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Chemotherapy and other systemic treatment regimens may change due to COVID-19. Find out more at Systemic Treatment Regimens During COVID-19.

lenalidomide

( LEN-a-LID-o-mide )
Funding:
Exceptional Access Program
  • lenalidomide - Anemia due to MDS, with specific criteria
  • lenalidomide - For the maintenance treatment of patients with newly diagnosed multiple myeloma, following autologous stem-cell transplantation, according to specific criteria.
  • lenalidomide - Treatment of multiple myeloma in combination with dexamethasone in patients who are not candidates
    for autologous stem cell transplant, with specific criteria
  • lenalidomide - In combination with carfilzomib and dexamethasone for the treatment of relapsed multiple myeloma
  • lenalidomide - For the treatment of patients with multiple myeloma with good performance status who have received at least one prior therapy.
Other Name(s): Revlimid®
Appearance: capsule in various strengths

Medication Information Sheet
lenalidomide (LEN-a-LID-o-mide)
This document provides general information about your medication. It does not replace the advice of your health care professional. Always discuss your therapy with your health care professional and refer to the package insert for more details.

Other Name: Revlimid®

Appearance:
capsule

in various strengths

What is this medication for?
  • For treating certain types of blood cancers such as multiple myeloma, lymphomas or myelodysplastic syndromes.
What should I do before I have this medication?
  • Your doctor and pharmacy must be registered with the RevAid® program and you must register with this program before starting lenalidomide.
     
  • Tell your health care team if you have or had significant medical condition(s), especially if you have or had:
     
    • bleeding problems or a history of blood clots,
    • liver, kidney or heart problems (including irregular heartbeat, heart attack),
    • high blood pressure or cholesterol,
    • a history of viral infections such as shingles or hepatitis, 
    • an organ or stem cell transplant,
    • if you cannot tolerate thalidomide, or
    • have any allergies.
       
  • This drug contains a small amount of lactose. If you cannot tolerate lactose, talk to your health care team.
  • People with cancer have a higher risk of getting other cancers or developing blood clots. Some cancer medications may increase these risks, especially if used for a long period of time. Discuss any concerns about this medication with your health care team.
How will this medication affect sex, pregnancy and breastfeeding?
  • The use of this medication in men or women may cause harm to the unborn baby if pregnancy occurs. Let your health care team know if you or your partner is pregnant, becomes pregnant during treatment, or if you are breastfeeding.

  • If there is ANY chance that you or your partner may become pregnant, you and your partner together must: 

    • ► Use 2 effective forms of birth control at the same time while taking this drug AND have regular pregnancy tests. (See the RevAid® program for full details of requirements.) Avoid hormonal contraception such as birth control pills as these can increase your risk of blood clots.

  • Do not breastfeed while taking this drug.

  • This medication is unlikely to affect fertility (ability to get pregnant).

How is this medication given?
  • Take it exactly as directed by your doctor.
  • Swallow whole with a glass of water, with or without food.

  • Take the dose at about the same time each day.

  • Do not crush or open the capsules.

  • Do not remove capsule(s) from blister packs until ready to take the dose.
     
  • You may need capsules of more than 1 strength to have the correct dose. Ensure you identify the capsules correctly to get the right dose.
     
  • If you miss a dose, take it if it is within 12 hours of the missed dose, otherwise skip and take your next dose as scheduled. Do not double the dose to make up for the forgotten one.
What else do I need to know while on this medication?
  • This medication can interact with other medications and can result in the treatment not working as well or cause severe side effects.

  • Make sure your health care team knows about all your medications (prescription, over-the-counter, herbals and supplements). Check with your health care team before starting or stopping any of them.

  • For mild aches and pain or fever:

    • If you feel unwell, take your temperature before taking any medications for pain or fever. They may hide a fever. 
       
    • You may take acetaminophen (Tylenol®) tablets. Ask your health care team about the right dose for you. 
       
    • Ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or aspirin (acetylsalicylic acid, ASA), including low dose aspirin for heart conditions, may increase your chance of bleeding. Talk to your health care team before you start or stop these medications.
       
    • Talk to your health care team or go to the closest emergency room right away if you have a fever.  See the Fever pamphlet for more information.
  • Drinking alcohol and smoking during your treatment may increase some side effects and make your medication less effective. Speak to your health care team about smoking and drinking alcohol while on treatment.

  • Do not donate blood or sperm during lenalidomide treatment and for 4 weeks after the last dose.
How should I safely store this medication?
  • Keep this medication in the original packaging at room temperature in a dry place, away from heat and light. Keep out of sight and reach of children and pets.

  • Do not throw out any unused medications at home. Bring them to your pharmacy to be thrown away safely.

What are the side effects of this medication?

You may not have all of the side effects below. You may have side effects that are not listed.
 

