Lenalidomide is used to treat people with myeloma, a type of cancer that affects the plasma cels inside bone marrow.

WHAT IS LENALIDOMIDE?

Lenalidomide belongs to a new class of drugs called immunomodulators.

HOW DOES LENALIDOMIDE WORK?

Lenalidomide affects the way the immune system functions, though the exact way it works is not completely understood.

It also blocks the development of new blood vessels. The development of blood vessel is called angiogenesis. Cancer cells need new blood vessels to grow and spread.

WHEN IS LENALIDOMIDE USED?

Lenalidomide is used to treat people who have already had at least one other type of treatment. It is given together with a steroid called dexamethasone.

Sometimes, a chemotherapy drug called cyclophosphamide is given alongside lenalidomide and dexamethasone. This drug combination is called CRd.

Lenalidomide is available in capsules of 5, 10, 15, and 25 mg.

TAKING LENALIDOMIDE

Lenalidomide is normally taken once a day. You should take the tablets at about the same time each day. The tablets should be taken with a glass of water, on an empty or a full stomach. The tablets should not be chewed or opened up.

PREVENTING PREGNANCY WHILE TAKING LENALIDOMIDE

You should not get pregnant or conceive while taking lenalidomide, as it can cause severe abnormalities in developing babies.

Women of childbearing age will have a pregnancy test to confirm that they are not pregnant. This normally happens in the first three days after starting to take lenalidomide and is given again every four weeks until four weeks after the treatment has concluded.

Women of childbearing age should use a highly effective contraceptive, such as an implant or injection or the progesterone-only pill. It is not recommended to take the combined oral contraceptive pill, as this increases the risk of developing blood clots, and this risk is even higher if you are taking lenalidomide and dexamethasone. Women should use contraception for four weeks before starting treatment, then throughout the duration of the treatment and the four weeks after it has concluded.

Men who are taking lenalidomide should use a condom while having sex with women of childbearing age or if the woman is pregnant. They should continue to wear a condom while having sex for the entire treatment with lenalidomide and for one week after they have completed their treatment.

Due to the lenalidomide's potential for causing birth defects, it is likely you will have to participate in a birth-control program. You will have to sign a consent form.

POSSIBLE SIDE EFFECTS OF LENALIDOMIDE

Each person reacts differently to cancer treatment. Some people have very few side effects, while others may develop more. The side effects described here will not affect everyone who is treated with the drug.

We outline the most commonly side effects, though we have left out the rarer ones. If you notice you develop any side effects that are not listed here, talk to your doctor or specialist nurse.

The side effects of lenalidomide are normally mild; however, because it is given with other treatments to fight cancer, there may also be certain side effects associated with these other treatments.

RISK OF INFECTION

Lenalidomide can reduce your number of white blood cells, which help fight off infection. White blood cells are produced by bone marrow. If your white blood cell count is low, you will be more prone to infection. A low number of white blood cells is called neutropenia.

The number of white blood cells normally increases gradually, returning to normal before your next chemotherapy treatment. You will have a blood test before the next treatment to check your white blood cells. It may sometimes be necessary to delay the treatment if your blood count shows that you still have a low number of white blood cells.

Contact your doctor or your hospital immediately if:

• your temperature rises above 38 ° C
• you suddenly feel unwell, even if your temperature is normal.

BRUISING AND BLEEDING

Lenalidomide can reduce the production of platelets, which help the blood to clot. Tell your doctor if you have any unexplained bleeding or bruising, such as nosebleeds, bleeding gums, blood spots, or skin rashes. You may have a platelet transfusion if your platelet count is low.

INCREASED RISK OF BLOOD CLOTS

If you have chest pain, feel breathless, or have painful swelling in your legs, this could be a sign of a blood clot. If you think you might have a blood clot, tell your doctor immediately. You can take drugs to thin your blood and help prevent clots from forming while you are taking lenalidomide.

RASH

Lenalidomide can produce a rash, which may cause itchiness. Your doctor can prescribe a treatment to help with this.

CONSTIPATION

In general, it helps to drink lots of fluids, eat more fiber, and get some light exercise. You may need to take drugs (laxatives) to help.

SLEEP DISTURBANCES

You may have trouble sleeping or your sleep pattern may be altered.

TIREDNESS (FATIGUE)

Tiredness is a common side effect, especially toward the end of treatment and for a few weeks after the treatment has finished. It is important that you try to pace yourself and rest as much as you need to. Try to balance this with light exercise, such as taking short walks. If you feel drowsy, don't drive or operate heavy machinery.

NAUSEA AND VOMITING

Your doctor can prescribe antiemetic drugs to prevent or greatly reduce your nausea or vomiting. If your nausea remains uncontrolled or continues, tell your doctor.

Some of these drugs can cause constipation. Tell your doctor or nurse if this is a problem.

ADDITIONAL INFORMATION ON LENALIDOMIDE

DRIVING

Lenalidomide may affect your ability to drive. Do not drive if you feel dizzy, have blurry vision, or feel excessively tired or drowsy.

OTHER MEDICINES

Some drugs, including those bought over the counter in a store or pharmacy, may be harmful to you while you are undergoing cancer treatment. Tell your doctor if you are taking any medicines, including over-the-counter medications, complementary therapies, and herbal medicines.

FERTILITY

This treatment may affect your ability to conceive. It is important that you talk to your doctor before beginning treatment.

BREASTFEEDING

There is a potential risk that lenalidomide may be present in breast milk, and therefore women are recommended not to breast feed during the treatment and for a few months afterward.

HOSPITAL ADMISSION

If you are admitted to the hospital for any reason not related to cancer, it is important that you tell your doctors and nurses caring for you that you are being treated with lenalidomide.

OTHER ISSUES TO KEEP IN MIND ABOUT LENALIDOMIDE CAPSULES

It is important to take your capsules as your doctors said.

Keep them in a safe place out of the reach of children. Pregnant women should not handle the capsules.

If you forget to take a capsule, do not take a double dose. Tell your doctor and maintain your normal dose schedule.

Tell your doctor if you vomit right after taking the capsules. You may have to take another dose. Do not take any more until you talk to your doctor, nurse, or pharmacist.

If your doctor decides to halt your treatment, return the remaining capsules to the hospital. Do not flush them down the toilet or throw them away.