not keep any medicines that are out of date. Check with your pharmacist about the best way to throw away outdated or leftover medicines.
  

Gardez le cladribine hors de la vue et de la portée de votre enfant. Conservez-le sous clé dans un endroit sécuritaire. Si votre enfant ingère trop de cladribine, téléphonez à votre centre antipoison local à l'un des numéros suivants. Ces appels sont gratuits.

• Composez le 1-800-POISON-X, ou 1-844-764-7669, de n'importe où au Canada sauf au Québec.
• Composez le 1-800-463-5060 si vous habitez au Québec.