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At a glance

Lenalidomide is used for the treatment of multiple myeloma, myelodysplastic syndromes (MDS), mantle cell lymphoma (MCL), follicular lymphoma (FL), and marginal zone lymphoma (MZL). It has immunomodulatory, antiangiogenic, and antineoplastic properties.

Indications
  • Multiple myeloma (in combination with Dexamethasone; maintenance therapy after auto-HSCT)
  • Myelodysplastic syndromes (MDS) - transfusion-dependent anemia with deletion 5q cytogenetic abnormality
  • Mantle cell lymphoma (MCL) - relapsed or progressed after 2 prior therapies including Bortezomib
  • Follicular lymphoma (FL) - in combination with Rituximab for previously treated patients
  • Marginal zone lymphoma (MZL) - in combination with Rituximab for previously treated patients
Pharmacology

Lenalidomide acts through cereblon to cause ubiquitination and degradation of Aiolos, Ikaros, and CK1α proteins, increasing T cell and NK cell number and activation, increasing IL-2 and interferon-γ secretion, and inhibiting pro-inflammatory cytokines (TNF-α and IL-6).

Dosage

Multiple Myeloma: 25 mg PO daily, Days 1-21 (28-day cycles) + Dexamethasone

MDS: 10 mg PO daily

MCL: 25 mg/day, Days 1-21 (28-day cycles)

FL/MZL: 20 mg PO daily, Days 1-21 + Rituximab

Renal Impairment: Dose adjustment needed in moderate-severe cases

Side effects

Common Side Effects:

  • Headache, weakness, nausea, rash, dizziness, drowsiness
  • Edema, loss of appetite, decreased white blood cell count, decreased calcium, weight gain
  • Muscle weakness, fatigue, fever, anxiety, blood clots, dry skin
  • Weight loss, confusion, decreased neutrophils, neuropathy, constipation, tremor
Use in pregnancy

Use in Pregnancy: Lenalidomide is highly unsafe during pregnancy (FDA Category X). Can cause severe fetal harm. Absolutely contraindicated.

Pregnancy Category: X — always consult a doctor before taking during pregnancy.

Precautions & warnings
  • Embryo-fetal toxicity - absolutely contraindicated in pregnancy
  • Hematologic toxicity - monitor CBC regularly
  • Venous and arterial thromboembolism - thromboprophylaxis recommended
  • Hepatotoxicity - monitor liver enzymes
  • Severe cutaneous reactions - angioedema, SJS, TEN, DRESS
  • Monitor for tumor lysis syndrome and tumor flare reaction
Overdose effects

No specific experience in overdose management; symptomatic and supportive measures should be employed.

Storage conditions

Store below 30°C in a dry place, protected from light; keep out of reach of children.

Lenalidomide — see the full informationPharmacology, precautions, pregnancy, overdose and the rest on the generic page
⚠️ This information is for educational purposes only — not a substitute for medical advice. Consult a registered physician before taking any medicine.