My name is Beki. I live in Oklahoma. I was diagnosed with relapsing MS in 2000. I started MAVENCLAD in 2021. I was four years into my nursing career at the time of my diagnosis. I had started feeling a lot of fatigue, weakness, tremor, and I was encouraged by my family and friends to go to the doctor. I started with visiting my primary care physician who ordered an MRI. And she said, “Well, the good news is is you don’t have MS.” And I was like, “Hmm, I didn’t even know you were testing me for MS or checking that out.” So she said, “You know I think these symptoms are probably due to stress.” Well, my gut told me, “No, something’s going on.” So with the encouragement of family, friends, and some nursing colleagues, I sought out a second opinion. A few days later, I had a lumbar puncture that confirmed my diagnosis of...relapsing multiple sclerosis. And so that kind of started my journey.

When I was first diagnosed...I felt hopeless. I was lonely. I was afraid. I was very discouraged. Being someone in my mid-20s... had my full life ahead of me, and now I was facing this unpredictable diagnosis of relapsing MS. There were very few treatments available. There were only injections. There were no oral therapies. I’ve been on a weekly injection. I’ve been on an injection I took daily, and an injection I took three times a week. In the spring of 2021, I started having more symptoms. And I had an MRI at that time that showed progression of disease. So, I talked with my doctor’s physician’s assistant and he told me what options were available for treatment. I had no interest in going in for an infusion. I had no interest in taking any more injections. I was so thankful for an option of an oral therapy... and that’s why I chose MAVENCLAD. There’s no injections, there’s no infusion. It’s a very convenient dosing schedule with five days one month…The next month, five more days, and then you’re done till the next year…and then you just have to repeat it one more year.

Before starting MAVENCLAD, I talked to my doctor about the potential side effects, including cancer and the risk of birth defects. I was screened before, during, and after MAVENCLAD and regularly monitored by my doctor. I love the fact that with MAVENCLAD, I didn’t have to take off any work for appointments, for infusions or lab. I did experience some side effects that I have talked to my doctor about. Since finishing MAVENCLAD...I’ve not had any increase in symptoms and I’ve had an MRI that shows that my MS is stable. I’ve been able to continue to exercise by taking daily walks... I love to stretch, which helps with my flexibility. I also love to hike and stay active that way though I’m not hiking crazy mountains and whatnot. I just love being out in nature and MAVENCLAD has helped me continue to do those things. This is my experience. Your experience may be different.

I definitely feel encouraged. And one of the things I have learned is to surround myself with positive people. Having positive people in your life can make a huge difference in any kind of stress that you may have. So my advice to someone with this disease...is don’t be afraid. Don’t give up hope. Don’t be discouraged. Surround yourself with positive people.

MAVENCLAD (cladribine) tablets

Indication and Important Safety Information

WHAT IS MAVENCLAD?

MAVENCLAD is a prescription medicine used to treat relapsing forms of multiple sclerosis (MS), to include relapsing-remitting disease and active secondary progressive disease, in adults. Because of its safety profile, MAVENCLAD is generally used in people who have tried another MS medicine that they could not tolerate or that has not worked well enough.

MAVENCLAD is not recommended for use in people with clinically isolated syndrome (CIS).

It is not known if MAVENCLAD is safe and effective in children under 18 years of age and is therefore not recommended.

Important Safety Information

MAVENCLAD may cause serious side effects, including:

• Risk of cancer (malignancies). You should follow healthcare provider instructions about screening for cancer.
• MAVENCLAD may cause birth defects if used during pregnancy. Women must not be pregnant when they start treatment with MAVENCLAD or become pregnant during MAVENCLAD dosing and within 6 months after the last dose of each yearly treatment course. You should stop treatment with MAVENCLAD and contact your healthcare provider right away if you become pregnant during treatment with MAVENCLAD.
  • For women who are able to become pregnant:
    • Your healthcare provider should order a pregnancy test before you begin your first and second yearly treatment course of MAVENCLAD to make sure that you are not pregnant.
  • Ask your healthcare provider which contraceptive method is right for you. Women and men being treated with MAVENCLAD should use effective birth control (contraception) on the days on which they take MAVENCLAD and for at least 6 months after the last dose of each yearly treatment course.

Do not take MAVENCLAD if you:

• have cancer (malignancy).
• are pregnant, plan to become pregnant, or are a woman of childbearing age or a man able to father a child and you are not using birth control.
• are breastfeeding.
• are human immunodeficiency virus (HIV) positive.
• have active infections, including tuberculosis (TB), hepatitis B or C.
• are allergic to cladribine.

