b'oI f you miss a dose, take it as soon as you rememberdecreased strengthon the same day. If the whole day passes before youproblems with balanceremember, take your missed dose the next day. Do not take 2 doses at the same time. Instead, changes in your visionyou will extend the number of days in that changes in your thinking or memory treatment week. confusion Your healthcare provider will continue to monitor yourhealth during the 2 yearly treatment courses, and for changes in your personalityaat least another 2 years during which you do not needo l iver problems. MAVENCLAD may cause liver problems. a to take MAVENCLAD. It is not known if MAVENCLAD isYour healthcare provider should do blood tests tosafe and e\x1eective in people who restart MAVENCLADcheck your liver before you start taking MAVENCLAD. treatment more than 2 years after completing 2 yearlyCall your healthcare provider right away if you have treatment courses.any of the following symptoms of liver problems: What are the possible side e\x1fects of MAVENCLAD? nauseaMAVENCLAD can cause serious side e\x1fects, including:vomiting oSee What is the most important information stomach painI should know about MAVENCLAD?t irednessol ow blood cell counts. Low blood cell counts haveloss of appetite happened and can increase your risk of infections during your treatment with MAVENCLAD. Youryour skin or the whites of your eyes turn yellowhealthcare provider will do blood tests beforedark urine you start treatment with MAVENCLAD, during oallergic reactions (hypersensitivities). MAVENCLAD your treatment with MAVENCLAD, and afterward, can cause serious allergic reactions. Stop your as needed. treatment with MAVENCLAD and go to the closest o serious infections such as:emergency room for medical help right away if youTB, hepatitis B or C, and shingles (herpes zoster).have any signs or symptoms of allergic reactions. Fatal cases of TB and hepatitis have happenedSymptoms of an allergic reaction may include: skin with cladribine during clinical studies. Tell yourrash, swelling or itching of the face, lips, tongue or healthcare provider right away if you get anythroat, or trouble breathing.symptoms of the following infection related problems or if any of the symptoms get worse, including: oheart failure. MAVENCLAD may cause heart failure, feverwhich means your heart may not pump as well as it should. Call your healthcare provider or go to the aching painful muscles closest emergency room for medical help right awayheadache if you have any signs or symptoms such as shortness of breath, a fast or irregular heart beat, or unusual feeling of being generally unwellswelling in your body. Your healthcare provider may loss of appetite delay or completely stop treatment with MAVENCLAD burning, tingling, numbness or itchiness of the if you have severe side e\x1eects.skin in the a\x1eected areaThe most common side e\x1fects of MAVENCLAD include: s kin blotches, blistered rash and severe pain o upper respiratory infection progressive multifocal leukoencephalopathy (PML).o headache PML is a rare brain infection that usually leads too low white blood cell counts death or severe disability. Although PML has not been seen in MS patients taking MAVENCLAD, it mayThese 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.Symptoms of PML get worse over days to weeks. You may report side e\x1eects to FDA at 1-800-FDA-1088.S Call your healthcare provider right away if you haveDistributed by: EMD Serono, Inc., Rockland, MA 02370any new or worsening neurologic signs or symptoms 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 1-877-447-3243 l oss of coordination in your arms and legs or go to www.mavenclad.comw 2019 EMD Serono, Inc.All rights reserved.US/CLA/0219/0040Printed in USA04/19'