How it Works

Revlimid (lenalidomide) is an "immunomodulatory agent," meaning it works by regulating the immune system. It appears to work in several ways, including inhibiting the formation of blood vessels, which tumors use to get nutrients needed to survive and grow. 

Revlimid (lenalidomide) also enhances the status of the immune system and decreases cytokine and growth factor production (substances capable of stimulating cell proliferation and wound healing) that the cancer cells need to grow and survive, causing cell death. This is done by binding to cereblon and directing the CRL4–CRBN E3 ligase (which regulates the disposal of proteins) toward the transcription factors Ikaros and Aiolos to cause their degradation. Proteins that play a key role in the B-cell differentiation process (in which the cells can evolve into plasma cells), survival of malignant cells, regulation of the aberrant myeloma-specific gene (indirectly regulated by Aiolos), and reduction of the proliferation of cancer killer immune cells, like natural killer T cells, and CD4+ T cells (a process which is also indirectly regulated by Aiolos). 

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How it’s Administered

Available in 2.5 mg, 5 mg, 7.5 mg, 10 mg, 15 mg and 20 mg capsules for oral administration.

Take at the same time every day. Swallow the capsules whole; do not break, chew or open the capsules. Skip the missed dose if it has been more than 12 hours since your regular time.

Take with or without food. High-fat meals decrease absorption, but not to a clinically significant extent. If you touch a broken capsule or come into contact with the medicine inside, wash the area with soap and water. 

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Who Should Take Lenalidomide

The FDA and EU approve lenalidomide for the treatment of adult patients with multiple myeloma (MM) in combination with dexamethasone. 

It is also indicated as maintenance therapy in multiple myeloma following autologous hematopoietic stem cell transplantation (auto-HSCT).

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Who Shouldn’t Take Lenalidomide

• You should not be treated with lenalidomide if you are allergic to it.
• Women should not become pregnant for four weeks before therapy, during therapy, and four weeks after therapy is stopped; fetal exposure to lenalidomide can cause severe congenital disabilities. Men taking lenalidomide should not father a child in the same period because it is present in sperm. 

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The Most Common Side Effects of Taking Lenalidomide Include: 

The most common side effects of lenalidomide in people with multiple myeloma include:

• Increase the risk of blood clots, stroke, and heart attack 
• Low white blood cell counts (leukopenia or neutropenia)
• Low red blood cell counts (anemia)
• Low platelet counts (thrombocytopenia)
• Diarrhea
• Fatigue
• Constipation
• Fluid Retention / Swelling
• Muscle and joint pain/aches
• Shortness of breath (dyspnea)
• Skin changes (rash)
• Decrease in appetite

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Commonly Used With

• Velcade
• Carfilzomib
• Ixazomib
• Elotuzumab
• Daratumumab
• Dexamethasone

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Currently Being Tested With Lenalidomide

• Corticosteroids: Dexamethasone, Prednisone, Methylprednisolone
• Monoclonal antibodies: Daratumumab, Elotuzumab, Isatuximab, Elotuzumab, Ipilimumab, Daratumumab and hyaluronidase-fihj, Durvalumab, Pembrolizumab
• Bispecific antibodies: Talquetamab, Teclistamab
• Selective inhibitor of nuclear export: Selinexor
• Antibody-drug conjugate: Belantamab Mafodotin
• Bispecific engagers: Elranatamab
• Histone deacetylase inhibitors: Vorinostat, Citarinostat
• Proteasome inhibitors: Bortezomib, Ixazomib, Carfilzomib
• Protease inhibitor: Nelfinavir
• Tyrosine kinase inhibitors (TKIs): Ibrutinib
• Antineoplastic agents: Cyclophosphamide, Melphalan Flufenamide
• Antibiotics with antineoplastic activity: Clarithromycin
• BCL-2 inhibitors: Venetoclax
• Others: Tasquinimod
• Histone deacetylase (HDAC) inhibitors: Vorinostat, Citarinostat
• Autologous stem cell transplantation
• BCMA CAR-T cell therapy

Learn more about your treatments in Cure Hub

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For more information, go to www.revlimid.com

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Date last updated: 6/14/22