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Lenalidomide

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Lenalidomide is an immunomodulatory medication used in the management of multiple myeloma and certain myelodysplastic syndromes. It works by altering immune system responses and interfering with the blood supply to abnormal cells, thereby supporting bone marrow function in adult patients.


Ingredient
Availability
In Stock
Delivery Time
Airmail (14-21 days) | EMS trackable (5-9 days)
Product is shipped in a fully discreet envelope with no content disclosure, including all required documentation inside

Product Sheet

Active Ingredient(s)
Lenalidomide
Reference Brand
Revlimid
Product Form
Capsule
Regulatory Classification
Rx
Primary Category
Cancer Treatment, Immune System Modulator
Product Category
Antineoplastic Agents, Immunosuppressants, Other Immunosuppressants
Pharmacological Class
Thalidomide analogues
Manufacturer Description
A powerful medication used to treat various blood cancers and bone marrow disorders by modulating the immune system.
Mechanism of Action
Lenalidomide works in several ways: it helps the immune system better recognize and attack cancer cells, prevents the growth of blood vessels that feed the cancer, and directly triggers death in certain types of abnormal blood cells.
Route of Administration
Oral
Onset Time
Varies by condition; usually monitored via blood tests
Duration
Prescribed in cycles (e.g., 21 days on, 7 days off)
Contraindications
Pregnancy, Hypersensitivity to lenalidomide
Severe Adverse Events
Blood clots (DVT or PE), Severe birth defects, Liver failure, Tumour Lysis Syndrome
Common Side Effects
Constipation, Tiredness, Muscle cramps, Dry skin
Uncommon Side Effects
Reduced white blood cell count, Reduced platelet count, Diarrhoea, Rash
Drug Interactions
Digoxin, Warfarin, Erythropoietin
Pregnancy Safety Warnings
Highly dangerous in pregnancy; strict Pregnancy Prevention Programme (PPP) must be followed.
Age Restrictions
Adults 18 years and older.
Storage Guidelines
Store at room temperature.
Related Products
Thalidomide, Pomalidomide, Bortezomib

Lenalidomide FAQ

Can I travel internationally with lenalidomide capsules?

Yes, but you should carry a copy of the prescription and a letter from your oncologist stating the medical necessity. Verify the destination country's import regulations, as some nations require prior approval for oncology medications.

What should I do if I miss a dose while on a 21-day cycle?

If the missed dose is less than 12 hours before the next scheduled dose, simply skip the missed one and continue as planned. Do not double the dose to make up for the omission.

Do lenalidomide capsules contain any allergens?

The capsule shell is typically composed of gelatin, which is derived from animal sources. Inactive ingredients may include lactose and magnesium stearate; patients with relevant allergies should discuss alternatives with their pharmacist.

How does lenalidomide differ from thalidomide?

Both drugs belong to the same immunomodulatory class, but lenalidomide has a more potent anti-tumour effect and a lower incidence of peripheral neuropathy. It also carries a stricter pregnancy-prevention program.

Is it safe to receive a flu vaccine while taking lenalidomide?

Inactivated (non-live) vaccines, such as the seasonal flu shot, are generally considered safe. However, the immune response may be reduced, so timing the vaccination during a stable disease phase is advisable.

Can lenalidomide cause hair loss?

Hair thinning or loss is not a common side effect of lenalidomide. If you notice significant hair changes, report them to your oncologist as they may be related to other concurrent treatments.

What are the signs of a serious infection while on lenalidomide?

Fever above 38 °C, chills, persistent cough, shortness of breath, or any new skin lesions should prompt immediate medical evaluation, as the drug can suppress immune defenses.

Do I need to avoid sunlight while taking lenalidomide?

Lenalidomide does not typically cause photosensitivity. Standard sun protection measures are sufficient unless your dermatologist advises otherwise.

How long can I stay on lenalidomide therapy?

Duration depends on disease response and tolerability. Some patients continue treatment for many years under close monitoring, while others may stop after achieving a sustained remission. Your oncologist will determine the optimal treatment length for you.

