The mechanism of action of Lenalidomide is mainly through targeted binding to Cereblon protein (CRBN), regulating the activity of E3 ubiquitin ligase complex, promoting ubiquitination degradation of specific substrate proteins (such as Ikaros, Aiolos, and CK1 α), thereby inhibiting tumor cell proliferation and inducing apoptosis.

1、 Drug name

1. Product Name: REVLIMID

2. Common name: Lenalidomide

2、 Indications

1. Adult multiple myeloma (MM): in combination with dexamethasone; As a maintenance therapy after autologous hematopoietic stem cell transplantation.

2. Transfusion dependent anemia is caused by low-risk or moderate risk type 1 myelodysplastic syndrome (MDS) with abnormal deletion of the long arm of chromosome 5.

3. Recurrent or refractory mantle cell lymphoma (MCL), previously treated with two therapies, one of which includes bortezomib.

4. Used in combination with rituximab products for previously treated follicular lymphoma (FL) or marginal zone lymphoma (MZL).

3、 Specifications

Specification: 5mg capsules

4、 Main components

Active ingredient: Lenalidomide

5、 Usage and dosage

1. MM combination therapy: 25mg once daily, oral, 1-21 days, every 28 days for one cycle.

2. MM maintenance treatment: 10mg once daily, taken continuously every 28 days.

3. MDS: 10mg once daily.

4. MCL: 25mg once daily, orally, from day 1-21, every 28 days in a cycle.

5. FL or MZL: 20mg once daily, orally, from day 1-21, every 28 days for a maximum of 12 cycles.

6、 Dose adjustment

1. Adjust the starting dose according to the degree of renal dysfunction.

2. Dose interruption and/or reduction based on hematological toxicity (such as neutropenia, thrombocytopenia).

7、 Medication precautions

1. Before and after meals: can be taken with food or on an empty stomach.

2. Missed dose: If missed and less than 12 hours before the next dose, skip the dose and take it on time next time; If it exceeds 12 hours, take the next dose according to the original plan.

3. Vomiting: If vomiting occurs after taking medication, there is no need to take additional medication, and continue taking the medication according to the original plan.

8、 Medication for special populations

1. Pregnancy: Prohibited, may cause embryo fetal toxicity.

2. Breastfeeding period: It is recommended to avoid breastfeeding.

3. Women and men with reproductive potential: dual contraception measures should be taken to prevent pregnancy.

4. Children: Safety and efficacy have not yet been established.

5. Elderly people: Adjust the dosage according to kidney function and pay attention to the increased risk of adverse reactions.

6. Renal dysfunction: Adjust the starting dose based on creatinine clearance rate.

9、 Adverse reactions

1. Common adverse reactions:

Diarrhea, fatigue, anemia, constipation, neutropenia, leukopenia, peripheral edema, insomnia, muscle spasms, abdominal pain, back pain, nausea, weakness, fever, upper respiratory tract infections, bronchitis, nasopharyngitis, joint pain, rash, dyspnea, dizziness, decreased appetite, thrombocytopenia, and tremors.

2. Serious adverse reactions:

Embryo fetal toxicity, hematological toxicity, venous and arterial thromboembolism, secondary primary malignant tumors, hepatotoxicity, severe skin reactions, tumor lysis syndrome, tumor flare response, impaired stem cell mobilization, thyroid dysfunction, increased early mortality in MCL patients, and hypersensitivity reactions.

10、 Contraindications

1. Pregnant women.

2. Patients who are severely allergic to lenalidomide.

11、 Drug interactions

1. When used in combination with digoxin, the plasma concentration of digoxin may increase, and digoxin levels need to be monitored.

2. When used in combination with erythropoietin stimulants or estrogen containing therapies, there may be an increased risk of thrombosis, and the risk benefit ratio should be carefully evaluated.

3. When combined with warfarin, no effect on the pharmacokinetics of warfarin was observed, but PT and INR need to be monitored.

12、 Storage method

Stored at 20 ° C-25 ° C (68 ° F-77 ° F), with allowable deviation up to 15 ° C-30 ° C (59 ° F-86 ° F).

Lenalidomideinformation