b'o If you miss a dose, take it as soon as you remember decreased strengthon the same day. If the whole day passes before youproblems with balanceremember, take your missed dose the next day. Mc Do not take 2 doses at the same time. Instead, changes in your visionmyou will extend the number of days in that changes in your thinking or memory t treatment week.confusion Your healthcare provider will continue to monitor yourahealth during the 2 yearly treatment courses, and for changes in your personalitya at least another 2 years during which you do not need oliver problems. MAVENCLAD may cause liver problems. a to take MAVENCLAD. It is not known if MAVENCLAD is Your healthcare provider should do blood tests to safe and e\x1eective in people who restart MAVENCLAD check your liver before you start taking MAVENCLAD.Mk treatment more than 2 years after completing 2 yearly Call your healthcare provider right away if you havectreatment courses.any of the following symptoms of liver problems:rWhat are the possible side e\x1eects of MAVENCLAD?nauseaYh MAVENCLAD can cause serious side e\x1eects, including: vomitingi h oSee What is the most important informations tomach paina I should know about MAVENCLAD? tiredness o low blood cell counts. Low blood cell counts have a loss of appetite thappened and can increase your risk of infections m during your treatment with MAVENCLAD. Youryour skin or the whites of your eyes turn yellowhealthcare provider will do blood tests before dark urineyou start treatment with MAVENCLAD, during oallergic reactions (hypersensitivities). MAVENCLAD your treatment with MAVENCLAD, and afterward, can cause serious allergic reactions. Stop youras needed. treatment with MAVENCLAD and go to the closest t o serious infections such as:emergency room for medical help right away if youh TB, hepatitis B or C, and shingles (herpes zoster). have any signs or symptoms of allergic reactions.YFatal cases of TB and hepatitis have happenedph with cladribine during clinical studies. Tell your Symptoms of an allergic reaction may include: skinrash, swelling or itching of the face, lips, tongue orhhealthcare provider right away if you get any throat, or trouble breathing.Msymptoms of the following infection related problemspaor if any of the symptoms get worse, including: oheart failure. MAVENCLAD may cause heart failure,w owhich means your heart may not pump as well asi feverit should. Call your healthcare provider or go to theUh aching painful muscles closest emergency room for medical help right awayd lrheadache if you have any signs or symptoms such as shortnessoof breath, a fast or irregular heart beat, or unusualt p f eeling of being generally unwellswelling in your body. Your healthcare provider mayT l oss of appetite delay or completely stop treatment with MAVENCLADsif you have severe side e\x1eects.c y burning, tingling, numbness or itchiness of the hskin in the a\x1eected areaThe most common side e\x1eects of MAVENCLAD include:oss kin blotches, blistered rash and severe pain o upper respiratory infection fh o headache y progressive multifocal leukoencephalopathy (PML).PML is a rare brain infection that usually leads to o low white blood cell counts Fakdeath or severe disability. Although PML has notb Dbeen seen in MS patients taking MAVENCLAD, it may These are not all the possible side e\x1eects of MAVENCLAD.happen in people with weakened immune systems. Call your doctor for medical advice about side e\x1eects.UMSymptoms of PML get worse over days to weeks. You may report side e\x1eects to FDA at 1-800-FDA-1088.tS Call your healthcare provider right away if you have Distributed by: EMD Serono, Inc., Rockland, MA 02370f any new or worsening neurologic signs or symptomsy y of PML, that have lasted several days, including: MAVENCLAD is a registered trademark of Merck KGaA,Darmstadt, Germany.weakness on 1 side of your body For more information, call toll-free 1-877-447-3243l oss of coordination in your arms and legs or go to www.mavenclad.comr rLpn pM hrt T m w M 2019 EMD Serono, Inc.All rights reserved.US/CLA/0619/0371Printed in USA07/19'