lenalidomide

What is the most important information I should know about lenalidomide?

Use birth control to prevent pregnancy, whether you are a man or a woman. For women: Use two forms of birth control beginning 4 weeks before you start taking lenalidomide and ending 4 weeks after you stop taking it. For men: Use a condom to prevent pregnancy during your treatment, and for up to 4 weeks after your treatment ends.

What is lenalidomide?

Lenalidomide is used to treat multiple myeloma (bone marrow cancer), either in combination with another medicine or after stem cell transplant.

Lenalidomide is also used to treat anemia (a lack of red blood cells) in patients with myelodysplastic syndrome caused by an abnormal chromosome. This disorder is also called deletion 5q MDS, because part of chromosome 5 is missing. In people with this disorder, the bone marrow does not produce enough healthy blood cells.

Lenalidomide is also used to treat mantle cell lymphoma, follicular lymphoma, or marginal zone lymphoma, after other medications have been tried without success.

Lenalidomide is available only under a special program. You must be registered in the program and understand the risks and benefits of this medicine. You must also agree to use birth control measures as required by the program.

Lenalidomide may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking lenalidomide?

For Women: If you have not had a hysterectomy, you will be required to use two reliable forms of birth control beginning 4 weeks before you start taking lenalidomide and ending 4 weeks after you stop taking it. Even women with fertility problems are required to use birth control while taking this medicine. You must also have a negative pregnancy test at 10 to 14 days before treatment and again at 24 hours before. While you are taking lenalidomide, you will have a pregnancy test every 2 to 4 weeks.

The birth control method you use must be proven highly effective, such as birth control pills, an intrauterine device (IUD), a tubal ligation, or a sexual partner's vasectomy. The extra form of birth control you use must be a barrier method such as a latex condom, a diaphragm, or a cervical cap.

For Men: If a man fathers a baby while using lenalidomide, the baby may have birth defects. Use a condom to prevent pregnancy during your treatment, and for up to 4 weeks after your treatment ends. You must agree in writing to always use latex condoms when having sex with a woman who is able to get pregnant, even if you have had a vasectomy. Contact your doctor if you have had unprotected sex, even once, or if you think your female sexual partner may be pregnant.

Tell your doctor if you have ever had:

• an allergic reaction to thalidomide;
• kidney disease (or if you are on dialysis);
• liver disease;
• a blood clot or stroke;
• high blood pressure, high cholesterol or triglycerides;
• a thyroid disorder;
• lactose intolerance; or
• if you smoke

Using lenalidomide may increase your risk of developing other types of cancer, such as leukemia or lymphoma. Talk with your doctor about your specific risk.

How should I take lenalidomide?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed. Never share this medicine with another person, even if they have the same disorder you have.

Take the medicine at the same time each day, with or without food.

Lenalidomide can increase your risk of bleeding or infection. You will need frequent medical tests.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if you are more than 12 hours late for the dose. Do not use two doses at one time.

What happens if I overdose?

What should I avoid while taking lenalidomide?

What are the possible side effects of lenalidomide?

• signs of a stroke or blood clot --sudden numbness or weakness, severe headache, problems with speech or vision, shortness of breath, swelling or redness in your arm or leg;
• heart attack symptoms --chest pain or pressure, pain spreading to your jaw or shoulder, sweating;
• liver problems --upper stomach pain, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
• low blood cell counts --fever, chills, swollen gums, mouth sores, skin sores, easy bruising, unusual bleeding;
• signs of a tumor getting worse --swollen glands, low fever, rash, or pain; or
• signs of tumor cell breakdown --lower back pain, blood in your urine, little or no urinating; numbness or tingly feeling around your mouth; muscle weakness or tightness; feeling short of breath; confusion, fainting.

Common side effects may include:

• cold symptoms such as stuffy nose, sneezing, sore throat;
• sleep problems, tiredness;
• weakness;
• headache;
• tremors;
• nosebleed;
• muscle cramps;
• joint pain;
• shortness of breath;
• fever, cough, tiredness;
• itching, rash, swelling; or
• stomach pain, nausea, vomiting, diarrhea, constipation.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect lenalidomide?

Tell your doctor if you also use pembrolizumab (Keytruda).

Other drugs may affect lenalidomide, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

Where can I get more information?

Your doctor or pharmacist can provide more information about lenalidomide.