Lenalidomide Side Effects

Medically reviewed by Drugs.com. Last updated on Mar 28, 2025.

Applies to lenalidomide: oral capsule.

Precautions

It is very important that your doctor check your progress closely at regular visits to see if the medicine is working properly and to allow for a change in the dose. Blood and urine tests may be needed to check for any unwanted effects.

Women should take the necessary precautions to avoid pregnancy while using lenalidomide. Begin 2 forms of reliable contraception 4 weeks before starting lenalidomide. Continue contraceptive measures during treatment and for at least 4 weeks after the last dose. Routine pregnancy tests are necessary with this medicine. Call your doctor for emergency contraception information if you think you are pregnant.

Men, even those who have had a vasectomy, must prevent pregnancy in their sexual partners during treatment with this medicine and for at least 4 weeks after the last dose. Do not donate sperm while using this medicine. Call your doctor for emergency contraception information if you think your sexual partner may be pregnant.

Do not donate blood during treatment and for at least 4 weeks after the last dose.

This medicine lowers the number of some types of blood cells in your body. Because of this, you may bleed or get infections more easily. To help with these problems, avoid being near people who are sick or have infections. Wash your hands often. Stay away from rough sports or other situations where you could be bruised, cut, or injured. Brush and floss your teeth gently. Be careful when using sharp objects, including razors and fingernail clippers.

This medicine may increase your risk of having blood clots. Check with your doctor right away if you have anxiety, chest pain, fainting, a fast heartbeat, trouble breathing, or pain, redness, or swelling in the arm or leg.

This medicine may increase your risk of having a heart attack or stroke. This is more likely to occur if you already have a heart disease, high cholesterol, or if you smoke. Check with your doctor right away if you are having chest pain or discomfort, fast or irregular heartbeat, nausea, vomiting, pain or discomfort in the arms, jaw, back, or neck, sweating, or trouble breathing.

Do not receive pembrolizumab together with dexamethasone and lenalidomide or similar medicines if you have multiple myeloma.

Serious liver problems can occur with this medicine. Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, vomiting, or yellow skin or eyes.

Serious skin reactions, including Stevens-Johnson syndrome, toxic epidermal necrolysis, and drug reaction with eosinophilia and systemic symptoms (DRESS) can occur with this medicine. Check with your doctor right away if you have black, tarry stools, blistering, peeling, or loosening of the skin, chest pain, chills, cough, diarrhea, itching, joint or muscle pain, painful or difficult urination, red irritated eyes, red skin lesions, often with a purple center, sore throat, sores, ulcers, or white spots in the mouth or on the lips, swollen glands, unusual bleeding or bruising, or unusual tiredness or weakness while you are using this medicine.

Lenalidomide may cause a serious type of reaction called tumor lysis syndrome. Call your doctor right away if you have a decrease or change in urine amount, joint pain, stiffness, or swelling, lower back, side, or stomach pain, a rapid weight gain, swelling of the feet or lower legs, or unusual tiredness or weakness.

This medicine may increase your risk of getting certain cancers (eg, acute myelogenous leukemia, myelodysplastic syndrome). Talk to your doctor if you have concerns about this risk.

This medicine may cause a tumor flare reaction. Tell your doctor if you have swollen and painful lymph nodes, a mild fever, pain, or a rash.

This medicine may cause a serious allergic reactions, including anaphylaxis and angioedema, which can be life-threatening and require immediate medical attention. Tell your doctor right away if you have a rash, itching, hoarseness, large, hive-like swelling on face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs, trouble breathing, or trouble swallowing after using this medicine.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Serious side effects of lenalidomide

Along with its needed effects, lenalidomide may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking lenalidomide:

Other side effects of lenalidomide

Some side effects of lenalidomide may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

For healthcare professionals

Applies to lenalidomide: oral capsule.

