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Lenalidomide [Specialist drug]: Indications, Dosing, Side Effects and Interactions
Lenalidomide [Specialist drug] clinical drug profile including indications, dosing, side effects, cautions and interactions.
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Lenalidomide [Specialist drug]: Indications, Dosing, Side Effects and Interactions
Lenalidomide [Specialist drug] clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Multiple myeloma,Myelodysplastic syndromes,Mantle cell lymphoma,Follicular lymphoma**
- **Adult** (By Mouth): Specialist drug - access specialist resources for dosing information.
Side effects
For lenalidomide [Specialist drug] Common or very common Anaemia; appetite decreased; arthralgia; asthenia; atrial fibrillation; chills; constipation; cough; decreased leucocytes; dehydration; diarrhoea; dizziness; dry mouth; dyspnoea; electrolyte imbalance; embolism and thrombosis; fall; fever; gastrointestinal discomfort; haemorrhage; headache; heart failure; hyperglycaemia; hypertension; hyperthyroidism; hypotension; hypothyroidism; increased risk of infection; influenza like illness; insomnia; interstitial lung disease; iron overload; lethargy; mood altered; muscle complaints; muscle weakness; myocardial infarction; nausea; neoplasms; nerve disorders; neutropenia; night sweats; pain; pancytopenia; paraesthesia; peripheral oedema; renal failure; respiratory disorder; rhinorrhoea; sepsis; skin reactions; taste altered; thrombocytopenia; toothache; tumour flare; vertigo; vomiting; weight decreased Uncommon Angioedema Rare or very rare Hypersensitivity; severe cutaneous adverse reactions (SCARs); tumour lysis syndrome Frequency not known Acquired haemophilia; gastrointestinal disorders; hepatic disorders; hypersensitivity vasculitis; pancreatitis; progressive multifocal leukoencephalopathy (PML); reactivation of infections; solid organ transplant rejection Side-effects, further information Patients aged 75 years and over-increased risk of serious side-effects. Hepatic disorders Hepatic failure, including fatal cases, have been reported. Abnormal liver function tests are generally reversible upon dosing interruption; once returned to baseline, consider restarting treatment at a reduced dose. Neutropenia and thrombocytopenia Reduce dose or interrupt treatment if neutropenia or thrombocytopenia develop. Rash If grade 2 or 3 rash occurs, treatment should be discontinued and only restarted following appropriate clinical evaluation. Discontinue permanently if grade 4, exfoliative, or bullous rash, or if drug reaction with eosinophilia and systemic symptoms (DRESS), Stevens-Johnson syndrome, or toxic epidermal necrolysis is suspected. Thromboembolism If thromboembolic event occurs, discontinue lenalidomide and treat with standard anticoagulation therapy; consider restarting with continued anticoagulation therapy once thromboembolic event resolved.
Pregnancy
Important safety information For lenalidomide [Specialist drug] Pregnancy Prevention Programme Important: teratogenic risk. Lenalidomide is structurally related to thalidomide and there is a risk of teratogenesis. Patients, prescribers, and pharmacists must comply with the manufacturer's Pregnancy Prevention Programme. Every prescription must be accompanied by a completed Prescription Authorisation Form. For females of childbearing potential, each prescription for lenalidomide should be limited to a maximum supply of 4 weeks' treatment. Pregnancy testing should ideally be carried out on the same day as prescription issuing and dispensing. MHRA/CHM advice: Immunomodulatory drugs and pregnancy prevention: temporary advice for management during coronavirus (COVID-19) (May 2020) The MHRA has issued temporary guidance for female patients on lenalidomide during the coronavirus (COVID-19) pandemic to support adherence to the Pregnancy Prevention Programme (see Conception and contraception ), particularly for those who are shielding due to other health conditions, and should be followed until further notice. MHRA/CHM advice: Risk of thrombosis and thromboembolism (December 2014) The MHRA advises that patients treated with lenalidomide for the management of multiple myeloma should be closely monitored for evidence of arterial and venous thromboembolic events, and risk factors for thromboembolism (such as smoking, hypertension, hyperlipidaemia) should be minimised. Healthcare professionals should consider appropriate thrombotic prophylactic medication during treatment with lenalidomide after assessment of the risks and benefits.
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Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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