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lenalidomide

Generic Name: lenalidomide (LEN a LID oh mide)
Brand Name: Revlimid

What is lenalidomide?

Lenalidomide affects the immune system. It promotes immune responses to help slow tumor growth.

Lenalidomide is used to treat multiple myeloma (bone marrow cancer), either in combination with another medicine or after stem cell transplant.

Lenalidomide is also used to treat anemia (a lack of red blood cells) in patients with myelodysplastic syndrome caused by an abnormal chromosome. This disorder is also called deletion 5q MDS, because part of chromosome 5 is missing. In people with this disorder, the bone marrow does not produce enough healthy blood cells.

Lenalidomide is also used to treat mantle cell lymphoma (a rare cancer of the lymph nodes), after other medications have been tried without success.

Lenalidomide should not be used for chronic lymphocytic leukemia (CLL) unless you are in a controlled medical study. Lenalidomide can increase the risk of death from serious heart problems in people with CLL.

Lenalidomide is available only from a certified pharmacy under a special program called Revlimid REMS. Your doctor must be registered in the program in order to prescribe lenalidomide for you. You must be registered in the program and sign documents stating that you understand the dangers of this medication and that you agree to use birth control measures as required by the program.

Lenalidomide may also be used for purposes not listed in this medication guide.

What is the most important information I should know about lenalidomide?

Never use this medicine if you are pregnant. Even one dose of lenalidomide can cause severe, life-threatening birth defects or death of a baby if the mother or the father is taking this medicine at the time of conception or during pregnancy.

Use birth control to prevent pregnancy, whether you are a man or a woman. For women: Use two forms of birth control beginning 4 weeks before you start taking lenalidomide and ending 4 weeks after you stop taking it. For men: Use a condom to prevent pregnancy during your treatment, and for up to 4 weeks after your treatment ends.

Lenalidomide may cause blood clots. Stop using this medicine and call your doctor at once if you have symptoms such as sudden numbness, severe headache, problems with vision or speech, chest pain, shortness of breath, coughing up blood, or swelling in your arm or leg.

What should I discuss with my healthcare provider before taking lenalidomide?

You should not use lenalidomide if you are allergic to it.

Lenalidomide can cause severe, life-threatening birth defects or death of a baby if the mother or the father is taking this medicine at the time of conception or during pregnancy. Even one dose of lenalidomide can cause major birth defects of the baby's arms and legs, bones, ears, eyes, face, and heart. Never use lenalidomide if you are pregnant. Tell your doctor right away if your period is late while taking lenalidomide.

For Women: If you have not had a hysterectomy, you will be required to use two reliable forms of birth control beginning 4 weeks before you start taking lenalidomide and ending 4 weeks after you stop taking it. Even women with fertility problems are required to use birth control while taking this medicine. You must also have a negative pregnancy test at 10 to 14 days before treatment and again at 24 hours before. While you are taking lenalidomide, you will have a pregnancy test every 2 to 4 weeks.

The birth control method you use must be proven highly effective, such as birth control pills, an intrauterine device (IUD), a tubal ligation, or a sexual partner's vasectomy. The extra form of birth control you use must be a barrier method such as a latex condom, a diaphragm, or a cervical cap.

Stop using lenalidomide and call your doctor at once if you quit using birth control, if your period is late, or if you think you might be pregnant. Not having sexual intercourse (abstinence) is the most effective method of preventing pregnancy.

For Men: If a man fathers a baby while using lenalidomide, the baby may have birth defects. Use a condom to prevent pregnancy during your treatment, and for up to 4 weeks after your treatment ends. You must agree in writing to always use latex condoms when having sex with a woman who is able to get pregnant, even if you have had a vasectomy. Contact your doctor if you have had unprotected sex, even once, or if you think your female sexual partner may be pregnant.

To make sure lenalidomide is safe for you, tell your doctor if you have:

  • a history of allergic reaction to thalidomide;

  • kidney disease (or if you are on dialysis);

  • liver disease;

  • a history of blood clots or stroke;

  • high blood pressure, high cholesterol or triglycerides;

  • a thyroid disorder;

  • lactose intolerance; or

  • if you smoke.

Using lenalidomide may increase your risk of developing other types of cancer, such as leukemia or lymphoma. Talk with your doctor about your specific risk.

It is not known whether lenalidomide passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine.

