LENALIDOMIDE
Background and Date of Approval
Lenalidomide is an antiangiogenic agent that blocks the formation of blood vessels and was approved for medical use on 27 December 2005.
Uses
Lenalidomide has been developed to treat Multiple myeloma and myelodysplastic syndrome, mantle cell lymphoma and follicular lymphoma.
How is it administered?
Lenalidomide is available in the form of capsule in the doses 2.5mg, 5mg, 10mg, 15mg, 20mg, and 25mg. You shall take Lenalidomide capsule with or without food by swallowing the capsule with water once a day. If you have kidney problem, your healthcare provider will adjust the dose after measuring your creatinine clearance.
Side Effects
Common side effects of Lenalidomide are: Diarrhoea Rashes & itching Nausea Constipation Tiredness & weakness Fever & headache Bronchitis Inflammation of the stomach and intestine Muscle cramps Sleep problems Cough & sore throat Joint pain Nosebleeds Back pain Serious side effects of Lenalidomide are: Thyroid problems Dizziness Confusion Tumour lysis syndrome Secondary cancers Liver problems Low blood cell counts Allergic reactions (e.g., swelling of lips, eyes, face, or tongue, hives, breathing trouble)
Warnings
Allergies : Monitor for signs of hypersensitivity and discontinue Lenalidomide if you experience angioedema or anaphylaxis. Shortness of breath, abnormal bleeding, or extreme tiredness : Contact your doctor immediately if you experience these symptoms. Blood monitoring : Your doctor will monitor your blood cell counts, platelets, blood sugar, electrolytes, and liver and kidney function during Lenalidomide treatment. Pre-existing conditions : Inform your doctor if you have been diagnosed with anaemia, liver problems, kidney disease, or heart problems. Skin reactions : Seek immediate medical attention if you develop red, itchy skin, rashes, peeling of the skin, yellowing of the skin and eyes, severe itching, very fast heartbeat, or fever. Liver problems : Monitor your liver function, as hepatic failure and fatalities have been reported. Stop Lenalidomide if you experience hepatotoxicity. Severe skin reactions : Discontinue Lenalidomide if you experience severe cutaneous reactions. Tumor lysis syndrome (TLS) : Monitor patients at risk for TLS and take precautions, as fatalities have been observed. Tumour flare reactions : Report serious tumour flare reactions, including fatal ones, during treatment for CLL and lymphoma.
Precautions
It is not recommended to get pregnant or breastfeed during treatment with Lenalidomide. Tell your physician before starting this treatment if you are pregnant, breastfeeding, think you could be pregnant or planning to have a baby. Discuss effective contraceptive methods with your physician and use them to prevent pregnancy. Your healthcare provider will conduct pregnancy test every 4 weeks if your menstrual cycle is regular and every 2 weeks if irregular.
Word of Advice
Lenalidomide may cause dizziness and confusion. Avoid driving and activities requiring sustained attention during treatment. Inform your healthcare provider if you have lactose intolerance. Lenalidomide may impact liver function and requires frequent monitoring. Contact your healthcare provider before initiating treatment if you have pre-existing liver disease.
References
1. Bristol Myers Squibb, US Food & Drug Administration, [Revised on May 2022] [Accessed on 7th Sep 2022], https://packageinserts.bms.com/pi/pi_revlimid.pdf 2. Anton Wellstein, Giuseppe Giaccone, Michael B. Atkins, and Edward A. Sausville, Pathway-Targeted Therapies: Monoclonal Antibodies, Protein Kinase Inhibitors, and Various Small Molecules, Goodman & Gilmanâs Pharmacological Basis of Therapeutics, 13th Edition, 2018, 1203-1236.
Frequently Asked Questions
Is it safe to use Lenalidomide during pregnancy?
Lenalidomide is unsafe during pregnancy as it has the tendency to cause fetal harm and miscarriage. Your healthcare provider will conduct pregnancy test before and during treatment with Lenalidomide to rule out pregnancy and prevent complications.
Who should not take Lenalidomide Capsule?
People who have experienced allergic reactions to Lenalidomide and Thalidomide should not take Lenalidomide Capsule. Consult your healthcare provider before taking Lenalidomide Capsule if you have been diagnosed with lactose intolerance.
What are the common side effects of Lenalidomide?
Diarrhoea, rash, nausea, constipation, tiredness, weakness, fever, itching, bronchitis, inflammation of the stomach and intestine, muscle cramps, headache, sleep problems, cough, sore throat, joint pain, nosebleeds, back pain are the most common side effects of Lenalidomide.
When should you contact your physician?
Reach out to your health care provider and immediate medical attention if you experience symptoms of tumor lysis syndrome which include abnormal heart rhythm and seizures.
What parameters will be monitored during treatment with Lenalidomide?
During treatment with Lenalidomide, your health care provider will monitor RBC, WBC, platelets, liver, blood glucose and kidney parameters.
How would you know if you are allergic to Lenalidomide?
Hypersensitivity reactions like severe itching, rashes, fever, peeling of skin, redness, rapid heartbeat, breathing trouble, dizziness and swelling of lips, mouth, tongue or throat indicate that you are allergic to Lenalidomide. Seek medical attention from your healthcare provider immediately if you experience any of the above symptoms.
What should you avoid during treatment with Lenalidomide?
Donating blood or sperm while on treatment with Lenalidomide is not recommended.
Does lenalidomide cause hair loss?
Yes, lenalidomide can cause hair loss, although it is not a common side effect. Some people may experience thinning or shedding of hair during treatment.