Description. Lenalidomide is a thalidomide analog with potential antineoplastic activity. Lenalidomide inhibits TNF-alpha production, stimulates T cells, reduces serum levels of the cytokines vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF), and inhibits angiogenesis
What is REVLIMID and how is it used?
REVLIMID is a prescription medicine, used to treat adults with:
- multiple myeloma (MM)
- in combination with the medicine dexamethasone, or
- as maintenance treatment after autologous hematopoietic stem cell transplantation (a type of stem cell transplant that uses your own stem cells)
- a condition called myelodysplastic syndromes (MDS). REVLIMID is for the type of MDS with a chromosome problem where part of chromosome 5 is missing. This type of MDS is known as deletion 5q MDS. People with this type of MDS may have low red blood cell counts that require treatment with blood transfusions.
- mantle cell lymphoma (MCL) when the disease comes back or becomes worse after treatment with 2 prior medicines, one of which included bortezomib. MCL is a cancer of a type of white blood cell called lymphocytes that are in the lymph nodes.
How to use Lenalidomide Capsule
Read the Medication Guide provided by your pharmacist before you start taking lenalidomide and each time you get a refill. If you have any questions, ask your doctor or pharmacist.
Take this medication by mouth with or without food as directed by your doctor, usually once daily. Swallow this medication whole with water. For treatment of certain conditions, you may be instructed to take this medication in cycles (once daily for 21 days, then stopping the medication for 7 days). The dosage is based on your medical condition, response to treatment, and lab test results. Be sure to follow your doctor's directions carefully.
Do not open, chew, or break the capsules, or handle them any more than needed. If any of the powder from the capsule gets on your skin, wash the area with soap and water.
Uses of Lenalid (Lenalidomide) Capsule
- Multiple Myeloma
Lenalid (Lenalidomide) is the generic name of the Revlimid. It used to treat Multiple Myeloma with the combination of dexamethasone.
- Myelodysplastic syndrome
This medication is also used in the treatment of Myelodysplastic syndrome, which is a certain type of blood/bone disorder characterized by immature cells.
Lenalid (Revlimid) also approved by the FDA in order to treat Mantle Cell Lymphoma in the patients whose disease has relapsed or progressed after two prior consecutive therapies including bortezomib.
General Warning:
- Lenalidomide is not recommended during pregnancy, it may cause adverse effects on the unborn child.
- Lenalid needs to avoid while breastfeeding. Talk to your doctor they will suggest you alternate treatment in such circumstances.
- This medication is not for children aged below 18 years.
Overdose:
By mistake, if anyone has overdosed Lenalid 25 mg medication, and has a few signs & symptoms such as difficulty in breathing then immediately call your physician or poison control center.
Missed dose:
If you forget to take a dose of this medication, take it as quickly as possible but if more than 10-12 hours have passed just skip the particular day and take it on the next day at the same time. Never take the double dose in order to maintain the cycle.
What is Lenalid or Lenalidomide?
LENALID is indicated for the treatment of patients with:
- Multiple myeloma (MM), in combination with dexamethasone
- Transfusion-dependent anemia due to low- or intermediate-1-risk myelodysplastic syndromes (MDS) associated with a deletion 5q abnormality with or without additional cytogenetic abnormalities
- Mantle cell lymphoma (MCL) whose disease has relapsed or progressed after two prior therapies, one of which included bortezomib.
How Lenalidomide (Revlimid/Lenalid) works:
Lenalid 5 mg, 10 mg, and 25 mg is the newest treatment for Multiple Myeloma. Lenalidomide is the active substance in the Revlimid. It works by blocking the development of abnormal cells.
In tumors, it resists the progress of blood vessels and also stimulates the healthy cells of the immune system to fight off infectious cells.
Common side effects
These side effects happen in more than 10 in 100 people (10%). You might have one or more of them. They include:
Increased risk of getting an infection
Increased risk of getting an infection is due to a drop in white blood cells. Symptoms include a change in temperature, aching muscles, headaches, feeling cold and shivery and generally unwell. You might have other symptoms depending on where the infection is.
