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Cladribine (Leustat, LITAK)

Read about the chemotherapy drug cladribine, how you have it and other important information. 

Cladribine is a chemotherapy drug used mainly to treat hairy cell leukaemia and occasionally other types of leukaemia and lymphoma.

How it works

Cladribine is one of a group of chemotherapy drugs known as anti metabolites. These stop cells making and repairing DNA. Cancer cells need to make and repair DNA so that they can grow and multiply. Cladribine kills abnormal white blood cells.

How you have it

There are 2 types of cladribine, these are called Leustat and LITAK.

You have Leustat into your bloodstream (intravenously). Or you have LITAK as an injection just under the skin (subcutaneous injection).

Into your bloodstream

You have the treatment through a drip into your arm. A nurse puts a small tube (a cannula) into one of your veins and connects the drip to it.

You might need a central line. This is a long plastic tube that gives the drugs into a large vein, either in your chest or through a vein in your arm. It stays in while you’re having treatment, which may be for a few months.

Injection under your skin

You usually have injections under the skin (subcutaneous injection) into the stomach, thigh or top of your arm.

You might have stinging or a dull ache for a short time after this type of injection but they don't usually hurt much. The skin in the area may go red and itchy for a while.

The video below shows you how to give an injection just under your skin (subcutaneously). 

When you have Leustat

For hairy cell leukaemia you usually have intravenous Leustat as a continuous drip for 7 days. 

For chronic lymphocytic leukaemia you usually have Leustat as a 2 hour drip each day for 5 days every 4 weeks. Each 4 week period is called a cycle of treatment. You may have up to 6 cycles. 

When you have LITAK

You have LITAK as injections just under the skin each day for 5 days. Your doctor or nurse may show you how to do this yourself. 

Your doctor may prescribe a medicine called allopurinol to lower blood levels of uric acid which can build up in your blood when the leukaemia cells are killed. 

If you inject a wrong dose of LITAK by accident, tell your doctor straight away. If you accidentally forget a dose, don't inject a double dose to make up for it but let your doctor know as soon as possible.

Tests during treatment

You have blood tests before starting treatment and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.

Side effects

Important information

Other medicines, foods and drink

Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.

Pregnancy and contraception

This drug may harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment with this drug and for at least 6 months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.

Loss of fertility

You may not be able to become pregnant or father a child after treatment with this drug. Talk to your doctor before starting treatment if you think you may want to have a baby in the future. Men may be able to store sperm before starting treatment. Women may be able to store eggs or ovarian tissue but this is rare.

Breastfeeding

Don’t breastfeed during this treatment because the drug may come through in your breast milk.

Treatment for other conditions

Always tell other doctors, nurses or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.

Immunisations

Don’t have immunisations with live vaccines while you’re having treatment and for at least 6 months afterwards.

In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and Zostavax (shingles vaccine).

You can:

  • have other vaccines, but they might not give you as much protection as usual
  • have the flu vaccine
  • be in contact with other people who've had live vaccines as injections

Avoid contact with people who’ve had live vaccines taken by mouth (oral vaccines). This includes the rotavirus vaccine given to babies. The virus is in the baby’s urine for up to 2 weeks and can make you ill. So, you mustn't change their nappies for 2 weeks after their vaccination.

You also need to avoid anyone who has had oral polio or typhoid vaccination recently.

Sodium and cladribine

This drug contains sodium (salt). You might need to take account of this if you are on a controlled sodium diet. Tell your doctor if you are on a low salt diet. 

More information about this treatment

For further information about this treatment go to the electronic Medicines Compendium (eMC) website.

You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.

Information and help

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