Drug interactions
Axicabtagene ciloleucel + Cladribine
Severity: Major
Axicabtagene ciloleucel and Cladribine: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Cladribine is toxic to lymphocytes and may impair collection or expansion of T cells, and may reduce CAR-T cell function and persistence. The combination also adds to immunosuppression and infection risk.
What this interaction means in plain words
Axicabtagene ciloleucel and Cladribine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Axicabtagene ciloleucel belongs to Oncology; Cladribine belongs to Oncology.
Why it happens
Lymphotoxic effect of cladribine reduces T-cell numbers and function, affecting CAR-T manufacturing and expansion, and adds to immunosuppression.
What to do
Avoid cladribine in the period before leukapheresis and CAR-T infusion; follow the product labeling for the washout interval. Monitor closely for infections if exposure has occurred.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Cladribine
- Adenovirus types 4 and 7 live + Cladribine Contraindicated
- Cladribine + Siponimod Contraindicated
- Cladribine + Tofacitinib Contraindicated
- Belatacept + Cladribine Major
- Brexucabtagene autoleucel + Cladribine Major
- Cholera vaccine + Cladribine Major
Other interactions of Axicabtagene ciloleucel
Frequently asked questions
Can I take Axicabtagene ciloleucel with Cladribine?
MediHelp rates the interaction as major. Axicabtagene ciloleucel and Cladribine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Cladribine is toxic to lymphocytes and may impair collection or expansion of T cells, and may reduce CAR-T cell function and persistence. The combination also adds to immunosuppression and infection risk.
How serious is the interaction between Axicabtagene ciloleucel and Cladribine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid cladribine in the period before leukapheresis and CAR-T infusion; follow the product labeling for the washout interval. Monitor closely for infections if exposure has occurred.
What other medicines interact with Cladribine?
MediHelp also lists interactions of Cladribine with, for example, Adenovirus types 4 and 7 live, Siponimod, Tofacitinib. The full list is on the Cladribine page.
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