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Drug interactions

Brexucabtagene autoleucel + Cladribine

Severity: Major

Brexucabtagene autoleucel 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 depletes lymphocytes and may compromise collection, expansion, and activity of CAR-T cells. It also adds to the infection risk from immunosuppression.

What this interaction means in plain words

Brexucabtagene autoleucel 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.

Brexucabtagene autoleucel belongs to Oncology; Cladribine belongs to Oncology.

Evidence level: Low

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 before leukapheresis and CAR-T infusion, observing the washout interval in the product labeling. Monitor 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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Brexucabtagene autoleucel with Cladribine?

MediHelp rates the interaction as major. Brexucabtagene autoleucel 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 depletes lymphocytes and may compromise collection, expansion, and activity of CAR-T cells. It also adds to the infection risk from immunosuppression.

How serious is the interaction between Brexucabtagene autoleucel 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 before leukapheresis and CAR-T infusion, observing the washout interval in the product labeling. Monitor 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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