Lenalidomide: Generic Medication Overview

Lenalidomide is an immunomodulatory agent used in oncology to support treatment of certain blood-cancer conditions. In the United Kingdom it is a prescription-only medicine (POM) regulated by the Medicines and Healthcare products Regulatory Agency (MHRA). The medication is supplied as a 10 mg hard-gelatin capsule (cap). Lenalidomide belongs to the class of oncology-support drugs that modify the immune response and inhibit tumour growth.

How Lenalidomide Works in the Body

Lenalidomide’s therapeutic effect stems from several inter-related actions:

  • Immunomodulation - It enhances the activity of natural killer (NK) cells and T-lymphocytes, boosting the body’s ability to recognise and destroy malignant cells.
  • Anti-angiogenesis - The drug interferes with the formation of new blood vessels that tumours need to grow and spread.
  • Direct anti-tumour activity - Lenalidomide binds to cereblon, a component of the E3 ubiquitin ligase complex, leading to the degradation of transcription factors (IKZF1 and IKZF3) that are essential for the survival of certain cancer cells.

These mechanisms together reduce tumour proliferation and improve the effectiveness of other therapies such as chemotherapy or monoclonal antibodies. The onset of action is typically observed within a few days, with peak pharmacodynamic effects occurring after several weeks of continuous dosing. Lenalidomide is rapidly absorbed from the gastrointestinal tract, reaching maximum plasma concentrations in about 3-4 hours. It is largely excreted unchanged in the urine, making renal function an important consideration in dosing.

Conditions Treated by Lenalidomide

Lenalidomide is approved in the UK for the following indications, based on MHRA and European Medicines Agency (EMA) assessments:

  • Multiple Myeloma - Used in combination with dexamethasone, either as a frontline treatment or after prior therapy.
  • Myelodysplastic Syndromes (MDS) with 5q Deletion - Administered as a single agent to improve blood counts and reduce transfusion dependence.
  • Mantle Cell Lymphoma - Given in combination with rituximab for patients who have received at least one prior therapy.

These approvals reflect clinical trial evidence showing that lenalidomide can extend progression-free survival and, in some settings, overall survival when used according to the recommended regimens.

Evidence-Based Off-Label Uses

Lenalidomide has been investigated in several off-label contexts, most notably for certain solid tumours and as a maintenance therapy after stem-cell transplantation. While early-phase studies suggest possible activity, these uses remain not approved by the MHRA or EMA. Off-label administration should only occur under the supervision of a specialist haematologist or oncologist, with a clear risk-benefit assessment for each individual patient.

Who Should (Not) Use Lenalidomide?

Absolute Contraindications

  • Known hypersensitivity to lenalidomide or any of its capsule excipients.
  • Pregnancy - Lenalidomide is teratogenic and embryotoxic; it is contraindicated in all trimesters.

Relative Contraindications

  • Severe renal impairment (creatinine clearance <30 mL/min) - dose adjustment may be required; consult a renal specialist.
  • Hepatic dysfunction - limited data; use with caution in patients with Child-Pugh class B or C liver disease.
  • Concurrent use of certain immunosuppressants - may increase the risk of infections.

Special Populations

  • Women of child-bearing potential - Must enroll in a risk-evaluation and mitigation strategy (REMS) program, use two reliable forms of contraception, and undergo regular pregnancy testing.
  • Elderly patients - May experience higher rates of cytopenias; close monitoring of blood counts is advised.
  • Pediatric use - Not approved; safety and efficacy have not been established in children.

If any of these conditions apply, a thorough discussion with the treating oncologist is essential before initiating therapy.

Safety Profile: Side Effects and Interactions

Common Side Effects

  • Neutropenia (low neutrophil count) - reported in more than 10 % of patients; monitoring is mandatory.
  • Thrombocytopenia (low platelet count) - similarly frequent; may require dose interruption.
  • Fatigue - often mild to moderate, improving with continued treatment.
  • Diarrhoea - usually self-limiting; maintain hydration.

Serious Adverse Events

  • Severe infections - Including opportunistic pathogens; patients should be educated on signs of infection and seek prompt medical attention.
  • Venous thromboembolism (VTE) - Risk is increased, especially when lenalidomide is combined with dexamethasone; prophylactic anticoagulation may be considered.
  • Secondary primary malignancies - A small but recognized risk; long-term surveillance is recommended.