Side effects and what to do When to contact doctor?
Common Side Effects (in 25 to 49 out of 100 people)

Fatigue (tiredness)

  • Be active and aim to get 30 minutes of moderate exercise (you are able to talk comfortably while exercising) on most days. Check with your health care team before starting any new exercise.
  • Pace yourself, do not rush. Put off less important activities. Rest when you need to.
  • Eat well and stay hydrated by drinking at least 6 to 8 glasses of water or other liquids every day (unless your doctor told you to drink more or less).
  • Avoid driving or using machinery if you are feeling tired

See our Fatigue pamphlet for more information. 

Contact your health care team if no improvement or if severe

Constipation

To help prevent constipation :

  • Drink more liquids and eat well. Drink at least 6 to 8 cups of liquids each day unless you have been told otherwise.
  • Be Active. Exercise can help to keep you regular.
  • Try to eat more fiber (e.g. fruits with skin, leafy greens and whole grains). If you take opioid pain medication, ask your health care team if eating more fibre is right for you.

To help treat constipation :

  • If you have not had a bowel movement in 2 to 3 days you may need to take a laxative. Ask your health care team what to do.

See the Constipation Pamphlet for more information.

Contact your health care team if no improvement or if severe

Diarrhea

May happen days to weeks after you get your treatment.

If you have diarrhea :

  • Take anti-diarrhea medication if your health care team prescribed it.
  • Avoid foods or drinks with artificial sweetener (e.g. chewing gum, “diet” drinks), coffee and alcohol.
  • Eat many small meals and snacks instead of 2 or 3 large meals.
  • Drink at least 6 to 8 cups of liquids each day. Talk to your health care team if you can’t drink 6-8 cups of liquids each day when you have diarrhea. You may need special liquids with salt and sugar, called Oral Rehydration Therapy.

​See the Diarrhea pamphlet for more information.

Contact your health care team if no improvement or if severe

Low platelets in the blood (may be severe)

  • Watch for bleeding (such as unusual nosebleeds or bleeding from the gums) or bruising easily (this is rare).
  • Very rarely, severe symptoms can happen. If you notice black coloured stools (poo), red or pink coloured urine (pee), red or brown coloured mucus when you cough, severe headache/confusion or bleeding that will not stop, you need to talk to your health care team or go to the nearest emergency room right away.

See the Low Platelet Count pamphlet for more information.

Fever, chills, infection (may be severe)

You have a fever if your temperature taken in your mouth (oral temperature) is:

  • 38.3°C (100.9°F) or higher at any time OR
  • 38.0°C (or 100.4°F) or higher for at least one hour.

While you are getting treatment:

  • Keep a digital thermometer at home and take your temperature if you feel hot or unwell (for example, chills).
  • Avoid taking medications that treat a fever before you take your temperature (for example, Tylenol®, acetaminophen, Advil® or ibuprofen) as they may hide a fever.
  • Do not eat or drink anything hot or cold right before taking your temperature.
  • Wash your hands often to prevent infection.
  • Check with your doctor before getting any vaccines, surgeries, medical procedures or visiting your dentist.


If you have a fever, talk to your health care team or go to the closest emergency room. 
See our Neutropenia (Low white blood cell count) pamphlet for more information.

Get emergency medical help right away

Headache; mild joint, muscle pain or cramps 

  • Take your pain medication as prescribed by your doctor.
  • You can take acetaminophen (Tylenol®) tablets as needed for mild aches and pains. Ask your doctor or pharmacist about the right dose for you.
  • Talk to your doctor or pharmacist first before taking ibuprofen (Advil®, Motrin®), naproxen (Aleve®) or aspirin. These medication may increase bleeding risk.
  • Rest often and try light exercise as it may help.
Contact your health care team if no improvement or if severe

Mild swelling in arms and legs; puffiness

To help prevent swelling :

  • Eat a low-salt diet.
  • Avoid tight fitting clothing.

If you have swelling in your legs, keep your feet up when sitting.

Contact your health care team if no improvement or if severe

Cough; feeling short of breath

You may have cough and feel short of breath without any signs of infection, such as a sore throat or a stuffed nose.

Rarely this may be severe with chest pain, trouble breathing or coughing up blood.  If this happens get medical help right away.

Contact your health care team if no improvement or if severe

Nausea and vomiting (generally mild)

May occur in hours to days after your treatment. 

If you have nausea or vomiting:

  • Take anti-nausea medication(s) as prescribed to you by your doctor. 
  • Drink clear liquids and have small meals. Get fresh air and rest.
  • Do not eat spicy, fried foods or foods with a strong smell.
  • Limit caffeine (e.g. coffee, tea) and alcohol.
  • Contact your health care team if the prescribed anti-nausea medications are not helping to control your nausea and vomiting.

 Also see Nausea & Vomiting pamphlet for more information.

Contact your health care team if no improvement or if severe

 

Side effects and what to do When to contact doctor?
Less Common Side Effects (in 10 to 24 out of 100 people)

Dizziness, tremors (shaky movements)

  • Do not drive a motor vehicle or use machinery if you feel dizzy or have tremors.
  • Get up and move slowly once you feel better.

