Description: Lenalidomide, a thalidomide analogue, is an immunomodulatory agent w/ antiangiogenic and antineoplastic property. It inhibits proinflammatory cytokines secretion, increases interleukin-2 and interferon-γ secretion, and increases cytolytic T-cell and natural killer cell response. It also inhibits the growth of myeloma cells by inducing cell cycle arrest and cell death.


Absorption: Rapidly absorbed. Time to peak plasma concentration: Approx 0.6-1.5 hr. Extent of absorption may be reduced by high-fat and high-calorie meal.

Distribution: Present in semen in small amounts. Plasma protein binding: Approx 30%

Metabolism: Poorly metabolised.

Excretion: Via urine (approx 66% as unchanged drug). Elimination half-life: 3-5 hr.

This medication is used to treat anemia in patients with certain blood/bone marrow disorders (myelodysplastic syndromes-MDS). It is believed to work by decreasing the immune system’s response. This medication may also be used to treat certain cancers (multiple myeloma, mantle cell lymphoma-MCL). It is not recommended for the treatment of a certain type of chronic lymphocytic leukemia.


How to use lenalidomide

This medication must be used only within the Revlimid REMS guidelines in order to avoid possible exposure of an unborn baby to the drug. Consult your doctor or pharmacist.


Read the Medication Guide and, if available, the Patient Information Leaflet provided by your pharmacist before you start taking lenalidomide and each time you get a refill. If you have any questions, ask your doctor or pharmacist.


Before starting therapy, women of childbearing age should have two negative pregnancy tests before taking the drug. (See Warning section.)


Take this medication by mouth with or without food as directed by your doctor, usually once daily. Swallow this medication whole with water. For treatment of certain conditions (multiple myeloma, MCL), you may be instructed to take this medication in cycles (once daily for 21 days, then stopping the medication for 7 days). Dosage is based on your medical condition, response to therapy, and laboratory test results. Be sure to follow your doctor’s directions carefully.


Do not open, chew, or break the capsules, or handle them any more than needed. If any of the powder from the capsule gets on your skin, wash the area with soap and water.


Since this drug can be absorbed through the skin and lungs and may harm an unborn baby, women who are pregnant or who may become pregnant should not handle this medication or breathe the dust from broken capsules. All people should wash their hands thoroughly after handling this drug.


Use this medication regularly in order to get the most benefit from it. Remember to take it at the same time each day.


Inform your doctor if your condition persists or worsens.

Lenalidomide can cause severe birth defects or death in unborn babies. This drug must never be used during pregnancy nor by women who could become pregnant while using this drug.


It may increase your risk of developing serious bone marrow problems such as low white blood cell counts or low platelet counts.


Lenalidomide may rarely cause blood clots (such as pulmonary embolism, stroke, heart attack, deep vein thrombosis). Your risk is increased if you smoke, have a history of blood closts, immobile, or use estrogen-containing products.

Notify your doctor or pharmacist promptly if any of these effects persist or worsen:


  • Diarrhea
  • Tiredness
  • dry skin
  • constipation
  • nausea
  • stomach pain
  • vomiting
  • dry mouth
  • unpleasant taste
  • loss of appetite
  • headache
  • trouble sleeping



Tell your doctor right away if you have any serious side effects, including:


  • mental/mood changes
  • pounding heartbeat
  • shaking (tremor)
  • swelling ankles/feet/hands



This medication may rarely cause other cancers (such as acute leukemia, lymphoma) or serious (possibly fatal) liver disease.


Lenalidomide sometimes causes side effects due to the rapid destruction of cancer cells (tumor lysis syndrome). Tell your doctor right away if you have symptoms such as:


  • low back/side pain (flank pain)
  • pink/bloody urine
  • change in the amount of urine
  • painful urination
  • muscle spasms/weakness



Lenalidomide for MCL sometimes have worsening of their MCL symptoms (tumor flare reaction). Contact your doctor immediately if you have tender/swollen lymph nodes, fever, pain, or rash.


A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including:


  • Rash
  • itching/swelling (especially of the face/tongue/throat)
  • severe dizziness
  • trouble breathing



This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

    • Allergic reaction to medication
    • Patients with medical history of:
    • kidney disease
    • liver disease
    • high blood pressure
    • high cholesterol
    • This drug may make you dizzy
    • You are more likely to get infections or may worsen any current infections
    • Do not have immunizations/vaccinations without the consent of your doctor
    • Avoid contact with people who have recently received live vaccines
    • Older adults may be more sensitive to the side effects of this drug, especially kidney problems, blood clots in the veins or lungs, irregular heartbeat
    • Do not donate blood while using lenalidomide and for 4 weeks after stopping this drug
    • Do not donate sperm while using lenalidomide and for 4 weeks after stopping the medication, and always use a latex condom when having sexual intercourse with a woman of childbearing age
    • Immediately tell your doctor if your period is late or if you have abnormal vaginal (menstrual) bleeding
    • Lenalidomide must not be used during pregnancy
    • breast-feeding is not recommended while using lenalidomide

    Consult your doctor regarding the precautions mentioned above.





    Other drugs which can harm the liver (such as acetaminophen) may interact with this drug.

    • Also marketed asRevlimid [ Celgene ]

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