Infections can sometimes be life threatening. You should contact your advice line urgently if you think you have an infection.
Breathlessness and looking pale
You might be breathless and look pale due to a drop in red blood cells. This is called anaemia.
Bruising, bleeding gums or nosebleeds
This is due to a drop in the number of platelets in your blood. These blood cells help the blood to clot when we cut ourselves. You may have nosebleeds or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs (known as petechiae).
Tiredness and weakness (fatigue)
You might feel very tired and as though you lack energy.
Various things can help you to reduce tiredness and cope with it, for example exercise. Some research has shown that taking gentle exercise can give you more energy. It is important to balance exercise with resting.
Diarrhoea
Contact your advice line if you have diarrhoea, such as if you've had 4 or more loose watery poos (stools) in 24 hours. Or if you can't drink to replace the lost fluid. Or if it carries on for more than 3 days.
Your doctor may give you anti diarrhoea medicine to take home with you after treatment. Eat less fibre, avoid raw fruits, fruit juice, cereals and vegetables, and drink plenty to replace the fluid lost.
Constipation
Constipation is easier to sort out if you treat it early. Drink plenty of fluids and eat as much fresh fruit and vegetables as you can. Try to take gentle exercise, such as walking. Tell your doctor or nurse if you are constipated for more than 3 days. They can prescribe a laxative.
Blood clots
Blood clots can develop in the deep veins of your body, usually the leg. This is called deep vein thrombosis (DVT). A blood clot can be very serious if it travels to your lungs (pulmonary embolism), although this isn’t common.
Symptoms of a blood clot include:
• pain, redness and swelling around the area where the clot is and may feel warm to touch
• breathlessness
• pain in your chest or upper back – dial 999 if you have chest pain
• coughing up blood
Skin rash
Skin problems include a skin rash, dry skin and itching. This usually goes back to normal when your treatment finishes. Your nurse will tell you what products you can use on your skin to help.
Eyesight problems
You might have blurred vision or clouding of the lens (cataract). Contact to your team if you have any new problems with your vision.
Shaky hands (tremor)
Talk to the team looking after you about this.
Numbness or tingling in fingers or toes
Numbness or tingling in fingers or toes is often temporary and can improve after you finish treatment. Tell your doctor if you're finding it difficult to walk or complete fiddly tasks such as doing up buttons.
Headaches and dizziness
Let your doctor or nurse know if you have headaches. They can give you painkillers. Don’t drive or operate machinery if you feel dizzy.
Feeling or being sick
Feeling or being sick is usually well controlled with anti sickness medicines. Avoiding fatty or fried foods, eating small meals and snacks, drinking plenty of water, and relaxation techniques can all help.
It is important to take anti sickness medicines as prescribed even if you don’t feel sick. It is easier to prevent sickness rather than treating it once it has started.
Changes in mineral levels in the blood
You may have changes in levels of minerals and salts in your blood, including low levels of sodium or high levels of uric acid (causing gout). You have regular blood tests during treatment to check this.
Kidney changes
To help prevent kidney damage, it is important to drink plenty of water. You might also have fluids into your vein before, during and after treatment. You have blood tests before your treatments to check how well your kidneys are working.
Fluid build up
You may have swelling of your hands and legs due to a build up of fluid (oedema).
Taste changes
Taste changes may make you go off certain foods and drinks. You may also find that some foods taste different from usual or that you prefer to eat spicier foods. Your taste gradually goes back to normal a few weeks after your treatment finishes.
Changes in blood sugar levels
You have regular blood and urine tests to check this. If you have diabetes you may need to check your blood sugar levels more often than usual.
Mood changes and difficulty sleeping
Talk to your healthcare team if your mood is affected.
It can help to change a few things about how you try to sleep. Try to go to bed and get up at the same time each day and spend some time relaxing before you go to bed. Some light exercise each day may also help.
Pain
You may have painful bones and joints or muscle pain. Some people have tummy (abdominal pain). Talk to your healthcare team, they may be able to prescribe pain relief.
Flu-like symptoms
You may have headaches, muscle aches (myalgia), a high temperature and shivering. You should contact your advice line urgently if you have these symptoms.