Hematologic adverse events

• Very common (10% or more): Neutropenia (79%), thrombocytopenia (72%), anemia (44%), leukopenia (32%), lymphopenia (18%), neutropenic infection (18%), febrile neutropenia (17%)
• Common (1% to 10%): Pancytopenia, autoimmune hemolytic anemia
• Uncommon (0.1% to 1%): Hypercoagulation
• Frequency not reported: Warm type hemolytic anemia, splenic infarction, bone marrow depression, coagulopathy, hemolysis, refractory anemia, decreased hemoglobin, acquired hemophilia^[Ref]

Gastrointestinal

• Very common (10% or more): Diarrhea (55%), constipation (41%), nausea (26%), gastroenteritis (23%), abdominal pain (21%), vomiting (12%), dyspepsia (11%)
• Common (1% to 10%): Upper abdominal pain, dry mouth, gastrointestinal hemorrhage, glossodynia, loose stools, toothache
• Uncommon (0.1% to 1%): Cecitis
• Frequency not reported: Clostridium difficile colitis, ischemic colitis, intestinal perforation, rectal hemorrhage, colonic polyp, diverticulitis, dysphagia, gastritis, gastroenteritis, gastroesophageal reflux disease, obstructive inguinal hernia, irritable bowel syndrome, melena, pancreatitis, perirectal abscess, small intestinal obstruction, upper gastrointestinal hemorrhage, oral infection, pelvic pain^[Ref]

Respiratory

• Very common (10% or more): Bronchitis (47%), nasopharyngitis (35%), cough (28%), upper respiratory tract infection (27%), dyspnea (24%), pneumonia (18%), pharyngitis (16%), rhinitis (15%), epistaxis (15%), sinusitis (14%), oropharyngeal pain (10%)
• Common (1% to 10%): Respiratory tract infection, lung infection, lower respiratory tract infection, bacterial lower respiratory tract infection, exertional dyspnea, rhinorrhea, pulmonary embolism, respiratory distress, hoarseness, pleural effusion, hypoxia
• Frequency not reported: Chronic obstructive pulmonary disease, pulmonary edema, lobar pneumonia, respiratory failure, interstitial lung disease, lung infiltration, wheezing
• Postmarketing reports: Pneumonitis^[Ref]

Other

• Very common (10% or more): Fatigue (44%), asthenia (30%), pyrexia (28%), peripheral edema (26%), influenza (13%), edema (10%)
• Common (1% to 10%): Non-cardiac chest pain, sepsis, Staphylococcal sepsis, fall, infection, bacteremia, herpes zoster, lethargy, malaise, pain, rigors, general physical health deterioration, chills, deafness (including hypoacusis), tinnitus
• Frequency not reported: Disease progression, abnormal gait, intermittent pyrexia, nodule, sudden death, central line infection, clostridial infection, ear infection, Enterobacter sepsis, fungal infection, Klebsiella sepsis, localized infection, Pseudomonas infection, septic shock, transfusion reaction, overdose, post procedural hemorrhage, road traffic accident
• Postmarketing reports: Viral reactivation^[Ref]

Dermatologic

• Very common (10% or more): Pruritus (42%), rash (36%), dry skin (14%), hyperhidrosis (10%)
• Common (1% to 10%): Cellulitis, hirsutism, exanthema, skin hyperpigmentation, contusion, night sweats, ecchymosis, erythema, urticarial, eczema
• Uncommon (0.1% to 1%): Photosensitivity reaction
• Frequency not reported: Acute febrile neutrophilic dermatosis
• Postmarketing reports: Stevens-Johnson Syndrome, toxic epidermal necrolysis, leukocytoclastic vasculitis^[Ref]

Musculoskeletal

• Very common (10% or more): Muscle cramp (33%), muscle spasms (33%), back pain (32%), arthralgia (22%), bone pain (16%), pain in extremity (15%), musculoskeletal pain (13%), musculoskeletal chest pain (11%)
• Common (1% to 10%): Muscular weakness, neck pain, myalgia, peripheral swelling
• Uncommon (0.1% to 1%): Joint swelling
• Rare (less than 0.1%): Rhabdomyolysis
• Frequency not reported: Femur fracture, cervical vertebral fracture, femoral neck fracture, fractured pelvis, hip fracture, rib fracture, spinal cord compression, spinal compression fracture, connective tissue pain/discomfort, arthritis, gouty arthritis, chondrocalcinosis pyrophosphate^[Ref]

