Lenalidomide

Indications & Dose:

Multiple myeloma (newly diagnosed) in patients not eligible for transplant, given in combination with dexamethasone until disease progression

BY MOUTH

Adult: 25 mg once daily for 21 consecutive days of repeated 28-day cycles, for doses of dexamethasone, and dose adjustments due to side-effects, consult product literature

Multiple myeloma (newly diagnosed) in patients not eligible for transplant, given in combination with melphalan and prednisone followed by maintenance monotherapy

BY MOUTH

Adult: 10 mg once daily for 21 consecutive days of repeated 28-day cycles for up to 9 cycles, for doses of melphalan and prednisone, and dose adjustments due to side- effects, consult product literature

Multiple myeloma in patients who have received at least one prior therapy, given in combination with dexamethasone

BY MOUTH

Adult: 25 mg once daily for 21 consecutive days of repeated 28-day cycles, for doses of dexamethasone,and dose adjustments due to side-effects, consult product literature

Treatment of transfusion-dependent anaemia due to lowor intermediate-1-risk myelodysplastic syndromes (MDS) associated with an isolated deletion 5q cytogenetic abnormality when other treatment options are insufficient or inadequate

BY MOUTH

Adult: 10 mg once daily for 21 consecutive days of repeated 28-day cycles, for dose adjustments due to side-effects, consult product literature

Contraindications:

-

Side Effects:

Common or very common Abdominal pain . anaemia . arrhythmias . arthralgia . ataxia . atrial fibrillation . bacterial infections . bradycardia . cardiac failure . cataract . cerebrovascular events . chest pain . cholestasis . constipation . decreased appetite . deep vein thrombosis . dehydration . depression . diarrhoea . dizziness . dry mouth . dyspepsia . dysphagia . dyspnoea . electrolyte disturbances . falls . flu-like illness . fungal infections . haematoma . haematuria . haemorrhagic disorders . headache . hearing disturbances . hyperglycaemia . hyperhidrosis . hypertension. hypotension . hypothyroidism . insomnia . iron-overload . lethargy . leucopenia . malaise . mood changes . musculoskeletal disorders . myalgia . myocardial infarction . nausea . oedema . peripheral neuropathy . pneumonia . pruritus . pulmonary embolism . pyrexia .rash .renal failure . respiratory distress .respiratory tract infections . sepsis . severe neutropenia . sexual dysfunction . sinusitis . skin disorders . stomatitis . syncope .tachycardia .taste disturbance .thrombocytopenia .tremor. urinary incontinence . urinary retention . vasculitis . viral infections . visual disturbances . vomiting

Uncommon Acquired Fanconi syndrome . angioedema . blindness . caecitis . clotting disorders . colitis . haemolysis . hepatic failure . ischaemia . secondary malignancies

Rare Stevens-Johnson syndrome .toxic epidermal necrolysis .tumour lysis syndrome

CONCEPTION AND CONTRACEPTION For women of childbearing potential, pregnancy must be excluded before starting treatment with lenalidomide (perform pregnancy test on initiation or within 3 days prior to initiation). Women must practise effective contraception at least 1 month before, during, and for at least 1 month after treatment, including during dose interruptions (oral combined hormonal contraceptives and copper-releasing intra-uterine devices not recommended) and men should use condoms during treatment, during dose interruption, and for at least 1 week after stopping if their partner is pregnant or is of childbearing potential and not using effective contraception.

PREGNANCY Important: teratogenic risk. Lenalidomide is structurally related to thalidomide and there is a risk of teratogenesis.

BREAST FEEDING Discontinue breast-feeding-no information available.

RENAL IMPAIRMENT Reduce dose in moderate to severe impairment consult product literature.

Cautions:

High tumour burden-risk of tumour lysis syndrome . patients with risk factors for myocardial infarction

Precautions:

-

Interaction:

-

Warnings:

-

Adverse Effects:

-

Lactations:

-

Special Precautions:

-

Counselling:

-

Side Effects Or Adverse Reactions:

-

Patient And Carer Advice:

-