Dry, sore mouth
Your mouth might get sore. You will have mouth washes to keep your mouth healthy. You can have painkillers to reduce the soreness. Take them half an hour before meals to make eating easier.
If you have a dry mouth it can help to drink plenty of fluids after treatment. An artificial saliva spray into your mouth might help. Ask you healthcare team about this.
Occasional side effects
These side effects happen in between 1 and 10 out of every 100 people (1 to 10%). You might have one or more of them. They include:
- heart problems such as heart failure or a heart attack
- loss of appetite and weight loss
- low levels of thyroid hormones, causing tiredness for example
- liver changes
- hearing problems such as hearing loss or ringing in your ears (tinnitus)
- difficulty balancing
- itching of skin and sweating
- urine infections
- darkening of the skin
- increased risk of certain blood disorders
- difficulty getting an erection
- depression
- heartburn and indigestion
Rare side effects
These side effects happen in fewer than 1 in 100 people (1%). You might have one or more of them. They include:
- severe allergic reaction
- loss of interest in sex
- bloating, and diarrhoea caused by inflammation of the bowel
- skin sensitivity to sunlight
- bleeding in the brain
- severe kidney changes
Coping with side effects
We have more information about side eff
Call your doctor for Medical Advice about side effects and get emergency medical help if you have any upper signs.
Precautions:
- Do not start taking lenalidomide without the approval of your doctor.
- Before taking this medication intimate your doctor if you have any medical history such as Hepatitis B, organ transplant, Kidney or Liver disease.
- This medication with a combination of Alcohol or cannabis may lead you towards the dizziness. So avoid driving and other machinery. Reduce the consumption of Alcohol.
- Strictly avoid the donation of sperm or blood when you`re taking lenalidomide.
- Use of Lenalid may push you towards the infections so avoid the contact of such people who have recently been sick due to infections than can pass in others such as measles, chickenpox, etc. Contact your medical team if any such kind of circumstances appears.
- Do not involve in such activities through which you may be injured or cut.
- Make sure this medication need to avoid while breastfeeding.
- Do not take Lenalid 25 mg tablet during pregnancy that may affect the unborn baby.
Interactions:
All the drugs interact in a different way from person to person. Penned down a list of products you use including herbal products, prescription, and nonprescription drugs and discuss it with your medical team.
Never start or stop any medication without the consent of your physician/doctor.
Self Care Tips:
- Invest your time in a moderate workout.
- Drink plenty of fluids including juices and energy drinks.
- Add more yogurt, Garlic, Ginger, and Turmeric in your meal.
- Take sufficient rest and sleep at least for 9-10 hours.
- Plan your diet enriched with protein, fiber, vitamins, and minerals.
- Keep your surroundings neat and clean and wash your hands properly at every necessary juncture.
- You may get infections easily so try to avoid the crowd. Prefer malls and movies for entertainment.
- Use electric razor, nail cutters in order to minimize unnecessary bleeding.
- Do not consume alcohol and tobacco-related products.
- If you feel any serious symptoms, call your doctor in order to get better treatment.
FDA approves Lenalidomide for Myeloma:
In the year 2005, Lenalidomide was approved to use for Multiple Myeloma in the United States. It is the most impacting and safest medicine on the World Health Organization`s enlisted Essential Medicines.
Later, in the year 2017 FDA approved Lenalidomide as standalone maintenance therapy for the people with Multiple Myeloma.
Chemo Drugs Used to Treat Multiple Myeloma include:
Melphalan
Vincristine (Oncovin)
Cyclophosphamide (Cytoxan)
Etoposide (VP-16)
Doxorubicin (Adriamycin)
Liposomal doxorubicin (Doxil)
Bendamustine (Treanda)
Oncovin (Vincristine)
BORTENAT (Bortezomib 2 mg)
POMALID™ (Pomalidomide)
DARZALEX (Daratumumab)
KYPROLIS™ (Carfilzomib)
CARFILNAT™ (Carfilzomib)
Thalix (Thalidomide 100 mg)
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