Psychiatric

• Very common (10% or more): Insomnia (28%), depression (11%), anxiety (10%)
• Common (1% to 10%): Mood swings, hallucination, loss of libido, erectile dysfunction, confusional state, altered mood^[Ref]

Nervous system

• Very common (10% or more): Dizziness (23%), tremor (21%), headache (20%), dysgeusia (15%), peripheral neuropathy (15%), paresthesia (13%), hypoesthesia (10.)
• Common (1% to 10%): Neuropathy, syncope, cerebrovascular accident, cerebral ischemia, ataxia, impaired balance, vertigo
• Uncommon (0.1% to 1%): Intracranial hemorrhage, transient ischemic attack
• Frequency not reported: Vertigo, aphasia, cerebellar infarction, cerebral infarction, depressed level of consciousness, dysarthria, migraine, subarachnoid hemorrhage^[Ref]

Metabolic

• Very common (10% or more): Decreased appetite (23%), decreased weight (20%), hypokalemia (17%), anorexia (16%), hypocalcemia (11%)
• Common (1% to 10%): Dehydration, gout, hypophosphatemia, hyponatremia, hypomagnesemia, increased c-reactive protein, iron overload
• Frequency not reported: Hypernatremia^[Ref]

Ocular

• Very common (10% or more): Blurred vision (17%), cataracts (14%)
• Common (1% to 10%): Subcapsular cataract, unilateral cataract, blindness, ocular hypertension, reduced visual acuity^[Ref]

Hepatic

• Very common (10% or more): Hyperbilirubinemia (15%)
• Common (1% to 10%): Increased ALT, increased AST, abnormal liver function tests
• Frequency not reported: Cholecystitis, hepatic failure, kidney infection
• Postmarketing reports: Toxic hepatitis, cytolytic hepatitis, cholestatic hepatitis, mixed cytolytic/cholestatic hepatitis, cholestasis^[Ref]

Genitourinary

• Very common (10% or more): Urinary tract infection (14%)
• Common (1% to 10%): Dysuria, hyperuricemia, hematuria, urinary retention, urinary incontinence
• Frequency not reported: Urosepsis^[Ref]

Endocrine

• Very common (10% or more): Hyperglycemia (12%)
• Common (1% to 10%): Diabetes mellitus, acquired hypothyroidism
• Frequency not reported: Basedow's disease, hypoglycemia
• Postmarketing reports: Hypothyroidism, hyperthyroidism^[Ref]

Cardiovascular

• Very common (10% or more): Deep vein thrombosis (10%)
• Common (1% to 10%): Hypertension, hypotension, atrial fibrillation, myocardial infarction, tachycardia, congestive cardiac failure, bradycardia, hematoma, angina pectoris, palpitations, vasculitis
• Uncommon (0.1% to 1%): Arrhythmia, QT prolongation, atrial flutter, ventricular extrasystoles, ischemia, peripheral ischemia, intracranial venous sinus thrombosis
• Frequency not reported: Supraventricular tachycardia/arrhythmia, cardiac arrest, cardio-respiratory arrest, cardiomyopathy, myocardial ischemia, cardiac failure, cardiogenic shock, ventricular dysfunction, increased troponin, aortic disorder, ischemia, superficial thrombophlebitis, thrombosis^[Ref]

Oncologic

• Very common (10% or more): Tumor flare (10%)
• Common (1% to 10%): Squamous cell carcinoma, basal cell carcinoma, myelodysplastic syndrome
• Frequency not reported: Acute leukemia, acute myeloid leukemia, bronchoalveolar carcinoma, metastatic lung cancer, lymphoma, metastatic prostate cancer, tumor lysis syndrome^[Ref]

Renal

• Very common (10% or more): Renal failure (10%)
• Uncommon (0.1% to 1%): Renal tubular necrosis, acquired Fanconi syndrome
• Frequency not reported: Increased blood creatinine, azotemia, ureteric calculus, renal mass^[Ref]

Hypersensitivity

• Frequency not reported: Hypersensitivity
• Postmarketing reports: Angioedema, acute graft-versus-host disease (following allogeneic hematopoietic transplant)^[Ref]

See also:

Frequently asked questions

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Further information

Lenalidomide side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.

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