💊 DESCRIPTION
Lenalidomide is an immunomodulatory and anti-neoplastic agent used to treat certain cancers, particularly blood cancers. It is structurally related to thalidomide, but with enhanced potency and reduced neurotoxicity.
- Form: Capsule
- Strength: 5 mg
- Route: Oral (by mouth)
- Drug Class: Immunomodulatory agent (IMiD), antiangiogenic agent
- Indications:
- Multiple Myeloma (MM) (in combination with dexamethasone)
- Myelodysplastic Syndromes (MDS) with 5q deletion
- Mantle Cell Lymphoma (MCL)
- Chronic Lymphocytic Leukemia (CLL) – in certain cases
✅ ADVANTAGES
- Multiple mechanisms of action: immune stimulation, anti-angiogenesis, and direct tumor suppression
- Improved safety vs. thalidomide (especially lower neurotoxicity)
- Effective in relapsed/refractory as well as frontline settings (in combination)
- Oral route: convenient administration
- Demonstrated improvement in progression-free survival in MM
🌿 NATURE / MECHANISM
- Immunomodulatory effects:
- Enhances T-cell and natural killer (NK) cell activity
- Inhibits pro-inflammatory cytokines (e.g., TNF-α, IL-6)
- Anti-angiogenic: suppresses blood vessel formation in tumors
- Antineoplastic: causes cell cycle arrest and apoptosis of malignant cells
- Targets cereblon E3 ubiquitin ligase complex – leads to degradation of tumor-promoting transcription factors
⚠️ PRECAUTIONS
- Teratogenicity (severe birth defects):
- Contraindicated in pregnancy
- Requires REMS program enrollment (in some countries)
- Use strict contraception for both males and females
- Hematologic toxicity:
- Neutropenia, thrombocytopenia, and anemia common – monitor CBC regularly
- Venous thromboembolism (VTE):
- Risk increases when used with dexamethasone
- Prophylactic anticoagulation may be needed
- Secondary malignancies: risk may increase with long-term use
- Hepatic and renal monitoring: adjust dose in renal impairment
🧊 STORAGE
- Store at room temperature (15°C to 30°C)
- Keep in original blister pack or container
- Protect from moisture and heat
- Keep out of reach of children
👨⚕️ PATIENT ADVICE
- Women of childbearing potential must:
- Use two reliable forms of contraception
- Have negative pregnancy tests before and during treatment
- Men taking lenalidomide should use condoms during intercourse (and for a period after), especially if partner is pregnant or could become pregnant
- Do not donate blood or sperm during and for a period after therapy
- Report immediately:
- Signs of infection (fever, sore throat)
- Bleeding/bruising
- Symptoms of blood clots (leg pain/swelling, chest pain, shortness of breath)
- Take capsules whole with water – do not open, chew, or crush
- If a dose is missed and less than 12 hours have passed, take it as soon as possible; otherwise, skip the dose
📦 PACKAGING
- Primary Packaging:
- Capsules in blister strips or HDPE bottle
- Clearly marked with strength (5 mg)
- Secondary Packaging:
- Outer carton with prescribing information
- Warnings regarding teratogenicity, including special labeling (often with a red box or “Do Not Use in Pregnancy” icon)
- Includes patient medication guide
- Labeling:
- Contains batch number, expiry date, and dosage instructions
- May carry a cytotoxic handling warning