Revlimid Capsule: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Revlimid Capsule contains lenalidomide, an immunomodulatory agent that changes how the immune system works. It is used to treat certain blood cancers, including multiple myeloma and specific lymphomas, as well as anemia caused by myelodysplastic syndromes with a deletion 5q chromosome change. It carries serious risks, including severe birth defects if taken during pregnancy, so it is only available through a special safety program.

What is Revlimid Capsule

Revlimid is a prescription capsule medicine containing lenalidomide. It belongs to a group of drugs called immunomodulatory agents, which change how the immune system works. It is used to treat certain blood cancers and a type of anemia.

Revlimid Capsule uses

• Multiple myeloma, used together with dexamethasone
• Maintenance treatment after an autologous stem cell transplant for multiple myeloma
• Anemia caused by myelodysplastic syndromes (MDS) with a specific chromosome change called deletion 5q
• Mantle cell lymphoma that has come back or gotten worse after two other treatments, one of which included bortezomib
• Follicular lymphoma that has been treated before, used with a rituximab medicine
• Marginal zone lymphoma that has been treated before, used with a rituximab medicine

Benefits of Revlimid Capsule

• Can slow the growth of cancer cells
• Helps the immune system recognize and destroy cancer cells
• Blocks the growth of new blood vessels that tumors need to grow
• Maintenance use after stem cell transplant can lengthen the time before myeloma gets worse and can lengthen survival

How Revlimid Capsule works

Revlimid attaches to a protein in cells called cereblon. This triggers a process that breaks down certain proteins, which can kill myeloma cells directly. It also boosts immune cells (T cells and natural killer cells) that attack myeloma cells, and it blocks a growth factor (VEGF) that tumors need to form new blood vessels.

Revlimid Capsule dosage

Swallow the capsule whole with water; do not open, break, or chew it. It can be taken with or without food. Take it at about the same time every day. Avoid touching the capsule itself any more than needed; if the powder inside touches your skin, wash the area right away with soap and water, and flush your eyes, nose, or mouth with water if it gets there. Do not share this medicine with anyone else.

If you miss a dose and it has been less than 12 hours since your usual time, take it as soon as you remember. If it has been more than 12 hours since your usual time, skip the missed dose and do not take two doses together. People with kidney disease may need a different dose, as decided by the doctor.

Available forms and strengths

Capsule

Side effects of Revlimid Capsule

Common

• Diarrhea
• Constipation
• Fatigue or weakness
• Rash
• Itching
• Swelling in the arms, hands, legs, or feet
• Sleep problems (insomnia)
• Headache
• Muscle cramps or spasms
• Shortness of breath
• Cough, sore throat, or other cold symptoms
• Upper respiratory tract infection or bronchitis
• Stomach flu (gastroenteritis)
• Nosebleed
• Shaking or trembling (tremor)
• Joint aches
• Back or stomach-area pain
• Fever
• Nausea or vomiting
• Anemia (low red blood cells)

Serious

• Low white blood cells (neutropenia) and low platelets (thrombocytopenia), which can cause infection, bruising, or bleeding
• Blood clots in veins or lungs, heart attack, or stroke
• Serious liver problems, including liver failure
• Severe skin reactions that can be life-threatening
• Allergic reactions, including swelling of the face, lips, tongue, or throat, or trouble breathing
• Tumor lysis syndrome from fast breakdown of cancer cells
• Tumor flare reaction (sudden worsening of tumor symptoms)
• Increased risk of new cancers, such as leukemia or skin cancers
• Thyroid problems
• Increased risk of death in people with chronic lymphocytic leukemia (CLL)
• Birth defects or death of an unborn baby if taken during pregnancy

Warnings and precautions

• This medicine can cause severe, life-threatening birth defects or the death of an unborn baby. It must not be used during pregnancy. 
• Women who can become pregnant must use two reliable forms of birth control and have regular pregnancy tests before, during, and after treatment. Men must use a condom during sex with a partner who could become pregnant.
• Revlimid is only available through a special safety program because of its serious risks.
• This medicine lowers white blood cells and platelets in most people, which raises the risk of infection, bruising, and bleeding. Regular blood tests are needed.
• Blood clots, heart attacks, and strokes happen more often in people taking this medicine, especially when combined with dexamethasone. Most patients will also need to take a blood thinner.
• People with chronic lymphocytic leukemia (CLL) should not take this medicine outside of a clinical trial because of a higher risk of death and serious heart problems.
• This medicine can increase the risk of developing new cancers, including certain blood cancers and skin cancers.
• Do not donate blood or sperm while taking this medicine and for several weeks after stopping, because it could expose another person, including an unborn baby, to the drug.
• Do not breastfeed while taking this medicine, since it is not known if it passes into breast milk and could harm the baby.
• Tell your doctor if you have kidney problems before starting treatment, as people with kidney disease or who are on dialysis may need a different dose.
• Tell your doctor if you have liver problems before starting this medicine. Your doctor will check your liver function with blood tests during treatment, and liver injury including fatal liver failure has occurred in some patients.
• Alcohol use is listed as something to discuss with your doctor before taking this medicine.

Storage

• Store at room temperature between 68°F to 77°F (20°C to 25°C)
• Return any unused capsules to the pharmacy or healthcare provider rather than keeping them
• Keep out of the reach of children

When to see a doctor

• Get medical help right away if you have signs of a blood clot, such as sudden leg swelling, chest pain, or shortness of breath.
• Get medical help right away if you have signs of a heart attack, such as chest pain spreading to the arm, neck, jaw, or back, sweating, or feeling sick to your stomach.
• Get medical help right away if you have signs of a stroke, such as sudden numbness or weakness on one side of the body, severe headache, confusion, or trouble with vision, speech, or balance.
• Call your doctor right away if you notice yellowing of the skin or eyes, dark urine, pain in the upper right stomach area, unusual bruising or bleeding, or extreme tiredness, as these can be signs of liver problems.
• Get emergency help if you have swelling of the lips, mouth, tongue, or throat, trouble breathing or swallowing, hives, a very fast heartbeat, or feel dizzy or faint.
• Call your doctor right away if you develop a fever, sore throat, or other signs of infection, since this medicine can lower infection-fighting white blood cells.
• Tell your doctor right away if you notice tender, swollen lymph nodes, a low-grade fever, pain, or rash, which can be signs of tumor flare reaction.
• Call your doctor right away if you develop a severe skin rash, peeling or blistering skin, or severe itching, since serious skin reactions can occur.

Alternatives

• Pomalidomide
• Carfilzomib
• Thalidomide