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Lenalidomide Side Effects

Medically reviewed by Last updated on Oct 21, 2020.

In Summary

Commonly reported side effects of lenalidomide include: pneumonia, upper respiratory tract infection, urinary tract infection, neutropenia, thrombocytopenia, abdominal pain, anemia, arthralgia, asthenia, back pain, constipation, cough, diarrhea, dizziness, dyspnea, dyspnea on exertion, edema, epistaxis, fatigue, headache, hypokalemia, insomnia, limb pain, muscle cramps, nasopharyngitis, nausea, peripheral edema, pharyngitis, pruritus, skin rash, vomiting, anorexia, and xeroderma. Other side effects include: febrile neutropenia, cellulitis, chest pain, depression, dysuria, hypertension, hypoesthesia, hypomagnesemia, hypothyroidism, increased serum alanine aminotransferase, leukopenia, loose stools, myalgia, night sweats, pain, palpitations, peripheral neuropathy, rhinitis, upper abdominal pain, bruise, diaphoresis, dysgeusia, ecchymoses, erythema of skin, and xerostomia. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to lenalidomide: oral capsule


Oral route (Capsule)

Lenalidomide may cause birth defects or embryo fetal death and should not be used during pregnancy. Exclude pregnancy before starting treatment with 2 negative pregnancy tests. Prevent pregnancy with abstinence or 2 reliable contraception methods, during treatment and for 4 weeks after treatment. Lenalidomide may cause significant neutropenia and thrombocytopenia. When used in patients with del 5q myelodysplastic syndrome, monitor blood counts weekly for 8 weeks and monthly thereafter. Risk of venous and arterial thromboembolism (DVT, pulmonary embolism, myocardial infarction, and stroke) is significantly increased in patients with multiple myeloma who are treated with lenalidomide and dexamethasone therapy. Thromboprophylaxis is recommended and should be based on underlying risks.

Side effects requiring immediate medical attention

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:

More common

  • Black, tarry stools
  • bleeding gums
  • blood in the urine or stools
  • chest pain
  • chills
  • cough
  • decreased urine
  • difficult or labored breathing
  • dry mouth
  • fever
  • increased thirst
  • irregular heartbeat
  • loss of appetite
  • lower back or side pain
  • mood changes
  • muscle pain or cramps
  • nausea
  • numbness or tingling in the hands, feet, or lips
  • painful or difficult urination
  • pale skin
  • pinpoint red spots on the skin
  • seizures
  • sore throat
  • sores, ulcers, or white spots on the lips or in the mouth
  • swollen glands
  • tightness in the chest
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • vomiting

Less common

  • Burning or stinging of the skin
  • chest discomfort
  • confusion
  • difficulty with speaking
  • dilated neck veins
  • double vision
  • extreme tiredness or weakness
  • headache
  • inability to move the arms, legs, or facial muscles
  • inability to speak
  • irregular breathing
  • pain or discomfort in the arms, jaw, back or neck
  • painful cold sores or blisters on the lips, nose, eyes, or genitals
  • slow speech
  • sweating
  • swelling of the face, fingers, feet, or lower legs
  • weight gain

Incidence not known

  • Anxiety
  • blistering, peeling, or loosening of the skin
  • clay-colored stools
  • dark urine
  • depressed mood
  • diarrhea
  • difficulty having a bowel movement
  • dizziness or lightheadedness
  • dry skin and hair
  • fainting
  • fast heartbeat
  • feeling cold
  • general feeling of tiredness or weakness
  • hair loss
  • hoarseness or husky voice
  • itching or rash
  • joint pain, stiffness, or swelling
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals
  • muscle cramps and stiffness
  • pain, redness, or swelling in the arm or leg
  • red skin lesions, often with a purple center
  • red, irritated eyes
  • sensitivity to heat
  • slowed heartbeat
  • stomach pain, continuing
  • swelling of the feet or lower legs
  • trouble sleeping
  • troubled breathing
  • unpleasant breath odor
  • vomiting of blood
  • weight loss
  • yellow eyes or skin

Side effects not requiring immediate medical attention

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:

More common

  • Abnormal or decreased touch sensation
  • bloody nose
  • blurred vision
  • body aches or pain
  • bruising
  • burning feeling while urinating
  • burning, numbness, tingling, or painful sensations
  • change in taste
  • cough-producing mucus
  • difficulty with moving
  • drowsiness or tiredness
  • ear congestion
  • fast, slow, irregular, pounding, or racing heartbeat or pulse
  • flushing or redness of the skin
  • increased sweating or night sweats
  • irritability
  • itching, pain, redness, swelling, tenderness, or warmth on the skin
  • lack or loss of strength
  • large, flat, blue or purplish patches in the skin
  • loose stools
  • loss of interest or pleasure
  • muscle spasms or twitching
  • pain or tenderness around the eyes and cheekbones
  • shivering
  • tender, swollen glands in the neck
  • trembling
  • trouble concentrating
  • trouble swallowing
  • unsteadiness or awkwardness
  • upper abdomen or stomach pain
  • voice changes
  • weakness in the arms, hands, legs, or feet

Incidence not known

  • Feeling of constant movement of self or surroundings
  • sensation of spinning

For Healthcare Professionals

Applies to lenalidomide: oral capsule


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]


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]


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]


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]


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]


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]


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]


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]


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]


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]


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]


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]


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]


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]


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]


Frequency not reported: Hypersensitivity

Postmarketing reports: Angioedema, acute graft-versus-host disease (following allogeneic hematopoietic transplant)[Ref]


1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

2. Cerner Multum, Inc. "Australian Product Information." O 0

3. "Product Information. Revlimid (lenalidomide)." Celgene Corporation, Summit, NJ.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.