How long does Revlimid stay in your system?
Theoretically, Revlimid stays in your system for 15 to 25 hours (just over 1 day). This is based on the average half-life of Revlimid which is 3 hours in healthy people and 3 to 5 hours in people with multiple myeloma, myelodysplastic syndromes, and mantle cell lymphoma. A half-life is the time it takes for 50% of a drug to leave a person’s body, and experts estimate it takes 4 to 5 half-lives for a drug to be completely removed from the body, which calculates out to 15 to 25 hours. One study that tagged Revlimid with a radioactive compound showed that 82% of a dose was eliminated within 24 hours, but it took up to 10 days for 90% to be eliminated in the urine, and for 4% to be eliminated in the feces. At least 6% is excreted as the metabolites hydroxy-lenalidomide and N-acetyl-lenalidomide.
Renal function is another important factor affecting Revlimid’s half-life and time in your system. People with moderate to severe kidney disease have a 3-fold increase in half-life (new half-life of 9 to 15 hours) and a 66% to 75% decrease in drug clearance compared to healthy subjects. Patients on hemodialysis had an approximately 4.5-fold increase in half-life (new half-life 13 to 23 hours) and an 80% decrease in drug clearance compared to healthy subjects. Approximately 30% of Revlimid is removed during a 4-hour hemodialysis session.
For this reason, experts allow a wide safety margin for women and men intending to start a family following Revlimid treatment because Revlimid is a thalidomide analog that can cause serious, life-threatening, birth defects. Revlimid also distributes into semen.
People taking Revlimid should not donate blood while taking Revlimid, during dose interruptions, and for 4 weeks after stopping Revlimid.
How long after stopping Revlimid can you get pregnant?
Females of reproductive potential must avoid pregnancy while taking Revlimid and for at least 4 weeks after completing therapy. While they are taking Revlimid they must use 2 different forms of contraception and undertake a monthly pregnancy test.
Males should always use a latex or synthetic condom during any sexual contact with females of reproductive potential while taking Revlimid and for up to 4 weeks after discontinuing Revlimid, even if they have undergone a successful vasectomy. They must not donate sperm during this time either.
References
- Revlimid (lenalidomide) Updated 08/2021. Celgene Corporation https://www.drugs.com/pro/revlimid.html
- Chen N, Zhou S, Palmisano M. Clinical Pharmacokinetics and Pharmacodynamics of Lenalidomide. Clin Pharmacokinet. 2017;56(2):139-152. doi:10.1007/s40262-016-0432-1
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