How should I take lenalidomide?

Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended. Never share this medicine with another person, even if they have the same disorder you have.

Take the medicine at the same time each day, with or without food.

Take each dose with a full glass of water. Swallow the capsule whole, without breaking it open.

Lenalidomide can lower blood cells that help your body fight infections and help your blood to clot. This can make it easier for you to bleed from an injury or get sick from being around others who are ill. Your blood will need to be tested often.

The medicine from an open capsule can be dangerous if it gets on your skin. If this occurs, wash your skin with soap and water. Ask your doctor or pharmacist how to safely handle and dispose of a broken capsule.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If you are more than 12 hours late, skip the missed dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking lenalidomide?

You must not donate blood or sperm while you are using lenalidomide, and for at least 4 weeks after your last dose. Avoid exposing another person to your blood or semen through casual or sexual contact.

This medicine can pass into body fluids (urine, feces, vomit). Caregivers should wear rubber gloves while cleaning up a patient's body fluids, handling contaminated trash or laundry or changing diapers. Wash hands before and after removing gloves. Wash soiled clothing and linens separately from other laundry.

Lenalidomide side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • signs of a stroke or blood clot--sudden numbness or weakness, severe headache, problems with speech or vision, shortness or breath, swelling or redness in your arm or leg;

  • heart attack symptoms--chest pain or pressure, pain spreading to your jaw or shoulder, sweating;

  • liver problems--upper stomach pain, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

  • low blood cell counts--fever, chills, swollen gums, mouth sores, skin sores, easy bruising, unusual bleeding;

  • signs of a tumor getting worse--swollen glands, low fever, rash, or pain;

  • signs of tumor cell breakdown--lower back pain, blood in your urine, little or no urinating; numbness or tingly feeling around your mouth; muscle weakness or tightness; feeling short of breath; confusion, fainting; or

  • severe skin reaction--fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common side effects may include:

  • fever, cough, tiredness;

  • itching, rash, swelling; or

  • nausea, diarrhea, constipation.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Lenalidomide dosing information

Usual Adult Dose for Myelodysplastic Disease:

10 mg orally once a day
Duration of Therapy: Treatment is continued or modified based upon clinical and laboratory findings.

Use: Treatment of patients with transfusion-dependent anemia due to low- or intermediate-1-risk myelodysplastic syndromes (MDS) associated with a deletion 5q cytogenetic abnormality with or without additional cytogenetic abnormalities.

Usual Adult Dose for Multiple Myeloma:

-In combination with dexamethasone: 25 mg orally once a day on Days 1 to 21 of repeated 28-day cycles
-Maintenance therapy following autologous hematopoietic stem cell transplantation (auto-HSCT): 10 mg once a day continuously (Days 1 to 28 of repeated 28-day cycles) for 3 cycles, then increase to 15 mg once a day if tolerated.
-Duration of Therapy (both indications): Until disease progression or unacceptable toxicity.

Comments:
-Following auto-HSCT, initiate maintenance therapy after adequate hematologic recovery (ANC 1000/mcL or more AND/OR platelet count 75,000/mcL or more).
-For patients who are eligible for auto-HSCT, hematopoietic stem cell mobilization should occur within 4 cycles of a treatment regimen containing this drug.
-Consult the manufacturer product information for dexamethasone dosing recommendations.

Uses:
-In combination with dexamethasone, treatment of patients with multiple myeloma (MM).
-Maintenance therapy in patients with MM following auto-HSCT.

Usual Adult Dose for Lymphoma:

25 mg orally once a day on Days 1 to 21 of repeated 28-day cycles.
Duration of Therapy: Until disease progression or unacceptable toxicity; treatment is continued, modified, or discontinued based upon clinical and laboratory findings.

Use: Treatment of patients with mantle cell lymphoma (MCL) whose disease has relapsed or progressed after 2 prior therapies, one of which included bortezomib.

What other drugs will affect lenalidomide?

If you use hormonal birth control (pills, implants, injections) to prevent pregnancy: There are certain drugs that can make hormonal birth control less effective in your body. Tell your doctor about all other medicines you use. You may need to replace your hormonal birth control method with another effective form of contraception.

Other drugs may interact with lenalidomide, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about lenalidomide.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 8.02.

Date modified: June 01, 2017
Last reviewed: March 31, 2017

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