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Lenalidomide is available as a 2.5 mg, 5 mg, 10 mg, 15 mg, 20 mg, and 25 mg oral capsule.

Lenalidomide is an immunomodulator that is used to treat:

• Multiple myeloma, with dexamethasone or after stem cell transplant
• Myelodysplastic syndromes (deletion 5q)
• Mantle cell lymphoma, relapsed or refractory after 2 prior therapies, including Velcade (bortezomib)
• Follicular lymphoma, previously treated
• Marginal zone lymphoma, previously treated

Lenalidomide works by stimulating the immune system to fight cancer cells. It also targets specific proteins within cancer cells and stops the cancer cell from growing. In addition, Lenalidomide works by blocking the blood supply to certain tumor cells, which helps lower the growth of new cancer cells.

Lenalidomide is dosed as follows:

• Multiple myeloma and mantle cell lymphoma: The typical dose is 25 mg by mouth once daily for 21 days of a 28-day treatment cycle. If you’re being treated for multiple myeloma, you’ll take Lenalidomide in combination with dexamethasone
• Follicular lymphoma and marginal zone lymphoma: The typical dose is 20 mg by mouth once daily for 21 days of a 28-day treatment cycle, in combination with Rituxan (rituximab), for up to 12 cycles
• Myelodysplastic syndromes: The typical dose is 10 mg by mouth once daily
• Your dose might be different if you experience certain side effects, have kidney or liver problems, or you’re taking medications that might interact with Lenalidomide

Lenalidomide is a safe and effective treatment when used for FDA licensed indications. However, like all medications, they may give you unwanted side effects. You should always discuss potential side effects with your physician to ensure the medication is suitable and right for you. You should not use this medication in the following:

• Pregnancy
• Demonstrated severe hypersensitivity to Lenalidomide

Common side effects of Lenalidomide:

• Diarrhea
• Low red blood cell count
• Low neutrophil count
• Tiredness
• Back pain
• Weakness
• Difficulty sleeping
• Rash
• Cough
• Lowered appetite
• Trouble breathing
• Fever
• Low platelet count
• Stomach pain
• Muscle spasms

Serious side effects are rare with Lenalidomide. Contact your healthcare provider immediately if you experience any of the following.

• Serious liver problems: tiredness, loss of appetite, nausea or vomiting, dark urine, right-side stomach pain, easy bruising or bleeding, or yellowing of the eyes or skin
• Blood clot in the brain: weakness or numbness in your arms, legs, or face on one side of the body, trouble speaking, blurred vision, dizziness, loss of balance, trouble walking, confusion
• Heart attack: feeling tired, dizziness, chest pain, sweating, nausea
• Blood clot in the lungs: dizziness, cough, coughing up blood, trouble breathing, chest pain, pounding heart
  Blood clot in the legs: cramps, swelling, pain, or muscle tightness
• Severe skin reactions: painful blisters, skin wounds, peeling skin, painful sores in your mouth or around your eyes
• Tumor lysis syndrome: fever, chills, nausea or vomiting, confusion, trouble breathing, seizures, irregular heartbeat, dark or cloudy urine, muscle or joint pain, unusual tiredness
• Serious infections: fever, sore throat, chills, headache, body aches, cough
• Serious bleeds: bleeding that’s difficult to stop, bruises that don’t go away, dark or tarry stool

The following medications may interact with Lenalidomide:

• Digoxin: Monitor digoxin plasma levels periodically due to increased Cmax and AUC with concomitant Lenalidomide therapy
• Concomitant use of erythropoietin stimulating agents or estrogen containing therapies with Lenalidomide may increase the risk of thrombosis

Various FDA-approved generic manufacturers

Lenalidomide is contraindicated in pregnancy. Lenalidomide is a thalidomide analogue. Thalidomide is a known human teratogen that causes severe life-threatening birth defects. For females of reproductive potential: Exclude pregnancy before start of treatment. Prevent pregnancy during treatment by the use of 2 reliable methods of contraception.

• Revlimid