Drug Interactions

  • CYP450 Enzymes - Lenalidomide is not a significant CYP substrate, inhibitor, or inducer, but it can be affected by drugs that alter renal clearance.
  • Strong nephrotoxic agents (e.g., aminoglycosides) - May compound renal impairment; dose adjustments or alternative therapies should be considered.
  • Anticoagulants - Co-administration may increase bleeding risk; monitor INR or aPTT where applicable.

Food and Lifestyle Interactions

  • Food - Lenalidomide may be taken with or without food; however, high-fat meals can modestly reduce absorption, so consistency is advised.
  • Alcohol - Excessive intake can worsen cytopenias and liver stress; moderation is recommended.
  • Driving - The drug does not impair cognition, but severe fatigue or neuropathy (rare) could affect safe driving; assess individually.

Patients should provide a complete medication list, including over-the-counter products and herbal supplements, to their oncology team before starting lenalidomide.

How to Take Lenalidomide

  • Standard dosing - For the approved 10 mg capsule, the typical regimen is one capsule taken orally once daily. The exact schedule (continuous vs. 21 days on/7 days off) depends on the specific indication and is determined by the treating oncologist.
  • Renal adjustment - In patients with moderate renal impairment (CrCl 30-60 mL/min), the dose may be reduced to 5 mg daily; severe impairment often requires a further reduction or alternative therapy.
  • Administration - Swallow the capsule whole with a glass of water. Do not crush, chew, or open the capsule, as this may affect drug release.
  • Missed dose - If a dose is missed and the next scheduled dose is more than 12 hours away, skip the missed dose and continue with the regular schedule. Do not double-dose.
  • Overdose - Symptoms may include severe neutropenia, thrombocytopenia, and gastrointestinal upset. Seek emergency medical care; supportive measures such as growth-factor administration may be indicated.
  • Discontinuation - Lenalidomide is usually stopped abruptly under medical supervision; no tapering is required. However, abrupt cessation may precipitate disease flare-ups, so follow-up assessment is essential.

All dosing decisions must be individualized by the prescribing oncologist, taking into account disease status, laboratory results, and concomitant therapies.

Monitoring and Follow-Up

  • Complete blood count (CBC) - Baseline CBC before initiation, then weekly for the first eight weeks, followed by bi-weekly or monthly monitoring based on stability.
  • Renal function tests - Serum creatinine and eGFR at baseline and periodically; adjust dose as needed.
  • Pregnancy testing - For women of child-bearing potential, a negative serum β-hCG test is required before starting therapy and at regular intervals (typically monthly).
  • Infection surveillance - Prompt evaluation of fever, chills, or respiratory symptoms. Consider prophylactic antibiotics or antiviral agents in high-risk patients.
  • Thromboembolic risk assessment - Evaluate need for anticoagulation, especially when dexamethasone is co-prescribed.

Regular clinic visits enable early detection of adverse effects and optimal therapeutic adjustments.

Storage and Handling

  • Store capsules at room temperature (15-25 °C) away from excessive heat, moisture, and direct sunlight.
  • Keep the medication in its original container with the child-proof cap tightly closed.
  • Do not use the product after the expiry date printed on the packaging.
  • For safe disposal, return unused capsules to a pharmacy take-back program or follow local hazardous waste guidelines.

Medication-Specific Glossary

Cereblon
A protein that forms part of an E3 ubiquitin ligase complex; lenalidomide binding leads to degradation of transcription factors essential for cancer cell survival.
Anti-angiogenesis
The inhibition of new blood-vessel formation, which limits tumour growth and metastasis.
Neutropenia
An abnormally low concentration of neutrophils, a type of white blood cell crucial for fighting bacterial infections.

Medical Disclaimer

This article provides educational information about lenalidomide and is not a substitute for professional medical advice. Treatment decisions, including use for unapproved indications, must be made under the guidance of a qualified healthcare provider. The content is intended for informational purposes and does not constitute medical recommendations. Always consult a physician before starting, stopping, or changing any medication regimen.

Information for Lenalidomide is sourced from established medical standards and updated frequently. It is provided for general guidance and should be confirmed with a healthcare professional before use.
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