Contact your health care team if no improvement or if severe

Rash; dry, itchy skin

Rash may be severe in some rare cases and cause your skin to blister or peel, or you may also have a fever and swollen glands. If this happens, get emergency medical help right away.

To prevent and treat dry skin,

  • Use skin moisturizer.
  • Protect your skin from the sun and the cold.
  • Use sunscreen with UVA and UVB protection and a SPF of at least 30.
Contact your health care team if no improvement or if severe

Low appetite

  • You may not feel like eating or you may lose weight.
  • Try to eat foods that you like and eat small meals throughout the day. 
  • You may need to take meal supplements to help keep your weight up.
  • Talk to your health care team if you have a low appetite.
  • See our Loss of appetite pamphlet for more information.
Contact your health care team if no improvement or if severe

Eye problems 

  • You may have dry eyes, redness, irritation, pain, tearing, sensitivity to light or blurred vision.
  • Avoid wearing contact lenses.
  • You may try artificial tears or ointment. 
Contact your health care team as soon as possible

Heartburn; stomach upset

To help prevent heartburn:

  • Avoid fatty or spicy foods.
  • Remain upright after eating.
  • Drink clear liquids and eat small meals.
Contact your health care team if no improvement or if severe

High blood sugar 

  • You may feel thirsty and pee more often.
  • Your doctor may check your blood sugar level. You may be advised to change your diet or take medication to treat high blood sugar.
  • Check your blood sugar regularly if you have diabetes.
Contact your health care team as soon as possible

Salt imbalances

It may cause muscle twitching, severe weakness or cramping, confusion and irregular heartbeat.

Get emergency medical help right away

Taste changes

  • Eat food that needs less chewing.
  • Taste foods at different temperatures, since the flavor may change. 
  • Try different forms of foods, like fresh, frozen or canned.
  • Experiment with non-spicy foods, spices and seasonings. 
Contact your health care team if no improvement or if severe

Depression

Everyone feels sad sometimes and having cancer can cause you to feel down. Depression is when these feelings last for weeks or months.

To help prevent depression : 

  • Eating well and exercising may give you more energy and help you feel better.  Always check with your health care team before starting a new exercise program to make sure it is safe for you.
  • Get support from your family, friends, community and health care team.

If you have suicidal thoughts or think about hurting yourself, contact your health team or go to your closest Emergency Department right away.
See our Depression pamphlet for more information.

Contact your health care team if no improvement or if severe

Trouble falling asleep

  • This may be caused by one of your medications and may improve once your body gets used to the medication or when your treatment ends.
  • Talk to your doctor if this bothers you.
Contact your health care team if no improvement or if severe

Pains or cramps in the belly

  • If you have constipation or diarrhea it may be causing the pain in your belly.
  • If the pain is severe, gets worse or doesn’t go away, talk to your health care team about other possible causes.
Contact your health care team if no improvement or if severe

Other rare, but serious side effects are possible.
If you experience ANY of the following, speak to your cancer health care provider or get emergency medical help right away:

  • Signs of low thyroid such as unusual weight gain, feeling tired or having low energy, dry skin, nails or hair that breaks easily, and sensitivity to cold
  • Signs of overactive thyroid such as unusual weight loss, increased sweating and/or appetite, trouble sleeping, feeling irritable, rapid or irregular heartbeat
  • Chest pain, irregular heartbeat, shortness of breath or coughing up blood
  • Pain, swelling or hardening of a vein in the arm or leg
  • Sudden loss of vision, difficulty speaking or moving arms or legs
  • Severe pain and tenderness in the belly that may spread to your right shoulder or back
  • Signs of liver problems such as yellowing of skin, eyes or dark urine
  • Signs of kidney problems such as lower back pain, body swelling, passing little or no urine, or recent unusual weight gain
  • Signs of an allergy such as severe rash, itchiness, swollen face, lip or tongue, chest or throat tightness
  • Joint pain or swelling with fever, confusion, kidney problems
  • Severe muscle pain or weakness and dark pee
  • Symptoms of an organ transplant rejection or rare immune problems after a stem cell transplant (if these apply to you).  Your doctor may discuss these with you.
  • Second or new cancers (your doctor may discuss and monitor this with you.)
  • Darkening skin, feeling tired, have low blood pressure (dizziness or fainting)


For more links on how to manage your symptoms go to www.cancercareontario.ca/symptoms.

The information set out in the medication information sheets, regimen information sheets, and symptom management information (for patients) contained in the Drug Formulary (the "Formulary") is intended to be used by health professionals and patients for informational purposes only. The information is not intended to cover all possible uses, directions, precautions, drug interactions or side effects of a certain drug, nor should it be used to indicate that use of a particular drug is safe, appropriate or effective for a given condition.

A patient should always consult a healthcare provider if he/she has any questions regarding the information set out in the Formulary. The information in the Formulary is not intended to act as or replace medical advice and should not be relied upon in any such regard. All uses of the Formulary are subject to clinical judgment and actual prescribing patterns may not follow the information provided in the Formulary.