Drug Interaction Report

ADDITIONAL CONTRACEPTION RECOMMENDED: Coadministration with cladribine may reduce the efficacy of hormonal contraceptives. The mechanism has not been established. There are no clinical data regarding the use of cladribine with hormonal contraceptives.

MANAGEMENT: Although the clinical significance of this interaction is unknown, caution is advised when cladribine is prescribed concomitantly with hormonal contraceptives because of the potential to cause fetal harm. Women should avoid becoming pregnant during treatment with cladribine and for at least 6 months after the last dose in each treatment course. Women using hormonal contraceptives should add a barrier method during cladribine dosing and for at least 4 weeks after the last dose in each treatment cycle. In addition, male patients should take precautions to prevent pregnancy of their partner during cladribine dosing and for at least 6 months after the last dose in each treatment course.

ADJUST DOSING INTERVAL: Oral cladribine may increase the bioavailability of other drugs, which may increase the risk or severity of adverse reactions. Cladribine tablets may contain hydroxypropyl betadex, which could form a complex with the active ingredients of other drugs, especially agents with low solubility. The clinical relevance of this interaction remains unknown.

MANAGEMENT: Administration of oral cladribine should be separated from any other oral drug by at least 3 hours.