Lenalidomid Puren (Lenalidomide)

Lenalidomide is used in hematologic malignancies that respond to immunomodulatory therapy.

• Multiple myeloma: improves progression‑free survival and overall response rates in relapsed or refractory disease.
• Mantle cell lymphoma: contributes to disease control in patients who have received prior therapies.
• Myelodysplastic syndromes: reduces transfusion dependence and may improve blood counts in patients with del(5q) cytogenetic abnormality.

• Lenalidomide binds to the cereblon component of the CRL4‑CRBN E3 ubiquitin ligase complex, altering substrate specificity. This leads to ubiquitination and proteasomal degradation of transcription factors Ikaros (IKZF1) and Aiolos (IKZF3), resulting in modulation of cytokine production, anti‑angiogenic effects, and direct anti‑tumor activity in malignant plasma cells and lymphoid cells.

Common adverse reactions observed with lenalidomide include hematologic and gastrointestinal events.

Common Side Effects

• Neutropenia: decreased neutrophil count increasing infection risk.
• Thrombocytopenia: reduced platelet count leading to bleeding tendency.
• Fatigue: persistent tiredness affecting daily activities.
• Diarrhea: loose stools that may require supportive care.

Serious or Rare Side Effects

• Venous thromboembolism: deep vein thrombosis or pulmonary embolism requiring immediate medical attention.
• Secondary primary malignancies: emergence of new cancers distinct from the original disease.
• Severe skin reactions: Stevens‑Johnson syndrome or toxic epidermal necrolysis.

Patients should be monitored closely for hematologic and thrombotic complications.

• Baseline blood counts: obtain complete blood count before initiating therapy.
• Anticoagulation assessment: evaluate need for prophylactic anticoagulation in high‑risk patients.
• Pregnancy avoidance: ensure effective contraception for both male and female patients of reproductive potential.
• Renal function monitoring: adjust therapy based on creatinine clearance.
• Store at ambient temperature: keep below 25 °C, retain in original packaging, protect from moisture and direct sunlight.

Lenalidomide may interact with drugs that affect its metabolism or increase thrombotic risk.

Major Interactions (Avoid)

• Strong CYP3A4 inducers: may reduce lenalidomide exposure.
• Anticoagulants (warfarin, DOACs): additive risk of bleeding.

Moderate Interactions (Monitor Closely)

• Immunosuppressants (e.g., cyclosporine): may increase infection susceptibility.
• Vaccines: live attenuated vaccines should be avoided during treatment.
• NSAIDs: concurrent use may exacerbate thrombocytopenia.