pronounced as (len a lid' oh mide)

Brand Name(s): Revlimid®

Why is this medicine prescribed?

Lenalidomide is used to treat a certain type of myelodysplastic syndrome (a group of conditions in which the bone marrow produces blood cells that are misshapen and does not produce enough healthy blood cells). Lenalidomide is also used along with dexamethasone to treat people with multiple myeloma (a type of cancer of the bone marrow). It is also used to treat people with multiple myeloma after a hematopoietic stem-cell transplant (HSCT; procedure in which certain blood cells are removed from the body and then returned to the body). Lenalidomide is also used to treat people with mantle cell lymphoma (a fast-growing cancer that begins in the cells of the immune system) who have been treated with bortezomib (Velcade) and at least one other medication. Lenalidomide should not be used to treat people with chronic lymphocytic leukemia (a type of cancer of the white blood cells that gets worse slowly over time) unless they are participating in a clinical trial (research study to see whether a medication may be used safely and effectively to treat a certain condition). Lenalidomide is in a class of medications called immunomodulatory agents. It works by helping the bone marrow to produce normal blood cells and by killing abnormal cells in the bone marrow.

Are there other uses for this medicine?

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

How should this medicine be used?

Lenalidomide comes as a capsule to take by mouth. When lenalidomide is used to treat myelodysplastic syndrome, it is usually taken with or without food once daily. When lenalidomide is used to treat multiple myeloma or mantle cell lymphoma, it is usually taken with or without food once daily for the first 21 days of a 28-day cycle. When lenalidomide is used to treat multiple myeloma after HSCT, it is usually taken with or without food once daily for 28 days of a 28-day cycle. The 28-day cycle regimen may be repeated as recommended by your doctor based on your body's response to this medication. Take lenalidomide at around the same time of day every day that you take it. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take lenalidomide exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Swallow the capsules whole with plenty of water; do not break, chew, or open them. Handle the capsules as little as possible. If you touch a broken lenalidomide capsule or the medicine in the capsule, wash that area of your body with soap and water. If the medicine in the capsule gets into your mouth, nose, or eyes, wash it away with plenty of water.

Your doctor may need to interrupt your treatment or reduce your dose if you experience certain side effects. Be sure to tell your doctor how you are feeling during your treatment with lenalidomide.

What special precautions should I follow?

Before taking lenalidomide,

  • tell your doctor and pharmacist if you are allergic to lenalidomide, any other medications, or any of the ingredients in lenalidomide capsules. Ask your pharmacist or check the Medication Guide for a list of the ingredients.
  • tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention the medications listed in the IMPORTANT WARNING section and digoxin (Lanoxin). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
  • tell your doctor if you are lactose intolerant and if you have or have ever had kidney, thyroid, or liver disease. Also tell your doctor if you have ever taken thalidomide (Thalomid) and developed a rash during your treatment.
  • tell your doctor if you are breastfeeding or are planning to breastfeed.

What special dietary instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What should I do if I forget to take a dose?

If it has been less than 12 hours since you were scheduled to take the dose, take the missed dose as soon as you remember it. If it has been more than 12 hours, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What should I do in case of overdose?

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help . If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include the following:

  • itching
  • hives
  • rash

What side effects can this medicine cause?

Lenalidomide may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

  • diarrhea
  • constipation
  • stomach pain
  • loss of appetite
  • weight loss
  • weakness
  • dizziness
  • change in ability to taste
  • pain or burning of the tongue, mouth, or throat
  • decreased sense of touch
  • burning or tingling in the hands or feet
  • difficulty falling asleep or staying asleep
  • depression
  • joint, muscle, bone, or back pain
  • painful, frequent, or urgent urination
  • sweating
  • dry skin
  • abnormal hair growth in women
  • uncontrollable shaking of a part of the body
  • decrease in sexual desire or ability

Some side effects can be serious. If you experience any of these symptoms or those listed in the IMPORTANT WARNING section, call your doctor immediately or get emergency medical treatment:

  • swelling of the face, throat, tongue, lips, eyes, arms, hands, feet, ankles, or lower legs
  • difficulty breathing or swallowing
  • hoarseness
  • fast, slow, pounding, or irregular heartbeat
  • seizures
  • rash
  • skin pain
  • blistering, peeling, or shedding skin
  • swollen glands in the neck
  • muscle cramps
  • pain in the upper right part of the stomach
  • yellowing of the skin or eyes
  • dark colored urine
  • tiredness
  • bloody, cloudy, or painful urination
  • increased or decreased urination

If you are taking lenalidomide to treat multiple myeloma and you also receive melphalan (Alkeran) or a blood stem cell transplant, you may have a higher risk of developing new cancers. Talk to your doctor about the risks of taking lenalidomide. Your doctor will check you for new cancers during your treatment with lenalidomide.

Lenalidomide may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication.

What should I know about storage and disposal of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Return any medication that is outdated or no longer needed to your doctor, the pharmacy that gave you the medication, or the manufacturer.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

What other information should I know?

Keep all appointments with your doctor. Your doctor may order certain tests before and during your treatment to check your body's response to lenalidomide.

Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

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