Before you take MAVENCLAD, tell your healthcare provider about all of your medical conditions, including if you:

• think you have an infection.
• have taken, take, or plan to take medicines that affect your immune system or blood cells, or other treatments for MS. Certain medicines can increase your risk of getting an infection.
• have had a recent vaccination or are scheduled to receive any vaccinations. You should not receive live or live-attenuated vaccines within the 4 to 6 weeks preceding treatment with MAVENCLAD or receive these types of vaccines during your treatment with MAVENCLAD and unless directed by your healthcare provider.
• have heart failure.
• have or have had cancer.
• have liver or kidney problems.
• are breastfeeding or plan to breastfeed. It is not known if MAVENCLAD passes into your breast milk. Do not breastfeed on the days on which you take MAVENCLAD, and for 10 days after the last dose.

How should I take MAVENCLAD?

• MAVENCLAD is given as two yearly treatment courses, consisting of 2 treatment weeks (cycles) about a month apart.
• Handle MAVENCLAD with dry hands and take immediately after opening the blister pack. Take with water and do not chew the tablet. MAVENCLAD can be taken with or without food and should be taken at least 3 hours apart from other medicines.
• Wash your hands after handling MAVENCLAD. Limit contact with your skin (especially on your face). Wash skin and surfaces with water if contact occurs.
• If you miss a dose, take it as soon as you remember on the same day. If the whole day passes before you remember, take your missed dose the next day. Do not take 2 doses at the same time. Instead, you will extend the number of days in that treatment week.

Your healthcare provider will continue to monitor your health during the 2 yearly treatment courses, and for at least another 2 years during which you do not need to take MAVENCLAD. It is not known if MAVENCLAD is safe and effective in people who restart MAVENCLAD treatment more than 2 years after completing 2 yearly treatment courses.

MAVENCLAD can cause serious side effects. If you have any of these symptoms listed below, call your healthcare provider right away:

• low blood cell counts have happened and can increase your risk of infections during treatment with MAVENCLAD. Blood tests are needed before you start treatment with MAVENCLAD, during your treatment with MAVENCLAD, and afterward, as needed.
• serious infections such as:
  • life-threatening or fatal infections caused by bacteria, viruses, parasites or fungi.
  • TB, hepatitis B or C, and shingles (herpes zoster). Fatal cases of TB and hepatitis have happened with cladribine during clinical studies. Tell your healthcare provider right away if you get any symptoms of the following infection related problems or if any of the symptoms get worse, including fever, aching painful muscles, headache, feeling of being generally unwell, loss of appetite, burning, tingling, numbness or itchiness of the skin in the affected area, skin blotches, blistered rash, or severe pain.
  • progressive multifocal leukoencephalopathy (PML). PML is a rare brain infection that usually leads to death or severe disability. Although PML has not been seen in MS patients taking MAVENCLAD, it may happen in people with weakened immune systems. Tell your healthcare provider right away if you have any new or worsening neurologic signs or symptoms. These may include: weakness on 1 side of your body, loss of coordination in your arms and legs, decreased strength, problems with balance, changes in your vision, changes in your thinking or memory, confusion, or changes in your personality.
• liver problems. Blood tests should be performed to check your liver before you start taking MAVENCLAD. Symptoms of liver problems may include: nausea, vomiting, stomach pain, tiredness, loss of appetite, dark urine, or your skin or the whites of your eyes turn yellow.
• allergic reactions (hypersensitivities). You should stop treatment and seek immediate medical attention if any signs or symptoms of allergic reactions occur. Symptoms of an allergic reaction may include skin rash, swelling or itching of the face, lips, tongue or throat, or trouble breathing.
• heart failure. MAVENCLAD may cause heart failure, which means your heart may not pump as well as it should. Call your healthcare provider or go to the closest emergency room for medical help right away if you have any signs or symptoms such as shortness of breath, a fast or irregular heartbeat, or unusual swelling in your body.

The most common side effects of MAVENCLAD include: upper respiratory infection, headache, and low white blood cell counts.

These are not all the possible side effects of MAVENCLAD. Call your doctor for medical advice about side effects. To report SUSPECTED ADVERSE REACTIONS, contact EMD Serono at: 1-800-283-8088 ext. 5563 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.