Lenalidomide Brand Name– Revlimid
What is Lenalidomide
Lenalidomide is a structural analog of thalidomide that has immunomodulatory, antiangiogenic, and antineoplastic properties.
It is indicated for the treatment of adult patients with myelodysplastic syndrome, multiple myeloma, mantle cell lymphoma, follicular lymphoma, and marginal zone lymphoma. Use of lenalidomide for the treatment of chronic lymphocytic leukemia is not recommended outside of a clinical trial.
Lenalidomide is contraindicated in pregnancy due to a risk for birth defects or embryo-fetal death. Routine pregnancy testing is required.
All prescribers, pharmacists, and patients must be registered in the REVLIMID REMS program to prescribe, dispense, or receive lenalidomide.
Information about the drug and the program can be found at www.celgeneriskmanagement.com or by calling 1-888-423-5436.
Indications
- amyloidosis
- mantle cell lymphoma (MCL)
- multiple myeloma
- myelodysplastic syndrome (MDS)
- non-Hodgkin’s lymphoma (NHL)
NOTE: Treatment with lenalidomide was associated with a 92% increased risk of death (hazard ratio = 1.92; 95% CI, 1.08 to 3.41) and a higher incidence of serious cardiovascular adverse reactions (e.g., atrial fibrillation, myocardial infarction, heart failure) compared with chlorambucil in a randomized clinical trial in patients with chronic lymphocytic leukemia (CLL); therefore, use of lenalidomide for the treatment of CLL is not recommended outside of a clinical trial
Side Effects
- abdominal pain
- abdominal pain
- anaphylactoid reactions
- anemia
- anemia
- angina
- angioedema
- anorexia
- anorexia
- aphasia
- arthralgia
- arthralgia
- asthenia
- asthenia
- atrial fibrillation
- azotemia
- back pain
- back pain
- biliary obstruction
- bleeding
- blurred vision
- bone fractures
- bone pain
- bone pain
- bradycardia
- bullous rash
- cardiac arrest
- cardiomyopathy
- cataracts
- cataracts
- chest pain (unspecified)
- chest pain (unspecified)
- chills
- cholecystitis
- coagulopathy
- colitis
- confusion
- constipation
- constipation
- cough
- cough
- dehydration
- dehydration
- depression
- depression
- diabetes mellitus
- diabetes mellitus
- diarrhea
- diarrhea
- dizziness
- dizziness
- Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)
- dysarthria
- dysgeusia
- dysgeusia
- dyspepsia
- dyspepsia
- dysphagia
- dyspnea
- dyspnea
- dysuria
- ecchymosis
- edema
- elevated hepatic enzymes
- elevated hepatic enzymes
- epistaxis
- epistaxis
- erythema
- erythema multiforme
- exfoliative dermatitis
- fatigue
- fatigue
- fetal death
- fever
- fever
- gastritis
- gastroesophageal reflux
- GI bleeding
- GI obstruction
- GI perforation
- gout
- gout
- graft-versus-host disease (GVHD)
- hallucinations
- headache
- headache
- heart failure
- hematuria
- hemolysis
- hemolytic anemia
- hepatic failure
- hepatitis
- hepatotoxicity
- hirsutism
- hoarseness
- hyperbilirubinemia
- hyperbilirubinemia
- hyperglycemia
- hyperglycemia
- hyperhidrosis
- hyperhidrosis
- hypernatremia
- hypertension
- hyperthyroidism
- hyperuricemia
- hyperuricemia
- hypocalcemia
- hypocalcemia
- hypoesthesia
- hypoglycemia
- hypokalemia
- hypokalemia
- hypomagnesemia
- hyponatremia
- hyponatremia
- hypophosphatemia
- hypophosphatemia
- hypotension
- hypotension
- hypothyroidism
- hypoxia
- hypoxia
- impaired stem cell mobilization
- impotence (erectile dysfunction)
- infection
- infection
- influenza
- influenza
- insomnia
- insomnia
- interstitial lung disease
- interstitial nephritis
- intracranial bleeding
- lethargy
- leukemia
- leukopenia
- leukopenia
- libido decrease
- lymphadenopathy
- lymphoma
- lymphopenia
- lymphopenia
- maculopapular rash
- malaise
- melena
- migraine
- muscle cramps
- muscle cramps
- musculoskeletal pain
- musculoskeletal pain
- myalgia
- myalgia
- myocardial infarction
- myocarditis
- nausea
- nausea
- nephrotoxicity
- neutropenia
- neutropenia
- new primary malignancy
- night sweats
- ocular hypertension
- organ transplant rejection
- palpitations
- pancreatitis
- pancytopenia
- paresthesias
- paresthesias
- pelvic pain
- pericarditis
- peripheral edema
- peripheral neuropathy
- peripheral neuropathy
- pharyngitis
- pharyngitis
- phlebitis
- pleural effusion
- pneumonitis
- progressive multifocal leukoencephalopathy
- pruritus
- pruritus
- pulmonary edema
- pulmonary embolism
- pulmonary hypertension
- rash
- rash
- renal failure (unspecified)
- respiratory arrest
- rhinitis
- rhinorrhea
- sinus tachycardia
- sinusitis
- skin cancer
- skin hyperpigmentation
- spinal cord compression
- Stevens-Johnson syndrome
- stomatitis
- stroke
- supraventricular tachycardia (SVT)
- syncope
- teratogenesis
- thrombocytopenia
- thrombocytopenia
- thromboembolism
- thrombosis
- toxic epidermal necrolysis
- tremor
- tumor flare
- tumor flare
- tumor lysis syndrome (TLS)
- vertigo
- visual impairment
- vomiting
- vomiting
- weakness
- weakness
- weight loss
- weight loss
- wheezing
- xerosis
- xerostomia
Monitoring Parameters
- CBC with differential
- LFTs
- pregnancy testing
- serum creatinine/BUN
- serum electrolytes
- serum uric acid
- thyroid function tests (TFTs)
Contraindications
- angioedema
- bleeding
- blood donation
- breast-feeding
- contraception requirements
- dysfunctional uterine bleeding
- geriatric
- hepatic disease
- hepatitis
- hepatotoxicity
- hyperlipidemia
- hypertension
- hyperthyroidism
- hypothyroidism
- infection
- intrauterine fetal death
- lactase deficiency
- male-mediated teratogenicity
- menstrual irregularity
- neutropenia
- new primary malignancy
- peripheral blood stem cell (PBSC) mobilization
- pregnancy
- pregnancy testing
- renal disease
- renal failure
- renal impairment
- reproductive risk
- serious rash
- sperm donation
- thalidomide hypersensitivity
- thrombocytopenia
- thromboembolism
- tobacco smoking
- treatment outside of a clinical trial
- tumor lysis syndrome (TLS)
- vaccination
Interactions
- Bacillus Calmette-Guerin Vaccine, BCG
- Clozapine
- Darbepoetin Alfa
- Denosumab
- Digoxin
- Epoetin Alfa
- Estrogens
- Influenza Virus Vaccine
- Intranasal Influenza Vaccine
- Live Vaccines
- Measles Virus; Mumps Virus; Rubella Virus; Varicella Virus Vaccine, Live
- Measles/Mumps/Rubella Vaccines, MMR
- Rotavirus Vaccine
- Rubella Virus Vaccine Live
- Smallpox and Monkeypox Vaccine, Live, Nonreplicating
- Smallpox Vaccine, Vaccinia Vaccine
- Typhoid Vaccine
- Varicella-Zoster Virus Vaccine, Live
- Warfarin
- Yellow Fever Vaccine, Live