An immune-modulating medicine for myeloma and some blood cancers
Lenalidomide
An immune-modulating medicine used to treat myeloma and some other blood cancers, used under specialist care with strict pregnancy-prevention rules.
What is Lenalidomide?
Lenalidomide is a specialist immune-modulating medicine used to treat myeloma (a cancer of the bone marrow) and some other blood cancers. It is taken by mouth as capsules under close hospital supervision. Its most important safety point is that it can cause serious birth defects, so it is only given within a strict pregnancy-prevention programme. It also raises the risk of blood clots, so clot-prevention is usually given alongside it, and it can lower blood counts, which is why blood tests are done regularly. It is always used as part of a specialist cancer treatment plan.
Education and reference only. This is a plain-language guide to Lenalidomide — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Lenalidomide is an immunomodulatory medicine, meaning it works on the immune system and the environment around cancer cells. It is used mainly to treat myeloma, a cancer that affects plasma cells in the bone marrow, and certain other blood cancers and bone-marrow conditions. It is closely related to thalidomide and shares its serious risk of causing birth defects, which is why it is handled with great care. It is taken by mouth as capsules, in treatment cycles, always under the care of a specialist cancer team in hospital.
How it works
Lenalidomide works in several ways at once. It acts directly against certain cancer cells, helping to slow or stop their growth, and it changes the immune system so the body is better able to attack the cancer. It also affects the supporting cells and blood-vessel growth around tumours, making the environment less friendly to the cancer. Because it is so active on the immune system and bone marrow, it can lower the body's blood counts and increase the tendency for the blood to clot, which is why these effects are watched for and managed during treatment.
Company & origin
Originated / developed by: Specialist manufacturer.
A specialist medicine used in the UK to treat myeloma and certain other blood cancers, given under close hospital supervision with a strict pregnancy-prevention programme.
Practical use
How to take Lenalidomide
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take the capsules exactly as your cancer team directs, swallowing them whole with water and not opening or crushing them.
- Follow the pregnancy-prevention programme strictly, including reliable contraception and any required pregnancy tests.
- Take any clot-prevention medicine you are prescribed alongside it, and do not skip it.
- Attend all blood-test appointments so your blood counts can be checked between cycles.
- Do not donate blood, and follow the advice given to men and women about not donating sperm, while taking it and for the advised time afterwards.
Weighing it up
Advantages & disadvantages of Lenalidomide
Advantages
- An effective treatment for myeloma and certain other blood cancers, often used in combination regimens.
- Taken by mouth as capsules rather than by injection.
- Works in several ways at once, both against cancer cells and through the immune system.
Disadvantages
- Can cause very serious birth defects, so it requires a strict pregnancy-prevention programme.
- Raises the risk of blood clots, usually needing clot-prevention alongside it.
- Commonly lowers blood counts, increasing the risk of infection, bleeding and tiredness.
Practical use
Good to know
The single most important thing to know about lenalidomide is that it can cause very serious harm to an unborn baby, so it is only prescribed within a strict pregnancy-prevention programme: this involves reliable contraception, regular pregnancy tests where relevant, and careful rules for both women and men, including not donating blood or sperm. A second key point is that it raises the risk of blood clots in the legs or lungs, so a clot-preventing medicine such as aspirin or a blood thinner is usually given alongside it, and any leg swelling, chest pain or breathlessness should be reported urgently. It also commonly lowers blood counts, increasing the risk of infection, bleeding and tiredness, which is why regular blood tests are part of treatment. It is taken in cycles, and the specialist team adjusts treatment based on how you respond and tolerate it.
Who should not take it / use with caution
- It must not be used in pregnancy, or by anyone able to become pregnant who is not following the pregnancy-prevention programme.
- People who have had a serious allergic reaction to lenalidomide should not take it.
- It is used with great caution in people with kidney problems or a history of blood clots, under specialist guidance.
Monitoring
- Regular blood tests to check blood counts before and during each treatment cycle.
- Pregnancy testing and strict contraception checks as part of the pregnancy-prevention programme.
- Watching for signs of blood clots, infection and how well the cancer is responding.
Side effects
- Lowered blood counts, leading to a higher risk of infection, bleeding and tiredness.
- Blood clots in the legs or lungs, which is why clot-prevention is usually given.
- Tiredness, diarrhoea or constipation, rash and muscle cramps.
- Rarely but seriously, severe infections, serious skin reactions or new cancers, which the team watches for.
Key interactions
- Combining it with other medicines that lower blood counts increases the risk of infection and bleeding.
- Using it with hormone treatments or other clot-raising medicines may further increase the risk of clots.
- Tell your cancer team about all your medicines, including anything bought over the counter, as some can affect its safety.
Available as: Capsules taken by mouth.
Answers
Lenalidomide: frequently asked questions
What is lenalidomide used for?
It is a specialist medicine used to treat myeloma and certain other blood cancers and bone-marrow conditions, given as part of a hospital cancer treatment plan.
Why is the pregnancy-prevention programme so strict?
Lenalidomide can cause very serious birth defects, so a strict programme of reliable contraception and pregnancy testing is essential to prevent any pregnancy during treatment.
Why do I need a clot-prevention medicine with it?
Lenalidomide raises the risk of blood clots in the legs and lungs, so a clot-preventing medicine is usually given alongside it; report any leg swelling, chest pain or breathlessness urgently.
Why so many blood tests?
It commonly lowers your blood counts, increasing the risk of infection, bleeding and tiredness, so regular blood tests let your team adjust treatment safely.
Can I donate blood while taking it?
No. You should not donate blood while taking lenalidomide and for the advised time afterwards, and there are specific rules for men and women about donating, which your team will explain.
Authoritative sources
- BNF
- NICE CKS
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