Lenalidomide

Key facts

• Lenalidomide is chemically related to thalidomide and taken as a daily capsule, usually in cycles with rest periods between them.
• It causes severe, often fatal birth defects if taken during pregnancy, even from a single dose. Anyone who can become pregnant must use two reliable forms of contraception and have regular pregnancy tests; men taking it must use condoms.
• It significantly raises the risk of blood clots (deep-vein thrombosis and pulmonary embolism) and lowers blood cell counts, so blood tests are required regularly.
• Seek urgent care for sudden leg swelling or pain, shortness of breath, fever, or unusual bleeding or bruising.

What lenalidomide treats

Lenalidomide treats multiple myeloma, usually combined with dexamethasone, myelodysplastic syndromes with a chromosome 5q deletion, and certain lymphomas, including mantle cell and follicular lymphoma.

How lenalidomide works

Lenalidomide adjusts the immune system so it attacks abnormal cells more effectively, and it blocks the new blood vessels tumors need to grow, alongside a direct toxic effect on myeloma cells.

Before you take it

• Pregnancy is absolutely contraindicated. You must enroll in a controlled pregnancy-prevention program before you can receive lenalidomide.
• Tell your prescriber about any past blood clot, since the risk is compounded when lenalidomide is combined with dexamethasone.
• Kidney impairment requires a lower dose, so your prescriber will check kidney function before and during treatment.
• Never share this medicine with anyone else, including someone with a similar diagnosis.

Side effects

Common effects include low blood cell counts, fatigue, diarrhea or constipation, mild rash, and muscle cramps.

Stop and seek urgent medical care for any of these:

• Fever, persistent sore throat, or unexpected bleeding, signs of a severe drop in blood cells.
• Sudden leg swelling, pain, or shortness of breath, signs of a blood clot.
• Swelling of the face, lips, or throat, or difficulty breathing.

Safety essentials

• Pregnancy prevention is mandatory: reliable contraception, regular pregnancy testing, and dispensing only through the controlled distribution program. A single exposure during pregnancy is a medical emergency.
• Blood clot risk is significant; your prescriber may add aspirin or another blood thinner, especially alongside dexamethasone.
• Blood counts need checking regularly, often weekly at first, because lenalidomide suppresses bone marrow function.
• Long-term use is linked to a higher chance of new, unrelated cancers; your prescriber weighs this against the benefit for your condition.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.