Description of Lenalid 25
Lenalid (Lenalidomide) is grouped as an immunomodulatory agent and also comes under the group of an antiangiogenic agent.
Lenalidomide is a functional analogue of thalidomide.
Pharmacology of Lenalid 25
Lenalid (Lenalidomide) is antiangiogenic drug, proinflammatory cytokines secretions are inhibited by Lenalidomide. It is a potent inhibitor of tumor necrosis factor α secretion.
This tumor necrosis factor enlarges cell immediate immunity by provocation of anti-CD3 stimulated T cells.
T cells prohibit trophic signals to angiogenic factors in cells.
This will inhibits the growth of myeloma cells by activation of cell cycle arrest and cell death occurs.
Lenalid (Lenalidomide) is rapidly absorbed and absorption is not affected by food.
Normal Peak time: 0.6-1.5 hours; but in myeloma patient 0.5 to 4 hours.
The volume of distribution of Lenalid (Lenalidomide) is 76-85 L
The plasma protein binding of Lenalid (Lenalidomide) is 23-29%
Unchanged form of Lenalid (Lenalidomide) is prevalently circulating in the body. Two identified metabolites like hydroxyl Lenalidomide and N-acetyl-Lenalidomide.
Route of elimination is through renal. The half life of Lenalid (Lenalidomide) is around 3 to 5 hours.
Indication of Lenalid 25
Lenalid (Lenalidomide) is predominantly used for the conditions like;
- Multiple myeloma
- Transfusion dependent myelodysplastic syndrome (MDS) patients with deletion of 5q cytogenetic deformity with or without cytogenetic abnormalities
- Mantle cell lymphoma (MCL)
Dose & Dosage's of Lenalid 25
The strength of Lenalidomide is 25mg
The dosage of Lenalidomide is varying depending on the syndrome;
The adult dose of Lenalid (Lenalidomide) is 10mg should be taken as a single dose.
Depending on creatinine clearance level, dose of the Lenalidomide in renal impairment patient is recommended;
CrCl >60 ml/min: dose adjustment not necessary
CrCl 30-60 ml/min: 5mg PO qDay
CrCl <30 ml/min (nondialysis dependent): 2.5mg PO qDay
CrCl <30 ml/min: In dialysis dependent patients, 2.5mg PO qDay on dialysis day
Lenalid (Lenalidomide) is combined with dexamethasone: 25mg orally once a day on day 1 to 21 of repeated 28 day cycles. The dose of dexamethasone is 40mg orally on day 1-4, 9-12, 17-20 of each 28 days cycle for first 4 cycles.
Maintenance therapy following stem cell transplant: 10mg once a day for 3 cycles, then it is increase to 15mg as a single dose.
Mantle cell lymphoma:
The recommended dose should be 25mg PO qDay on day 1-21repeated for 28 days.
CrCl 30-60 ml/min: 10mg PO qDay
CrCl <30ml/min: 15mg PO q48hr
Pediatric: safety and effectiveness has not been established under the age of <18 years.
Side Effects of Lenalid 25
Blood related problems
Neutropenia, thrombocytopenia, anemia, leucopenia, Lymphopenia, neutropenia
Diarrhea, constipation, nausea, gastroenteritis, abdominal pain, dyspepsia, toothache, hemorrhage
Bronchitis, Nasopharyngitis, cough, upper respiratory tract infection, dyspnea, pneumonia, pharyngitis, rhinitis, Epistaxis
Non cardiac chest pain
Skin and subcutaneous:
Prurituses, rash, dry skin, hyperhidrosis, cellulitis, hirsutism, skin hyper pigmentation, Erythema
Muscle cramp, muscle spasm, back pain, arthralgia, bone pain, neck pain, joint swelling
Insomnia, depression, anxiety, hallucination, erectile dysfunction
Dizziness, tremor, headache, dysgeusia, peripheral neuropathy, paresthesia, hypoesthesia
Decreased appetite, decreased weight, hypokalemia, anorexia, hypocalcaemia, dehydration, gout, hypophosphatemia, hyponatremia, hypomagnesaemia
Blurred vision, cataract, blindness, ocular hypertension
Hyperbilirubinaemia, increased ALT, AST, abnormal liver function
Urinary tract infection, dysuria, hyperuricemia, Hematuria, urinary retention
Hyperglycemia, diabetes mellitus, hypothyroidism
Deep vein thrombosis, hypertension, atrial fibrillation, myocardial infarction, angina pectoris
Tumor flare, squamous cell carcinoma, basal cell carcinoma, myelodysplastic syndrome
Renal failure, renal tubular necrosis
Contraindication of Lenalid 25
Lenalid (Lenalidomide) is contraindicated in pregnancy condition.
Severe hypersensitivity reactions like angioedema, Stevens Johnson syndrome, toxic epidermal necrolysis to Lenalidomide
Drug Interaction of Lenalid 25
Some list of medicine interacts with Lenalidomide;
Precaution of Lenalid 25
While using Lenalid (Lenalidomide), care should be taken
Do not recommended for pregnant women or become pregnant
Venous and arterial thromboembolism
The safety and efficacy of Lenalidomide has not been established for patients who are younger than 18 years.
Usage & Safety profile of Lenalid 25 Pregnancy & Lactation
Lenalid (Lenalidomide) is comes under pregnancy category X
Lenalid should not be recommended for pregnant women and become pregnant.
Lenalid causes fetal death.
Storage of Lenalid 25
The storage of Lenalid tablet is between 20oC to 25oC (68oF to 77oF); excursion accepted to 15°C and 30°C (59°F and 86°F).